Injury Prevention 1997; 3: 165- 169

NEWS ANDNOTES

Burden of injury world wideA report on the global burden of disease(Lancet 1997, 349: 1269-76) has highlightedthe importance of injury as a cause of deathworld wide, accounting for 10% of totalmortality. Injury is ranked third in order offrequency for both developed and developingcountries, way ahead of HIV related deaths,maternal and perinatal causes, nutritionaldeficiencies, and even respiratory infections.

US National Academy of Sciences to lookat injuryThe National Academy of Sciences' Instituteof Medicine (IOM) has formed a new 18member Committee on Injury Prevention andControl to undertake an 18 month study toreview injury in America. The study is beingsponsored by three foundations-W K Kel-logg, John and Catherine T MacArthur, andRobert Wood Johnson. The expected com-

pletion date is summer 1998 and a shortreport will be issued.

In July 1997 a public meeting was held inWashington, DC to receive comments on thefederal response to injury prevention andcontrol and make suggestions for researchand practice in the field. For further informa-tion contact Sandra Au, fax: + 1 202 3342939, e-mail: injury(nas.edu.

The task of the committee is to characterizethe problem of injury in America includingthe patterns, causes, consequences, and costsof injuries. It will review the research accom-

plishments in the field of injury preventionand control and identify opportunities andbarriers for research and practice. The com-mittee will assess the current response bypublic and private agencies and consider thefindings and recommendations from pertinentreports on injury, including intentional andunintentional injury, disability, and rehabilita-tion, especially IOM/National ResearchCouncil reports. Finally, the committee willmake recommendations intended to furtherdevelop the field of injury prevention andcontrol and to reduce the burden of injury inAmerica.

Revised framework of E code groupingsThere is a revised framework of E codegroupings for presenting injury mortality andmorbidity data on the National Center forInjury Prevention and Control (NCIPC)home page, http://www.cdc.gov/ncipc/ncipchm.htm (then select 'what's new' and scrolldown). If you have any questions or concerns

or if you can't print the matrix, contact Lee

Annest, Director, Office of Statistics andProgramming NCIPC, mail stop K59, 4770Buford Hwy, NE, Atlanta, GA 30341-3724,USA, tel: +1 770 488 4804, fax: +1 770 4881665, e-mail: jlal@cdc.gov who will fax a

copy to you.

New secretary for British Standards In-stitution Consumer Policy Committee

Following several years of involvement inconsumer safety matters at the Laboratory of

the Government Chemist and more recentlyas a project manager at the British StandardsInstitution (BSI), Arnold Pindar has beenappointed as the new Head of ConsumerPolicy and Secretary of BSI's ConsumerPolicy Committee (CPC). Among otherthings, the CPC places consumer representa-tives on BSI, the European Committee forStandardization (CEN), the InternationalOrganization for Standardization (ISO), andthe International Electrotechnical Commis-sion (IEC) technical committees that have aninterest in consumer product safety.

Pediatricians extend counselling on cyclehelmet useThe American Academy of Pediatrics (AAP)reports in its AAP News April issue (AAPNews April 1997: 17) on results of a periodicsurvey conducted among random sample ofits members in 1994. Results show thatpediatricians' emphasis on bicycle helmetuse has increased, both among their patientsand in their personal lives. The proportion ofpediatricians who said they always wear ahelmet when riding increased from 30% in1990 to 48% in 1994. In 1990, 88% ofpediatricians who counsel patients on injuryprevention reported discussing helmet safetywith patients under age 13 and their parents;in 1994, that number rose to 93%. The 1990survey did not ask about counselling teens onhelmet use. The 1994 survey found 79% ofcounselling pediatricians included bicyclehelmet use in their messages. However, lessthan half of the pediatricians who wereparents of teenagers always wear a helmetthemselves, and only 35% of their childrenalways wear helmets. Pediatricians perceivedan increase in the proportion of their patientswho use bicycle helmets but the sameproportion (eight in 10) report treating bicycleinjuries within their practices.

