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Home/Toy Safety Elizabeth C. Powell, MD, MPH Pediatric Emergency Medicine Children’s Memorial Hospital Feinberg School of Medicine Northwestern University
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Objectives To describe types of injuries to children in the home Baby and toddler equipment Toys Small parts, balloons, and magnets Lead, phthalates, cadmium
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Injury rates in US children – hospital < 1 yo 3.4 per 1,000 1 yo 5.0 per 1,000 2 yo 3.9 per 1,000 3, 4 yo 2.9 per 1,000 15-19 yo 6.6 per 1,000 17 hospitalizations per death ED care-far more
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Types of injuries Common Falls Struck by/against Poisoning/transportation Serious Suffocation Choking Falls Burns
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Children’s equipment and toy safety Parent perception that equipment and toys on the market for children are safe Children often cannot recognize and avoid hazards Parent education important
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Falls Furniture Other from height Stairs Buildings Playground equipment
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Fall prevention Education window guards, stair gates behavior restraint use Engineering equipment design (infant chairs, strollers) Building codes
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Suffocation/strangulation Beds Portable cribs Drop side cribs Bedding and bumpers
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Burns Thermal – common Scalds – serious Developmental capabilities younger vs older children Prevention - Microwave oven latch
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Drowning Fatal Prevention-fencing, covers, alarms
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Toys Estimated 15 to 30 deaths per year, but reporting is incomplete Airway obstruction/suffocation from small toys, balloons
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Small Parts Regulation Bans toys intended for use by children <3 yo that have small parts Small parts present a choking, aspiration and ingestion hazard “Small part” defined using a truncated cylinder of designated diameter (1¼ in) and depth (1-2 ¼in) Small balls (diameter < 1 ¾ in) are also banned for children < 3 yo
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Small Parts Test Cylinder
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Toy Safety Labels Explain that a hazard exists if the toy is used by a child outside the recommended age range. The cautionary labeling for a toy or game is: Warning: CHOKING HAZARD – Small parts. Not for Children Under 3 yrs
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Marbles and small round objects Small round objects can easily block the back of the throat and be a choking hazard for children as old as 5 years old Compared to other shapes, toys with a round shape pose the highest risk of choking death
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Foreign Body aspiration Peak age is between 1 and 3 yrs Toys/small plastic objects account for 5- 15% Diagnosis may be delayed History not diagnostic Physical examination normal Plain films insensitive
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Toys with small parts Many parents aware of choking danger Older/younger siblings and shared toys Small parts that detach
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Deaths from Toy Balloons 1970’s 3-11 deaths/year 1980’s 2-11 deaths/year 1990’s* 4 deaths/year 2000’s 1-4 deaths/year In US, cases appear to be decreasing *limited data
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Small magnets Current technology allows the manufacture of small powerful magnets that are inexpensive Single magnet similar to other small FB that are ingested-pass Multiple magnets or magnet + other metallic object-potential for bowel complications
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Toys and toxins Lead – neurotoxin Learning, behavior, seizures Phthalates - ?Abnormal genital development, lower sperm counts Cadmium ?Kidney, bone
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Home/Toy safety issues- Summary Injuries are common; deaths less so Safe toys and equipment Education
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Thank you
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