1. CRICOS No. 00213J Kirsten McKenzie 1, Jesani Limbong 1, Dave Strachan 2 1 CARRS-Q, 2 Office of Fair Trading, Queensland Government 2 nd October 2012 Comparing child product safety concerns with injury incidents: Does the evidence support the response?

2. Presentation Aims 1.Describe methods to utilise existing injury data for product safety surveillance purposes 2.Discuss approaches to proactively prioritise areas for further investigation using injury data 3.Outline findings from comparison of product safety regulatory data and injury data for Qld children

3. Background Recent reviews of product safety regulation in Australia and legislative changes -> –Increasing requirement for safety of consumer goods –Reporting of injuries/deaths associated with products –Need for evidence-base to support system Reactive vs proactive surveillance Criticisms of utility of injury data for product safety surveillance but costs of establishing new system too high, thus need to use existing data sources

4. Product-focus vs Risk-focus Product-focused surveillance considers each product individually to assess level of risk and determine responses to a specific product Risk-focused surveillance prioritises hazards of concern –Specific hazards -> distinct injuries –Greater utility of injury data under hazard-based model –May be universal design/regulatory/information standards across range of products as preventative measures

5. HazardRiskInjury Moving and rotating objectsCutting/piercingOpen wounds, amputation Drowning Hazardous heightsFallsContusions, open wounds, fractures Inadequate stabilityFallsContusions, wounds, fractures, crush Inadequate structural integrityFallsContusions, wounds, fractures, crush FlammabilityFire/hot objectBurn Open flamesFire/hot objectBurn Small objectsForeign bodiesChoking, internal injuries ToxicityPoisoning ProjectilesStruck by objectOpen wounds Non-permeable enclosuresSuffocation Gaps and openingsSuffocation; Cutting/piercingAsphyxiation, strangulation, amputation Ch 19 Injury and Ch 20 Ext Cause Ch 19 Injury and Poisoning Chap

6. Utility of injury data for product safety regulators Data soughtData available FrequencyNational ED data, hospital data, and mortality data; two state-based injury surveillance system Product-specific dataBroad objects, ED text descriptions Risk-specific dataMechanism and type of injury SeverityAdmission rates, diagnosis-based injury severity, length of stay, discharge outcomes Vulnerable groupsDemographics (age, region, gender, country of birth etc) Injury scenarioPresenting problem and injury description text Accessible, recent dataSystematic compilation of data which is approx 6-12 months old is possible with ethics/health dept sign off Exposure dataNot available

7. Examples from Qld Child Product- Related Injury Study Data sources: –Product safety documents outlining investigations, recalls, compliance checks, bans/standards etc –Emergency department injury presentation data –Hospital admission injury data Scope: –Children under 18 years of age –Incident/investigation occurring in 2008 or 2009 –Queensland-based Document analysis, secondary data analysis and text mining

9. Product-focused surveillance Age groupProduct safetyInjury data (ED and hospital) <1 yearPacifiers, prams, cotsBeds, tables, couches, prams, change tables 1-3 yearsSqueeze toys, toy vehicles, projectile toys Tables, beds, chairs, couches, toys 4-12 yearsMagnets, bunk bedsTrampolines, scooters, bicycles, skateboards, balls

11. Product-focused surveillance Age groupProduct safetyInjury data (ED and hospital) <1 yearPacifiers, prams, cotsBeds, tables, couches, prams, change tables 1-3 yearsSqueeze toys, toy vehicles, projectile toys Tables, beds, chairs, couches, toys 4-12 yearsMagnets, bunk bedsTrampolines, scooters, bicycles, skateboards, balls Age groupProduct safetyInjury data (ED and hospital) <1 yearFalls, strangulation, choking Falls, burns, struck by objects 1-3 yearsChoking, fallsFalls, poisonings, struck by objects 4-12 yearsIngestions, fallsFalls, struck by objects, transport Risk-focused surveillance

12. Other important considerations Weighing up frequency and severity rankings (see Jesani Limbong’s poster) Consideration of proportion of consumer product involvement per mechanism Product causality (product fault vs user behaviour) Potential for product safety intervention Evaluation of efficacy of interventions Exposure and inherent risk ratios

13. Conclusions CAN the evidence support the response? YES, by: –Using a risk-focused proactive surveillance approach –Compiling injury data regularly to build an information resource –Using coded and text data to identify cases and explore circumstances –Using severity indicators as well as frequency data to prioritise rank order of hazards by age groups DOES the evidence support the response for product-related injury in children? PARTIALLY: –Age groups and some products/hazards concordant –Identification of hazards which require further investigation

14. Acknowledgements Research Team: Jesani Limbong, Debbie Scott, Dave Strachan, Emily Li, Jude Michel Members of Consumer Product Injury Research Advisory Group (CPIRAG) Office of Fair Trading, Product Safety unit Queensland Injury Prevention Council

15. Questions? k.mckenzie@qut.edu.au Full report available at: http://eprints.qut.edu.au/46518/ http://t2013.com Mark your Diaries! International Council on Alcohol, Drugs and Traffic Safety Conference (2013) 25-28 August 2013, Brisbane CRICOS No. 00213J