Call for ban on use of car phonesThe Royal Society for the Prevention ofAccidents (RoSPA) has called for new legisla-tion in Britain to stop drivers from usinghand-held and hands-free mobile phones.The call follows the death of an 11 year oldboy by a driver who was on the phone to hiswife. In another incident, a driver wasconvicted of causing death by dangerousdriving after ploughing into a van, killing itsdriver while using his phone. Britain's twolargest motoring organisations, the AA andRAC, both oppose such a ban. The govern-ment, however, agreed that action wasneeded, although it has no immediate plansto increase penalties.A study by Canadian researchers has

concluded that the use of cellular telephonesin motor vehicles is associated with a quad-rupling of the risk of collision during a call(New England J3ournal of Medicine 1997; 336:453; editorial article in the same edition,pages 501-2).

New UK government acts on injury issuesThe new Labour government in the UKannounced in the Queen's Speech that it willban all privately owned handguns. This goesfurther than the current ban, introduced afterthe Dunblane killings in March 1996, thatexempted .22 calibre pistols. The new ban isexpected to remove a further 200 000 gunsfrom circulation. It has also announced aphased ban on the manufacture, export, and

development of landmines.David Stone remarked when contributing

this item, 'Because politicians have a habit ofpromising more than they can deliver, injuryprevention professionals will be monitoringthe government's actions as closely as itswords-so watch this space!'

Childproofed handguns in MassachusettsMassachusetts is poised to become the firststate in the US to require childproofing (sic)and other safety devices on all handgunsmanufactured, sold, or purchased in the state.Acting in its capacity to ensure consumerprotection, the Massachusetts Office of theAttorney General has introduced a set ofregulations that require such devices as triggerlocks and load indicators on all handguns.The regulations would also require tamperresistant serial numbers, prohibit the sale ofhandguns made from inferior materials, andrequire safety warnings to accompany allhandguns sold. The Children's Safety Net-work (CSN) has compiled a packet 'Aconsumer protection approach to firearmsafety' which contains the proposed regula-tions, sample testimony from both publichealth practitioners and firearms manufac-turers, information of Project Lifeline andfrom the Johns Hopkins Center for GunPolicy and Research, and a bibliography ofrelevant resources. Copies are available fromCSN, Education Development Center, 55Chapel Street, Newton, MA 02158-1060,USA or e-mail to csn@edc.org.

Firearms injury prevention training pro-gram for pediatriciansThe AAP has received funding from theRobert Wood Johnson and Joyce Foundationsto develop a firearms injury prevention train-ing program for pediatricians. This programwill ultimately train 3000 pediatricians andother health care providers in the US. Thefirst train-the-trainers conference will be heldin spring of 1998.

Dangerous dogs debate in AustraliaOne ofthe key contributors to these News andNotes pages is Jan Shield from the ChildSafety Centre in Melbourne. Among herother contributions to this issue she sent theNews and Notes editor a sheaf of newspapercuttings about the death of a 12 year old boywho was mauled by a dog-a cross between abull mastiff and a great dane. There is anelement of d6ji vu about this subject. In theUK, the Dangerous Dogs Act was introduceda few years ago after a series of similar attacksand the ensuing public outcry.Among the clipping was an editorial from

The Age, noting that five breeds-rottweilers,dobermans, german shepherds, heelers, andbull terriers-account for only 30% of thecanine population but 75% of the dog attacksresulting in hospital admissions. The thought-ful leader, which draws comparisons betweenthe ownership of dangerous dogs and hand-guns, concludes with the following paragraph:

'Since these breeds are known to bedangerous, and indeed since some have beenbred to fight and to attack humans or otheranimals, it is pertinent to ask: what social orpsychological forces are at play that causesome people to choose to keep them ascompanions and family pets? Whatever thereasons, the rights of even well-meaningpeople to own dogs that can maim and

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kill should not override the rights of othermembers of the community to feel safe fromthem' (The Age (Melbourne), 18 April 1997).

