Consumer Product Safety Commission Research Articles

Out of the frying pan and into the fire: The gas stove toxicity debate

Out of the frying pan and into the fire: The gas stove toxicity debate Jeremy MacMahon, Chelsea Unkel and Pamela J. Lein from the University of California, Davis, unpack household air pollution, focusing on the gas stove toxicity debate. Recent comments by the U.S. Consumer Product Safety Commission about regulating gas stoves have triggered significant public debate in the United States (U.S.) about the harmful effects of gas stoves on human health. So, what is the science surrounding this issue?

Increasing trend in Brazilian Jiu Jitsu injuries presenting to U.S. emergency departments – a 10-year analysis and injury profile

ABSTRACT Objective Evaluate injury trends in Brazilian Jiu Jitsu (BJJ) participation by presenting to U.S. emergency departments over a 10-year period and formulate an injury profile. Methods The U.S. Consumer Product Safety Commission’s (CPSC) National Electronic Injury Surveillance System (NEISS) database was queried for martial arts related injuries from 1 January 2012 to 31 December 2021. Codes and narratives were examined to compile data for patients sustaining BJJ-related injuries. Results From 1 January 2012 to 31 December 2021 there were 7,722 (NE = 282,315) ED-diagnosed martial arts related injuries with 911 (NE = 36,023) BJJ-related injuries identified. Regression analysis demonstrated an increasing trend in the annual incidence of Brazilian Jiu Jitsu injuries presenting to the ED (R2 = 0.934; SE = 2.069: p < .0001). Average age was 25.68 years of age (range 4–83). The most common injury diagnoses were sprains/strains and other/not listed at 27.68% and 26.39%. The most commonly injured body parts were the upper trunk, and the shoulder comprising 13.66% and 12.14% of injured body parts, respectively. The most commonly fractured region was toes, at 14.15% of all fractures. The most common dislocations occurred at the shoulder and knee, at 32.49% and 28.45% of dislocations, respectively. The most common mechanisms of injury specifically identified were indeterminate contact between players, fall onto ground, or fall onto another player comprising 18.62% and 17.17%, of injuries, respectively. Conclusion There was an increasing trend of BJJ-related injuries presenting to U.S. Emergency Departments. The most common diagnoses and body parts injured were sprains/strains and upper trunk and shoulder, respectively. The most commonly fractured and dislocated regions were toes and shoulder, respectively. The most common mechanisms of injury were indeterminate contact or falling. This study provides novel information concerning trends in injury and injury profiles for Brazilian Jiu Jitsu related injuries.

Button Battery Ingestion in Children: A Dangerous Foreign Body

Pediatric morbidity and mortality related to button battery ingestion has increased since the introduction of lithium batteries inside common household electronics. Larger-diameter button batteries are more likely to result in esophageal impaction in children < 6 years old, resulting in tissue damage. Updated 2018 treatment recommendations include administering honey en route to the hospital for children > 1 year of age and the injection of acetic acid after the removal of the battery. In 2022, legislation was signed into law requiring the Consumer Product Safety Commission to implement specific consumer product safety standards on products that use button batteries.

Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth: A Pooled Study of 16 US Cohorts

