Prevalence of chemical related toy injury – How much do we know? − Rakyat Biologi

Information on disease, injury or death from chemicals in toys is not systematically collected. Individual case reports of acute poisonings appear in the medical literature. Most commonly these are related to heavy metal poisoning, such as lead, or mercury, following the inappropriate ingestion of a small toy, toy part, or toy fragment, by a young child.[i] Acute poisonings are also reported in older school aged children and adolescents who "sniff" or "snuff" volatile compounds such as glues, solvents, or fuels that are used in craft kits and art and craft supplies.[ii]^,[iii] Burns or perforations of the gut have been reported from ingestion of small button batteries, again usually by younger children.[iv] A few reviews of toy-related hospital emergency room visits are available.[v]^,[vi] A minority of these emergency events are chemical related. Most poison control centers do not separate out toy-related calls or emergency events as part of their standard reporting. The most recent report from US poison control centers does indicate that 13% of poisoning inquiries for children under 6 years of age were related to cosmetics and personal care products, and 2.4% were related to arts and crafts materials.[vii]

One source of data that illustrates to some extent the potential exposures of children to health hazards from toys is the record of toys recalled as unsafe by national consumer product safety agencies in a number of countries. While the majority of these recalls are due to potential mechanical risks, such as small parts violations,[viii] some are for chemical related risks.[ix] Table 2 lists examples of recent US Consumer Product Safety Commission recalls related specifically to chemicals in toys and children's jewelry.

Anecdotal evidence on risks posed by toys is available from media reports, studies by non-profit organization, and experts in child health and safety from developing countries and countries with economies in transition (CEIT). For example, two poison centers in Argentina (Children's Hospital Ricardo Gutierrez in Buenos Aires[x]^,[xi] and Serotox in Rosario[xii]) report cases of lead poisoning in children from ingestions of lead containing modeling plastic (plastilina), watercolors, crayons, pencils, jewelry, small toy parts, and metallic paper packaging materials for toys. The centers also treated a child with gastroenteritis from consuming "bola de moco" (plastic substance that looks like mucus), children with toluene poisoning from ingestion of the liquid in a toy known as “yo-yo loco”, and dermal reactions from exposure to brilliant powder used by girls on the skin (cosmetics).

These sources may capture only the most obvious and acute cases of toy-related chemical health effects, and may not present a full picture of the scope of the problem. It may be that this represents only a small portion of the problem, or it may be that in the end there is relatively little risk of harm from toy-related chemical exposures. At this time, there is not sufficient data to know if or how many children suffer acute, sub clinical, chronic, or delayed adverse health effects as a result of chemical exposures from toys.

[i] Center for Disease Control. Death of a child after ingestion of a metallic charm--Minnesota, 2006.
MMWR. 2006;:55(12);340-341. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5512a4.htm Accessed 23 May 2006

[ii] Anderson CE, Loomis GA. Recognition and prevention of inhalant abuse. Am Fam Physician. 2003:68(5);869-874.

[iii] Becker CEF, Lee DE, Troost BT. Glue-sniffing polyneuropathy: An unrecognized aspect of a public health hazard. J Adolesc Health 2004:34;94-96.

[iv] Banerjee R, Rao GV, Sriram PV, Pavan Reddy KS, Reddy DN. Button battery ingestion. Indian J Pediatr. 2005:72(2);173-174.

[v]Toy-Related Injuries Among Children and Teenagers -- United States, 1996 MMWR 1997:46(50);1185-1189

[vi]CPSC. Toy related deaths and injuries for 2004 (issued 10/05). Available at http://www.cpsc.gov/library/foia/foia06/os/toymemo04.pdf Accessed 24 May 2006

[vii]Watson WA, Litovitz TL, Rodgers GC, Klein-Schwarts W, Reid N, Youniss J, Flannagan A, Wruk KM. 2004 Annual Report of the American Association of Poison Control Centers Toxic Effects Surveillance System. Am J Emerg Med. 2005:23(5);589-666. Available on line at http://www.poison.org/prevent/documents/TESS%20Annual%20Report%202004.pdf Accessed 17 May 2006

[viii] ACCC recalls. Available at http://www.recalls.gov.au/view_recall_all.php?recall_type=all Accessed 25 May 2006

[ix]US Consumer Product Safety Commission. Toy Hazard Recalls. Available at http://www.cpsc.gov/cpscpub/prerel/category/toy.html Accessed 18 May 2006

[x] Nelson Albiano y Guillermo Lombardo "La contaminacion ambiental por plomo como causa de enfermedad" Unidad de Toxicologia y Farmacologia Hospital de Ninios, Buesno Aires, Argentina Revista del Hospital de Ninios, Buenos Aires, Vol XXXI, Numero 134, Agosto 1989.

[xi] Estela Gutierrez, Norma Vallejo, Nelson Albiano y otros. "Intoxicacion por plomo en la infancia"

Centro e Intoxicaciones Hospital de Ninios, Buenoa Aires, Argentina. Revista del Hospital de Ninios, Buenos Aires, Vol XXI, Numero 86, Octubre 1979.

[xii] Dr Juan Carlos Piola "Cuando los juguetes enferman”. Sertox, Rosario, Argentina

Published at the SERTOX Website, Junio 2006

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