US playground safety programThe National Program for Playground Safety(NPPS) has developed a national action planfor the prevention of playground injuries.Single copies are available from the programat NPPS, University of Northern Iowa, CedarFalls, IA 50614-0161, USA or visit theirwebsite at http://www.uni.edu/playground/.

Farm safety guideGuide to Communicating Farm Safety forEditors, Illustrators, Cinematographers, andPhotographers available from Joan White, USDepartment of Agriculture, CSREES-PAAP,Stop 2260, Washington DC 20250-2260,USA or e-mail: jwhite(REUSDA.gov.

New websitesThe CSN has updated and expanded its website. It contains information on school in-juries, traffic safety, E codes, and more. Takea look at http://www.edc.org/HHD/csn. TheCSN Rural Injury Prevention Resource Cen-ter has opened its web site dedicated to ruralchildhood injury prevention: http://www.marshmed.org/nfmc/projects/csnriprc.htm.

Bucket photo pulled by airlineNorthwest Airlines agreed with a request fromthe Chairman of the US Consumer ProductSafety Commission (CPSC) to pull an ad inUSA Today showing a child bending over withits head in a bucket. The airline agreed to pullthe ad and mount a safety campaign after theCPSC advised it that at least two children dieeach month in the US by drowning inbuckets.

'Northwest Airlines has been extremelycooperative' said CPSC chairman AnnBrown. 'It is in the same position as manyparent-it simply didn't know about thisdeadly hidden hazard. But it has agreed toact quickly, to pull the ad and to mount asafety campaign to let more people knowabout the drowning danger to children posedby buckets'.

New publications from the CSNThe CSN National Injury and ViolencePrevention Resource Center has three newpublications of interest to injury preventionprofessionals:

Violence and Teen Pregnancy: A ResourceGuide for MCH [Maternal and Child Health]Practitioners is designed to assist public healthprofessionals who work with pregnant andparenting adolescents. Drawing from bothresearch and practice settings, it synthesizesrelevant literature on battering during preg-nancy and presents practical measures that canbe taken by state and local public healthprofessionals. The guide also describes pro-grams in a variety of settings including healthclinics, Women, Infants and Children pro-grams, state and local health departments, andhealth maintenanance organisations working toprotect pregnant women and girls from abuse.Available for $10 plus $3 shipping from CSN.E-mail to inquire about international shippingrates.

Injuries in the School Environment: A Re-source Guide is a revised and redesigned

edition of CSN's popular resource guide onschool injuries. It provides information oninjury risks to students at school, including (1)an analysis of school injury data drawn fromthe National Pediatric Trauma Registry, (2) adiscussion of the circumstances surroundingschool injuries, using vignettes of real injuriesthat have occurred in the school environment,(3)descriptions of state and local programsaddressing the issue, and (4) an annotatedbibliography for further reading. Available onthe CSN web site.

Safe Work/Safe Workers is a new three hourcurriculum for teaching high school studentsabout occupational safety and health. Thecurriculum includes four leaming activitiesdesigned to educate students about hazard inthe workplace and to raise their awareness oftheir rights and responsibilities on the job. A13 minute video, Teens: the Hazards We Facein the Workplace, helps introduce the basicconcepts of occupational safety and healthand facilitates group discussion. The videoand learning activities were created with highschool students, who helped make themrelevant, age appropriate, and fun. Back-ground materials for instructors on pertinentoccupational health and safety topics areincluded, as are resource lists on helpfulagencies and organizations. Safe Work/SafeWorkers was developed jointly by the Massa-chusetts Department of Public Health's Oc-cupational Health Surveillance Program andthe CSN. It is available for $30 plus $5shipping. To order, make check payable toEducation Development Center and send to:Education Development Center, Inc, PO Box1020, Sewickley, PA 15149-1020. To orderby credit card, call +1 800 793 5076.

For more information about these publica-tions, contact CSN +1 617 969 7100, ext2207 or e-mail to: csn(edc.org.