ABSTRACT Preterm birth is a leading cause of neonatal mortality. Preterm birth is a public health burden, particularly in the United States, where approximately 10% of deliveries are preterm. Although the underlying cause of most preterm births is unknown, environmental chemical exposures (such as phthalates) possibly contribute. Phthalates are common in consumer products, and exposure can occur through diet, personal care products, and even household dust. Consequently, exposure is ubiquitous for pregnant individuals. Prenatal phthalate exposure has been associated with adverse neurodevelopment in children and disordered development of the male reproductive tract. This study reviewed 16 prospective studies conducted within the United States to pool individual-level data to examine prenatal urinary biomarkers of phthalate exposure and preterm birth. In addition, potential influence of exposure to overall phthalate mixture was assessed to determine the potential impact of reduced exposure on preterm birth. Results of the study indicated that of 6045 pregnant women, 539 (9%) delivered preterm. Overall, of the entire included cohort, 802 individuals were Black (13.3%), 2576 were White (42.6%), 2323 were Latina (38.4%), and 328 had other race identity (including Native Hawaiian, Alaskan Native, or American Indian). Characteristics of participants were similar between those who delivered preterm versus term. Some 96% of urine samples displayed detectable concentrations of urinary phthalate metabolites. As demonstrated by regression analyses, higher concentrations of most phthalate metabolites bore an association of slightly higher odds (12%–16% higher) for preterm birth. In addition, the study estimated that reducing the mixture of phthalate metabolite concentrations by 10%, 30%, or 50%, respectively, could prevent 1.8, 5.9, and 11.1 preterm births per 1000 live births. The study found a relationship between higher maternal pregnancy concentrations of urinary phthalate metabolites and preterm birth. The findings of this study identify a potential benefit of phthalate exposure reduction among pregnant individuals via either regulations or behavioral interventions. Because phthalate exposure can occur through many environments and sources, the US Consumer Product Safety Commission has attempted to pinpoint major sources of phthalate exposure and has determined that the predominate exposures appear to occur through food and medications, although uncertainty in the primary source of exposure remains. Phthalate exposure also widely varies in the United States based on several factors such as whether a person is at a disadvantaged socioeconomic status, is pregnant, or is of a marginalized race or ethnicity. Targeted interventions, such as altering personal care products, is made challenging as consumers are not readily able to access accurate ingredients lists. In the United States, for example, fragrance ingredient lists are not required to list phthalates when they are included in the product. Diet interventions intending to reduce phthalate exposure have had mixed results. Although federally mandated restrictions have limited the use of phthalates in products for children, few such restrictions exist for products intended for pregnant individuals. As 28 phthalates are currently allowed as food additives or in food contact materials, they are difficult to avoid. Mitigation of population-level health effects from phthalates through regulatory means would be most effective when considering phthalates not as individual chemicals, but rather as a class. This study found that higher concentrations of several urinary phthalate metabolites in pregnancy were associated with preterm birth, a consistent finding across 16 prospective US studies. Such findings emphasize the importance of the development of policy measures and public health around phthalate exposure reduction, especially among pregnant individuals.

Pediatric all-terrain vehicle (ATV) related head injury rates and patterns: A 10-year nationwide analysis

IntroductionThe use of all-terrain vehicles (ATVs) carries significant risk of permanent injury and death, disproportionately affecting children. These injuries commonly affect the head and are especially severe among children as they are often unhelmeted and more likely than adults to experience rollover injuries. Many studies examining patients with ATV-related injuries are single-center cohort studies, with few focusing specifically on head injuries. In the present study, we aimed to characterize the annual incidence of ATV-related head injuries between 2012 and 2021, classify and compare head injury types, and identify descriptive characteristics of ATV-related head injury victims. MethodsUsing the US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) database, we queried all head injuries associated with operating or riding an ATV in children under 18 years-old from over 100 emergency departments (EDs). Patient information regarding age, race, sex, location of incident, diagnoses, and sequelae were analyzed. We also collected the estimated number of ATV-related head injuries from all US EDs using the NEISS algorithm provided by the database. ResultsUsing the NEISS algorithm we identified 67,957 (95% CI: 43,608 - 92,305) total pediatric ATV-related head injuries between 2012 and 2021. The annual incidence of ATV-related head injury was similar throughout this study period except for a 20% increase during the COVID-19 pandemic period of 2019–2021 (2019: 6382 injuries, 2020: 6757 injuries, 2021: 7600 injuries). A subset of 1890 cases from approximately 100 EDs were then analyzed. Unspecified closed head injuries were the prevailing type of injury (38%, 900/1890), followed by concussions (27%, 510/1890). More severe injuries included intracranial hemorrhages in 91 children (3.8%, 91/1890). Injuries of all types were predominantly seen in 14–17 year-old's (780/1890, 41%) and in males (64.1%, 1211/1890). In addition, ATV-associated injuries were significantly more common in those coded as white (58.0%, 1096/1890) than any other racial group. ATV-associated accidents among children younger than 9 more commonly occurred at the home compared to accidents involving children older than 9 (57% vs. 32%, p < 0.0001). ConclusionATV-related head injuries cause a significant annual burden among children, with growing incidence in recent years. Further research may wish to explore potential benefits of helmet use and supervision of younger children in possible prevention of these accidents and their associated economic and non-economic costs.

