February 27, 2015

Uncertified Play Yards Present Risk of Suffocation

Product safety advocates have long warned parents about the suffocation dangers of padding and bedding in a child’s crib. Earlier this month, a related warning was given about padding in a play yard.

The issue was raised by The Safety Institute, a nonprofit organization that promotes injury prevention and advocates for product safety. It noted that The Juvenile Products Manufacturers Association (JPMA) advises consumers never to add a mattress, pillow, comforter or padding to a play yard.

These products are equipped by their manufacturers with a mattress properly sized for maximum safety, and designed to meet a standard established by ASTM International, a global outfit that establishes standards companies voluntarily accept.

But some companies, according to the JPMA, sell mattresses as “replacement” or “supplemental mattresses,” and the buyer must beware: An “add-on” or replacement mattress or bedding is not safe.

Potential danger lies in the gaps between a mattress that is too small or too thick, or with bedding a child can get wrapped up in — they present an immediate risk of suffocation.

A JPMA certification guarantees that products with its seal meet ASTM International safety standards. So if you’re shopping for a play yard, make sure you see that seal, which shows that it meets the voluntary standard.

Many of the supplemental, risky replacement parts are sold over the Internet, but bricks-and-mortar retailers offer them as well. Per the institute’s alert, “When industry suddenly creates a supplementary product which conflicts with the warning labels on the primary product it can be confusing and potentially dangerous. Products such as play yards are tested for foreseeable risks, and to the extent feasible, controllable risks are engineered out of the product.”

But consumers as well are responsible for ensuring the safety of these products. Don’t put anything on top of the existing mattress. If you need to replace it, call the company from which you bought the play yard. As the ASTM explains, each manufacturer tests its play yard with the mattress it supplies, so if you’re buying a replacement mattress from some other company, it hasn’t been tested for use with the play yard you have, and might not be safe.

Although the dangers are similar, play yards are a bit tougher to ensure for safety because their sizes and shapes vary more than cribs. Review the ASTM specifications here, and those for cribs here.

For play yards, the standard for total thickness of the mattress, including all fabric or vinyl layers, filling and material any structural components such as wood or hardboard, should not exceed 1.5 inches. Supplemental play yard mattresses and second-party replacement mattresses are available in different thicknesses, and some could raise the floor high enough so that a kid could get out of the enclosure.

The Consumer Product Safety Commission (CSPC), a federal agency, is in sync with the JPMA and Safety Institute concerning these products. It endorses the Keeping Babies Safe initiative; Chairman Elliot Kaye has said, “CPSC staff will continue to support these efforts as we all try to address this hazard and protect babies while they sleep.”

For crib and play yard safety tips, see JPMA videos here. Find out more about injuries to babies and children here.

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February 13, 2015

Feds Warn Against Bone Graft Implants in Kids

Bone graft surgery often involves bone morphogenic protein (BMP), an implanted material that encourages bone growth and fuses the gaps between spinal vertebrae. Instead of using natural bone, many people have been implanted with these substitute products, and too many have experienced horrible outcomes.

Now, the FDA officially is warning against their use for children.

Last month, the feds issued a safety communication to doctors advising against routine use of bone graft substitutes that contain certain proteins, like those in Medtronic Infuse, because they might cause bone growth problems for children. This product, as explained on AboutLawsuits.com, is widely used even though the FDA has approved it only for limited spinal procedures in adults. Its “off-label” use, however includes other types of spine fusion surgery that are associated with an increased risk of severe and painful complications caused by excessive bone growth, fluid accumulation, retarded healing and swelling.

“While these types of events are similar to those seen in patients over age 18,” the warning reads, “they are of more concern in patients under 18 because of their overall smaller size and because their bones are still growing.”

Three years ago, an article published in the Journal of the American Medical Association (JAMA), expressed concern about bone graft substitutes in children, indicating that nearly 1 in 10 spinal fusion surgeries relied on them despite long-term risks.

What’s possibly bad for adults, the FDA is saying, looks even worse for kids. “In a body that is still growing, vital organs and tissues are closer together than in a body that is done growing. This could potentially allow small changes from one organ/tissue to have serious effects on another,” the alert read. “For example, there is less space between the spinal cord and the bones surrounding it. If one of these products is used in the spine of a patient under age 18, who then experiences the same amount of excess bone growth or fluid accumulation as a patient over age 18, it may more easily lead to spinal nerve injury, pan, or weakness.”

If your doctor advises treating your child’s bone defect or bone disorder with a bone graft substitute, especially Medtronic Infuse, discuss your concerns and ask about other options, AboutLawsuits suggested, such as autograft bone. That involves taking bone from another part of the child’s body instead of using a substitute product. Another option to ask about is allograft bone, which is material transplanted from another person.

The FDA also recommended that doctors consider bone graft substitutes that do not contain recombinant proteins or synthetic peptides.

As we blogged regarding Medtronic Infuse, the company has vigorously promoted it since its introduction in 2002. But in 2008, the FDA warned about its risks for off-label uses after receiving many reports about serious complications and deaths.

And the company has been accused of promoting off-label use of Infuse, which is illegal. Although practitioners may use a drug or device off-label, manufacturers are not allowed to promote it for any use other than what the FDA approves. Medtronic has agreed to pay about $22 million to settle nearly 1,000 lawsuits associated with bone graft problems.

This is a dangerous device for anybody, and now, it seems, especially for kids.

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January 30, 2015

Why Should Toys Be Safer than Guns?

Guns don’t kill people, the saying goes, people kill people. Some of those people killers and their victims are children. It’s astonishing that this country seems unwilling to protect our young from the dangers of firearms.

A recent column in the New York Times by Nicholas Kristof recited figures from the FBI and the Centers for Disease Control and Prevention (CDC) that more preschoolers are killed by guns every year (about 80) than are police officers, about 50 of whom are killed by guns. According to a study published in the journal Pediatrics, 20 children and teenagers are shot every day in the U.S.

Death by gunfire is a public health issue from which children are not exempt, and Kristof reminded readers of some of their recent, sad stories:

  • Last month, Veronica Rutledge was shot by her her 2-year-old in a Wal-Mart when the little guy reached into his mom’s purse, found handgun that she legally carried and pulled the trigger.

  • In November, a 3-year-old boy was shot in the face by a 4-year-old, and a 2-year-old shot and killed his 11-year-old sister.

Maryland passed a law in 2002 to require gun dealers to sell handguns manufactured from 2003 onwards, only if the handgun is equipped with an "integrated mechanical safety device" to prevent discharge unless the device is deactivated. Older handguns can be legally sold by dealers only if they are provided with an external lock of some kind (like a locked case). Unfortunately the law has plenty of loopholes and hasn't had much impact to make all guns truly child-proof.

In this country, it’s common practice to childproof your cabinets and electrical outlets. It’s common sense to protect young ones from dangerous toys. So why did a Florida court rule that doctors who ask their patients if they own firearms violate the patients' right to privacy?

It’s not a privacy issue, it’s a health issue. As a story in The Atlantic explained, the American Medical Association (AMA) considers gun violence an epidemic; in 2011, it advised doctors to counsel patients on gun safety.

The American Academy of Pediatrics, the magazine said, considers gun safety counseling a doctor’s job just like it is his or her job to counsel patients about the dangers of lead paint, and the risks of not using seat belts. “Pediatricians,” the policy statement reads, are “urged to counsel parents about the dangers of allowing children and adolescents to have access to guns inside and outside the home.”

The kid death toll, Kristof wrote, “is utterly unnecessary, for the technology to make childproof guns goes back more than a century. Beginning in the 1880s, Smith & Wesson … actually sold childproof handguns that required a lever to be depressed as the trigger was pulled.”

“Doesn’t it seem odd,” he continued, “that your cellphone can be set up to require a PIN or a fingerprint, but there’s no such option for a gun?”

The investigative news site FairWarning.org recently published a story about how different states are addressing (or not) the issue of gun control. One of its sources, Daniel Webster, director of the Center for Gun Policy and Research at Johns Hopkins University in Baltimore, commented on NRA-backed measures to allow guns where alcohol is sold and on college campuses, and noted that a Missouri provision lowers the minimum age for a concealed carry permit to 19.

“That age group gets into a lot of trouble,” he told FairWarning. “I just really question how prudent it is to allow 19-year-olds to carry concealed handguns around. We don’t even let 19-year-olds drink a beer legally.”

Maybe it takes a kid to protect a kid. Kristof introduced readers to Kai Kloepfer, a 17-year-old in Boulder, Colo., who was inspired to do something after the cinema shooting in a Denver suburb in 2012. Kloepfer made childproofing guns his science fair project.

Kloepfer’s “smart gun” can be fired only by an authorized user recognized by the fingerprint on the grip. More than 1,000 fingerprints can be authorized per gun; neither a child nor a thief nor anyone can shoot it if their prints haven’t been authorized.

Kloepfer won a grand prize in the Intel International Science and Engineering Fair for his design, as well as a $50,000 grant from the Smart Tech Challenges Foundation to refine it. By the time he enters college, he hopes the technology will be ready to license to a manufacturer.

Kristof enumerated other ways to make smarter, safer guns, including the Armatix iP1, which can be fired only if the shooter is wearing a companion wristwatch.

But of course the NRA rejects the idea of smart guns because it doesn’t think any safety measure should become mandatory. “One problem has been an unfortunate 2002 New Jersey law,” Kristof wrote, “stipulating that three years after smart guns are available anywhere in the United States, only smart guns can be sold in the state. The attorney general’s office there ruled recently that the Armatix smart gun would not trigger the law, but the provision has still led gun enthusiasts to bully dealers to keep smart guns off the market everywhere in the U.S.”

Kristof quoted Stephen Teret, a gun expert at the Johns Hopkins Bloomberg School of Public Health, who said “Smart guns are going to save lives. They’re not going to save all lives, but why wouldn’t we want to make guns as safe a consumer product as possible?”

Indeed, why should safety take a back seat to commerce? Why can’t commerce embrace safety, as a promotional tool?

That’s what David Hemenway, a public health expert at Harvard whom Kristof interviewed, believes. He told the reporter that police departments or the military should buy smart guns to create the market and prove that they work.

“Something is amiss,” Kristof concluded, “when we protect our children from toys that they might swallow, but not from firearms. So Veronica Rutledge is dead, and her son will grow up with the knowledge that he killed her — and we all bear some responsibility when we don’t even try to reduce the carnage.”

You can read a summary of federal and state laws on "smart guns" and related issues at the website of the http://smartgunlaws.org/gun-policy/">Law Center to Prevent Gun Violence.

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December 12, 2014

Don’t Rely on High-Tech Baby Monitors

Baby monitors are a wonderful parental aid … or are they?

Dr. David King, a pediatric researcher at the University of Sheffield in England, recently wrote about his baby monitor studies in BMJ (the British Medical Journal). They indicate that the information provided by newer, high-tech devices isn’t a reliable signal of danger, and that they don’t provide reliable information about your child.

"It's not a medical device; it's not registered as a medical device. It's just for fun, really," King said in an interview for NPR. "But if you look at the marketing so far, I don't think that's the message that comes across."

His point is that companies are very good at capitalizing on parents’ concern over their newborn’s health. High-tech monitors are developed less to impart useful medical information than to address parental anxiety by monitoring a baby's vital signs and sending them to a smartphone.

When King first heard a discussion about baby vital sign monitors on the radio, he told NPR, "I suspected there wasn't much evidence behind it, because I knew cardiovascular monitoring wasn't recommended in SIDS."

Sudden infant death syndrome (SIDS), also known as crib death, is the unexplained death, usually during sleep, of an otherwise healthy baby younger than 1 year.

Experiments in the 1980s and 1990s using monitors as an intervention for SIDS failed to reduce its incidence in healthy infants. They’re no longer recommended by the American Academy of Pediatrics and other medical groups. "Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS," the academy says, because "there is no evidence that use of such devices decreases the incidence of SIDS."

The newer monitors include the Mimo, which costs about $200. It monitors a baby's breathing, body position, sleep activity and skin temperature via a sensor attached to a special onesie. But if you read its website terms of service carefully, you find this disclaimer:

The Mimo baby monitor system is not a medical device, is neither regulated nor approved by the U.S. Food and Drug Administration, and is not designed to detect or prevent causes of sudden infant death syndrome (SIDS). The Mimo baby monitor system is intended to help you monitor your baby and is not to be used as a substitute for parenting or other adult supervision. Use of the services and any content is entirely at your own risk.

Promotional language for similar monitors suggests that tracking a healthy baby like Russia tracks spies is what all good parents do.

But some parents won’t know how to use data on an infant's heart rate and blood oxygen level as a way of ensuring a kid’s safety. What’s the point of information if you can’t apply it?

And, according to NPR, a big problem with SIDS monitors is false alarms, which serves only to panic parents.

As we’ve blogged, to reduce the risk of SIDS, put babies to sleep on their backs, keep soft bedding out of the crib and don’t let them sleep on couches.

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December 5, 2014

Misleading Claims of Protection Against Allergy and Eczema

If you think a label claiming that the product is hypoallergenic will protect your kids against allergic reactions, think again. Research published in the Journal of Allergy and Clinical Immunology showed that a lot of products marketed for kids with itchy skin often contain ingredients that cause the very problem they’re promoted to address.

