Child Safety: More than Tree Stumps and Toe Mold

Dylan Bjorkman was days short of three years old when he let himself into his family’s unlocked car during his sister’s birthday party on an 86-degree day in West Virginia, and died of heatstroke.[1]

Tragedies like this one explain why Safe Kids Worldwide, a 25-year-old organization, advises parents to keep their cars locked in the driveway, just as we urge parents to never leave a child alone in a car.

Last year, 31 children aged two months to five years old died of heatstroke in cars in the United States.[2] Since 1998, we have lost 556 kids.[3] This is what happens to a young child left alone in a car: Even on a temperate day of say 80 degrees, a car with the windows closed or cracked open can heat up by 20 degrees in ten minutes, up to 100 degrees.[4] Because of the nature of a small child’s development, their bodies can heat up three to five times faster than an adult’s. When a child’s temperature reaches 104 degrees, major organs begin to shut down. At 107 degrees, the child dies.[5] Can death from heatstroke happen in the time it takes a parent to pick up the dry cleaning or a pizza? Yes.

Sometimes the parent leaves the child in the car because they are distracted, while in other cases it’s because they thought “just a few minutes” would be fine. I have met some of these parents, distraught, guilt-ridden, and wanting to be a part of an effort to educate other parents on the risk to kids. Heatstroke must be a horrific way to die, but it is also a tragic thing for a parent to survive.

Thus, is it an overreach for a police officer to act when they see a baby alone in a car? No. Is an organization like Safe Kids Worldwide, for which I work, “smothering” kids in hyper-safety by spreading the word about heatstroke deaths? No. Was Governor Susana Martinez of New Mexico acting as a headline-seeking politician when she saw a one-year-old child left alone in car parked at a Santa Fe Walgreens and called the police to find the parent?[6] No.

Lenore Skenazy tries to make the case—with few facts to back it up—that Governor Martinez and others involved in protecting kids from preventable injury are too zealous in these efforts. We are, she argues, politicians, principals and bureaucrats wanting to score points with the public. She’s wrong, on the facts and based on civic values. Her basic premise is that safety on steroids is making parenthood more anxiety-ridden than it needs be and taking the fun out of childhood.

We want kids to live their careers in childhood to the fullest, and we know fun and reasonable safety measures complement each other. For example, kids playing sports has great value—having fun, learning teamwork, making friends forever—but a concussion can be life-changing and there are ways to minimize their consequences. The national concern about concussions in kids and pro sports is ubiquitous.

The jury has rendered its verdict on the positive impact of child safety efforts. They work. They save lives. And we have much more work to do, because unintentional preventable injury remains the number one killer of kids. Moreover, we see some troubling upward trends. Poisoning death rates are increasing, due to death rates among teens aged 15-19 increasing 91%.[7] There’s been a 54% increase in infants dying from suffocation before they reach their first birthday.[8]

Again, some facts: Child injury death rates have decreased 29% in the last decade, 2000–2009, and the number is largely attributable to a 41% decline in motor vehicle traffic-related death rates.[9] This has occurred because of evidence-based preventative safety practices to meet injury risks. Ms. Skenazy thankfully blesses the use of seat belts, but there’s much more to the progress we have made in keeping kids safer in and around cars.

The requirement to wear seat belts and its success took some time to happen, as well as the passage of federal and state laws. Thirty years ago the country’s seat belt use rate was 14%. Today, overall seatbelt use is 84%.[10] The same can be said for booster seat laws. A child 4 feet 9 inches in height and between 8 and 12 years of age should be sitting in the back seat of the car in a correctly installed[11] child restraint system. That’s according to the American Academy of Pediatrics,[12] and adopted by a great majority of the states as law.[13] Among children ages 4 to 8, the use of a booster seat reduces the risk of nonfatal injury by 45% compared to the use of seat belts alone.[14] Today, every state except Florida and South Dakota has adopted booster seat laws.[15] It is because of these efforts that overall motor vehicle fatalities for children 19 and under have declined from 3,261 deaths to 1,350 deaths between 1987 and 2009.[16]

Beyond cars, the list of successful safety measures involving our kids is long—from bike helmets to toys with lead pulled from store shelves, from smoke alarm requirements to baby proofing homes.

Our job at Safe Kids, and all of us truly dedicated to preventing child injury from genuine risks, involves serving as a partner to parents, providing them with time- and research-tested advice and pursuing effective public policy. All of the work we do at Safe Kids is based on a foundation of research[17]—as is the work of the governmental agencies with which we collaborate. Actions based on evidence better ensures the success of a prevention measure. This explains the success of laws requiring seat belts and booster seats and smoke alarms in homes. Maybe it also explains the lack of research on the bogus risks and remedies dreamed up in the Skenazy blog like shag rugs or the mold between the writer’s toes.

Being a parent can be hard, not because of the tree stumps Ms. Skenazy picks on, but because there are real risks out there. The injuries which concern us are almost all preventable. What works in this effort is when parents hold hands with firefighters, pediatricians, children’s hospitals, focused local, state and federal agencies, mommy and daddy bloggers, and organizations like Safe Kids. Together, we reinforce safety practices that have endured over time and we vigilantly keep up with emerging trends.

One of those trends is when televisions and furniture tip over and kill kids. Recently, Safe Kids and the Consumer Product Safety Commission investigated this rising trend,[18] we found that between 2000 and 2010, every three weeks, a child died from a TV tipping over. We concluded that kids would be safer if televisions and furniture were effectively mounted to the wall.

Chance died this way. She was playing in a bedroom and began pulling out the drawers to a dresser in order to climb up and reach a TV, which was sitting on top.[19] In an instant, both the TV and dresser tipped over:

My daughter, Chance, was a beautiful, curious two-year-old. I think about her every minute of every day. I never thought this could happen to us. We’re just a normal family. But now I know it can happen to anyone and I want to tell people to check their homes. Because things can change in an instant.

One child dies from a preventable injury every hour,[20] kids like Chance and Dylan. This is why facts matter, why the work of the child protection community matters and why it’s important to be responsible in talking about these issues.

It is simplistic and wrong to create a rivalry between fun and safety. It is also unfair to create this imaginary army of purported kid-coddling, fun-inhibiting evil doers out of police officers, fire fighters, coaches, pediatricians, child safety researchers and professionals, children’s hospitals, all with a proven track record of saving lives. Common sense measures such as taking a kid out of a football game after a hard hit are intended to raise a kid for a lifetime of play, fun and sports activity. That’s not a team of rivals, but rather a community of care.

Notes

[1]Toomer-Cook, J and Dobner, J, “W.V. boy found dead in car,” Deseret News, September 8, 1998, http://news.google.com/newspapers?nid=336&dat=19980908&id=u-5LAAAAIBAJ&sjid=2OwDAAAAIBAJ&pg=4173,3673706.

[2] Null, Jan, “Hyperthermia Deaths of Children in Vehicles,” Department of Geosciences, San Francisco State University, January 7, 2013, http://www.ggweather.com/heat/.

[3] Ibid.

[4] “How Fast a Car Heats Up,” http://www.youtube.com/watch?feature=player_detailpage&v=7hfCM4Zo37Y.

[5] “Fact Sheet: Children Left in Cars and Heatstroke,” National Highway Traffic Safety Administration, http://www.safercar.gov/parents/downloads/pdfs/Sample_Fact_Sheet.pdf, last accessed 01.31.2013

[6] Miller, J, “Governor sees unattended baby, tracks down father,” CBS News, October 5, 2012, http://www.cbsnews.com/8301-250_162-57526816/governor-sees-unattended-baby-tracks-down-father/.

[7] Vital Signs: Unintentional Injury Deaths Among Persons Aged 0–19 Years — United States, 2000–2009, Morbidity and Mortality Report, April 16, 2012 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm61e0416a1.htm.

[8] Ibid.

[9] Ibid.

[10] “Occupant Restraint Use in 2011: Results From the National Occupant Protection Use Survey Controlled Intersection Study,” NHTSA, January 2013, available at http://www-nrd.nhtsa.dot.gov/Pubs/811697.pdf.

[11] To have your baby’s car seat checked, find a location near you here.

[12] Iannelli, V., M.D.“New AAP Car Seat Recommendations,” American Academy of Pediatricians, March 21, 2011, http://pediatrics.about.com/b/2011/03/21/new-aap-car-seat-rules.htm.

[13] “Car Seat Safety for Kids,” The Children’s Hospital of Philadelphia, http://www.chop.edu/service/car-seat-safety-for-kids/car-seat-safety-by-age/for-your-4-to-8-year-old-child.html.

[14] Ibid.

[15] “Child Passenger Safety Laws,” Governor’s Highway Safety Association, available at http://www.ghsa.org/html/stateinfo/laws/childsafety_laws.html, last accessed 01.31.2013.

[16] “Injury Trends Fact Sheet,” Safe Kids Worldwide, http://www.safekids.org/our-work/research/fact-sheets/injury-trends-fact-sheet.html.

[17] “Research and Statistics,” Safe Kids Worldwide, http://www.safekids.org/our-work/research.

[18] Ferguson, R.W., Mickalide, A.D.. “A Report to the Nation on Home Safety: The Dangers of TV Tip-Overs.” Washington, DC: Safe Kids Worldwide, December 2012.

[19] To see the power of a tip-over, see Rossen, J, “Toppling TVs,” Today Show, December 13, 2012, http://video.today.msnbc.msn.com/today/50185372#50185372.

[20] “National Action Plan for Child Injury Prevention: Protecting our Nation’s Future,” Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, http://www.cdc.gov/safechild/nap/overviews/index.html.

Also from this issue

Lead Essay

  • Lenore Skenazy argues that when it comes to children, we have gone too far in the pursuit of safety at all costs. This isn’t just a cultural phenomenon, either; it has serious implications for public policy, in the form of consumer product regulations and family and even criminal law. She suggests that it’s time to start learning to relax about children’s safety. In particular, allowing kids to take controlled risks is one of the ways that we introduce them to the real world, which is not and should not be risk-free.

Response Essays

  • Anthony Green argues that child safety is nothing to joke about. It is not an overreach to call the police if you see a child alone in a locked car; on the contrary, you should certainly do it. Real progress has been made in child safety in recent years, even as new threats emerge, including toppling television sets and poisoning among older children. The child protection community has done tremendous good, and safety enables fun rather than inhibiting it.

  • James A. Swartz argues that the multibillion dollar corporations that make children’s products have a responsibility to deliver them without any safety hazards. Recalls and labeling are not enough, and a close examination of many such cases reveals a disturbing trend: Corporations are often indifferent to children’s safety. We ought not to excuse or make light of such behavior.

  • Joel Best identifies two changing factors in American culture that have contributed to overblown fears related to children. The first is the mass media, which excels at spreading alarming stories, whether true or fictionalized. The second is the declining birthrate, coupled with increased safety itself: There are fewer children per family, and losing one is not an experience we suffer so often nowadays. As a result, smaller problems appear more alarming.