An Epidemiological Study of Cell Phone-Related Injuries of the Hand and Wrist Reported in United States Emergency Departments From 2011 to 2020

Increasing ownership and use of mobile phones has been recently linked to reports of hand and wrist pain from overuse, as well as more serious injuries related to distracted behaviors, such as falls and texting while driving. We describe the epidemiology of hand and wrist injuries presenting to US emergency departments from 2011 to 2020, which were associated with cell phone use using the Consumer Product Safety Commission's National Electronic Injury Surveillance System. The National Electronic Injury Surveillance System database was queried for treatment records from 2011 through to 2020 for all cell phone-related injuries of the lower arm, wrist, hand, and fingers. Using parameters provided by the National Electronic Injury Surveillance System database, there were 1,213 unique cases, yielding a total weighted estimate of 50,487 national cases presenting to emergency departments in the United States. Between 2011 and 2020, the weighted estimate of annual cell phone-related injuries ranged from 3,389 to 7,320 cases. Falls were the most common cause of injury, accounting for 29.8% of estimated cases. The most common types of injuries were lacerations (22.3%). The national estimate of cell phone-related injury was the highest in the age range of 11-20 years (26.4%), followed by 21-30 years (22.2%). Women were affected more frequently than men (59.6% vs 40.4%). Upper extremity injuries related to cell phone use represent an increasing burden of disease to the US healthcare system. Raising awareness regarding cell phone-related injuries and in-home fall-prevention strategies, especially among elderly individuals, should be considered as means of decreasing the number of such injuries. Strategies for decreasing the burden of cell phone-related injuries occurring as a result of falls among teenagers and young adults should focus on minimizing distractions while using a cell phone. Limitations of the study include inaccuracies related to probability-weighted case estimation and limitations in reporting injuries. Knowledge of the burden of upper extremities injuries associated with this common handheld device can help to both raise awareness of this issue, as well as to potentially inform injury-prevention strategies.

Stock market reactions to US Consumer Product Safety Commission enforcement actions

AbstractThis study examines stock market reaction to violations of product safety regulations and firm product responsibilities in the post‐enforcement period. Our event study results show that market reaction was negative to failures by firms to report product defects in a timely way. Our results also show that the stock market reaction varies depending on the type of violations, and whether there are single or multiple violations. Firms spend more on research and development and advertising in the post‐enforcement period, in addition to investing in their compliance programmes which have a significant positive impact on product responsibility stewardship. Our empirical results show that the stock market reacts negatively to recall volume and refund remediation strategy. The stock market reaction is negative to social media communication about product recalls initiated by manufacturers. However, this negative effect appears to be counteracted by the positive corporate social responsibility (CSR) reputation effect of the manufacturers. Our findings imply that US manufacturing firms dealing with product recalls must be sensitive to how consumers and investors interpret the communication.

Microscopy in the Study of Asbestos-Containing Joint Compound and Patching Products, Including Spackling

Drywall (wallboard, plasterboard, gypsum board) became the common construction material for interior walls in buildings in the later 1940s. Joint compound (mud, spackling, taping compound, joint treatment material) and patching products such as spackle or spackling were used to seal the seams between the boards and cover cracks and nail indentations. Most joint compounds from the 1940s into the later 1970s contained chrysotile asbestos in various formulations. Analyses by microscopy determined the chrysotile asbestos content of samples of Bondex, Georgia-Pacific, and Reardon products to be 1–5%, 3–8%, and 1–2% asbestos, respectively. Information compiled from several sources, including corporate responses to the U.S. EPA Asbestos Information Act of 1988 and other documents, suggest that asbestos-containing joint compounds and patching products from the 1930s into the late 1970s contained chrysotile in the range of 0.5% to 23%, with one company having a few formulations with asbestos levels as high as 45.2%. Although there were no documents showing that amphibole asbestos was intentionally added to joint compounds, there is some evidence of amphibole asbestos fibers in certain joint compound products, probably as accessory minerals with added chrysotile, talc, or limestone. No amphibole asbestos fibers were found in a Georgia-Pacific joint compound product tested using the acid/base digestion preparation procedure. During simulation testing, the asbestos level in the breathing zone of a worker during the mixing of Bondex Joint Compound ranged from 6.9 to 12 asbestos fibers per cubic centimeter of air (F/cc) (phase contrast microscopy modified by transmission light microscopy). The level was below detection during application. During sanding, the asbestos level in the breathing zone of the worker ranged from 1.9 to 5.5 asbestos F/cc. The simulations showed results that were within the ranges reported in the scientific literature for airborne asbestos levels caused by dry mixing and sanding of asbestos-containing joint compound. The sale of joint compound and spackling sold for consumer use with intentionally added asbestos was banned by the Consumer Product Safety Commission in 1977.