Paracetamol sales being restrictedThe British government has announced that itis restricting sales of the common analgesic,paracetamol, as a suicide prevention measure.At least 200 people die and over 30 000people are admitted to hospital annually as aresult of paracetamol poisoning. Non-phar-macy outlets will only be allowed to sell 12tablets and pharmacies will be restricted to 50tablets (without a doctor's prescription).

US Department of Labor reportUS Department of Labor has released a newreport The Apparel Industry and Codes ofConduct: A Solution to the International ChildLabor Problem? This report is the latest in aseries of publications from the Bureau ofInternational Labor Affairs on this topic; thisparticular document reports on surveys ofUSretailers and manufacturers of apparel anddiscusses developing and implementing in-dustry codes of conduct. Available on theinternet at http://www/ilr.cornell.edu/library/e_archive/ChildLabor/.

Safety in indoor recreational areasAlthough much attention has been paid tooutdoor recreation areas such as amusementparks and camivals, very little attention hasbeen paid to preventing injuries at indoorrecreation areas. Many of these serve refresh-ments, host birthday parties, and have ridesfor young children, including mechanizedtrains, small Ferris wheels, playgrounds, andso forth. The Massachusetts Department of

Public Health (MDPH) has issued Health andSafety Guidelines for Operators of Indoor PlayAreas, available from MDPH, Injury Preven-tion and Control Program, 250 WashingtonStreet, 4th floor, Boston MA 02108-4619,USA.

Update on multipurpose helmetsSnell has a multipurpose helmet standard N-94 which covers bikes, inline skates, skateboards, and other non-motorized sports.According to Snell's web page five manufac-turers have helmets which meet this standard.This helmet has more coverage in back and isa multi-impact helmet.

The American Society for Testing andMaterials has a standard (F-1751-96) forhelmets used in recreational roller skating. Itdoes not cover trick or freestyle skating wheremultiple impacts often occur. This standard isidentical in coverage and performance re-quirements to their bike helmet standard, so itreally isn't a multisport helmet.

Updated information is usually availableon various websites, notably the BicycleHelmet Safety Institute (BHSI) http://www.helmets.org or Snell http://www.smf.org/. TheBHSI site has multiple links. Snell's standardscan be downloaded at their site.

CPSC recall announcements and safetywarningsLawn darts-After a serious injury caused by alawn dart, the US CPSC has reissued itswaming that lawn darts are banned andshould be destroyed. Effective on 19 Decem-ber 1988, the CPSC banned the sale of alllawn darts in the US. Pointed lawn darts,intended for use in an outdoor game, havebeen responsible for the deaths of threechildren. The most recent injury occurred inElkhart, Indiana, when a 7 year old boysuffered a brain injury after a lawn dartpierced his skull.

'CPSC banned lawn darts in 1988, butsome of these dangerous products may still bein garages, basements, or second-handstores', said CPSC Chairman Ann Brown.'Parents should destroy these banned lawndarts immediately'. Before the 1988 ban, lawndarts were sold in sets that usually includedfour large darts and two targets. Lawn dartsalso were sold in packages with other sportsequipment. The darts typically are about 12inches long with a heavy metal or weightedplastic tip on one end and three plastic fins ona rod at the other end. The darts are intendedto be grasped by the rod and thrown under-hand toward a target. Lawn darts can causeskull punctures and other serious injuries.The CPSC urges customers to discard ordestroy all lawn darts immediately. Theyshould not be given away since they may beof harm to others.

Baby cribs-In cooperation with the USCPSC, Coaster Company of America Inc ofSanta Fe Springs, California, has recalled1856 full size metal baby cribs. There are twomodels of cribs being recalled as they presententrapment or choking hazards to babies thatcould lead to serious injury or death. TheCPSC and Coaster Company of America Incare not aware of any injuries involving thesecribs. This recall is being conducted toprevent the possibility of injury. Some ofthese cribs have slat spacing that could entrapbabies' heads. They also have scrolls thatcould seriously injure or strangle babies iftheir clothing gets caught on them or if their

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limbs get caught in the spaces around thescrolls. Finally, the plastic end caps coveringthe end of each scroll could separate, pre-senting a small parts choking hazard to babies.

