Polite Dissent

Tiny Toys Remain Major Cause of Child Deaths screams the Associated Press headline in an article about the annual toy survey from the United States Public Interest Reseach Group (USPIRG) carried by many local papers, national news outlets and local news stations yesterday. From the article:

The U.S. Public Interest Research Group’s 20th survey noted that the Consumer Product Safety Commission reported the deaths of 16 children in toy-related incidents last year, along with another 210,000 emergency room visits. Choking on small parts, balls and balloons remains a leading cause of death and injury in children younger than 15.

This makes no sense. How can 16 deaths lead to the conclusion that choking on toys is a “leading cause of death and injury” or a “major cause of child deaths”?

Let’s take a minute to look at the actual statistics:

• The 210,300 toy-related injuries estimated by the Consumer Product Safety Commission (CPSC) is for all ages. 77% of these injuries (161,100) were to children under 15.
• Riding toys were the leading cause of toy-related injuries (34%), and most of these were due to unpowered scooters.
• The NEISS database estimates that there were 12,206 aspiration injuries to children under 15 in 2004. Note that this number includes all aspiration injuries, not just those related to toys. (In contrast, children had 2.3 million falls, three-hundred-thousand bite and stings, and two-hundred-thirty-thousand motor vehicle accidents requiring emergency room visits in 2004).

The CPSC reports 16 toy-related deaths in 2004.

• Choking made up 44% of these injuries (7)
• Riding toys made up 38% (6)

The main causes of death in children depends greatly on age. For children under 15, the leading causes of death include accidents, congenital malformations, assault, cancer, heart disease, influenza and pneumonia. If you have time to kill, the National Vital Statistics Report can be found here (warning, it is a 90 page pdf file).

Here’s a list I compiled of deaths in children under 15 in the US in 2004 due to various causes. This list contains some — but not all — of the leading causes of death and also lists some less common causes. These numbers are presented to contrast to the 16 toy-related deaths in 2004:
Motor vehicle accidents, 2505; Malignant Cancer, 1548; Assault, 1082; Heart Disease, 920; Drowning, 838; Suicide, 273; Falls, 95; Medical or Surgical Complications, 69; HIV, 37.

The following charts do an excellent job presenting the leading causes of deaths and non-fatal injuries in children. You’ll notice that “toy aspiration” is not listed as one of the leading causes. It probably falls under the heading “Unintentional Foreign Body,” but that category includes all foreign body injuries, not just choking, and not just toys.

Conclusion: The statistics simply do not support the claim that “choking on small parts, balls and balloons remains a leading cause of death and injury in children younger than 15.” Nor do the statistics support the headline that small toys are a leading cause of children’s deaths.

Where did these ridiculous claims come from?

• NOT from the CPSC. Their Toy-Related Deaths and Injuries, Calendar Year 2004 makes no such claims (pdf file).
• NOT from the USPIRG. Both their press release and annual Toy-Report are generally level headed and full of good advice. The press release does state “choking on small parts, small balls and balloons remains a leading cause of toy-related deaths and injuries,” which is a much more reasonable claim (the death part anyway, I see no statistics to support choking being a leading cause of toy-related injury).
• Since these are the only sources the Associated Press names, the only reasonable conclusion is that the AP themselves must have come up the misleading statements. Their reporters either misunderstood and misreported the data, or went for the eye-catching headline and sound bite without bothering to accurately report the actual evidence.

Toy-related deaths are tragic and preventable, but they are not the epidemic the Associated Press article claims. The USPIRG Toy Report has good information and I recommend it to parents, grandparents and physicians.

UPDATE:
Apparently the headline I quoted above is just CNN only, other media sources have less salacious headlines. The rest of the article remains the same however.