Comparing Musculoskeletal Injuries across Dance and Gymnastics in Adolescent Females Presenting to Emergency Departments.

(1) Background: Studies have yet to identify if there are any differences in musculoskeletal injury patterns between dance and gymnastics. This study aimed to determine if different injury patterns exist in adolescent females participating in those two popular sports. (2) Methods: A cross-sectional study was conducted using data collected from patients presenting to U.S. emergency departments participating in the publicly available, de-identified U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) throughout the year 2020. Regression analyses were performed to explore if injury patterns were predictive of gymnastics or dancing participation. (3) Results: 518 adolescent females with dance-related injuries and 597 adolescent females with gymnastics-related injuries in 2020 were examined. Strain/sprains (33.3%) and fractures (37.3%) were the most reported dance- and gymnastics-related diagnoses, respectively. Participants were 74% less likely to have a strain/sprain diagnosis in gymnastics compared to dance (OR = 0.26, 95% CI [0.18, 0.38]) and were 3.84 times more likely to have a fracture diagnosis from gymnastics compared to dance (OR = 3.84, 95% CI [2.67, 5.57]), even after adjusting for body party injured. (4) Conclusions: Dance is associated with more sprains while gymnastics typically resulted in a greater likelihood for fractures.

Seven-year-long screening of phthalate esters in clothing and textile products from a quality control laboratory

The results of extensive yearly screening (2014–2020) of ortho-phthalate ester levels in textiles sent to a quality control laboratory by textile companies from southern European and northern African countries are presented. Six different regulated phthalates: benzyl butyl phthalate, di-butyl phthalate, di-(2-ethylhexyl) phthalate, di-iso-decyl phthalate, di-iso-nonyl phthalate and di-n-octyl phthalate, were measured in 4729 samples of textile materials from 10 different groups. Analyses were carried out according to the standard gas chromatography–mass spectroscopy procedure, as described by the US Consumer Product Safety Commission. The results revealed a high level of compliance with the European Union legislation (97.25%). In the group of noncompliant samples (total phthalate content &gt;0.1% w/w), positive results were due to the presence of two or more phthalates in almost 60% of the cases. The phthalate esters most commonly detected were di-(2-ethylhexyl) phthalate, followed by di-iso-nonyl phthalate and di-butyl phthalate. In the group of compliant samples (total phthalate &lt;0.1% w/w), the same frequency of occurrence was identified, but in this case most of the samples (almost 90%) contained only one phthalate. In addition, a growing tendency for a decrease in di-(2-ethylhexyl) phthalate levels and an increase in di-iso-nonyl phthalate and di-iso-decyl phthalate concentrations were detected throughout the study, due to replacement of the former by the latter in the use as a plasticizer. No significant differences between countries were noted with regard to the frequency or concentration of phthalates in the textile samples. The study findings contribute to advancing knowledge about the phthalate content of textiles and to evaluating and controlling the potential risks of exposure to these compounds.

Recalls.gov: Your Online Resource for Recalls

The United States Food and Drug Administration, National Highway Traffic Safety Administration, United States Environmental Protection Agency, The United States Department of Agriculture, United States Coast Guard, and United States Consumer Product Safety Commission joined together to provide alerts for the American people when products are unsafe, hazardous, or defective. While in need of an update, Recalls.gov provides one web page where consumers can obtain recall information, report a dangerous product, and learn important safety updates to stay healthy.

Improving text classification with transformers and layer normalization

More than 25,000 injuries and 25 fatalities occur each year due to unstable furniture tip-over incidents. Classifying these furniture tip-over incidents is an essential task for understanding incident patterns and building safer products. For example, this classification can help standards development organizations (SDOs) and policy makers discover hidden insights, which can be used to develop standards and regulations that help improve furniture and make homes safer. Since 2000, the U.S. Consumer Product Safety Commission (CPSC) has published data related to consumer product injuries. The amount of data has grown rapidly, and the process of manually reviewing and classifying individual incidents has correspondingly become very resource intensive. This paper proposes an improved method that employs a combination of natural language processing (NLP) techniques and machine learning (ML) algorithms to classify textual data. Machine learning models can help reduce time and effort by streamlining incident narrative classification for determining whether incidents are related to furniture tip-overs. Challenges often presented by real-world data sets (such as the CPSC data used in our experiment) include imbalanced target classes and narratives requiring domain knowledge, since the data sets contain abbreviations and jargon. Using out-of-the-box, default classification models such as bidirectional encoder representations from transformers (BERT) might not yield adequate results. Our proposed method adds layer normalization and dropout layers to a transformer-based language model, which achieves better classification results than using a transformer-based language alone with imbalanced classes. We carefully measure the impact of hidden layers in order to fine-tune the model.