Pencils-In cooperation with the USCPSC, Papel Freelance Inc of Cranbury,NJ, has recalled about 28 000 pencils thathave miniature pacifiers where erasers arenormally found. These miniature pacifiersdetach very easily from the pencils, presentinga choking hazard to young children. TheCPSC and Papel Freeland Inc are not awareof any injuries involving these pencils but therecall has been conducted to prevent thepossibility of injury.

Toy police cars-the CPSC has announcedthat, although there have been no knowninjuries, Fisher-Price is voluntarily recalling17 000 toy police cars as the back ofsome carscould crack and present a potential chokinghazard.

Necklaces-High lead levels in almost 5000metallic necklaces, presenting a risk of leadpoisoning, has resulted in their recall in acooperative exercise between manufacturersCharming Shoppes Inc and the CPSC.

keeping safe and healthy. Consultation tookplace with key organisations and agenciesthroughout the UK.

The key concepts around which the re-source has been developed are:

Risk-Understanding and managing risk iscentral. Understanding the range of differentperceptions of risk and the factors thatcontribute to level of risk, for example lackof experience, complacency through muchexperience, tiredness, alcohol, drugs, stress,tiredness, and self image are fundamental.

Self image-If we value ourselves we aremore likely to care about our safety and ourhealth. As self image is very much a reflectionof the way others see us, all those who have aninput into young people's lives have aresponsibility for the way young people viewthemselves.

Collaboration and consultation-Valuing andutilising expertise is central to the philosophyof the resource, ensuring a consistent andunified approach and obviating the potentialfor mixed messages.

Recent events that have breached school

security and the safety of children havehighlighted implications for the developmentand management of schools' health andsafety, and the importance of having relevantpolicies, procedures, and learning opportu-nities in place.

The resource Together Safely-Developing aWhole School Approach to Health and Safetywas launched at the end of last year and anevaluation of its take-up and use is about to beundertaken. For further details of this re-source, its availability and the training thatsupports its use, contact Sue Aucott, Curri-culum Development Manager, RoSPA, Edg-baston Park, 353 Bristol Road, BirminghamB5 7ST, UK, tel: +44 121 248 2000; fax: +44121 249 2001.

IM-PACT annual reportInjuries Manitoba-prevention of Adolescentand Childhood Trauma, a program of theChildren's Hospital in Winnipeg, is two yearsold. Its newspaper style 1996 annual reportoudines the breadth ofIM-PACT's initiatives,

Whole school safety training resourceIn 1992, the UK Goveimment set targets forthe reduction of deaths from various keycauses, and accidents were identified for thefirst time as a health issue. Information,education, and collaboration were identifiedas ways forward in meeting those targets,rather than through regulations or legislation.The White Paper highlighted the opportunityfor the development of a resource whichwould provide schools, and those workingwith them, with a process for gaining a clearerand broader understanding of safety and itsrelationship to health; to understand that, infact, health and safety are inseparable. Thingsthat are unsafe cannot be healthy, neither canthings that are unhealthy be safe.

The emphasis for accident prevention/reduction in young people in the UK hastended to be one of protection-putting upbarriers and guards, encouraging the wearingor use of protective items, or prohibiting theuse of potentially dangerous things and areasthrough regulations and legislation. Thereasons for this? ...It is easy to see that actionis taking place, something visible is beingdone. It is also easier to measure the effec-tiveness of such strategies, and thereforejustify expenditure and secure funding.

