Think outside toy box to find hazards

Parents scoured children’s playrooms and retailers scurried to clear their shelves after manufacturers ordered a series of recalls this summer, saying millions of popular toys may have been made with lead paint.

But the risk of lead poisoning is as strong as ever, experts say; it’s just that the biggest threat probably isn’t in the toy box.

Children are at greater risk of lead poisoning from living in a home with deteriorating old paint, or one that is going through a remodel, than they are from most toys, according to federal tallies. Toys with lead paint don’t even pose the biggest threat among playthings.

Lead paint has been banned in the U.S. since 1978, but older homes typically have layers of the dangerous wall covering beneath newer coats. In good condition and left undisturbed, the lead paint poses little threat. But after it’s chipped or begins creating dust, the danger grows.

“By far and away historically, the major concern about sources for lead has been your home,” said Dr. Helen Binns, a professor of pediatrics and preventive medicine at Northwestern University’s medical school.

“You may handle your toy for a few moments a day, but if you’re in a home going through remodeling, you generate dust throughout your whole house,” Binns said. “So you’re exposed everywhere you go, not just when you’re playing.”

Lead paint on toys still poses some risk, health officials say. But when it comes to toys, the biggest dangers don’t come from the paint on a truck, train or doll.

Instead, the deadliest playthings are among the oldest and simplest: balloons and small rubber balls or marbles.

“I think people don’t always worry about the right things,” said Dr. Garry Gardner, chairman of the American Academy of Pediatrics’ committee on injury, violence and poison prevention.

He says that is partly because there is so much for parents to worry about: “Is their child in a properly fastened car seat? Do they have a smoke detector and a carbon monoxide detector working? Is their hot water heater turned down so that there isn’t a scalding risk? Do they have a pool that isn’t fenced on all four sides?

“It’s hard telling parents to relax a bit,” Gardner said.

A wave of recalls

Although there have been fewer toy recalls so far this year than for the same period in 2006, the millions of toys deemed unsafe this summer struck a nerve with consumers and thus with manufacturers, retailers and politicians.

Part of the heightened concern stems from timing.

Last winter, thousands of pets were sickened or killed because of tainted Chinese ingredients used to make animal foods. Over the following months, toothpaste, tires, fish and other products imported from China also were recalled on safety grounds.

So by the time RC2 Corp. in June recalled 1.5 million Chinese-made Thomas & Friends wooden train toys because of lead paint, Americans had plenty of reason to be concerned about Chinese products.

Those fears were amplified in August when Mattel Inc. -- the world’s largest toy maker -- launched a series of recalls of Chinese-made goods.

The question for some in pediatric medicine is whether worry about imported lead paint obscures equal or greater perils much closer to home.

In 2005, the most recent year for which data are available, 20 children younger than 15 died from toy-related injuries, according to the federal Consumer Product Safety Commission.

Nine children -- ages 15 months to 8 years old -- died after choking on toys. Six of them died after swallowing balls that blocked their airways. One breathed in a balloon or part of a balloon. One died after swallowing a bead from a toy horse, and one choked on a toy dart.

Ball-shaped objects are particularly dangerous, said Dr. Gary Smith, director of the Center for Injury Research and Policy at the Columbus, Ohio, Children’s Hospital.

“If you took the best engineers in the world and asked them to design a perfect plug for a child’s airway, you couldn’t do much better than a round rubber ball,” Smith said. “It’s airway-sized, it’s airway-shaped and it will wedge itself in so that it is very hard to dislodge and will completely block the airway.”

Balloons also have long been a hazard with the potential for terrible consequences, Smith said. The danger lies in a child blowing up a latex balloon and breathing it in by mistake, or swallowing a balloon or part of a popped balloon.

“Balloons tend to drape themselves over the top of the voice box like shrink wrap; there’s a suction that’s created,” Smith said. “It will conform to the shape of the entrance of the larynx and will completely block off the airway.”