Pediatric Softball Injuries Presenting to Emergency Departments.

This study sought to characterize the mechanisms of injury responsible for common softball-related injuries in recent years. The National Electronic Injury Surveillance System database was queried for all pediatric softball-related injuries presenting to participating US emergency departments from 2010 to 2019. Patients were classified by age as children (7-12 years), adolescents (13-18 years), or young adults (19-21 years). The case narrative of each injury was used to establish the mechanism of injury: hit by bat, hit by ball, sliding into base, collision with another player, catching, running, and throwing. Statistical weights provided by the Consumer Product Safety Commission were used to produce national injury estimates. There were an estimated 511,117 pediatric softball injuries presenting to the emergency department over the study period, with a mean patient age of 14.3 years (95% confidence interval [CI], 14.1-14.4 years). The head/neck was the most commonly affected body part, making up 30.2% of cases (95% CI, 28.2%-32.2%). Injuries to the head/neck were most often caused by being hit by the ball (78.4%; 95% CI, 76.4%-80.3%) and most commonly resulted in a superficial injury (36.9%), internal injury (22.2%), or concussion (16.3%). Foot/ankle injuries were most frequently caused by sliding into base (51.5%; 95% CI, 47.0%-55.2%) and typically resulted in a sprain/strain (65.5%). The most frequent causes of shoulder/elbow injuries were being hit by the ball (33.3%; 95% CI, 28.6%-38.3%) and throwing the ball (27.6%; 95% CI, 22.8%-32.9%). These resulted most frequently in a sprain or strain (39.5%), followed by a superficial injury (28.2%). The proportion of softball injuries affecting the shoulder and elbow and the lower extremities increased with athlete age, whereas the proportion of injuries affecting the remainder of the upper extremities decreased with athlete age. Being hit by the ball was the most common mechanism of injury, especially in the head/neck region, and shoulder/elbow injuries increase with athlete age. Coaches and leagues may consider mandating helmets for infielders and pitch counts for pitchers, especially among adolescent athletes.

Sledding Accidents at a Level 1 Pediatric Trauma Center Between 2006 and 2016.

Sledding is not a risk-free winter sport. According to the US Consumer Product Safety Commission, there were an estimated 13,954 sledding accidents requiring medical care in 2010. However, specific information concerning pediatric injuries related to sledding is not well defined. This study aimed to identify the most common types of injuries associated with sledding accidents and demographic factors related to risk of injury in pediatric patients, and to compare injuries associated with 2 different age groups and sexes. This is a retrospective descriptive study of pediatric patients (<18 years of age) presenting to a regional level I pediatric trauma center secondary to a sledding injury between 2006 and 2016. Demographic information including sex, age, mechanism of injury, and injury severity score was captured and analyzed using descriptive statistics. There were 209 patients identified for 10 years. There were no mortalities. There were 85 patients with primary head injury, of which 82 (96.5%) were hospitalized and 33 (38.8%) required an intensive care unit (ICU) stay. Seventy-five patients primarily suffered from extremity injuries, of which 56 (74.6%) had lower extremity fractures requiring operative intervention. There was no difference in ICU or length of stay between younger children (0-11 years) and adolescents (12-18 years) or between male and female patients. Childhood sledding can result in a variety of significant injuries requiring surgical intervention and hospitalization. Children pulled on sleds behind motorized vehicles are at higher risk for more severe injuries resulting in a higher rate of ICU admission.

Epidemiology of welding-associated ocular injuries.

