Child and Youth Injury in Review, 2009 Edition - Spotlight on Consumer Product Safety

Table of Contents

• Acknowledgements
• Foreward
• Introduction
• Executive Summary
• Injury Overview
  • 1. Unintentional Injury Deaths
  • 2. Unintentional Injury Hospitalizations
  • 3. Emergency Department Visits: Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP)
• Spotlight on Consumer Product Safety
  • 4. Consumer Product-Related Injuries
  • 5. Bunk Beds
  • 6. Magnets
  • 7. Baby Walkers
  • 8. OtherHousehold Products
• Appendices
  • A. External Cause of injury Groupings
  • B. Report Methodology

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Acknowledgements

Produced by the Public Health Agency of Canada, in collaboration with Health Canada and Safe Kids Canada.

About the Injury and Child Maltreatment Section, Public Health Agency of Canada

The Injury and Child Maltreatment Section manages national surveillance programs for child health including unintentional injury. Collaboration with partners, such as those below, supports injury-related research and provides information on injuries and their risk factors for evidence-based injury and safety promotion.

For more information on the Injury and Child Maltreatment Section, please visit: www.phac-aspc.gc.ca/injury-bles/

Current injury surveillance data is available from the Injury Surveillance On-Line (ISOL) Website which hosts Canadian injury statistics. Users can customize their queries by province and territory, by age group, and over time. Please visit:
dsol-smed.phac-aspc.gc.ca/dsol-smed/is-sb

About Consumer Product Safety, Health Canada

Consumer Product Safety helps protect the Canadian public by researching, assessing and collaborating in the management of the health risks and safety hazards associated with the many consumer and cosmetic products that Canadians use every day.

Consumer Product Safety is actively involved in injury prevention through promoting safety and the safe use of products to consumers, providing industry with hazard and technical information, and enforcing legislation by conducting investigations and inspections, and
initiating corrective action.

For more information: Please visit the Consumer Product Safety Website for more information for consumers and professionals: www.healthcanada.gc.ca/cps

For a listing of Consumer Product Recalls, visit: www.healthcanada.gc.ca/cps-recalls

To report a consumer complaint, or if you have an inquiry, please contact: 1-866-662-0666 or 613 952-1014 or by email CPS-SPC@hc-sc.gc.ca

About Safe Kids Canada

Serious childhood injuries can be prevented. Safe Kids Canada collaborates with partners across the country to conduct research, raise awareness, educate families, and advocate for safer environments to protect children from injury. As a national leader, Safe Kids Canada promotes effective strategies to prevent unintentional injuries. By building partnerships and using a comprehensive approach, Safe Kids Canada advances safety and reduces the burden of injury to Canada's children and youth.

Call 1-888-SAFE-TIP (723-3847) or visit the website at: www.safekidscanada.ca

Safe Kids Canada is the national injury prevention program of The Hospital for Sick Children. It is generously funded by corporate sponsors who support the goal of keeping kids safe. Safe Kids Canada is part of Safe Kids Worldwide, a global movement to prevent childhood injury.

Foreword

Message from Canada's Chief Public Health Officer

I am pleased to introduce Child and Youth Injury in Review, 2009 Edition – Spotlight on Consumer Product Safety. This report presents national surveillance and prevention information on unintentional injuries to children and youth in Canada, with a focus on some important consumer product-related injuries. The document is a collaborative effort of the Public Health Agency of Canada, Health Canada and Safe Kids Canada.

Child and youth injuries are a major public health challenge for Canada. While the rates of death and hospitalization due to unintentional injury have declined considerably over the past two decades, there is more work to be done. We hope that this report will contribute to effective injury prevention and safety promotion policies, programs and activities for Canada's children and youth.

This report also contains important information and tips for parents, caregivers, and anyone interested in helping to prevent injury among children and youth.

Dr. David Butler-Jones
Chief Public Health Officer
Public Health Agency of Canada

Introduction

Unintentional injuries are the leading cause of death for Canadian children and youth from one to 19 years of age¹. Infants under one year are excluded from this statistic due to distinct patterns of mortality for this age group. The most common cause of death for infants under one year is immaturity, followed by congenital anomalies²; however, injury-related deaths among infants are also of concern. In 2005, a total of 720 Canadians under the age of 20 years died as a result of injury³. Furthermore, there were 29,142 injury hospitalizations for this age group in the year spanning 2005/06. Injuries were the third leading cause of hospitalizations among all children and youth, behind respiratory and digestive disease⁴. Many non-fatal injuries result in impairments and disabilities such as blindness, spinal cord injury and intellectual deficit due to brain injury. The economic burden of unintentional and intentional injuries combined, for Canadians of all ages in 2004, is estimated to be $19.7 billion per year, including both direct and indirect costs⁵.

This report, Child and Youth Injury in Review is presented in two parts. Injury Overview contains information based on Public Health Agency of Canada analysis of the most current national data available from Statistics Canada (mortality data, 2005) and the Canadian Institute for Health Information (hospitalization data, 2005/06). Deaths and hospitalizations from injury and poisoning are assigned an external cause of injury code based on the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10)⁶. For the purposes of this report, only unintentional data were analyzed. The following external cause of injury code groupings were used:

Information on emergency department visits collected through the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) will also be presented. Analysis focuses primarily on Canadians 19 years of age and younger.