But there is a limit to the amount ofprotection we can provide, for however hardwe try to create a completely safe environ-ment, no environment can ever be totally safe,and human beings seem to have an innatedesire to take risks. All of us in one way oranother take risks in our lives. People enjoythe thrill of being UNsafe sometimes, ofhaving the opportunity to CHOOSE to takerisks in one way or another. But everyone'sperception of risk varies. What one personmight regard as risky, another would not. Soperhaps the emphasis should be on enablingpeople to understand risk in order to manageit. And the skills and strategies needed formanaging risk in one setting are transferableto other contexts.

With funding from the Departments ofHealth, Education and Employment, Trans-port, Health and Safety Executive, and theScottish Office a training resource has beendeveloped for schools, and those working withthem, which provides processes and activitiesto teach fundamental skills and strategies for

Unsafe/unhealthy school-pupil perception

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Safe/healthy school-pupil perception

From the resource Together Safely-Developing a Whole School Approach to Health and Safety, availablefromRoSPA.

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ranging from community projects, researchand program evaluation, and advocacy tocommunity resource development. The re-port is available from IM-PACT, Children'sHospital, CN 104, 840 Sherbrook Street,Winnipeg, Manitoba R3A 15, Canada, tel:+1 204 787 1873, fax: +1 204 787 2070,e-mail: impact@infobahn.mb.ca.

Baby walkers flood inDespite frantic preparations for unprece-dented spring flooding, dozens of families inWinnipeg, Canada, responded to an incentivedriven recall campaign to get rid of babywalkers. A project called 'Babies Don'tBounce' collected 168 walkers in a one dayblitz in April. A chain of hardware/housewarestores (Canadian Tire) assisted by thankingresponders with a $5 gift certificate and byproviding publicity and collection points.

'We are overwhelmed with the success ofthis event, especially considering the extremeconditions in the city the week before theflood's crest', said Dr Michael Moffatt,director of IM-PACT. The injury preventioncentre, based at Children's Hospital,launched the project after research using localCanadian Hospitals Injury Reporting andPrevention Program (CHIRPP) data showedthe emergency department continues to seeseveral infants each month with walker relatedinjuries. CHIRPP collects data on injuryrelated emergency room visits at 15 Canadianhospitals including Winnipeg Children's Hos-pital.A voluntary standards change in June 1989

produced a de-facto ban on wheeled walkersin Canada, but the injuries continue asfamilies pass on their old walkers, buy themsecondhand, or purchase them across theborder in the USA where they are stillavailable new. Changes in product standardsdo not address the problem of longevity inhazardous products. Several of the walkersrecovered were more than 30 years' old and ingood condition.

'The success in Winnipeg shows that, evenunder adverse conditions, people will respondto an incentive driven recall program', said DrMilton Tenenbein, director of the emergencydepartment at Winnipeg Children's Hospitaland an author of the Winnipeg study. 'Wehope other communities will follow thisexample of putting research into action'. Aninner city community clinic had earliercollected 20 walkers during a similar recallevent. The community clinic paid $10 cashfor each walker brought in over a one monthperiod. As part of their efforts to provideneighbourhood injury prevention centres, thecity fire department has also agreed to be adrop-off point for baby walker. All walkerscollected will be destroyed.

The project also demonstrated that, de-spite evidence to the contrary, baby walkersare still controversial. Numerous shopperswanted to know if the walkers piling up atcollection points were for sale; they expressedfrustration at their inability to find themanywhere. One young father demanded toknow, 'how children were going to learn towalk' if walkers were not available any longer.In a letter to the editor, the mother who toldher personal walker injury story at TM-PACT's press conference was criticised fornot doing a better job of blocking the stairs.

Only a repeat of the campaign in Winnipegor a similar community may prove whetherthe flood emergency helped or hurt the effort.A media conference to announce the project

was poorly attended because the provincialgovernment had declared a state ofemergencythat very morning. On the other hand,warnings from civic officials that basementsmight soon be flooded by overloaded sewerssent many residents to move their belongingsto higher floors. The clean-up frenzy mayhave uncovered more old walkers than wouldotherwise have appeared for the one dayevent.