Currently, there exists a lack of recent epidemiological data concerning ocular injuries due to welding related activities. Our study analyzes trends in ocular injuries related to usage of welding equipment in the U.S. from 2010 to 2019. Using the Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) Database, we queried data from January 1st 2010 to December 31st 2019 using the corresponding product code for welding equipment (896). Results were stratified by year, and standard descriptive statistical methods were applied to components including gender, age, diagnoses, and ED disposition. Circumstances leading up to the injuries were reviewed as well. Between 2010 and 2019 a total of 109,127 welding-associated ocular injuries occurred in the United States (95% CI, 86937-131,316). Estimates show a decreasing trend in cases from 13,415 (95% CI, 9979-16,851) in 2010 to 6944 (95% CI, 4868-9020) in 2019. A majority of cases occurred in men (98.2%) and in the 10-49 year age range (83.8%). 3.3% of cases involved spectators and 44% were bilateral. The top three ocular injury diagnoses were flash burns (62.1%), foreign body implantation (19.6%), and contusions/abrasions (11.1%). The number of radiation injuries trended down from 9286 in 2010 to 4023. With respect to a documented location, 38.9% occurred at home and 4.5% occurred in a school setting. Most patients (99.9%) were discharged from the ED; 0.1% were admitted to the hospital. The data suggests that number of ocular injuries related to welding has decreased significantly over the past 10 years. The most common injuries were radiation burns, foreign body disruption, and contusions/abrasions of the eye. Patients were predominantly men and between the ages of 10 and 49. Of note, almost half of all ocular injuries due to welding were bilateral, and 3% of ocular injuries were seen in spectators.

Contamination by hazardous elements in low-priced children's plastic toys bought on the local markets of Karachi, Pakistan.

Children's plastic toys may contain toxic metals to which infants and young children can be orally exposed and may pose acute or chronic adverse health effects. This research aims to evaluate the total metal concentrations (TMCs) of Pb, Cd, Cr, Ni, Zn, Cu, and Mn in children's plastic toys bought in the local markets of Karachi, Pakistan, and compare TMCs to different toy safety regulatory limits. A total of 44 children's plastic toys sourced in the Karachi local markets were analyzed by an atomic absorption spectrophotometer for contamination of hazardous elements. Toy samples were divided into two groups: plastic toys (DCT) and plastic toys with paints or coatings (DPCT). For plastic toys, 83% (19) of samples had TMCs that exceeded European Union (EU) toy safety regulation limits for Pb, and 65% (15) of samples that exceeded for Cd. For plastic toys with paints or coating, 43% (9) of samples had TMCs that exceeded EU migration limits for Pb and 24% (5) for Cd. More than 20 samples exceeded the United States Consumer Product Safety Commission (US CPSC), Canadian, and Bureau of Indian Standards (BIS) toy safety regulation limits. In toy samples (n = 44), very high TMCs of Pb (64%), Cd (45%), Cr (5%), and Ni (2%) were observed. Zn, Cu, and Mn TMCs existed but were below the regulation limits. The contamination levels of Pb, Cd, Cr, and Ni and smaller extent of Zn, Cu, and Mn still pose health issues in children and may cause serious problems in their health.

Characterization of More Than a Third of a Million Toy-Related Fractures.

Introduction:The toy industry has grown substantially over time, with billions of dollars of toys sold each year in the United States alone. Even after safety considerations, injuries can result. This study examined toy-related fractures in the US Emergency Departments (ED).Methods:The 1999 to 2018 National Electronic Injury Surveillance System from the US Consumer Product Safety Commission was examined data for fractures involving a toy-related injury. The incidence, trends, and anatomic locations for such fractures were assessed.Results:In total, 347,135 toy-related fractures were identified, of which 237,754 (68%) were in patients younger than 18 years, 182,516 (53%) were sustained by male subjects, and a 95% yearly incidence increase was observed over the years of the study. Anatomically, 37% were shoulder/arm/elbow, 24% wrist/hand/finger, 19% ankle/toe/foot, 10% leg/knee, 6% face/neck/head, and 4% trunk/pubic region.Discussion:Despite safety considerations with toy design, more than a third of toy-related fractures were seen in the ED, with a nearly doubling yearly incidence over the study period. This could be contributed to by increased production and prevalence of toys and/or rougher play and increased overall violence. These results are important not only for patient safety but also for orthopaedic surgeons, EDs, toy manufacturers, and policymakers.