The second half of the report, Spotlight on Consumer Product Safety, increases the resolution of the information using the high level of detail from CHIRPP, related to consumer products. The CHIRPP injury reports and profiles are generally descriptive in nature and provide preliminary data for hypothesis generation and further study. Safe Kids Canada is raising awareness of consumer product safety for children by focusing on this topic in their 2009 Safe Kids Week campaign. Opportunities for action from a consumer perspective, as well as regulatory, compliance and enforcement activities are discussed for each consumer product.

Injury prevention is a complex issue. This report will contribute to our knowledge by providing both an overview of all unintentional injuries, and detailed CHIRPP profiles focused on a specific group of injuries related to selected consumer products. Understanding the magnitude, trends and nature of injury is a critical first step on the road to a safer Canada.

See Appendix A for all external cause of injury ICD-10 groupings, and Appendix B for full details on the methodology (including abbreviations).

References

1. Public Health Agency of Canada. Facts on Injury [Online]. Ottawa. [cited 2009 Feb 19]. Available from: www.phac-aspc.gc.ca/injury-bles/facts-eng.php
2. Public Health Agency of Canada. Canadian Perinatal Health Report, 2008 Edition. Ottawa, 2008.
3. Injury and Child Maltreatment Section analysis of Statistics Canada mortality data. Public Health Agency of Canada, Ottawa, Ontario, Canada.
4. Injury and Child Maltreatment Section analysis of Canadian Institute for Health Information hospitalization data. Public Health Agency of Canada, Ottawa, Ontario, Canada.
5. SmartRisk. The Economic Burden of Injury in Canada, in press 2009.
6. World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 10th rev. Geneva: World Health Organization; 1996.

Executive Summary

Background

This report is intended to provide an overview of unintentional injuries among young Canadians, with a specific focus placed on injuries associated with consumer products in the second half of the report.

The data presented are based on Public Health Agency of Canada analysis of the most current national data available from Statistics Canada (mortality, 2005), the Canadian Institute for Health Information (hospitalizations, 2005/06) and emergency department data collected through the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP).

Collaboration with Safe Kids Canada and Health Canada provided injury prevention guidelines for consumers, as well as background on regulatory, compliance and enforcement activities underway in Canada.

An overview of child and youth injury in Canada:

• Unintentional injuries are the leading cause of death among Canadian children and youth, from one to 19 years of age
• In 2005, 720 young Canadians (19 years and younger) died as a result of injuries, a reduction of just over 40% since 1990 due primarily to the decline in motor vehicle traffic collision deaths.
• In 2005/06, there were 29,142 hospitalizations for treatment of injuries (19 years and younger); a reduction of almost 40% since 1994/95.
• Between 1990 and 2007 more than 1.6 million injuries were treated in the emergency departments of the 16 hospitals participating in CHIRPP(19 years and younger).
  • In recent years, almost half of these emergency department visits involved consumer products (e.g. furniture, window coverings, toys).

Consumer product-related injuries

CHIRPP data were analyzed to profile multiple types of consumer product-related injuries in children and youth. Details on the circumstances surrounding injuries associated with bunk beds, magnets, baby walkers and other household hazards were reported.

Bunk Beds

• Bunk beds present numerous hazards to young children resulting in injuries such as falls and strangulations.
• Between 1990 and 2007, 5,403 cases of injuries associated with bunk beds were identified.
• Patients who sustained injuries involving a top bunk were almost twice as likely to be admitted to the hospital compared to the CHIRPP average (10.8% vs. 6.8%).

Magnets

• Magnet-related injuries have increased sharply in recent years.
• Between 1993 and 2007 there were 328 cases of children aged 13 years or younger who sustained an injury associated with magnets.
• Just over half of these incidents involved ingestion of a magnet.
• About 60% of the magnets were associated with a toy and about one-quarter involved jewellery.

Baby Walkers

• In April 2004, Health Canada acted to ban the sale, advertisement and importation of baby walkers in Canada.
• Between 1990 and 2007 there were 2,192 baby walker-related injuries among children aged 5-14 months, accounting for 2.6% of all injury events among this age group.
• Of the children in baby walkers who fell down stairs or fell from a height, 88.8% sustained head injuries and 8.2% required admission to hospital.

Other Household Products

• There are numerous hazards in and around the home which present an injury risk to children and youth.
• Trampoline-related injuries have become increasingly common in recent years due to the availability of relatively low-cost backyard models. Falls from the trampoline involving impact with the ground surface are the most severe, generating almost two-thirds of all fractures and one in five patients admitted to hospital.
• Drownings and near-drownings can occur in association with bath seats, in particular when a child is left unattended.
• Children playing around dangling blind or curtain cords are exposed to a strangulation hazard.
• Furniture, televisions and large appliances are frequently associated with injuries sustained in the home. Injury mechanism varies by furniture type.
• Between 1990 and 2007 injury events involving furniture, televisions and large appliances averaged about 9,000 cases per year, 71% of which involved children less than 5 years of age.