Tuesday, March 3, 2009

With children comes dangerous play (Marin IJ)

Dr. Dustin Ballard: With children comes dangerous play
Dr. Dustin Ballard
Posted: 02/01/2009 06:04:55 PM PST

Some time ago, I learned about a children's product called "Aqua Dots" that, as it turns out, was the perfect toyÉ for a raver.

Aqua Dots (also known as Bindeez) was an ingenious craft kit that made Etch-A-Sketch look Mesozoic. Using a plastic pneumatic pen, children could set colorful little beads into mosaics and permanently bond their creations simply by adding water - thus creating lasting tributes to their artisanship. Creative, fun and priced under $30, Aqua Dots sold millions of sets and was named Australia's Toy of the Year in 2007.

But there was one problem: if your little Picasso ingested the Skittle-esque Aqua Dots, he might suffer an abstracted level of consciousness, like Pablo in the sky with diamonds. This is what happened to dozens of children, aged 2 to 10, after swallowing Aqua Dots. Several of them were hospitalized with seizures, lethargy and respiratory distress. No children died, but parents and physicians were puzzled until the culprit was identified - Aqua Dots were laced with GHB. GHB, as in the popular club drug from the 1990s, that is known in the media as a "date-rape drug" and on the streets as Scoop, Liquid X, Easy Lay and G-Riffick.

How did a date-rape drug get into a children's art toy? Remember the recent Chinese infant formula scandal? Well this situation involved a similar cost-cutting measure. The Chinese plant manufacturing Aqua Dots decided to substitute a cheaper solvent (1,4-butanediol or 1,4-BD) for its nontoxic counterpart (1,5-pentanediol). When ingested, 1,4-BD is metabolized to gamma-hydroxybutyrate (GHB) and within 15 to 30 minutes severe changes in mental state result.

After the GHB discovery in late 2007, 4.2 million units of Aqua Dots were recalled. Subsequently, the product was renamed "Beados" and marketed as containing a "new bead formula," one without the toxic solvent and with a bitter-tasting additive to discourage ingestion. You can still find it online today (just Google "Beados Beads.")

As frightening as this story is, it is just one of many examples of child's play gone awry. Radar Online has recently hailed Aqua Dots, alongside nine other disastrous inventions, as the "most dangerous playthings of all time." Some of the other ill-considered products included lawn darts (Jarts) that impaled younger siblings, Easy Bake Ovens that toasted little hands, BattleStar Galactica Missile Launchers that fired missiles into mouths and throats, and Johnny Reb Canons that blinded eyeballs with miniature plastic cannonballs.

But, minimalists beware; it's not just specialty toys that can cause problems. Marbles have a strong affinity for the nasal passages of 2-year-old boys and 3-year-old girls have an unfortunate tendency to run around with pencils pointed upwards in a manner that can lead to punctured lips and tongues. Several years ago, I treated a youngster with unusual breathing. The parents thought it might be pneumonia or asthma, but I was befuddled. There was an unusual noise in the child's lungs - something high pitched and squeaky. An X-ray revealed the culprit; a small metal whistle that the child had surreptitiously aspirated (swallowed into the lungs).

Even a balloon, so gentle and buoyant, can be a dangerous hazard. A child who accidentally swallows the remnants of a popped balloon may suffer a horrific airway emergency because a balloon can lodge in the trachea and - because of its elasticity - be difficult to remove. In fact, a study from the Cook County Medical Examiner's Office in Illinois found that toy balloon aspiration was the most common cause of fatal aspiration in children under age 14.

For as long as there have been children, there have been children who discover pain in their play. As any parent can attest, kids are very consistent in when they choose to play dangerously; at exactly the moment mom or dad looks the other way. Short of locking up little Sally in a padded cell, there is really no way to keep your child completely safe. But, it would be reassuring if toy makers would help out just a bit and avoid throwing lawn darts. A good place to start would be to stop confusing terrific toys with G-riffick toys. Leave the latter to the clubbing crowds.


- For tips on choosing safe toys, check out the American Academy of Pediatrics Web site at www.aap.org/publiced/br_toysafety.htm

- For more information about recalled toys, go to the Consumer Product Safety Commission at www.cpsc.gov

Dr. Dustin W. Ballard is an emergency physician at Kaiser Permanente San Rafael and the author of "The Bullet's Yaw: Reflections on Violence, Healing and an Unforgettable Stranger." His Medically Clear column appears every other Monday.