Document Sample
choking-strangulation-suffocation Powered By Docstoc
					Childhood Choking,
Strangulation and Suffocation
· Airway and breathing-related injuries            fatal. Several such incidents involving
  occur less frequently than other injury          children between one and 10 years of age
  causes, but are often fatal1.                    have been reported around the world. The
                                                   European Commission has published a
· Choking is defined as blockage of the            Decision requiring magnetic toys to dis-
  airway due to round and cylinder shaped          play a specific warning about the safety
  food products such as candies, nuts,             risks and it is anticipated that this issue
  grapes and also non-food products such           will be covered by an amendment to the
  as coins, buttons, small toy parts, under-       Toy Safety Directive5.
  sized pacifiers, uninflated latex balloons
  and inedibles in food products.                · Children placed in adult beds are at in-
                                                   creased risk for airway obstruction injury.
· Suffocation is defined as death due to           In the United States for example since
  oxygen deprivation from external causes          1990 at least 296 children aged 2 and
  like plastic bags, entrapment in sealed          under have died in adult beds as a result
  containers (i.e. toy chest) and spaces2.         of entrapment in the bed structure7. Dur-
                                                   ing this same period at least 57 children,
                                                   nearly all aged 3 and under, have died
· Strangulation is defined as death due to
                                                   due to entrapment in bunk beds alone.
  lack of oxygen from pressure on the
                                                   Additionally, 209 children in this age group
  trachea from items such as clothing draw-
                                                   died in adult beds from suffocation as a
  strings, crib bars, window blinds and
                                                   result of being covered by another per-
  drapery cords.
                                                   son’s body.
· In England and Wales, 61 children died in
                                                 · Strangulation is the leading cause of
  a two-year period due to choking, strangu-
                                                   deaths on playgrounds and deaths have
  lation or suffocation, with the majority
                                                   been related to both playground equip-
  being boys, under 3 years of age3. A
                                                   ment design and as a result of cords and
  further 5,000 children aged 15 or under
                                                   drawstrings on children's clothing getting
  were brought to accident and emergency
                                                   caught in the equipment9. Since 2007
  units in the United Kingdom because of
                                                   there have been onerous restrictions on
  choking, with the majority of these injuries
                                                   the use of cords and drawstrings on
  occurring in the home3.
                                                   children’s clothing in the European Union
                                                   to address this risk6.
· Studies in Greece, Germany and Israel all
  confirm that food products containing
                                                 · The total annual cost of airway obstruction
  inedibles are inherently unsafe and that
                                                   injury among children ages 14 and under
  labelling is not an adequate protection. It
                                                   in the United States is estimated to be
  is estimated that 2,000 injuries occur
                                                   nearly $3.7 billion. Children aged 4 and
  annually in the European Union due to
                                                   under account for more than 78% of these
  inedibles in food products alone4.
· It has been identified that four main prod-
                                                 Prevention Effectiveness
  uct characteristics should be considered
  when evaluating products for safety: size/     The following product requirements, modifi-
  diameter, compressibility, flexibility and     cations and legislation have proved to be
  configuration2. Another factor that has        successful in reducing deaths from choking,
  emerged as potentially dangerous is            suffocation and strangulation:
  magnetic strength.
                                                 · Warning labels - labels placed on prod-
· Recently there have been a number of             ucts that explain the hazard, not just a
  accidents and incidents happening with           label stating “for children aged 3 years
  children swallowing small toy magnets.           and up”, have raised carers’ awareness of
  They pose a risk to the health and safety        the dangers they pose8.
  of children as they are made of small and
  often powerful magnetic pieces. If more        · Product bans – the United Kingdom
  than one piece is swallowed the magnetic         banned clothing drawstrings in 1976 and
  pieces can be attracted to each other and        no known deaths from drawstring-related
  cause twisted/knotted intestines, intestinal     injuries have been reported since then9.
  perforation or blockage which may be             Thus regulations and/or standards that
  restrict cords or drawstrings on clothing      · For the European Commission to ban
  and inedibles in food products are effec-        latex balloons, inedibles in food products
  tive in reducing hazards.                        and drawstrings in clothing.

· Product modification – product require-        · For the European Commission to adopt a
  ments for slat spacing for crib designs,         mandatory standard for bunk beds to
  balconies, and outdoor fencing have been         address entrapment hazards. The stan-
  effective in reducing strangulation. But         dard would restrict opening sizes, require
  older crib models that do not meet the           guardrails and specify company identifica-
  requirements need to be removed from             tion and age-specific warning labels to be
  homes and not passed to other families,          present on all new bunk beds.
  especially immigrants and poorer families
  purchasing used cribs2. Another issue is       · For the European Commission to adopt,
  the need to lower the minimum force              as a mandatory standard, the EN 1176
  required to open a lid or door to a sealed       series of standards relating to playground
  container in order to allow children to          equipments and surfacing.
  escape when trapped (i.e., lids on toy
  boxes)2.                                       EU Collaboration