Shopping cart safety programTo help parents and caregivers prevent unin-tentional childhood injuries associated withfalls from shopping carts, the US CPSC, theNational SAFE KIDS Campaign, the FoodMarketing Institute, Johnson and Johnson,and Safe-Strap Company Inc announced anational shopping cart safety program.

According to the CPSC, from 1985 to1996 an annual average of 12 800 childrenages 5 and under were treated in US hospitalemergency rooms for falls from shoppingcarts. In fact, fall related injuries significantlyincreased during that period, rising from 7800in 1985 to more than 16 000 in 1996. TheCPSC data also show that during 1995 and1996 two thirds of the fall victims were treatedin hospital emergency rooms for head injuries,and more than half of the head injury victimssuffered severe injuries such as concussionsand fractures.

This nationwide effort aimed to providefamilies with the information and the safetygear necessary to reduce the number of fallsfrom shopping carts. The program's compo-nents included educational materials and ashopping cart seat belt discount program.

Newsweek recallIn May Newsweek magazine recalled a specialedition on children because it recommendedthat parents allow babies as young as 5months to eat foods that could cause choking.It suggested, incorrectly, that infants of 5months can eat raw carrot chunks and zwie-back toast.

Home accidents in the UK cost £25.7billion a yearDrawing on previous work on the costs ofnon-fatal road casualties, the Transport Re-search Laboratory (TRL) has estimated thatthe total cost of home accidents in the UKexceeds £25 billion per annum. It alsodemonstrated that the total value of avoidanceper seriously injured casualty is about onethird ofthat for road accidents. Further detailsare in TRL report 225 Valuation of HomeAccidents by Jean M Hopkin and Helen FSimpson. Contact TRL library by e-mail atSandrao@lib.trl.co.uk.

Hockey helhnets standardA new European standard, BS EN 967: 1997Head protectors for Ice Hockey Players has beenpublished by the BSI.

Product safety in PortugalFor several years, Portugal has had a commis-sion, coordinated by the Consumer Institute,to assess the risk of products and servicesbrought to them by consumers' organisations.Recently, this commission asked the Ministerfor Environment and Consumer Affairs toproduce legislation to control food products

containing inedibles. There have been pro-blems with these all over Europe. In Portugal,a 3 year old child died after choking on a 'peg'that came in a cereal packet.

In 1996 and early 1997, the commissiontook action by recommending withdrawalsand recalls of the following products:Two brands of candies that were sold in

packages similar to the ones used to sellmedicines (blister packs and plastic flasks) asthere was a fear that they could encouragechildren to take medicines, mistaking themfor candies. The commission recommendedthat the Consumer Institute should examinethis case and other similar ones and take theproper action, because there is no specificlegislation for this type of situation where it isnot possible to say that the product itself isdangerous.Two brands of air fragrances: the first

brand looked and smelled like small pieces offruit (lemon, pineapple, strawberry) that wereconsidered to be dangerous imitations forchildren, presenting the risk of choking notonly because they could be mistaken for food,but also because they fitted in the test cylinderfor small parts referred to in the Europeantoys standard, EN7 1. The second brand camein glass pots looking and smelling life fruitpuree. It was considered as a dangerousimitation not only because it could bemistaken for baby food but also because itwas toxic! The General Inspectorate forEconomic Activities was informed and seizedthe products already on the market.

After a notification through the Rapexsystem-the system that links product safetyenforcement officers throughout the Eur-opean Union-eight soother holders (fromChina, Italy, Spain, France, and Portugal)were seized by the Portuguese authorities.The commission recommended an immediaterecall of all these products.On the 27 May, a new commission came

into being, resulting from the transposition ofa European Directive into Portuguese law.The new commission has enlarged andstronger powers, notably its ability to assessregulated products. The old commissioncould only analyse unregulated products.

Child restraint campaign in PortugalPortugal has a good rate of seat belt usage inthe front seat, in urban and suburban areas:85 to 89% of drivers and front seat passengersuse seat belts but only 11% do so in the backseat. However, when it comes to childrenunder 12, only 15% are properly restrained,either in the front or back seat. For childrenunder 3 years, 26% are properly restrainedwhile for 4 to 13 years old the rate is only 9%.This may be a reason why one in every fourpassengers killed is a child or teenager,although children travel much less by car thanadults.

APSI-the Portuguese association for chil-dren and adolescent injury prevention-haslaunched a national campaign with the trafficpolice to promote the use of child seats andseat belts by all children and teenagers,whether they travelled in the back or frontseats. As part of the campaign, attention wasdrawn to the danger of interaction betweenairbags and children, although cars with apassenger airbag are still a minority.

The campaign, sponsored by the Ford carcompany, involved the three Portuguese TVchannels, several radio stations, newspapers,and magazines. Information leaflets weredistributed through the National Health

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Services network, creches, kindergartens,schools, and other means. Posters appearedin police stations, on buses, outdoors, and athealth centres, kindergartens, mobile infor-mation centres, and check points. The cam-paign was launched at a press conferencewhere influential Portuguese authorities wererepresented. The launch was transmitted on-line to Barcelona, Athens, and Israel throughthe Medsalus project.

EuoNCAPThe European New Car Assessment Pro-gramme went public for the first time inFebruary. The programme includes a frontalcrash test at 40 mph into a partial overlap,deformable barrier, a side impact and childand adult pedestrian dummy impacts on thefront structures. The cars were all fitted withchild restraints recommended by the carmanufacturers containing 3 year old dum-mies. the first series of tests were to sevenpopular small cars on sale in Europe. Theinvestigators report that generally the dum-mies in the child restraints exhibited con-siderable movement, especially in the sideimpacts. A 10 minute video Only time willtell..., has been produced by one of thesponsors of the test programme, International

Testing. Contact Peter Sand, InternationalTesting, 65 New Cavendish Street, LondonWIM 8AX, UK, tel: +44 171 436 0657, fax:+44 171 436 0944.

Mandatory smoke alarms in homes inVictoria, AustraliaBrian Welch, of the Master Builders Associa-tion of Australia, writing in the Melbournenewspaper, The Age, reminds all Victoriansthat from February this year it becamemandatory to have a smoke alarm in allVictorian homes. The new requirement ex-tends the law beyond that previously in force,which applied only to new dwellings. Whilethe regulations allow up to two years' grace,any property being sold much be fitted withan alarm within 30 days of settlement.

Toothbrush injuriesTwo case reports of intraoral injuries to youngchildren from falls while having a toothbrushin the mouth were reported in a paper in theBMJ (1997; 314: 50-1, 4 Jan). The authorshave asked the toothbrush manufacturers toplace a warning on their packaging and reportthat the market leaders will be acting on thisrecommendation.

Adolescent and Student Health MonitorA four page newsletter crossed my desk thatmay be interest to those of you workingamong adolescents. The Adolescent and Stu-dent Health Monitor is published by theNational Adolescent and Student HealthUnit, PO Box 777, Oxford OX3 7LF, UK,fax: +44 1865 226773. It will differ slightlyfrom the related review that appears inAmbulatory Child Health, focusing morestrongly on UK issues. The winter editioncontains abstracts of several papers that relateto injury or to research into techniques forreaching adolescents. Dr Aidan Macfarlane,the monitor's editor, would welcome contri-butions in the form of abstracts of interestplus any comments on the article that youmay wish to make.

Contributors to these pages include Anara Guard,Diane Thompson,Rosie Mercer, Barry Pless, AmyZierler, Jan Shield, Sue Aucott, Ian Scott, SusanGallagher, and David Stone. Contributions havebeen edited by Michael Hayes. Contributions forfuture issues should be sent to Michael Hayes at theChild Accident Prevention Trust, 18-20 FarringdonLane, London ECIR 3AU, UK, fax: +44 171 6083674, e-mail: mh@qcapt.demon.co.uk.

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