As explained in a story by Reuters, labels with the word “hypoallergenic,” which means unlikely to cause or designed to reduce an allergic reaction, are not regulated by the FDA. That means there’s no oversight of the claim and nothing to enforce its veracity.

The study tested products that might be used by children with eczema, a red, itchy skin condition common among children, but which can strike anyone at any time. It’s chronic, and tends to flare up, then die down without any clear cause. There is no cure for the long-lasting condition, known formally as atopic dermatitis.

Eczema affects nearly 18 million people in the U.S.

“Kids who have eczema or atopic dermatitis use more lotions and creams and ointments, …,” Carsten Hamann told Reuters. He’s the medical student who was lead author of the study. “Ostensibly, their caregivers who purchase these products to use on the kids' skin, give preference to products using these meaningless marketing terms.”

His team tested 187 cosmetic products sold in six different stores in California. They looked for any of the 80 most common known allergens identified by the North American Contact Dermatitis Group.

All of the products tested were promoted as safe for use by children, and all were labeled as “hypoallergenic,” “dermatologist recommended/tested,” “fragrance-free” or “paraben free.”

  • Nearly 9 in 10 products contained at least one allergen.

  • More than 6 in 10 contained two or more, and more than 1 in 10 contained five or more.

  • The average number of allergens per product was 2.4.

  • Preservatives and fragrances accounted for nearly 6 in 10, and 3 in 10 allergens, respectively.

  • One in 10 products contained methylisothizolinone, a preservative the European Union plans to ban because it can cause severe skin irritation, according to the researchers.

Doctors usually advise eczema patients to use moisturizer on inflamed skin, but a lot of people with eczema also suffer from so-called “contact allergies.” That is, they might have allergic reactions to substances that touch their skin, including fragrances and preservatives.

“It would be very difficult for even the most caring, intelligent and well-read parent to know the names of 80-plus allergens and their synonyms,” Hamann told Reuters, “let alone compare that list of allergens to a 15-plus long ingredient list on the back of a pediatric product.”

The study wasn’t universally embraced. Dr. Donald Belsito, Professor of Dermatology at Columbia University Medical Center in New York, commented to Reuters Health that the study “misrepresents a lot of these chemicals because they’re listing the frequency with which they were found in a product, not the frequency at which they cause allergy. … Many of the chemicals on that list are very, very rare causes of allergy.”

Another skin disease specialist, Dr. Michael Ardern-Jones from the University of Southampton in the U.K., noted the difficulty of defining terms associated with allergies. “Almost any chemical compound could be implicated as an allergen, so it is almost impossible for a cream to be truly nonallergic,” he told Reuters. “… as there is no true ‘hypoallergenic’ cream, there is no agreed meaning of ‘hypoallergenic.’”

But the greater point is that consumers — parents — believe that something called “hypoallergenic” offers a degree of protection. And with or without this study, it doesn’t, because there is no regulatory standard or oversight for the claim.

Both experts recommend treating eczema with ointments rather than creams and lotions, which contain water and therefore also must contain preservatives. That makes them more likely to contain allergens.

Belsito recommends petroleum-based products such as Vasoline, and advises keeping skincare products simple. Ardern-Jones said that prescription moisturizers generally are reliable, and advises against using products that contain fragrance and color, and that lack a list of ingredients.

The National Eczema Association reviews products and, according to Reuters, “is a more reliable resource than the product labels.”

To learn more about an additional risk factor for children developing eczema, see our blog, “Early Use of Antibiotics May Lead to Eczema Later”

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November 21, 2014

Laundry Detergent Pods Remain Risky for Kids

More than two years ago we blogged about the toxic quality of laundry detergent packaged in colorful plastic pods that look like candy to some small children. Although the danger flag was raised then by poison control centers, and the Consumer Product Safety Commission issued a safety alert, these products are still harming wee ones.

A recent study published in the journal Pediatrics found that between 2012 and 2013, U.S. poison control centers fielded more than 17,000 reports of kids younger than 6 who swallowed, inhaled or were otherwise exposed to the chemicals in laundry detergent pods.

That’s about one kid an hour. About 770 children were hospitalized, an average of one a day, and one died.

The highest risk was for 1- and 2-year-olds, which won’t surprise parents who know that these small fry explore the world largely through putting stuff in their mouths. Nearly half of children vomited after being exposed to these products, and other problems were coughing, choking, eye pain or irritation, drowsiness, lethargy and “pink eye” ( conjunctivitis).

Some manufacturers are modifying pod packaging to be more kid-resistant, and some include warning labels to the containers. But a lot of detergent pods are available in see-through packages easily opened.

“It is not clear that any laundry detergent pods currently available are truly child resistant; a national safety standard is needed to make sure that all pod makers adopt safer packaging and labeling,” said Dr. Gary Smith in a news release. Smith is the study’s senior author and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio.

Keep kids safe from laundry detergent products by:

  • using traditional laundry detergent, which is much less toxic than laundry detergent pods;

  • storing any detergent pods you might have high and out of sight; a locked cabinet is best;

  • closing the containers and storing them immediately after use.

If your child does ingest a laundry detergent pod or has a bad reaction after exposure, call the national Poison Help Line number at (800) 222-1222. Of course, if he or she is having trouble breathing or otherwise shows serious problems, head for the emergency room.

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August 29, 2014

Worrisome Trend: Sunscreen Use Declines Among Teens

Although the rate of some cancers has declined in recent years, melanoma — the most serious form of skin cancer — is not among them. The situation is more troubling with the news of a new study that fewer teenagers are using sunscreen than they used to.

Because sun damage is cumulative — that is, like X-rays and other forms of radiation, the more exposure you have and the longer you have it, the greater the risk of developing cancer — the news is particularly unsettling. The earlier in life you develop the habit of reducing sun exposure, and of using sunscreen when you are outside, the greater your chances of minimizing the risk.

The study about teens was part of the Youth Risk Behavior Surveillance System, an initiative of the Centers for Disease Control and Prevention (CDC). It reviewed use of sunscreen and indoor tanning devices among high-school students across the U.S. between 2001 and 2011. Even though teens generally practice fewer skin-protection habits than adults, this study, as reported on AboutLawsuits.com, showed a decline sunscreen use and an increase in indoor tanning use even from previous reviews.

The number of teens who use sunscreen dropped by more than 1 in 10 from 2009 to 2011. The lowest rate of sunscreen use was in 2005, when only 5 in 100 teens applied it. The rate teens used indoor tanning devices varied less in that period, from 15 in 100 in 2009 to 13 in 100 in 2011, but it still declined.

Although as adults, more women than men wear sunscreen, the CDC study showed that girls used indoor tanning devices more than boys. In 2009, 1 in 4 girls tanned indoor regularly compared with 6 in 100 boys. And their use of tanning beds increased as they got older. Sunscreen use was fairly consistent across all grade levels.

A few years ago, we blogged about the dangers of kids and tanning beds, “Youth and Tanning Beds: Do Not Mix,” but it appears American youth — and their parents — aren’t getting the message.

According to the American Cancer Society, melanoma is diagnosed in about 69,000 Americans each year, and about 8,650 die from it. The CDC says that rates of melanoma rose 1.6% among men and 1.4% among women every year from 2001 to 2010.

Other forms of skin cancer are less lethal than melanoma, but are still problematic and require treatment. AboutLawsuits refers to a study from a few months ago that showed that teenagers who use tanning beds are more likely to develop basal cell carcinoma, one of those forms, and that they were more likely to be diagnosed at a much earlier age.

However you get harmful radiation, and wherever it shows up on your body, it’s not good. And, often, it’s preventable. Adults should make sure they minimize exposure to the sun, and should spurn the use of tanning beds, and they should make sure their kids do, too. It’s an investment in future health.

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August 15, 2014

All-Terrain Vehicles Are Not Toys

Here’s a “Say what?” statistic that should give parents pause: More than half of all teens who have driven an all-terrain vehicle (ATV) have been involved in an accident.

So says research recently published in the Annals of Family Medicine. The report also shows a propensity for teens to engage in several kinds of risky behavior when they ride on an ATV.

As explained on AboutLawsuits.com, researchers from the University of Iowa Carver College of Medicine found that 3 in 4 teenagers in the state of Iowa have driven an ATV and that kids 15 and younger represented 1 in 5 ATV-related deaths.

The findings about the number of teens who had been in crashes were similar to previous studies from other states.

The conclusions were based on a survey of 4,684 youngsters between 11 and 16 taken over 2½ years at 30 different schools throughout Iowa. More than 1 in 3 of the kids who said they’d ridden an ATV reported doing so every day or every week. More than half of the ATV riders said they’d been in at least one accident, and nearly all of them acknowledged having engaged in risky behavior, which was defined as:

  • riding with a passenger (9 in 10 reported doing this);

  • riding on public roads (8 in 10);

  • riding without a helmet (more than 6 in 10).

Six in 10 respondents reported having engaged in all three dangerous behaviors at some point. A scant 2 in 100 said they had engaged in none of them.

According to the ATV Safety Information Center, an initiative of the U.S. Consumer Product Safety Commission, of about 100,000 ATV injuries in 2012, one-quarter were kids younger than 16, and of the 353 ATV fatalities that year, 54 were from that group.

Even for people who are careful, ATVs are dangerous — they’re powerful and can be unstable, especially if they have more riders than they’re built to accommodate.

The most fearsome accidents, of course, involve brain injuries, which, according to the new study, “are among the leading cause of death and disability from ATV crashes. They are more likely to occur on the roadway than off road, even when controlling for helmet use. Helmets are estimated to reduce the risk of fatal ATV-related head injuries by 40% and of nonfatal head injuries by 60% or more.”

To learn more about brain injuries, see our backgrounder.

If you and your family enjoy riding all-terrain vehicles, make sure you follow the safety guidelines provided by the CPSC:

  • Do not drive ATVs on paved roads.

  • Do not allow a child under 16 to drive or ride an adult ATV.

  • Do not drive ATVs with a passenger or ride as a passenger.

  • Always wear a helmet and other protective gear such as eye protection, boots, gloves, long pants and a long-sleeved shirt.

  • Take a hands-on safety training course.

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July 25, 2014

Spray-On Sunscreen Is Not for Small Fry

Except for the youngest infants, using sunscreen is a good idea for anyone hoping to avoid the cancer and cosmetic risks of too much sun exposure. But one form of protection is not recommended for children: spray-on sunscreen.

Infants younger than 6 months should not use sunscreen; the best protection for them is to keep them out of the sun. That’s because their skin is immature and they have a higher surface-area-to-body-weight ratio compared with older children and adults. Those two characteristics make an infant’s exposure to the chemicals in sunscreens much greater, increasing their risk of side effects.

As explained by Consumer Reports, aerosol applications of sunscreen present the risk of inhaling ingredients that irritate the lungs. Earlier this summer, according to the magazine, the FDA said it was investigating these potential risks. Also, spray products are flammable, so don’t use them near a grill or fire, and don’t let even older kids fool around with them near an open flame.

No one of any age should inhale this stuff, but children are at greater risk because they’re more likely to move around while they’re being sprayed and accidentally get a dose where it doesn’t belong.

The safe use of sunscreen, says Consumer Reports, includes these practices:

  • Don’t use sprays on children, unless you have no other product available. In that case, spray the sunscreen onto your hands and rub it on. As with all sunscreens, be especially careful on the face, taking care to avoid the eyes and mouth.

  • Adults can use sprays, but don’t spray your face. Spray your hands and rub it on your face, making sure to avoid your eyes and mouth. Avoid inhaling it.

  • Make sure you apply enough. The magazine’s tests have found that sprays can work well when used properly, but it’s more difficult to gauge if you apply enough, especially when it’s windy. Spray as much as can be evenly applied, and then repeat the application, just to be safe. On windy days, spray the sunscreen on your hands and rub it on, or go with a lotion instead.

To see the FDA’s sunscreen recommendations, link here. For the agency’s sun safety tips for infants, link here. For Consumer Report’s recommendations for sunscreens for kids and babies, link here. To see what Consumer Reports has to say about sunscreens generally, and to review its list of recommended products, link here (some pages are subscription only).

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June 6, 2014

Dangerous Flame Retardant Chemicals Are Everywhere

Parents of small children know that day care centers and preschools are notorious providers of germs the whole family can share, but what they might not be aware of is that they also pose a danger because their furnishings often are treated with flame retardants.

The chemicals in flame retardants, polybrominated diphenyl ethers (PBDEs) and tris phosphate compounds, have been linked to hormone disruption and lower IQs in children. According to a study published in the journal Chemosphere, they were found in 100% of the dust samples collected from 40 child care centers serving more than 1,760 children in Northern California.

As reported by the San Francisco Chronicle, the study was conducted by researchers from the University of California, Berkeley’s Center for Environmental Research and Children’s Health. They said that the results were representative of what's found in many homes and other environments because the chemicals have been widely used for decades in the polyurethane foam inside upholstered furniture.

In the early 1970s, California imposed requirements that upholstered furniture be manufactured with flame retardant chemicals. Those measures became standard elsewhere as well. But they were changed to enable flammability standards to be met without the use of the chemicals. As we noted earlier this week in our Patient Safety blog, “Burn Surgeon’s Testimony Tainted by Conflict of Interest,” chemical industry interests have tried to promote these dangerous substances using unsavory and misleading means.

Although PBDEs have been banned in California for almost a decade, they’re still found in older furniture and other products. And in many cases, their replacement was chlorinated tris, never mind that it had been removed from children's pajamas in 1977, according to The Chronicle, after it was found to mutate the DNA of people exposed to it. In California, it’s considered a carcinogen, or cancer-causing substance.

The Chemosphere study found levels of PBDEs in the child-care facilities to be somewhat lower than what previous studies found in residences. But the amounts of chlorinated tris were similar or higher than household levels found in other reports.

The authors said that the higher tris levels probably were found in the mats children use for napping, as well as in furniture. Of the facilities studied, 29 had upholstered furniture and 17 had napping mats made of foam.

To minimize your child’s exposure to these chemicals:

  • Choose natural fiber wall coverings instead of paint.

  • Use cleaning supplies without harsh chemicals.

  • Maintain a low level of dust.

  • Cover childrens' mats with cotton sheets.

And don’t despair: Despite the study's results, Asa Bradman, its lead author and an environmental health scientist, told The Chronicle, "People shouldn't panic and feel like child care is toxic for children."

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May 30, 2014

Preventable Injuries Bring Many Children to ERs

A recent report by the National Center for Health Statistics (NCHS) paints a clear portrait of what most often brings kids into the emergency department.

As you might expect, injury is the leading cause of death and also a major source of morbidity (the relative incidence of a disease within a population) among children and adolescents, and the emergency room is where a lot of these victims land first. The report looked at ER visits throughout the nation by children and adolescents 18 years and younger from 2009 to 2010. Different age groups for injury-related visit rates were: as old as 4; 5 to 12; and 13 to 18 (that is, preschool, school-age and teenagers).

The key findings?

  • The annual average of injury-related emergency department (ED) visits made by children and adolescents 18 years and younger was 11.9 million. (Total visits were about 33.7 million.)

  • The injury-related ED visit rate was 151 per 1,000 patients 18 years and younger. Rates were higher for males than for females for all age groups.

  • Injury-related ED visit rates among patients 5 to 12 and 13 to 18 were higher for non-Hispanic blacks than for other race and ethnic groups.

  • Leading causes of injury-related ED visits among both males and females included falls and striking against or being struck unintentionally by objects or people. Visit rates were higher for males than for females for both causes.

As far as cost was concerned, public funds (Medicaid or Children's Health Insurance Program) covered 41.7% of injury-related visits, and private insurance covered. 40.7%. Youngsters with no insurance represented 8.6% of visits.

“Child and adolescent injuries represent a serious public health problem in the United States,” the report concluded, and more than one-third were the result of injuries.

It’s not always, or usually, possible to foresee and forestall your child’s illness, but injuries are often the result of inattention or lack of preparation (see our recent blog, “Ensuring the Safety of Baby Gates.”) Preventing injuries requires covering a lot of bases that can seem overwhelming to parents.

Proven strategies include researching the safety and recall information for childrens’ products on sites including the Consumer Products Safety Commission, sponsored by the federal government. Visit the Safety Research & Strategies Inc. website, which investigates, analyzes and advocates about safety issues.

Other guidelines are provided by Healthy People 2020, a federal government initiative to improve the health of all Americans that includes preventing injury and violence and reducing their consequences.

And review our blogs about a wide range of products including car seats, sleep machines, recreational equipment and rides, medicines and more.

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May 23, 2014

Ensuring the Safety of Baby Gates

Part of making your home safer for young children often includes installing a baby gate. But the risk of injury is high if it’s not set up right and used properly.

The Center for Injury Research and Policy at Nationwide Children’s Hospital conducted a study from 1990 through 2010 that was the first one of national scope to analyze injuries associated with the gates parents often install to keep the wee ones from tumbling down the stairs or entering a room where other harmful things pose a risk.

The rate of baby gate injuries more than tripled during the two decades of study, from nearly 4 in 100,000 children in 1990 to 12.5 in 100,000 in 2010. The researchers used data from the National Electronic Injury Surveillance System (NEISS), which is operated by the U.S. Consumer Product Safety Commission, and provides information on consumer product-related and sports- and recreation-related injuries treated in hospital emergency departments.

The study, published in Academic Pediatrics, showed that U.S. emergency departments treated about 37,675 kids younger than 7 for injuries related to baby gates. As explained on ScienceDaily.com, that averages out to about five injured children a day.

More than 6 in 10 of the injured children were younger than 2. The most common circumstance for injury was falling down the stairs after a gate collapsed or wasn’t closed. The problems range from soft-tissue sprains to traumatic brain injuries. Children between 2 and 6 were injured frequently because they were climbing on the gate and got cut on its edges.

To reduce the chances of your kid having an unpleasant encounter with the thing that’s supposed to protect her, make sure it’s the correct type of gate for the location where you want to install it. And check to see if it meets the industry’s voluntary safety standards.

Pressure-mounted gates should be used only to divide rooms or at the bottom of stairs, not to prevent falls; they’re not designed to withstand much force. If you want to bar access at the top of a staircase, use only gates with hardware that requires screwing into the wall or railing.

Although the voluntary standards set by the American Society for Testing and Materials have helped make baby gates less hazardous, as the researchers noted, there is no substitute for mandatory standards for demonstrating a true commitment to safety.

In addition to the tips noted above, follow these to minimize the chances of injury:

  • Install gates in homes with children between 6 months and 2 years old.
  • Remove the gate when the child turns 2, or when he or she has learned to open it or climb over it. If you still need the gate because there are other little ones in the home, use a model without notches or gaps that could be used for climbing.

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April 25, 2014

Devices Approved for Pediatric Use Often Aren’t Tested on Children

An unsettling study recently published in the journal Pediatrics shows that most medical devices that the FDA has approved to treat children weren’t tested on them first.

Mostly, such devices were tested in clinical trials on patients at least 18 years old.

One of the study’s authors, Thomas J. Hwang, a research fellow at Harvard Medical School, told Reuters.com, "Children are not simply 'small adults,' and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population."

"Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment," he said.

The practice of ignoring how kids might respond differently to treatments given to adults is hardly new — last year we wrote about how pharmaceutical companies often don’t conduct clinical trials with children for drugs tested on and approved for adults.

The Pediatrics study reviewed testing that had been done on medical devices meant for kids since an act of Congress helped spur their development seven years ago. Researchers analyzed data from the main clinical trial used for the 25 medical devices approved by the FDA for use in patients 21 and younger between 2008 and 2011. Nearly half — 11 — weren’t tested on any patients younger than 21, and only four of the devices had been tested on patients younger than 18.

Three of the devices included in the study were approved specifically for people younger than 18, whom the FDA considers pediatric; the rest were approved for 18- to 21-year-olds.

Researchers said, however, that devices approved only for older adolescents probably are used "off-label" in younger children because, often, there are no alternatives.

Doctors may prescribe a treatment for something other than what it was approved for (“off-label), but it’s illegal for manufacturers to promote such use.

Most of the devices in the Pediatrics study had been approved with a stipulation that their manufacturers conduct post-market trials after they reached the commercial market. The idea was to ensure they were safe and effective. But only three required that youngsters be included in the trials, and none of those was complete.

"Designing devices for children is more complex because they are still growing and may need to have the device for many decades, in contrast to older adults," Dr. Katherine Bates, a cardiology fellow at The Children's Hospital of Philadelphia, told Reuters.

There are ethical and practical issues about using children with rare diseases in clinical trials, even though without them you can’t determine how a device will perform in the long term. And government incentives for conducting clinical trials with children are available for drug manufacturers, but not for device makers.

Some of the devices in the Pediatrics study were approved from observational study data, not the more rigorous results of randomized, controlled trials. The FDA requires at least one clinical trial demonstrating that a device is safe and effective before it approves it for general patient use. But these trials don't necessarily have to include the same type of patients who will get it once it’s marketed.

Just as women don’t necessarily respond to a drug or device as men will, or the elderly versus middle-aged people, children might not either.

Cardiologist Rita F. Redberg, editor of JAMA Internal Medicine, told Reuters “Common sense would dictate that devices would be studied in the appropriate populations before they are used on the market.”

As Reuters notes, approval requirements exempt “high-risk” devices, or those that support or sustain life for patients with rare diseases (fewer than 4,000 people in the U.S. each year); such devices must demonstrate only that they are safe and probably beneficial. But they can’t be sold for profit.

The 2007 act of Congress eliminated the nonprofit provision for devices intended for children, and established grants for nonprofit pediatric device developers.

Three of the 25 devices included in the Pediatrics study invoked the rare disease exemption.

If your pediatrician, or any other doctor, recommends a certain device to treat your child, ask if it has been tested on children, or how much evidence there is that it will be effective and safe. And consider enrolling your child in a trial in order to enlarge the small body of current knowledge about how devices work in children.

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April 11, 2014

The Cost of a Car Seat Defect Was a Child’s Life

More than two years after a horrendous accident in which an infant lost her life because of a defective car seat, federal authorities are still diddling around in their investigation and the car seat manufacturer, Graco, continues to blame its customers.

The story was reported in sad detail on The Safety Record.

In August 2011, Samika Ramirez was driving with her 2-year-old, Leiana Marie Ramirez. When the car started to swerve, Ramirez pulled to the left side of the parkway and turned on her flashers. The divided road had only a narrow shoulder. She was about to call the auto club when another driver rear-ended her car.

It caught fire, and Ramirez tried frantically to unbuckle her daughter, but couldn’t release the harness of the Graco Nautilus child safety seat. With flames engulfing her car, passersby Ramirez pulled out of the car, and Leianna was burned alive.

More than a year later the National Highway Traffic Safety Administration (NHTSA) opened an investigation. The results are still pending, but the the Graco Nautilus and 17 other models with buckles difficult to unlatch were recalled. Some consumers told NHTSA that they had to cut the belt webbing to release their children from the seat.

From the beginning, according to The Safety Record, Graco conceded that it was “keenly aware of the issue.” It had received more than 6,100 complaints about it, but said that the difficult of getting a kid out of a seat was merely “a consumer frustration and a consumer experience that Graco has been working to improve.”

So far, Graco hasn’t acknowledged that the defect caused a horrific death, not to NHTSA, not in a defect and noncompliance report, not in NHTSA’s Early Warning Reports.

In 2005, Graco paid a $4 million fine after the U.S. Consumer Product Safety Commission (CPSC) cited its long history of failing to report injuries and deaths. “Even now,” The Safety Record reports, “with the initial recall expanded and under a Special Order to answer all questions truthfully, Graco comforts its customers on its website:

Graco can assure you there have been no reported injuries as a result of the harness buckles used on Graco car seats. We want to stress that our car seats are safe and effective in restraining children. And, the safest way to transport a child is always in a car seat."

NHTSA wouldn’t comment to The Safety Record, but did confirm that the investigation remains open. Christine Spagnoli, an attorney representing the Ramirez family, says that Graco’s failure to acknowledge Leiana’s death undermines the recall, and calls it a consumer safety issue.

“[B]y saying something false to the public,” she said, “they’re trying to save money, at the expense of kids getting hurt.”

After NHTSA began investigating, Graco started blaming consumers, saying they allowed food, drink and bodily fluids to muck up the buckle apparatus, making it difficult for the button to release the metal tongues. Graco said they were just frustrated with the “perception” of difficulty, that they unlatched the harness incorrectly and that the complaint rate was approximately 1 in 1,000.

The feds weren’t buying it, and expressed concern that the malfunction of the quick-release mechanism created “an unreasonable safety condition in that the unlatching of the buckle and/or the extracting of the child would take an excessive amount of time, or may not be possible at all in a post-crash or other emergency situation where time is a critical factor.

"Additionally, First Responders or Good Samaritans, who are unfamiliar with the buckles operation or its sticking characteristics, also may not be able to unlatch the buckle.”

They called Graco’s claim that a child could be removed even when he or she was still buckled “unsustainable” in a post-crash situation.

The to-and-fro between the company and the investigators is as wearying as it is painfully slow. Consumers shopping for child car seats might want to keep in mind, as The Safety Record recounts, that Graco has a history of denial, foot-dragging and responsibility-shifting when it comes to the requirements of NHTSA’s early warning reporting, which compels manufacturers to supply access to recall information.

Graco is obligated to report “any claim against and received by the manufacturer. Claims are merely requests or demands for relief related to a crash, the failure of a component or system, or a fire originating in or from a vehicle. These claims are unverified allegations. They may help NHTSA identify a possible defect, but in and of themselves the claims are not evidence of a defect.”

To see the Graco car seat models that have been recalled, link here.

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March 14, 2014

Sleep-Inducing Machines Might Invite Hearing Problems

It seems like such a good idea. As so many get-the-kid-to-sleep tricks do. But new research shows that using a machine that produces soothing sounds to lull a baby to sleep might damage his or her hearing.

A study published in Pediatrics last month analyzed 14 popular sleep machines at maximum volume and found that they produced between 68.8 to 92.9 decibels from 30 centimeters away. That’s about how far one might be placed from an infant’s head. Three of the machines exceeded 85 decibels, which is what the National Institute for Occupational Safety and Health deems the threshold of workplace safety for adults over the course of an eight-hour shift.

One of the baby machines was so loud that two hours of use would exceed workplace noise limits.