Trends in pediatric baseball and softball injuries presenting to emergency departments

ABSTRACT Background Millions of youth participate in baseball and softball in the United States and these youth account for a large number of pediatric sports injuries. This study sought to characterize annual, seasonal, and age-related trends in pediatric softball and baseball injuries presenting to the Emergency Department (ED). Methods The National Electronic Injury Surveillance System (NEISS) database was retrospectively examined for all softball and baseball injuries from 2010 to 2019 involving pediatric patients aged 7–21 years. Patients were classified by age as children (ages 7–13), adolescents (ages 14–18), or young adults (ages 19–21). Case narratives were used to assign mechanisms of injury. National injury estimates were calculated using statistical weights provided by the Consumer Product Safety Commission. Results An estimated 1,372,573 pediatric softball and baseball ED visits occurred from 2010 to 2019. The mean age of the patient population was 13.6 years old (95% CI = 13.5–13.8 years), and baseball athletes were younger than softball athletes (13.2 years and 14.3 years) (p < 0.01). Moreover, baseball athletes hit by the bat were younger than their softball counterparts (11.8 years and 13.4 years). Most baseball and softball injuries were the result of being hit by the ball (52.8% and 54.2%) or sliding into a base (13.1% and 15.8%). The annual number of injuries decreased during the studied time period by 41.1% for baseball injuries and by 38.3% for softball injuries. The annual number of injuries related to all injury mechanisms decreased over the studied time period for both sports, with the exception of baseball throwing injuries, which increased by 8.6%. Baseball and softball injuries were both most likely to be present to the ED on Sunday (16.3% and 17.9%) and during the Spring (53.2% and 55.3%). Conclusion Safety guidelines should focus on reducing the prevalence of injuries acquired by younger baseball and softball players during practice and educating coaches and players on existing pitch count guidelines.

High-Powered Magnet Exposures in Children: A Multi-Center Cohort Study.

High-powered magnets were effectively removed from the US market by the Consumer Product Safety Commission (CPSC) in 2012 but returned in 2016 after federal court decisions. The United States Court of Appeals for the 10th Circuit cited imprecise data among other reasons as justification for overturning CPSC protections. Since then, incidence of high-powered magnet exposure has increased markedly, but outcome data are limited. In this study, we aim to describe the epidemiology and outcomes in children seeking medical care for high-powered magnets after reintroduction to market. This is a multicenter, retrospective cohort study of patients aged 0 to 21 years with a confirmed high-powered magnet exposure (ie, ingestion or insertion) at 25 children's hospitals in the United States between 2017 and 2019. Of 596 patients with high-powered magnet exposures identified, 362 (60.7%) were male and 566 (95%) were <14 years of age. Nearly all sought care for magnet ingestion (n = 574, 96.3%), whereas 17 patients (2.9%) presented for management of nasal or aural magnet foreign bodies, 4 (0.7%) for magnets in their genitourinary tract, and 1 patient (0.2%) had magnets in their respiratory tract. A total of 57 children (9.6%) had a life-threatening morbidity; 276 (46.3%) required an endoscopy, surgery, or both; and 332 (55.7%) required hospitalization. There was no reported mortality. Despite being intended for use by those >14 years of age, high-powered magnets frequently cause morbidity and lead to high need for invasive intervention and hospitalization in children of all ages.

CEO Tenure and Recall Risk Management in the Consumer Products Industry

Firms dread product recalls. Consequently, firm leaders may take steps to avoid recalls when possible, or to avoid the blame for them when there is someone else to blame. We analyze how the appointment of a new chief executive officer (CEO) for a firm in the consumer product industry influences the hazard of subsequent recalls initiated by that firm. Using 25 years of consumer product industry data, including 125 publicly traded firms that experienced 307 new CEOs and 584 voluntary recalls from 1992 to 2016, we find a unique recall pattern following new CEO appointments. The hazard of a recall is high immediately following a new CEO appointment, and then decreases significantly until the next CEO is appointed. We contend that the high hazard of a recall early in CEO tenure may be due to the attribution of blame to the prior CEO. We find evidence to support this contention by showing that the increase in recalls is even higher when the prior CEO was forced out. We also propose that the low hazard of a recall later in CEO tenure may be explained by recalls that can be more easily hidden, allowing them to go unannounced. We find evidence supporting this contention by showing that the decrease in recalls late in a CEO's tenure is stronger when recalls are more discretionary. We conclude with one firm governance recommendation and four regulatory policy recommendations for the Consumer Product Safety Commission.