· Product safety commission – National           · For the European Commission to support
  consumer safety organisations in Europe          an educational campaign to the public
  have improved the safety of consumer             regarding safety practices to prevent
  products in their country. In the United         choking, suffocation and strangulation
  States it is estimated that the work done        injuries in children.
  by the Consumer Product Safety Commis-
  sion has contributed to a 30 percent
                                                 · For the European Commission to estab-
  decline in the rate of deaths and injuries
                                                   lish a European Product Safety Commis-
  associated with consumer products over
                                                   sion whose purpose would be to provide a
  the past 30 years11.
                                                   clearinghouse of child product safety
                                                   information for consumers and a hotline
Recommended Policy Actions                         for consumers to report unsafe products
                                                   and to ensure the collection and review of
                                                   data on product related injury incidents to
                                                   assess the need for product recalls.
· For the European Commission to improve
  the requirements relating to warning labels
  placed on products so that labels explain      · For the European Commission and Mem-
  the hazard in addition to identifying it.        ber States to support a Europe-wide
                                                   surveillance system for injury data related
                                                   to product involvement on a population
· For the European Commission to adopt a           level that is accessible online and updated
  mandatory standard to lower the minimum          monthly.
  force that is required to open a lid or door
  to any toy or container that a child can
                            References                                             County, 1990–1995. Am J Public Health.
                            1. World Health Organization, The Injury Chart-
                                                                                10. Thompson DC, Rivara FP. Pool fencing for
                               book: A graphical overview of the global bur-
                                                                                    preventing drowning in children (Cochrane
                               den of injuries. Geneva, 2002.
                                                                                    Review). In: The Cochrane Library, Issue 1,
                            2. Meyer R et al. Childhood drowning. Pediatrics        2002.
                               in Review, 2006, 27:163-169.
                                                                                11. Rabinovich BA, Lerner ND, Huey RW. Young
                            3. European Report on Child Injury Prevention,          children’s ability to climb fences. Hum Fac-
                               World Health Organization, 2008.                     tors. 1994;36:733–744.

                            4. Fields A. Near-drowning in the Pediatric         12. Brenner RA. Prevention of drowning in in-
                               Population. Progress in Pediatric Medical            fants, children, and adolescents.
                               Care.1992;8(1):113-129.                              Pediatrics. 2003 Aug;112(2):440-5.

                            5. The Royal Society for the Prevention of acci-    13. Consumer Safety Committee, Opinion On The
                               dents. Water Safety Fact Sheet. Accessed             Safety Of Children’s Buoyancy Aid Products,
                               November 30, 2004.             Consumer Code, and specifically articles
                               waterandleisuresafety/factsheets/                    L.224-1, L.224-4, R.224-4 and R.224-7 to
                               watersafety.htm                                      R.224-12, request no. 01-073A. Paris, 7 May
                            6. Mortality Statistics, Statistics Netherlands
                               1998-2001: Dutch Information System on           14. Brenner RA, Saluja G, Smith GS. Swimming
                               Hospital Care and Nursing, Prismant (1998-           lessons, swimming ability, and the risk of
                               2001); Dutch Injury Surveillance System              drowning. Inj Control Saf Promot. 2003
                               1998-2001, Consumer Safety Institute.                Dec;10(4):211-6.

                            7. World Health Organization. Guidelines for        15. Consumer Safety Committee. Opinion On The
                               Safe Recreational-Water Environments.Vol. 2:         Safety Of Children Bath Aids (bath seats, bath
                               Swimming pools, spas and similar recrea-             rings, reclining bath seats, bath hammocks,
                               tional-water environments. Chapter 2: Drown-         bath pads, bathtubs for children). Consumer
                               ing, Injuries and Pool Safety Management.            Code, and specifically Articles L.224-1, L.224-
                                                                                    4, R.224-4 and R.224-7 to R.224-12, petition
                            8. Quan L, Gore EJ, Wentz K, Allen J, Novack            no. 00-038 and 01-052. Paris, 17 September
                               AH. Ten-year study of pediatric drownings            2003.
                               and near-drownings in King County, Washing-
                               ton: lessons in injury prevention. Pediatrics.   16. World report on child injury prevention, World
                               1989;83:1035–1040                                    Health Organization, 2008.

                            9. Morgenstern H, Bingham T, Reza A. Effects        17. Child safety product guide, European Child
                               of pool-fencing ordinances and other factors         Safety Alliance, November 2006.
                               on childhood drowning in Los Angeles
                                                                                                           (printed October 2009)

The European Child Safety Alliance is a Programme of EuroSafe and is hosted by the Consumer Safety Institute in the Netherlands

               PO Box 75169 1070 AD Amsterdam The Netherlands Tel. +31 20 511 45 13 Fax +31 20 511 45 10

Shared By: