Toy-Related Deaths and Injuries Calendar Year 2019 Angie Qin Division of Hazard Analysis Directorate for Epidemiology U.S. Consumer Product Safety Commission 4330 East West Highway Bethesda, MD 20814 November 2020 This analysis was prepared by CPSC staff. It has not been reviewed or approved by, and may not necessarily reflect the views of, the Commission. CPSC Hotline: 1-800-638-CPSC (2772) CPSC’s website: http://www.cpsc.gov 1 TABLE OF CONTENTS EXECUTIVE SUMMARY ...................................................................................................................... 3 INTRODUCTION ..................................................................................................................................... 4 TOY-RELATED DEATHS ..................................................................................................................... 4 TABLE 1: REPORTED TOY-RELATED DEATHS AMONG CHILDREN 14 YEARS OF AGE OR YOUNGER, 2017–2019 ........................................................................................................................ 5 TABLE 2: REPORTED TOY-RELATED DEATHS AMONG CHILDREN 14 YEARS OF AGE OR YOUNGER, 2019 .................................................................................................................................... 6 ESTIMATED TOY-RELATED INJURIES ....................................................................................... 8 TABLE 3: TOY-RELATED EMERGENCY DEPARTMENT-TREATED INJURY ESTIMATES FOR DIFFERENT AGE GROUPS, 2019 ...................................................................................................... 8 FIGURE 1: DISTRIBUTION OF TOY-RELATED INJURY ESTIMATES BY THE BODY REGIONS INJURED MOST FREQUENTLY FOR DIFFERENT AGE GROUPS, 2019 ................................. 9 FIGURE 2: DISTRIBUTION OF TOY-RELATED INJURY ESTIMATES BY THE TYPE OF INJURIES DIAGNOSED MOST FREQUENTLY FOR DIFFERENT AGE GROUPS, 2019 ........................ 10 TABLE 4: TOY CATEGORIES ASSOCIATED WITH THE LARGEST NUMBER OF ESTIMATED EMERGENCY DEPARTMENT-TREATED INJURIES FOR DIFFERENT AGE GROUPS, 2019 ...................................................................................................................................................... 10 TABLE 5: NONMOTORIZED SCOOTER-RELATED EMERGENCY DEPARTMENT-TREATED INJURY ESTIMATES FOR CHILDREN OF DIFFERENT AGE GROUPS, 2015–2019 .......................... 11 TABLE 6: EMERGENCY DEPARTMENT-TREATED INJURY ESTIMATES ASSOCIATED WITH PRODUCT CODE, “TOYS, NOT ELSEWHERE CLASSIFIED,” FOR DIFFERENT AGE GROUPS, 2015–2019 ........................................................................................................................ 12 TABLE 7: EMERGENCY DEPARTMENT-TREATED INJURY ESTIMATES ASSOCIATED WITH PRODUCT CODE, “TOYS, NOT SPECIFIED,” FOR DIFFERENT AGE GROUPS, 2015–2019 .......................................................................................................................................... 12 APPENDIX A: ESTIMATED NUMBER OF TOY-RELATED INJURIES FROM 2011 THROUGH 2019 .................................................................................................................................... 13 TABLE 8: TOY-RELATED EMERGENCY DEPARTMENT-TREATED INJURY ESTIMATES FOR DIFFERENT AGE GROUPS, 2011–2019 ....................................................................................... 13 FIGURE 3: TOY-RELATED EMERGENCY DEPARTMENT-TREATED INJURY ESTIMATES FOR DIFFERENT AGE GROUPS, 2011–2019 ....................................................................................... 14 FIGURE 4: TOY-RELATED EMERGENCY DEPARTMENT-TREATED INJURY ESTIMATES FOR DIFFERENT AGE GROUPS NORMALIZED BY NUMBER IN THE AGE CATEGORY, 2011–2019 ......................................................................................................................................... 15 APPENDIX B: NEISS PRODUCT CODES FOR TOYS ............................................................. 16 2 Executive Summary In this report, U.S. Consumer Product Safety Commission (CPSC) staff presents the latest available statistics on deaths and emergency department-treated injuries associated with toys. For toy- related deaths and injuries, it is important to note that although a toy was associated with many of the incidents, the toy was not necessarily the cause of the death or injury. Additionally, due to delays in death certificate reporting, fatality information is not yet complete for 2017, 2018, or 2019. Reported Toy-Related Fatalities in Calendar Year 2019 • CPSC staff received reports of 14 toy-related deaths that occurred in the 2019 calendar year among children 14 years of age or younger. • Nonmotorized scooters were associated with five of the 14 fatalities: four deaths were due to motor vehicle involvement, and one death was due to a fall. Small plastic balls were involved in four fatalities, due to airway obstruction. Emergency Department-Treated Toy-Related Injuries in Calendar Year 20191 • An estimated 224,200 toy-related injuries were treated in U.S. hospital emergency departments in 2019, and males accounted for 59 percent of the injuries. • Of the 224,200 estimated toy-related, emergency department-treated injuries, an estimated 73 percent happened to children 14 years of age or younger; 70 percent occurred to children 12 years of age or younger; and 35 percent happened to children 4 years of age or younger.2 • Forty-one percent of the estimated emergency department-treated injuries were classified as lacerations, contusions, or abrasions. Forty-six percent of the estimated injuries were to the head and face area, the most commonly affected area of the body. • Ninety-four percent of the emergency department-treated, toy-related injury victims were treated and released. • Nonmotorized scooters were associated with the most estimated injuries among the specifically identified toys for children 12 years of age or younger and children 14 years of age or younger (21 percent and 22 percent, respectively). Emergency Department-Treated Toy-Related Injuries from 2015 to 2019 • Staff observes a statistically significant decreasing trend in the estimated number of injuries associated with nonmotorized scooters from 2015 to 2019, for children 12 years of age or younger, children 14 years of age or younger, and all ages. 1 The percentages are calculated from the unrounded injury estimates. 2 All toys intended for use by children 12 years of age and under must be third party tested and be certified in a Children’s Product Certificate as compliant with the federal toy safety standard enacted by Congress, and to other applicable requirements as well. Additional age breaks are provided in this report to describe hazards to older and younger children, as we provided in prior reports. 3 Introduction This report provides updated summary information on toy-related fatalities for the years 2017 and 2018, along with detailed information on toy-related fatalities for 2019. CSPC staff bases fatality counts on reports obtained from the CPSC databases—Consumer Product Safety Risk Management System (CPSRMS) and the National Electronic Injury Surveillance System (NEISS). In addition, staff presents in this report the estimated emergency department-treated injuries associated with toys for the 2019 calendar year and the injury estimates from 2015 to 2019, based on the NEISS. In Appendix A, staff presents historical estimated toy-related, emergency department-treated injuries from 2011 to 2019, along with the coefficient of variations for the injury estimates. Appendix B lists the NEISS product codes used to generate this report. Toy-Related Deaths3 Tabel 1 summarizes fatalities of children 14 years of age or younger that were associated with a toy and that occurred from 2017 to 2019, as reported to CPSC staff. The reported death totals for each year and age groups are listed at the top of the table, with each year’s reported deaths detailed by the type of toy, with a parenthetical description of the hazard in the rows that follow. Table 1 also lists toy types that are associated with more than one death that happened in the period 2017 to 2019, to highlight the toys (and associated hazards). For other types of toys associated with only one fatality across the 3 years, the information is summarized in the final row of the table. Staff considered fatalities in-scope if a toy was present, and based on statements by investigators, police, family members, or medical examiners, the toy may have played a contributing role in the death. Due to delays in death certificate reporting, fatality information is not yet complete for 2017, 2018, or 2019. At the time of data extraction for this report, death certificate reporting was 98 percent, 90 percent, and 51 percent complete for 2017, 2018, and 2019, respectively.4 The data for 2017 and 2018 have been updated to include the eight new incident reports CPSC staff received—two fatalities that occurred in 2017, and six fatalities that occurred in 2018. Thus, the data differ from the reported fatality tabulations detailed in the previous report for the calendar year 2018.5 Of the eight newly reported fatalities, three incidents involved choking on a toy (a rubber ball, a toy portion of a pacifier, and a toy dart); one incident involved ingesting a small plastic ball; one incident involved suffocation by a foil balloon; one incident involved strangulation by a kite string; one incident involved positional asphyxia, where the child was covered by toys and soft bedding; and one incident involved