At 100 centimeters away, all the machines tested still were louder than the 50-decibel limit set in 1999 by an expert panel for an hour’s exposure in hospital nurseries in 1999.

“These machines are capable of delivering noise that we think is unsafe for full-grown adults in mines,” Dr. Blake Papsin told the New York Times. He is senior author of the study, and the chief otolaryngologist (disorders of the ear, nose and throat) at the Hospital for Sick Children in Toronto.

“Unless parents are adequately warned of the danger, or the design of the machines by manufacturers is changed to be safer, then the potential for harm exists, and parents need to know about it,” Dr. Gordon B. Hughes, the program director of clinical trials for the National Institute on Deafness and Other Communication Disorders, told The Times.

Newborn brains are learning to differentiate sounds at different pitches even during sleep, according to Lisa L. Hunter, scientific director of research in the division of audiology at Cincinnati Children’s Hospital. “If you’ve conditioned them to white noise, there’s every indication that they might not be as responsive as they otherwise should be to soft speech,” she told The Times.

The idea behind infant sleep machines is that their white noise or nature sounds drown out the normal ambient sounds that can disturb a baby’s sleep — voices, vehicle noise, music, etc. The machines come in many forms, including embedded in stuffed animals, and frequently are recommended by parenting books and websites.

Even some sleep experts advise parents to use them all night, every night, and many parents say their babies become so used to the sounds of rainfall or birds that they will not nap without them.

Despite their apparent potential to damage hearing, sleep machines can be used safely, according to the researchers. Papsin suggested placing the devices farther away, lowering the volume and using them for shorter periods to deliver less sound pressure to the baby. That means you should be wary of the models designed to be affixed to the crib.

The researchers also recommended that device manufacturers limit the maximum noise level of infant sleep machines.

Dr. Marc Weissbluth, a pediatrician and author of “Healthy Sleep Habits, Happy Child,” agreed that you don’t necessarily have to throw out the baby noise machine with the bath water. He told The Times that parents could use one, if they were careful. “If it’s too close or it’s too loud, this might not be healthy for your baby,” he said. But “a quiet machine that’s far away may cause no harm whatsoever.”

Maybe. But one Times reader posted an interesting comment to the story: “If the sound of a sleep machine is dangerously loud, I hate to think about all of the noise my premie was exposed to while in the n.i.c.u. [neonatal intensive care unit] for several weeks. Constant beeping, lights on, etc. I don't think she's worse for the wear, but hospitals need to be much more mindful about all of the environmental noise babies are exposed to in the n.i.c.u.”

To learn more about babies and sleep, see our blog, “Getting Your Baby to Sleep.”

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January 31, 2014

Making Liquid Medicine Less Likely to Harm Kids

We’ve written frequently about how difficult it can be to give children proper dosages of medicine — “How Big Pharma and the Fed Caused Infant Death Over Confusing Acetaminophen Dosages” and “Cold Medicines Are Dangerous for Very Young Children,” for example. ProPublica.org, the investigative news site, recently discussed how a certain safety device on medicine for kids could prevent drug accidents and overdoses.

Now, as reported by that outfit, New York Sen. Charles E. Schumer is urging the FDA and the Consumer Product Safety Commission (CPSC) to require drug makers to install flow restrictors in all liquid children’s medication within a year.

“If they don’t do it on their own, I will seriously consider legislation,” he said at a news conference last week.

Flow restrictors, as described by ProPublica, are small, plastic valves inserted into the necks of bottles of liquid medicine to slow the release of medication. That makes it more difficult for children to swallow a harmful amount. Approximately 10,000 children are seen every year in emergency rooms for potential medication overdoses, according to the Centers for Disease Control and Prevention (CDC). Some are hospitalized, and about 20 kids die from overdoses.

In 2011, drug makers voluntarily placed flow restrictors in bottles of infant’s acetaminophen, the active ingredient in Tylenol. Many also put them in children’s acetaminophen products.

But acetaminophen, says ProPublica, is involved in only about 1 in 4 of those emergency room visits. Other common over-the-counter medicines, including ibuprofen, cough and cold formulations and antihistamines, account for most of the rest.

Although industry trade groups say they are studying ways to minimize these accidents, federal regulators haven’t exactly been aggressive in making the industry do more. For one thing, FDA officials hold differing opinions about whether they have the power to mandate the devices.

Last year, the CPSC promoted the establishment of a voluntary set of standards for flow restrictors, working with a nongovernmental organization composed of industry representatives, federal officials and independent researchers.

The companies that make acetaminophen products have installed flow restrictors of varying efficacy, according to ProPublica. Different models were tested, and so-called “closed” restrictors — resealing rubber coverings that must be punctured by a syringe — worked better than “open” designs, typically plastic discs with small holes at their centers. But of the 31 bottles tested, only five had closed restrictors.

Schumer wants all the meds to have the closed restrictors. In his news conference, he said, “The closed restrictor, the foolproof kind, is 8 to 10 cents a bottle. You’re paying five, six, seven dollars, even more for this medication, so another dime to keep your kids safe is a choice that just about every parent would make.”

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November 15, 2013

Helmet Claims Don’t Stand Up in Preventing Football Concussions

The topic of sports-related concussions, especially from football, remains front and center among health professionals and any player or parent who cares about his brain function. Equipment manufacturers have jumped aboard the protect-your-head bandwagon, but, as a recent story on USNews.com makes clear, helmet product claims of reducing the risk of injury aren’t borne out by the facts.

We’ve reported on concussion-related brain injury and the ways in which product manufacturers have tried to address it.

Summarizing research presented at a meeting of the American Academy of Pediatrics last month, USNews reported that “… neither the brand nor the age of a helmet is associated with fewer concussions in young athletes, …”

During the 2012 football season, researchers tested a variety of mouth guards and football helmets worn by 1,332 high school football players from 36 different schools. The players had completed a pre-season questionnaire about previous injuries. The athletic trainers reported the number and severity of sports-related concussions throughout the season.

At season's end, no significant difference was found in the frequency of concussions among players, regardless of the brand or age of their helmets. And the severity of the concussions, as measured by the number of days players were absent from play, was no different among players wearing different brands. Among the brands tested were Riddell, Schutt and Xenith.

Many helmets promoted for reducing the risk of concussion are more expensive, so the researchers questioned the wisdom of investing in such equipment.

According to the Centers for Disease Control and Prevention (CDC), more than 173,000 recreation-related traumatic brain injuries to children and adolescents are treated in U.S. emergency departments in the United States every year. Boys between 10 and 19 who play football are far more likely to suffer such injuries. Nearly 3 in 4 ER visits for brain trauma are among males, and most often involve football or bicycling. The recent research showed that about 40,000 sports-related concussions occur in U.S. high schools every year.

Although helmets reduce the risk of skull fractures and scalp injuries, the researchers doubt that they’ll ever be able to protect athletes completely from concussions and brain injuries. That’s not likely, as the chief researcher told USNews, "because the brain is floating freely inside the skull, I think most experts doubt whether it is possible to ever develop a helmet design that can prevent concussion."

Gregory Myer, director of research for the Division of Sports Medicine at Cincinnati Children's Hospital Medical Center, said it's difficult to protect the brain from the outside, especially when you add mass to an athlete's head with a helmet.

"That's why we've seen no reduction in the number of concussions from the development of any helmet," he told USNews.

You can prevent the incidence and severity of concussions by increasing peripheral vision to enable a player to avoid or prepare for a collision, and by improving neck strength. But Myer said it's possible that helmets could increase the risk of concussions.

That comes from a sense of invincibility—some players might be less fearful if they’re wearing a helmet they believe has protective powers that it doesn’t.

"They're more likely to use their head as a weapon," Myers told USNews. "If you took that away, athletes would never lead with their head."

Learn more about concussions on HealthyChildren.org, an informational website of the American Academy of Pediatrics.

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October 25, 2013

Too Many Car Seats Are Installed Improperly

With the exception of seatbelts, fewer products have done so much so fast as child car seats in the category of transportation safety. But as a recent story in the New York Times explains, improper installation of the tiny chairs is common, and seriously compromises the restraint’s ability to protect the child.

What should be a fairly simple operation can be devilishly complicated. One father in The Times story spent more than two hours trying to secure his kids’ car seats. He wasn’t sure he’d done it right, so he went to a local fire rescue unit that helps parents install seats and found out he’d done it wrong. And he’s a research scientist with a Ph.D.

Approximately 3 in 4 car seats are installed improperly, says the National Highway Traffic Safety Administration (NHTSA). And in communities without education programs or places to check installation, that ratio is higher.

Automobile crashes are a leading cause of death for children 13 and younger; many fatalities involve children in car seats.

Although deaths of children in car seats declined from 614 in 2002 to 397 in 2011, according to The Times, the numbers could be even lower if car seats were easier to install.

It’s not as if people haven’t tried to simply the process. In 2000, NHTSA implemented a latch system to enable car seats to be secured to anchors in a vehicle’s seats instead of looping a seat belt through the car seat. Automakers were required to design cars to facilitate easier kid-seat installation.

Still, many parents use only seat belts to secure the car seats, Times’ sources said.

One explained that, in a collision, a car seat can move much farther forward if it is installed using only a seat belt and the top of the seat is not secured. That presents a much higher likelihood of the child incurring head or spine injuries.

To address the car-seat information gap, the feds are developing a new program to encourage automakers to recommend the most appropriate child seats for use in each of their models. Regulators hope parents will choose the type of seat — rear-facing, forward-facing or booster — that works best for their children, based on age and size.

But car seat manufacturers don’t work closely with a lot with automakers, largely because the car people don’t like to divulge their future designs. The automakers say they offer as wide a range of child restraint systems as possible.

Safety advocates point to constant vehicle redesign as a primary challenge to routine, proper installation of car seats. They recommend parents seek help from local safety programs and car-seat specialists.

To find one in your area, link to Safe Kids Worldwide. To learn more about specific products, link to the Juvenile Products Manufacturers Association. For general car-seat safety and installation information, link to the Car Seat Lady, a group headed by a New York pediatrician.

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May 24, 2013

Danger Lurks on Innocent-Looking Mall Rides

Sometimes it’s a mechanical pony. Sometimes it’s a small-scale race car. It might be at the mall or outside the supermarket—any prime territory to amuse and divert little ones while mom or dad needs to get the errands done.

Usually, it’s mission accomplished, but sometimes someone gets hurt.

As reported by CBSnews.com, between 1990 and 2010 nearly 93,000 children were treated in U.S. emergency rooms because of ride-related injuries. More than 7 in 10 such injuries occurred from May through September; about 20 injuries occurred daily during the summer months.

The study, published in Clinical Pediatrics, analyzed child injuries on rides found in amusement parks, fairs, festivals, arcades, restaurants, stores and malls. More than 4,400 ride-related injuries send kids to the ER every year, many of which occurred outside of traditional amusement park settings.

Researchers found that kids who use "mall rides" might face a higher risk of head, neck or face injuries or concussions.

In a news release, study author Gary Smith, professor of pediatrics at The Ohio State University College of Medicine said, "Injuries from smaller amusement rides located in malls, stores, restaurants and arcades are typically given less attention by legal and public health professionals than injuries from larger amusement park rides, yet our study showed that in the U.S. a child is treated in an emergency department, on average, every day for an injury from an amusement ride located in a mall, store, restaurant or arcade. We need to raise awareness of this issue and determine the best way to prevent injuries from these types of rides."

Amusement parks feature "fixed-site rides"; fairs or festivals feature "mobile rides"; those at an arcade, strip mall or restaurant are "mall rides." They’re subject to different oversight.

The U.S. Consumer Product Safety Commission oversees mobile rides at fairs, but state or local governments regulate fixed-rides at amusement parks (see our blog about amusement park ride safety). The study found that 1 in 3 injuries occurred on a fixed-site ride; 29 in 100 on mobile rides and 12 in 100 on mall rides. Although they represent the smallest percentage of injuries, they are under the most direct control of parents, so probably are the easiest injuries to avoid.

Most injuries were caused by a fall—nearly 1 in 3 injuries reported over the 20-year span; 18 in 100 were caused by being hit by something while riding or by hitting a part of the body on the ride.

Head and neck injuries accounted for 28 in 100 injuries; nearly 1 in 4 injuries involved arms; the face was involved in18 in 100, and legs accounted for 17 in 100. Soft-tissue injuries, such as bruises, were common, as were sprains, cuts and broken bones.

Although injuries serious enough to require hospitalization were relatively rare, they are more common during the summer—one occurs about every three days.

Because nearly 3 in 4 mall ride injuries occur when a child falls, parents should ensure that these rides have restraints, especially if they are located on hard surfaces, which they invariably are. In addition:

  • Follow all posted height, age, weight and health restrictions.

  • Follow any special seating order and/or loading instructions.

  • Use safety equipment such as seat belts and safety bars.

  • Keep the hands and feet inside the ride at all times.

  • Know your child: If you don't think he or she will follow the rules, give that ride a pass.

  • Follow your instincts: If you don’t trust the ride, stay away.

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January 25, 2013

Don’t Let a Bouncy House Fling You Into the Emergency Room

Bouncy houses have become a go-to activity for childrens’ birthday parties and other outdoor celebrations that include kids. But, as a recent study in the journal Pediatrics finds, they’re not without risk.

Claire McCarthy, a primary care physician and medical director of Boston Children’s Hospital’s Martha Eliot Health Center, advises parents on KevinMD.com to be mindful of the potential danger if they’re considering renting a bouncy house, and to take measures to minimize it.

Between 1990 and 2010, about 65,000 children were treated in U.S. emergency rooms for injuries they got in bouncy houses. “That’s about 31 kids a day,” McCarthy writes. According to Pediatrics, the number and rate of injuries increased fifteen-fold during the study’s 20-year period.

Most of the injuries were arm and leg fractures or sprains. Fortunately, only 3 in 100 required hospitalization. More than half of the injured kids were 6 to 12 years old; most of the rest were younger.

A bouncy house seems like a safe, padded environment to horse around in, but it still presents a lot of ways for a kid to get hurt. Most of the injuries documented in the Pediatrics study resulted from falls, many of them falling out of the bouncy house, but kids pushing, pulling and crashing into each other caused a lot of hurt, too.

This isn’t to suggest you reject the idea of a bouncy house for your child’s party—but you should take some precautions. Like wearing helmets when you ride a bike, there are guidelines for using bouncy houses, also known as “inflatable amusement devices.” The Pediatrics researchers suggest that, beyond the manufacturers’ information, rules should be devised similar to those for trampolines, because the injuries are very similar.

The best thing you can do, McCarthy says, is use common sense:

  • Always follow the manufacturer’s directions and safety guidelines.

  • Be especially careful with children younger than 6, or wait until kids are that old to use a bouncy house.

  • Don’t overcrowd the house--keep numbers of kids using it small. Everyone inside should have their own personal space.

  • Make sure kids keep body parts to themselves.

  • No flips or other stunts.

  • Supervise! Make sure there are enough grownups to monitor the bouncy house activity at all times during its use, and make sure they enforce the rules.

  • Have zero tolerance for rough-housing or other dangerous behavior. Consider using a whistle, like a lifeguard.

For more specific, detailed guidelines on bouncy house use, consult the Consumer Products Safety Commission guidelines.

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December 28, 2012

Better Protection for Kids from Fireplace Burns

Few things are more comforting on a cold winter’s night than a roaring fire. That is, unless you’re one of the hundreds of young children burned each year by contact with the unprotected glass on a fireplace. According to FairWarning.org., a public interest investigative news organization, a federal database compiled over 10 years indicated that 2,000 kids younger than 5 suffered 2nd and 3rd degree burns.

After at least a dozen lawsuits and a call by the Consumer Product Safety Commission (CPSC) for federal standards, manufacturers have agreed to provide protective mesh screens as standard equipment with new gas fireplaces.

That’s the good news; the bad news is that although some companies are reconfiguring their products now, manufacturers have until 2015 to outfit them all with the screens. Oh, and the effort is voluntary. Protective screens are not required.

FairWarning says there are approximately 11 million gas fireplaces in the U.S. whose glass fronts can get dangerously hot. Many of their owners inherited them, and were not apprised of warning information when the appliances were new.

Most manufacturers have been reluctant to provide screens or issue prominent safety warnings because the former compromises the visual appeal of the fireplace and the latter might scare off customers.

The standards call for screens to be supplied with each unit, and installed by the homeowner or installer. They can be removed for cleaning. And some homeowners, of course, would choose not to install them in the first place.

According to the FairWarning story, one official of a Canadian fireplace maker was asked in a deposition why the company had not warned that touching the glass could result in 3rd degree burns. The response? That it would be “fear-mongering.” Another official testified that, with that warning, “As a parent, I don’t know if you’d buy such a fireplace.”

But if you’re afraid of something that could hurt your kid, is raising the issue really “fear-mongering” or just telling the truth?

Before providing specific screen regulations, the CPSC is waiting to see how well the industry responds to the need. The FairWarning story indicates that so far, reviews are mixed. One Alabama attorney who has litigated lawsuits against fireplace makers called it “very troubling’’ that it will take more than two years before full compliance with the provision of screens, and that there are no plans to offer retrofits to current owners.

A commission spokesman told FairWarning that it might be tough to meet a shorter deadline for issuing screens because making federal rules takes so much time and because, by law, the commission may not regulate when a voluntary standards groups is taking action similar to what the agency would take.

But Dan Dillard, executive director of the nonprofit Burn Prevention Network and chairman of the prevention committee of the American Burn Association, wants the CPSC to adopt mandatory, not voluntary standards. Dillard also believes the federal estimate of 200 child burn cases per year to be low, and his committee is preparing injury data to prove it.

FairWarning says the voluntary standards allow the glass to reach temperatures between 500 degrees and 1,328 degrees, depending on the type of glass used. Those limits are supposed to prevent the glass from failing, not prevent people from getting burned.

Some people say that the burn risk associated with a fireplace is so obvious that you’d have to simply be a bad parent not to keep your kid safe. Those are probably the people who aren’t aware that the glass in front of a fire can remain dangerously hot for at least a half-hour after the flame is turned off.

Two major manufacturers provide safety screens with new gas fireplaces—Hearth & Home Technologies and Lennox Hearth Products (which began offering a free attachable screen with each fireplace as part of the settlement of a class action lawsuit).

To learn more about how to protect your children from burns and general fire safety tips, the Burn Prevention Network offers help here. And the Hearth, Patio & Barbecue Association has initiated a fireplace safety campaign for consumers.

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November 30, 2012

Our Annual Hazardous Toy Review

For the last couple of years in advance of the holiday season, we have blogged about choosing safe toys here and here.

Last week, the U.S. Public Interest Research Group (USPIRG) released its 27th annual report, “Trouble in Toyland” in conjunction with the Consumer Product Safety Commission (CPSC). Here are some highlights to help you be a popular Santa’s helper while protecting the small fry from danger.

Some hazards never change: size (so small they present a risk for choking); toxins (lead, cadmium, phthalates); magnets (we recently blogged about their gastrointestinal danger.) Others are new: high volume of sound.

Among the more widely available toys deemed dangerous in “Trouble in Toyland” are plastic play food sold at Wal-Mart and Toys-R-Us (choking hazard) and Dora the Explorer guitar (hearing risk) sold at Target. For the full list, see the report.

In general, beware of toys posing these common hazards:

1. Choking. It’s the most common cause of toy-related deaths. According to the CPSC, from 2005-2009 at least 41 children choked to death on balloons, toys or toy parts.

  • Don’t buy small toys or toys with small parts for children younger than 3. If it can pass through a toilet paper tube, a toy or part is too small for toddlers and babies and any child who still puts things in his or her mouth.

  • Read and heed warning labels: Toys with small parts intended for children ages 3 to 6 are required to include an explicit choking hazard warning.

  • Never give young children small balls or balloons: They can block a child's airway. Balls for children younger than 6 must be larger than 1.75 inches in diameter. Never give latex balls to children younger than 8.

2. Lead and Other Toxic Chemicals. Some toys and children’s cosmetics may contain lead or other toxic chemicals, including phthalates. Most such chemicals are being phased out of toys, but older toys may still contain them.

Avoid toys made of PVC plastic, which can contain toxic phthalates; they pose developmental hazards. Choose unpainted wooden or cloth toys instead. High levels of lead paint have been found on toys, as well as in vinyl lunch boxes, bibs and in children's costume jewelry. All lead should be removed from a child's environment, especially lead jewelry and toys that can be swallowed. Use a home lead tester available at hardware stores to see if anything in your home presents this danger.

Read the labels of play cosmetics and avoid products with xylene, toluene or dibutyl phthalate.

3. Magnets. New, powerful small magnets used in most magnetic building toys, darts, magnetic jewelry and other items can fall out and look like shiny candy. If a child swallows more than one, they can cause life-threatening complications. If a child swallows even one magnet, seek immediate medical attention.

4. Watch or "Button" Batteries. Keep watch or "button" batteries away from children. If swallowed, the battery acid can cause fatal internal injuries.

5. Noise. Children's ears are sensitive. If a toy seems too loud to you, it’s probably too loud for a child. Remove the batteries from loud toys or cover the speakers with tape.

6. Strangulation. They include mobiles, cords and drawstrings. Keep them out of the reach of children in cribs and remove them before the baby is five months old or can push himself or herself up.

Remove knobs and beads from cords longer than one foot to prevent the cords from tangling into a dangerous loop. Don’t buy clothing with drawstrings on the hood—they can get caught on fixed objects like playground equipment and pose a strangulation hazard.

Tips for keeping kids safer:

  • Accessorize. Children should wear protective gear when riding bicycles, scooters, skateboards and inline skates. If your gift list includes them, also give a helmet, knee pads, elbow pads and wrist guards.

  • Stay informed of recalls. The CPSC recalls numerous toys and children's products each year. Find out what’s been recalled here. You can also sign up to receive email alerts of new recalls.

  • Visit this interactive website with tips for safe toy shopping. It also has recall information and is accessible via smartphone.

To report a dangerous toy, email the CPSC, file your comments on its website or call (800) 638-2772.

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August 31, 2012

Kids Don’t Know that Furniture Isn’t Recreational Equipment

If your kid sees the couch as a trampoline, the highchair as a jungle gym and the table as a chin-up bar, be aware that, according to the U.S. Consumer Product Safety Commission (CPSC), thousands of children suffer injuries every year from toppling furniture.

As Dr. Gary Smith, president of the nonprofit Child Injury Prevention Alliance, told the consumer news site Fair Warning, “Furniture was designed for the convenience of adults, child injury was never considered. …[Parents] simply don’t know that they’ve got this danger lurking.”

In 2010, the most recent year for which federal estimates are available, unstable furniture was responsible for 23,600 emergency room visits, the highest number since 2006. Most of those patients were younger than 10 years old.

Approximately 20,000 people that year were hurt by TVs, which often sit on furniture not designed to support them.

The injuries include serious bruising, damage to internal organ damage and fractures. From 2000 through 2010, the CPSC received reports of nearly 300 deaths, mostly involving children who were crushed.

These stories fuel efforts to inform parents and revise the manufacturing standards.

Jenny Horn’s 2-year-old son, Charlie, choked to death underneath a 30-inch dresser in his bedroom while his caretaker thought he was sleeping. She heard nothing even when the dresser toppled onto him after he apparently climbed on it. “They call it a silent death,” Horn told Fair Warning. Children “are a cushion for the fall of the dresser so you don’t necessarily hear a sound.”

A similar accident befell Meghan Packard, 3. “By the time we found her, it was too late,” Kimberly Packard said, explaining that her husband and Meghan’s twin brother, Ryan, discovered her underneath a dresser.

Horn and Packard had secured taller pieces of furniture in their homes to the walls; they never suspected that smaller pieces of furniture also posed a threat.

The furniture industry has been guided since 2000 by voluntary stability standards for dressers and other storage units. The current standard, in effect since in 2009, requires furniture to remain steady when all the drawers are open and when a 50-pound weight is placed in the front of a drawer to simulate a 5-year-old that sees it as monkey bars.

Chests and dressers are supposed to have tip restraints for consumers to affix to a wall.

A panel composed of CPSC, industry officials and consumer advocates are considering whether, and how, to toughen the standard. But is a tougher voluntary standard effective when some companies ignore it?

One product compliance manager at Stanley Furniture Co. told Fair Warning, “Where you get into trouble is with the furniture that is less expensive in some of the big box stores.” A person who worked in testing and distribution for Ethan Allen agreed that for some manufacturers, if the rules aren’t mandatory, “They won’t do it.”

Even what the panel’s considering falls short. At present, it would continue to exempt items without drawers, such as tables and bookcases. One trade group representative said that those furnishings are less likely to be involved in fatal accidents.

An accident doesn’t have to be fatal to be tragic and unnecessary, does it?

A bill introduced in Congress in 2005 to set mandatory safety standards on furniture and TVs was supported by the Consumer Federation of America, but failed.

One rationale given for not seeking a mandatory standard is that a voluntary standard can be developed and revised more quickly. A CPSC spokesman said that when immediate action is necessary to remove faulty furniture from the market, his agency works with industry to carry out product recalls.

According to the CPSC, there have been nine furniture industry recalls since 1992, covering nearly 1.7 million pieces of potentially wobbly furniture.

The popularity of big, flat-screen TVs has led to an increase in TV set-related accidents partly because after buying one, some people put their older, bulkier models on furniture unable to support them.

Sen. Dick Durbin, D-Ill., wants the CPSC to boost efforts to educate the public about the hazards unsecured TV sets can pose to children. The commission is studying what kinds of TVs tend to be involved in the incidents, but, really, it’s not rocket science—figure it out and tell people.

As always, even when safety initiatives are developed some people remain ignorant of or uninterested in them. A telephone survey earlier this year of 1,000 U.S. households by the American Home Furnishings Alliance found that only 36 in 100 with children younger than 6 anchored their TV or furniture to the wall to prevent tip-over accidents.

To learn how to secure furniture and protect children, visit the website of Charlie’s House, a nonprofit named for Jenny Horn’s son, that’s dedicated to child safety.

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August 24, 2012

Magnetic Toys for Grownups Prove Irresistible, and Dangerous, to Kids

The small, strong magnetic blocks are marketed for grownups only, something to fiddle with at the office, but they're proving irresistible to kids, and have caused a string of serious injuries. So how do you protect children from something that isn't intended as a kids' toy?

Several years ago, the Consumer Products Safety Commission (CPSC) raised a public alarm about the dangers posed to youngsters from magnetic toys. Kids, and not just babies, but those “old enough to know better” were known to have swallowed pieces of the popular desk-top accessory.

The magnets bunch together in the gastrointestinal tract, twisting or pinching the intestines, causing blockages, perforation or infection that can require surgery. Some kids have died.

Late last year, the CPSC ratcheted up its warning. “An increasing number of incident reports to the … CPSC indicate that high-powered magnets continue to be a safety risk to children,” its report said. “From toddlers to teens, children are swallowing these magnets and the consequences are severe.” The agency got one incident report in 2009, seven in 2010 and 14 through October 2011. They involved children from 18 months to 15 years old; 17 involved magnet ingestion and 11 required surgical removal. “When a magnet has to be removed surgically,” the agency said, “it often requires the repair of the child's damaged stomach and intestines.”

According to Reuters, the commission has received more than a dozen reports since then of children ingesting the magnets. Many required surgery.

So last month the CPSC effectively said, “Enough,” and ordered a halt to sale of Buckyballs and Buckycubes magnetic toys, deeming them a serious hazard. It was the commission’s first stop-sale order in 11 years.

The commission ordered distributor Maxfield & Oberton Holdings to halt sales because injuries to children who had swallowed them were on the rise. “[W]arnings are ineffective,” the CPSC said.

Maxfield & Oberton must stop importing and distributing the Chinese-made magnets. They also must issue refunds, according to the complaint, and direct retailers to stop distributing the toys.

More than 2 million Buckyballs and at least 200,000 Buckycubes have been sold in the U.S.

According to AboutLawsuits.com, Maxfield & Oberton and the commission had negotiated a Buckyball recall in May 2010 as a result of labels that read for “Ages 13+”; the commission said federal toy standards for powerful loose magnets may not be sold to children younger than 14. And in November, Maxfield & Oberton and the CPSC created an educational campaign to inform consumers that the magnets were intended only for adults.

In June, a report published by the American Academy of Pediatrics added fuel to the swallowed-magnet fire. It reinforced the need for medical practitioners and parents to understand the dangers of magnet toys. And last month, Battat Inc., manufacturer of the Magnabild Magnetic Building Sets, was fined $400,000 for allegedly failing to report problems with its magnetic toys, which were blamed for the death of at least one child.

This month, in only its second such action in 11 years, the CPSC filed an administrative complaint against Zen Magnets LLC, alleging that its products contain defects in the design, packaging, warnings and instructions, and pose a substantial risk of injury to the public.

The lawsuit seeks to stop the firm from selling Zen Magnets Rare Earth Magnet Balls, notify the public of the defect and offer consumers a full refund.

Eleven manufacturers and/or importers of sets of small, powerful, individual magnets voluntarily have agreed to the CPSC request to stop their manufacture, import, distribution and sale. Zen Magnets and Maxfield & Oberton are the only companies that have refused to comply, to date.

As noted by the Associated Press, attempting to remove a product from the market is a rare move for the CPSC, which prefers to work cooperatively with companies to stop the sale of hazardous products.

The commission's aggressive action raises questions about governmental authority to stop companies from selling products that, if used properly, are safe and legal. The Zen Magnets website posted this objection: "How much societal damage results from the slippery slope of absolving parents from the responsibility to read warnings?"

It’s a fair point. But it’s also clear that these products are unusually unsafe. Until they are removed from the market, the CPSC advises parents who suspect that their child has swallowed magnets:

  • Seek immediate medical attention.

  • Watch for these symptoms—abdominal pain, nausea, vomiting and diarrhea.

  • Remember that in X-rays, multiple magnetic pieces may appear as a single object.

  • Before buying toys, see our checklist for toy safety.

If you want to report a dangerous product or a product-related injury, call the CPSC’s hotline at (800) 638-2772 or go online to SaferProducts.gov. Additional consumer product safety information is available here, and you can join an e-mail subscription list for recalls, hazardous product notices, etc., here.

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August 10, 2012

Devices to Protect Children Against Heat Stroke in Cars Found Wanting

We’ve all heard horrific stories of children and animals locked inside a hot car, often to a fatal end. We recounted one such story in Florida a couple of years ago. Although parents and child-care providers are admonished never to leave a child unattended in a car, even briefly, accidents happen.

Between 1998 and 2009, nearly 500 children died from heat stroke after being locked in a vehicle. More than half of the fatalities were children younger than 2. Sometimes, deaths occur when parents or caregivers are unaware that a child has climbed into a car and become trapped.

Enter the market. Devices known as child safety seat monitoring systems were developed to prevent potentially dangerous heat stroke if a child becomes locked in a hot car. But according to a recent report by the National Highway Traffic Safety Administration (NHTSA), these products are neither reliable nor consistent.

The report is the result of a study by the NHTSA and Children’s Hospital of Philadelphia (CHOP), which reviewed three devices. The ChildMinder Smart Clip System, the ChildMinder Smart Pad and the Suddenly Safe Pressure Pad, it warns, can create a false sense of security. (These devices can't address the situation of an adult not knowing when a child has locked him or herself in a car, or when a child is left there intentionally; they must be activated.)

As reported on AboutLawsuits.com, there are about 18 similar products on the market. They can be difficult to install, which contributes to their unreliability.

Among the documented problems:

  • inconsistency of the arming sensitivity;

  • variations in the warning signal distance;

  • potential for interference by other electronic devices, such as cellphones;

  • potential for failure if liquid is spilled on them;

  • -potential for failure if the child is out of position.

To address the terrible tragedy of losing a car-bound child to heat stroke, the NHTSA has developed a campaign, “Where’s baby? Look before you lock.” It advises:

  • Never leave a child in a vehicle unattended, even if the windows are down, the air conditioning is on or the engine is running.

  • Do not allow children to play in an unattended vehicle.

  • Habitually look in the front and back of the vehicle before locking the door and walking away.

  • Make sure child-care providers call if a child does not show up for care on schedule.

  • Put your cellphone or a stuffed animal in the backseat to remind you that a child is there.
    Make sure the reminder is in the driver’s view.

  • Instruct children not to play in vehicles, and place keys where they cannot reach.

  • If you drop your child off at child care when it’s normally your spouse or partner’s job, have him or her call you to ensure the switch was completed.

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July 13, 2012

Trade Group Tantrum Undermines Play Yard Standards

In 1998, a 17-month-old boy confined in a folding Playskool Travel-Lite play yard at his day-care provider’s home died when the side rails collapsed around his neck. The play yard had been recalled, but the caregiver was unaware.

Last year, a 3-month-old girl was snoozing in a bassinet that was snapped onto the side of her play yard. Because the assembly was not proper, the bassinet somehow detached, tilted and pushed her face into the mesh side of the play yard. She suffocated.

We’ve written about injuries associated with cribs and playpens, and the tragedies noted above were remembered, according to a story in the Washington Post, when the Consumer Product Safety Commission’s (CPSC) mandated new safety standards for folding play yards last month. The problems that caused the first accident were addressed; the problems that caused the second were not.

The CPSC ensures the safety of approximately 15,000 consumer products. At least 19 deaths have been tied to the side rail defect that killed the little boy, and about 1.5 million portable cribs with the defect have been recalled. them. Deaths declined as the industry embraced stricter standards, but some of the pre-standard models remain unaccounted for, according to Kids in Danger, an organization founded by the parents of the little boy who died.

Since 1985, according to The Post, there have been 20 recalls of play yards—also known as pack-and-plays—representing numerous deaths. The play yard safety standards approved last month require that portable cribs be tested to ensure such serious hazards have been addressed, but in certain quarters, the bassinet accessory dangers aren’t considered serious enough.

“It’s disheartening that we couldn’t get this taken care of,” Nancy Cowles, executive director of Kids in Danger, told The Post.

Congress approved a bill in 2008 that added muscle to the CPSC. One element requires the agency to strengthen some voluntary standards. The play-yard standards were among them, and regulators had been working with the industry to effect the necessary product changes.

Shortly after the CPSC heard about the baby girl’s death, the relationship between the guards and the guarded deteriorated. The CPSC added language making it more difficult to assemble a play yard with missing parts, which contributed to the baby’s death last year. One proposal required manufacturers to stitch all the parts together so that none could go missing.

In May, the Juvenile Products Manufacturers Association (the industry’s trade group) requested that the provision take effect later than originally intended. The CPSC agreed. In June, however, half an hour before the commission held a briefing on the standards, it received a letter from the JPMA accusing the CPSC of violating the law because it hadn’t solicited public comment on that provision.

The commission now plans to deal with this issue separately, and in a statement after the decision, the JPMA said it is pleased with that outcome. It also promoted itself as a guardian of kid safety:

“Each year, JPMA sponsors Baby Safety Month in September to educate parents and caregivers on the importance of the safe use and selection of juvenile products. Baby Safety Month 2012 is dedicated to helping educate parents and caregivers on the importance of safely using second hand, hand-me-down, and heirloom baby gear.”

This expressed concern for child safety would have more credibility if those articulating it would do the right thing instead of standing on ceremony.

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July 6, 2012

Detergent Packs a Poison for Curious Kids

Packaging is a key part of consumer appeal, but a certain attractively designed laundry product can be far more problematic than a resistant ketchup stain.

As widely reported, including on NPR, the small, brightly colored single-use packets of laundry detergent—sometimes called detergent pods—can look like candy to a toddler or small child. When a kid bites into one, a burst of concentrated, corrosive detergent is released. Several hundred cases of illness have been reported this year. In California alone, 82 cases were reported through May.

According to the American Association of Poison Control Centers, youngsters who swallow the packets can become ill enough to require hospitalization. Some get the product in their eyes, resulting in significant irritation. Among the reports of children biting into a packet:

  • A 20-month-old child vomited profusely, wheezed and gasped, then became unresponsive to even painful stimuli.

  • A 15-month-old vomited profusely and had to be put on a ventilator at a hospital.

  • A 17-month-old rapidly developed drowsiness, vomited, breathed the product into the lungs and had to be put on a ventilator.

After sampling the detergent, kids can get sick in a hurry. They can grow excessively fatigued, lethargic and develop breathing difficulties. Symptoms of ingestion are worse than those seen from ingesting other types of detergent. Medical professionals aren’t certain why, but it might have to do with a constituent of the packets acting as a strong, short-acting sedative.

The good news is that symptoms generally resolve within a few hours, and the prognosis for full recovery is good, provided that the children get prompt care to support their breathing difficulties.

No deaths have been reported, and data from poison control centers is developing—the specific hazards of ingesting detergent packets were recognized only in the last couple of months.

A review in California found that the two most common single-dose detergent brands that children have consumed are Tide Pods Detergent and Purex Ultra Packs. But many other brands are marketed, and all should be considered as dangerous to children. Tide Pods is redesigning its packaging to make it more difficult to breach.

Parents and caregivers should ensure that detergent packets are treated like medication—they should not be accessible to children. If you suspect a child has had dangerous contact with a detergent packet, contact the poison control center at (800) 222-1222. If breathing difficulties develop, seek immediate care.

Apart from the new concern over detergent packets, there is good news from the harms department of household cleaning products: Injuries are declining. From 1990 to 2006, such misadventures declined from 22,000 to 12,000. Wee ones from 1 to 3 years old remain the most vulnerable to these accidents, representing nearly 3 in 4 incidents.

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June 21, 2012

Teething Products Can Be a Mouthful of Danger

It seems simple: A teething baby cries and a parent rubs the baby's gums with an analgesic to relieve the pain. But a recent FDA statement warns that this can lead to a serious disorder.

Methemoglobinemia, as described in a story on MedPage Today, can lead to oxygen deprivation and even death. Benzocaine, which is found in many over-the-counter products to relieve the pain of teething and toothache, is the source of concern. The greatest risk is for children younger than 2, who are also those most likely to get teething pain.

Methemoglobinemia is also known as “blue baby syndrome.”

This is not the first time the federal agency has warned about products containing benzocaine. In 2006 it issued a warning about such products, which include Baby Orajel, Orabase, Orajel, Anbesol and Huricaine. Since then, it has received 29 reports of benzocaine gel-related cases of methemoglobinemia. Nineteen of them were among children, 15 of whom were younger than 2.

A second warning was issued last year, and we wrote about it then. Given the dire nature of the disorder, the warning bears repeating.

FDA officials are concerned that parents might not be aware of the symptoms of methemoglobinemia. They include:

  • pale, gray, or blue-colored skin, lips and nail beds;

  • shortness of breath;

  • fatigue;

  • confusion;

  • headache;

  • light-headedness;

  • rapid heart rate.

Symptoms can occur shortly after use, or maybe not for several hours. A child can experience symptoms after the first use or not for several subsequent uses.

Parents have options for teething pain relief. The American Academy of Pediatrics (AAP) suggests a chilled teething ring or gum massage using your finger. If those don’t work, consult your pediatrician before using a topical agent.

Benzocaine is also used by physicians and dentists to numb parts of the mouth and throat before performing procedures such as transesophageal echocardiograms (in which an ultrasound probe the size of a small finger is inserted into the esophagus to view the heart), endoscopy (in which a scope is used to view the interior of a hollow body organ, such as the stomach) and feeding tube insertions.

If you are or a loved one is scheduled for any of these procedures, discuss the risk with your health-care provider.

Anyone can be at risk from benzocaine; the risk is higher for people with heart disease, asthma, bronchitis or emphysema, and for anyone who smokes.

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April 4, 2012

Common Products That Can Poison Children

According to the American Association of Poison Control Centers, approximately half of all poison exposures involve children younger than 6.

Most parents are pretty good at identifying and keeping their children safe from obvious toxins, from cleaning fluid to blood thinners. But many common household items, not to mention the contents of mom’s purse, are attractive and potentially lethal.

In his job as director of the Toxics Epidemiology Program for the Los Angeles County Department of Public Health, Dr. Cyrus Rangan tracks and responds to toxic exposures and consults with patients exposed to toxins. Following is his list of common products that pose a poison threat, and why.

  • Button batteries (for hearing aids, watches, etc.) can get lodged in the airway or the esophagus, causing third degree burns and bleeding. Note that these potentially lethal button batteries can even be found in toys.

  • Chewing gum is generally safe, but a young child can choke on pieces of gum. Nicotine gum is very poisonous to young children.

  • Cough drops taste sweet and might seem like candy to young children. But some contain medications like destromethorphan, which can cause gastrointestinal and vision problems, among others. Also, kids can choke on cough drops.

  • Sanitary gel can be 60 percent alcohol (120 proof). If ingested, a small bottle is like giving a kid a couple small shots of hard liquor.

  • Cigarettes carry a unique smell and taste that is attractive to some young children. Acute nicotine poisoning can result if they ingest a cigarette.

  • Nail polish remover can cause gastrointestinal distress, and can be even more harmful if vomited and inhaled into the airways. These products seldom come in child-resistant containers.

  • Pepper spray can be extremely irritating to the eyes, mouth, throat and lungs of anyone, but it’s worse for children, and such devices are easily deployed by accidental.

  • "Gummy" vitamins look and taste like candy. Although toxicity is likely to be low, there’s a larger issue here of referring to medicine as candy. Children should learn that medicine is medicine, candy is candy and confusing them is dangerous.
  • Over-the-counter medications, like cough drops and gummy vitamins, are often colorful, coated with sweetener and mistaken for candy. Some can be just as dangerous to a young child as prescription medications. We’ve tracked the checkered history of one such notable example, acetaminophen.

  • Prescription medications that aren’t stored safely away from youngsters are hazardous. We’ve addressed this hazard, and the fact that many can kill a 2-year-old in a single dose. Never store them in a container other than what they came in.

If your child has ingested a toxic product or substance, or has a reaction to something he or she has touched, contact the National Capital Poison Center at (800) 222-1222. If you think your child might have swallowed a button battery, go to the nearest emergency room.

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March 19, 2012

Is Spinbrush a Toothbrush or a Weapon?

It’s hard enough for some parents to get their kids to brush their teeth regularly. If your little ones use an electric device called the Spinbrush, your job just got a little harder.

According to the FDA, the Spinbrush, whose colorful packaging and design is aimed at children, can cause serious injuries, as reported on WebMD.com.

More than 39 million Spinbrushes have been sold, some models under the Arm & Hammer brand, others under Crest. All are manufactured by Church & Dwight Co. Inc, and are sold as Spinbrush.

According to the FDA’s website, parts can fly off the device and chip teeth, damage eyes, cut the mouth and gums and get stuck in the throat.

The FDA cites the potential for injury while using these Spinbrush models:

  • Spinbrush ProClean

  • Spinbrush ProClean Recharge

  • Spinbrush Pro Whitening

  • Spinbrush SONIC

  • Spinbrush SONIC Recharge

  • Spinbrush Swirl

  • Spinbrush Classic Clean

  • Spinbrush For Kids

  • Spinbrush Replacement Heads

The toothbrushes aren't being recalled, but Church & Dwight is informing consumers how to avoid injury on its website and via television and print advertising.

This isn’t the first time the FDA has come down on Church & Dwight. An inspection last year uncovered evidence that there had been numerous consumer complaints that had not been reported to the agency. In May, the FDA warned the company of its violations of the Federal Food, Drug and Cosmetic Act, including failure to report—within a reasonable period—serious injuries.

“Electric toothbrushes can be very effective in removing dental plaque, and so they can help prevent dental decay and gum disease,” says Susan Runner, D.D.S., chief of FDA’s dental devices branch. “At the same time, it’s important to supervise children when they use these brushes, and to look out for any malfunctions of the toothbrush that might cause an injury.”

If you or your child uses a Spinbrush:

  • Inspect the Spinbrush for damage or loose brush bristles. If it’s damaged, don’t use the toothbrush.

  • Check to ensure the headpiece is connected securely to the handle, and test it outside of the mouth. If the connection feels loose or the headpiece easily detaches from the handle, don’t use it.

  • Do not bite down on the brush head while brushing.

Report damaged toothbrushes to Church & Dwight toll-free at (800) 352-3384 or (800) 561-0752. Report injuries or problems with the Spinbrush to MedWatch, the FDA’s Safety Information and Adverse Event Reporting Program. You can file a report online, by regular mail or by fax or phone.

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December 9, 2011

Apple Juice for Kids: A Caution for Parents

We often take issue with careless, shallow and/or misleading media reports about health and safety issues. But in one high-profile case, the flashy TV doc got it right.

Consumer Reports investigated the claim of Dr. Mehmet Oz ("The Dr. Oz Show"), and found that, indeed, 1 in 10 of the juices tested contained more arsenic than is allowed in drinking water. One problem, investigators said, is that juice and similar beverages have no standards for arsenic content. Inorganic arsenic (that is, arsenic that does not occur naturally in some fruits) is carcinogenic. Lead content also was problematically high in many juices.

The EPA limits arsenic in drinking water to 10 parts per billion (ppb), and some health experts say that’s too high. According to AboutLawsuits.com, The FDA told Consumer Reports that it’s considering arsenic standards for juice. In September, the website reported, the FDA “believed apple juice consumption posed little or no risk, but since then it has received eight apple juice test samples with total arsenic levels of up to 45 ppb.”

Because arsenic and lead disproportionately damage smaller, growing brains, the American Academy of Pediatrics advises:

  • Don’t give infants younger than six months any kind of juice.

  • Limit juice for children 6 years and younger to six ounces a day.

  • Limit juice for children older than 6 years to 12 ounces a day.

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November 26, 2011

Read This Before You Shop for Any Toys This Year

For 26 years the California Public Interest Research Group (CALPIRG) has issued a report about toy safety. We wrote about it last year, and this year’s summary, “Trouble in Toyland,” was released earlier this week. It identifies hazardous toys and offers safety guidelines for consumers. Specific toys are listed in the complete report.

CALPIRG’s work has resulted in 150-some recalls of toys that posed hazards for a range of reasons, including strangulation, choking, toxins, noise and sharp edges. But as a consumer watchdog, the organization knows the work isn’t done. Although championing the Consumer Product Safety Improvement Act (CPSIA) of 2008 for its advances in toy safety, CALPIRG also notes that this year, “policymakers delayed implementation of its most stringent lead standard rules and enacted some narrow exceptions,” and we concur.

That said, here’s what you need to know as you embark on the toy-buying season.

Lead is especially problematic for the central nervous system; childrens’ developing brains are particularly at risk. Seven toys exceed levels CALPIRG finds excessive (the organization’s threshold is much lower than the CPSIA standard).

Phthalates are of concern particularly for premature delivery and reproductive defects. The CPSIA has banned toys containing three phthalates and set temporary limits on three others, while tests continue. CALPIRG found two toys that laboratory testing showed to exceed limits allowed by the CPSIA by 42 and 77 times, respectively.

Choking is a major cause of toy-related deaths and injuries. CALPIRG found several toys that violated standard intended for children younger than 3, and several others that support its call for the small parts test to be made less permissive. Some toys intended for older children failed to provide choking hazards warnings required for small parts or small balls.

One-third of Americans with hearing loss can attribute it in part to noise. One in 5 U.S. children will have some degree of hearing loss by the time they are 12. CALPIRG found three toys it considers too noisy.

Among CALPIRG’s suggestions for improving toy safety are:

  • The Consumer Product Safety Commission (CPSC) should review and, if necessary, expand its definition of a “small part” or “small toy” to include parts and toys that are larger than the current standard, but have been shown to pose a choking hazard to children.

  • Cadmium should be limited in children’s jewelry. See our recent post about the dangers of this toxic chemical.

  • Lead and phthalate standards in toys should be vigorously enforced, and lead standards should be lowered.

  • The CPSC must ensure that its product incident database it provides the information consumers need to make informed choices in the marketplace.
Consumers must realize that not all toys are tested, and not all toys on store shelves meet CPSC standards. There is no comprehensive list of potentially hazardous toys. Examine toys carefully for potential dangers before you make a purchase.

It's also a good idea to screen all children for exposure to lead via a simple and inexpensive blood test at a physician’s office or public health agency.

Report unsafe toys or toy-related injuries to the CPSC at www.cpsc.gov and to www.saferproducts.gov or call the CPSC at 1-800-504-7923.

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November 22, 2011

Dry Your Tears Over Baby Shampoo

Last week, Johnson & Johnson surrendered. After sustained pressure from consumer watchdog groups, the manufacturer has decided to eliminate from its baby products any preservatives that might release even trace amounts of formaldehyde.

In a letter to the Campaign for Safe Cosmetics, the company’s vice president for product stewardship & toxicology reiterated the safety of all of its products, and called the reformulation a response to consumers. Two weeks before the company’s announcement, the Campaign had called for a boycott of Johnson & Johnson baby shampoo.

The removal of the offending ingredients—quaternium-15 and 1,4-dioxane—from all products worldwide will take about two years, but the baby shampoo will be reformulated first. Quaternium kills bacteria, but releases formaldehyde, a known human carcinogen. Dioxane is a suspected carcinogen.

In addition to the Campaign for Safe Cosmetics, the Breast Cancer Fund and the Environmental Working Group lobbied Johnson & Johnson to make the switch.

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November 3, 2011

When Is It Safe for a Child to Graduate from a Car Seat?

Later than you might think, according to this guest blog from Beckley Mason, which explores important new safety developments in car seats:

Out here in California, a law was recently (and at long last) passed that raises the size and age requirements children must reach before they can leave their safety car seats. California joins Maryland and about 30 other states in requiring that children be eight years old or at least 4’9’’ (which ever comes first).

While the law may not be popular with kids eagerly awaiting the day they can sit like an adult, it’s an important step to keep kids safe. Even with advances in technology and awareness of child seat safety fairly high, motor vehicle crashes remain the leading cause of death for children between ages 3 to 14.

The reason that California, which was once the leader in child safety seat laws, fell so behind the times is that former governor Arnold Schwarzenegger twice vetoed similar laws. Schwarzenegger claimed that he would rather spend state money promoting education for parents on how to best use car seats than pass another difficult to enforce law. While it’s difficult to agree with his decision to veto, his reasoning does carry more than a bit of logic. In a state without our budget concerns this policy would be entirely indefensible, but research confirms that many parents all around the U.S. need more education on how to properly use booster and car seats to maximum effect.

In a groundbreaking year-long study of 79,000 car seats and their passengers, Safe Kids USA found that less than a third of all parents were both installing their car seats and strapping their children in properly. The primary issue was a failure to correctly use the top-most tethers that fully secure child seats during a crash. While at rest, these top tethers can seem superfluous, and often inspectors found that they were secured too lowly, or not at all. However when in a collision, the tethers are vital because they keep the passenger child’s head from moving dangerously during crashes.

The same study raised concerns that many parents who do their best to secure their children are not aware of the latest best practices for children of different heights and weights. New research doesn’t always reach the people who need to hear it, as in 2010, when American Academy of Pediatrics changed guidelines. The group now recommends that children under two years old ride in rear-facing seats. However a recent poll showed that barely a quarter of parents were aware of that fact. About three quarters of responding parents turned their kids around before year two, and 30 percent before year one.

It is at that young age that child seats are most vital to preventing serious injury. According to the National Highway and Traffic Safety Administration (NHTSA), properly using a child safety seat decreases the risk of death by 71 percent for infants and 54 percent for toddlers. Even older, less vulnerable children are 59 percent less likely to be injured in a booster seat that ensures the seatbelt fits across the chest instead of the collarbone or neck.

The NHTSA is trying to spread the latest word on child passenger safety by offering free educational resources to parents around the country. There are trained professionals at locations around the country that now offer 20-30 minute “courses” on properly installing car seats and their strapping in their passengers.

You can find a location near you by clicking over to the NHTSA website and searching by state or zipcode. It’s a great opportunity to get the latest information and training to make sure you keep your precious cargo safe.

Beckley Mason writes a Bay Area street safety blog for GJEL Accident Attorneys.

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November 2, 2011

Concussions and Kids and Consumers' Pocket Books

A hot topic in the world of sport safety these days is concussion. It’s not the first time we’ve covered the topic. Thanks to an increasing awareness that concussions can lead to traumatic brain injury (TBI), cognitive decline and other problems, athletes are monitored more closely for signs of head injury.

But greater awareness and better medicine have a concussion traveling companion of a decidedly consumer orientation. So-called “anti-concussion” sports equipment is making its market move. As always, it’s buyer beware.

As reported in the Los Angeles Times, no piece of equipment, no matter how technologically advanced, can indicate the presence of brain damage, or guarantee protection from it.

Testifying a couple of weeks ago at a U.S. Senate hearing, Jeffrey Kutcher, chairman of the American Academy of Neurology's sports section, said, "I wish there was such a product on the market. The simple truth is that no current helmet, mouth guard, headband or other piece of equipment can significantly prevent concussions from occurring."

Parents are a target market for these products, and football is a prime activity.

  • Item: a $149 chin strap made by Battle Sports Science called the Impact Indicator that features colored lights to "help" indicate whether a player has a concussion.

  • Item: the Brain-Pad LoPro mouth guard, which promises "brain safety space.

  • Item: Riddell's Revolution helmet, whose pitch is to reduce the number of concussions by 31%. Kutcher said research showed that the helmet decreased concussions by only 2.6%.

Good equipment is key, whether you’re a 12-year-old middle linebacker or a 47-year-old softball catcher. But the best way to prevent brain damage (or worse) after a head injury is to take the time necessary to recover. Children have relatively heavier heads than adults, and because their brains are still developing, the incidence and severity of their head injuries is higher.

According to the Centers for Disease Control and Prevention (CDC), the number of traumatic brain injuries among young athletes has increased 60% over the last 10 years. In 2001, 153,375 young athletes were admitted to emergency rooms for concussions and other sports-related head injuries. In 2009, that number had climbed to 248,418. Approximately 298 youths per 100,000 suffered a head injury in 2009. Males 10 to 19 had the highest rate of injuries.

Motorcycle and auto accidents account for about 20% of traumatic brain injuries. According to the CDC, the most common sports and games leading to TBI are:

  • bicycling

  • playground activities

  • football

  • basketball

  • soccer.

It’s difficult to resist the appeals of a kid who can’t wait to get back into the soccer game. But if she was dizzy, nauseous, had vision problems or a headache, even momentarily, she’s done until a doctor examines her. And certainly anyone who has gotten knocked out should be seen by a doctor immediately.

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October 18, 2011

Youth and Tanning Beds: Do Not Mix

The groundswell against the use of tanning beds got an additional boost last week when California Gov. Jerry Brown signed legislation prohibiting children younger than 18 from using the body-bronzers as of January 2012. California is the first state to enact such a ban.

In March, the American Academy of Pediatricians called for a tanning-bed ban for minors, and last year an FDA advisory committed made similar recommendations.

An increasing body of evidence says that the risk of skin cancer from tanning beds might be much higher than previously expected. According to the Journal of Investigative Dermatology, the ultraviolet rays produced by most tanning beds penetrate deeply into the skin, causing significant damage.

According to AboutLawsuits.com, some studies have shown that use of tanning beds by young adults results in eight times the risk of developing melanoma, a deadly form of skin cancer. A study by the World Health Organization indicated that use of tanning beds before the age of 30 might increase the risk of skin cancer by 75%.

The American Cancer Society says that melanoma is diagnosed in about 69,000 Americans each year and causes about 8,650 deaths annually. Melanoma is highly curable while it's confined to the skin, but once it penetrates deeper, it can go to the brain and other vital organs.

A memorable client of Patrick Malone's died from medical malpractice in the failure to remove a mole from his lower back before it turned into a fatal melanoma. You can read about Richard Semsker in Malone's book, "The Life You Save," and on Patrick Malone's law firm website. Mr. Semsker's case had nothing to do with tanning beds, but shows how simple missteps in communications among his doctors could cause an unnecessary death.

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July 21, 2011

Risky Play on Playgrounds Isn't Always Wrong

The parental instinct to protect one's child is evolutionary. If something isn't safe, the parent's instinct is to remove the child from the danger, or otherwise minimize the threat.

That's a noble instinct, But is it always the best instinct? A recent story in the New York Times suggests that too much protection can stunt growth and inhibit an otherwise healthy desire to try new things and expand horizons.

Parental concern, government regulation, product safety guidelines and the fear of lawsuits have all contributed to the makeover of playgrounds from tall, creaky equipment resting on hard surfaces to kinder, gentler forms of outdoor apparatus. Shorter equipment sited on enclosed platforms underlain with absorbment material unquestionably prevents some injuries. But experts wonder at what cost.

“There is no clear evidence that playground safety measures have lowered the average risk on playgrounds,” said David Ball, a professor of risk management at Middlesex University in London. He noted that the risk of some injuries such as arm fractures increased after the introduction of softer surfaces on playgrounds in Britain and Australia.

“This sounds counterintuitive, but it shouldn’t ...,” Ball told The Times. “If children and parents believe they are in an environment which is safer than it actually is, they will take more risks.”

Playground equipment should be age-appropriate, of course--lower monkey bars will help develop a toddler's physical abilities. But they might impede an older child's psychological development or, because they're insufficiently challenging, encourage her to engage in play somewhere else--goofing around a high bridge over a river--that's too risky.

A study published in Evolutionary Psychology describes the value of risky play in encouraging children to confront their fears in order to overcome them. "[W]e may observe an increased neuroticism or psychopathology in society," the authors suggest, "if children are hindered from partaking in age adequate risky play."

Some researchers aren't convinced that children do suffer fewer physical injuries when their recreational corners are padded, but if so, they contend that such playgrounds may stunt emotional development and leave children anxious and fearful. Isn't that worse than a broken ankle?

As Ellen Sandseter, co-author of the Evolutionary Psychology study, told the New York Times, “I think monkey bars and tall slides are great. As playgrounds become more and more boring, these are some of the few features that still can give children thrilling experiences with heights and high speed.”

Sandseter identified six categories of risky play: exploring heights, experiencing high speed, handling dangerous tools, being near dangerous elements (water, fire), rough-and-tumble play (wrestling) and wandering alone away from adult supervision. The most common is climbing heights.

Children progressively raise their adventure bar, Sandseter, said. And that's the way they learn to accept and master challenge. When they fail, they get hurt, physically or emotionally. But as The Times' story reports, if parents and psychologists worry that a kid who suffers a bad fall will develop a fear of heights, studies have shown the opposite: A child younger than 9 who gets hurt in a fall is less likely as a teenager to have a fear of heights.

The gradual exposure to increasing danger is known as habituation. It's the same technique therapists use to help people overcome phobias. And it's hard-wired into our primordial brains: As The Times summarizes, "While a youthful zest for exploring heights might not seem adaptive — why would natural selection favor children who risk death before they have a chance to reproduce? — the dangers seemed to be outweighed by the benefits of conquering fear and developing a sense of mastery."

“Paradoxically,” the authors write in Evolutionary Psychology, “we posit that our fear of children being harmed by mostly harmless injuries may result in more fearful children and increased levels of psychopathology.”

So, parents, here's your long-term homework assignment. Try to understand that your instinct to keep the kids safe is normal and laudable, but it can overrun your child's need to take risks. You can't soften every blow, and--here's the take-home--you shouldn't try.

On the other hand, efforts to remove safety hazards from playgrounds are still important. When the issue is not just bumps and bruises, but head injury and serious harm, parents have a right to insist that playgrounds conform to safety standards.

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May 12, 2011

Stroller manufacturer calls for mandatory regulation after massive recall

Maclaren USA, the stroller manufacturer which issued a massive recall in November 2009, is calling for mandatory federal regulations of standards for strollers and global harmonization of stroller safety.

In a press release to announce results of the 2009 recall, Maclaren says that umbrella strollers “remain unregulated with tremendous risk to consumers who expect and assume otherwise" and notes that the stroller hazards that prompted the 2009 recall “were inherent not just to Maclaren products, but to nearly all umbrella-fold models,”

In November 2009, the Consumer Product Safety Commission (CPSC) and Maclaren jointly announced a voluntary recall of approximately 1 million Maclaren single and double strollers, citing the risk of fingertip amputation and laceration while the parent/caregiver is unfolding/opening the stroller.

Maclaren has provided a kit to cover the elbow joint on their umbrella strollers’ hinge mechanism, to avoid the potential hazard to a child when the operator is opening or closing the umbrella stroller. Maclaren says more than 300,000 U.S. consumers have ordered the kits in the past 18 months. However, the company also says it has received 37 new reports of fingertip injuries since the recall was issued.

According to the CPSC, there are approximately 11,500 stroller-related injuries each year, about 500 of which relate to finger injuries, including the hinge-related injuries associated with umbrella strollers.

SOURCE Maclaren USA, Inc.

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April 28, 2011

Manufacturers dither while toddlers get strangled in window-blind cords

With an average of one child every two weeks strangled on the cords of window blinds, it’s no wonder that the Consumer Product Safety Commission (CPSC) has asked manufacturers to come up with a way to eliminate the risks to children from the cords or possibly face mandatory regulations.

In response, window blind manufacturers, working with a task force of regulators and consumer advocates, say they will come up with a fix by the fall. The decision to speed up work on solving the problem comes after an article in the Journal of the American Medical Association (JAMA) revealed that 49% of the deaths of children who strangle in window cords go unreported.

The article, which was co-authored by a CPSC staff member, estimates that the total number of window cord strangulations in the U.S. from 1981 to 1995 was 359 (i.e. one child strangling in window cords every 2 weeks). Most of the deaths (93%) are children 3 years and under.

Although window blind makers already install safety features and offer tips to parents to try to minimize the dangers from their products, critics complain that the manufacturers have dragged their feet on addressing safety hazards for decades, making minor tweaks or putting the onus on parents to shorten cords or buy tie-down devices, while regulators have done little to crack down.

In the current negotiations, manufacturers of window blinds have offered several fixes that they say would reduce the hazards, but consumer advocates on the task force say they are inadequate and have threatened to quit. “It was my understanding that we were eliminating the hazard,” said Carol Pollack-Nelson, a safety consultant and member of the task force. “Now they are talking about reducing the hazard. We don’t want reduced strangulation. We want no chance of it.”

CPSC regulators also rejected the industry’s proposals and urged the manufacturers to try again. Inez Tenenbaum, the commission’s chairwoman, emphasized that the commission staff plans to continue negotiating with manufacturers to find a solution.

One solution to the problem – cordless blinds -- has been available for several decades, but they are more difficult to produce and can cost twice as much as corded blinds. Due to the additional cost, CPSC also wants the task force to find cheaper alternatives, such as retractable cords or cords that are covered and therefore inaccessible to children.

Source: The New York Times

You can read the latest news release on window-blind safety from CPSC here, and the abstract of the JAMA article here.

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April 14, 2011

Benzocaine products carry risk of blood disorder, FDA warns

The Food and Drug Administration (FDA) says it continues to receive reports of methemoglobinemia, a serious and potentially fatal adverse effect, associated with benzocaine products both as a spray used during medical procedures to numb the mucous membranes of the mouth and throat, and benzocaine gels and liquids sold over-the-counter and used to relieve pain from a variety of conditions, such as teething, canker sores, and irritation of the mouth and gums.

Methemoglobinemia is a rare but serious condition in which the amount of oxygen carried through the blood stream is greatly reduced. In the most severe cases, methemoglobinemia can result in death. Patients who develop methemoglobinemia may experience signs and symptoms such as pale, gray or blue colored skin, lips, and nail beds; headache; lightheadedness; shortness of breath; fatigue; and rapid heart rate.

While methemoglobinemia has been reported with all strengths of benzocaine gels and liquids, most cases occurred in children aged two years or younger who were treated with benzocaine gel for teething. The signs and symptoms usually appear within minutes to hours of applying benzocaine and may occur with the first application of benzocaine or after additional use. The development of methemoglobinemia after treatment with benzocaine sprays may not be related to the amount applied. In many cases, methemoglobinemia was reported following the administration of a single benzocaine spray.

The FDA recommends that Benzocaine products not be used on children under 2 years except under the advice and supervision of a healthcare professional. It also recommends storing these products out of the reach of children.

Source: Food and Drug Administration

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March 16, 2011

Reports of eye damage from green laser pointers increase

Ophthalmologists worldwide are warning that recent cases of teenagers who suffered eye damage after playing with high-powered green laser pointers could be the beginning of a dangerous trend.

“In the hands of children, [they are] a very scary proposition,” said one ophthalmologist.

Meanwhile, other eye doctors interviewed by the New York Times said they were shocked at how easily available high-powered laser pointers are. And, they note, pointers 10 to 20 times more powerful than the legal limit set by the Food and Drug Administration are easy to order online. One physician was able to purchase a 100 milliwatt laser – 20 times the legal limit – online for $28, no questions asked.

Some physicians maintain that the dangers are so acute that even the FDA’s five-milliwatt limit is too high. And, in a consumer update in December, the FDA acknowledged that illegal laser pointers were being sold and warned that “a higher-powered laser gives you less time to look away before injury can occur, and as power increases, eye damage may happen in a microsecond.”

Steve Liu, chief executive of Wicked Lasers, said in an interview that the company's products did not violate FDA restrictions because those over the five-milliwatt limit were not called pointers, and that the company's web site clearly states that the lasers are eye and fire hazards. He also said his company would begin offering laser safety lessons to its customers before online checkout.

Laser experts concede that it is virtually impossible to control all the hazardous laser products currently available, and note that any talk of restricting availability would be resisted by the large community of laser enthusiasts, including those who use them professionally (e.g. contractors and astronomers).

Source: The New York Times

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