The most serious of this summer’s toy problems, Smith said, has nothing to do with lead either. Mattel recalled more than 18 million magnetic toys worldwide -- not because of a production problem in China but because of a design flaw that could have allowed the magnets to become detached from the toy, making them a danger if swallowed.

Several other companies also recalled toys made with small, powerful magnets because if a child swallows two or more, they can attract each other and cause intestinal perforation or blockage.

Altogether in 2005, more than 200,000 toy-related injuries were treated in U.S. emergency rooms, the safety commission reported. Riding toys, including nonpowered scooters, accounted for the largest portion -- about 29%.

Still, what scares parents and health officials about lead is the cumulative and particularly pernicious dangers of that substance, particularly to the developing brains and nervous systems of children. Consequences of ingesting lead can include learning disabilities and decreased intelligence.

Levels of fear

Pediatric health experts say they can’t pinpoint the dangers of playing with a lead-paint toy, primarily because the amount of lead on the object isn’t always known.

Even when the lead content of a toy is known, it’s usually tough to pinpoint children’s exposure, which comes from mouthing the toy or putting their hands in their mouths after playing with it.

“Can you suck on it five times and not 10 times? Nobody knows,” said Gardner of the American Academy of Pediatrics. “Quantifying that is a very difficult thing to do.”

In the most recent spate of toy recalls, levels of lead varied widely. Mattel executives recently told a House subcommittee that its recalled toys had paint with lead levels as high as 11%, or 110,000 parts per million -- nearly 200 times the federal limit of 600 parts per million, or 0.06%.

Tween Brands told the subcommittee that some of the 103,000 pieces of jewelry the company recalled in May contained clasps that had lead content higher than 35%.

RC2 declined to disclose to Congress the lead levels on its recalled trains, saying it released the information to the Consumer Product Safety Commission but not the public.

Still, the biggest source of lead poisoning in children, nationally and in Los Angeles County, comes from chipping lead paint at home. The second-biggest source is a parent or other adult who brings in lead dust from a job.

Lead from toys doesn’t even make the list as a stand-alone category. Even the federal agency that conducts the recalls noted that toys involved in the most recent recalls didn’t pose significant risks.

“I don’t want to minimize the problem of lead paint,” said Julie Vallese, a spokeswoman for the Consumer Product Safety Commission. “But there are times when lead poses a risk to children and times when a product simply violates the lead-paint standard. The last six or so recalls are because the products violate the lead-paint standard.”

Putting it in perspective

Binns of Northwestern University said that in about 85% of lead-poisoning cases, health officials could trace the source to deteriorating paint where the child lives or spends time.

In Los Angeles County from 2000 to 2007, health officials recorded more than 5,800 cases of lead poisoning in children younger than 6.

Many of them were exposed to more than one source of lead, according to county health department statistics. But the vast majority of the problems came from paint and dust in the home or the soil outside, or from dust tracked into the home from another source.

Only 1.8% of lead poisonings were attributed to “other” sources, which include candies, spices, mini-blinds and jewelry along with toys.

Lead fatalities as a result of toys are more rare. In 2005, more children died after kitchen ranges tipped over on them -- that happened twice -- than died of lead poisoning.

That year, one child died after swallowing a piece of lead jewelry, the federal agency said, the same number that died after being struck by lightning while flying a kite.

Still, Binns and others say no amount of exposure to lead is safe. Parents concerned about possible lead exposure should talk to their pediatricians about a blood test that measures lead content.

And although it might calm parents to put their children’s risks from recalled toys into context, that doesn’t mean any potential dangers ought to be tolerated, said Smith of the Columbus Center for Injury Research and Policy.

“We shouldn’t be so quick to put aside a preventable risk in one set of consumer products -- in this case toys -- just because there are other things that pose more of a risk,” Smith said. “We don’t usually trade off and say measles is less serious than polio, therefore I’m OK with measles.”

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abigail.goldman@latimes.com

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Deathly toys

Toy-related deaths of U.S. children under age 15, by category, 1990 to 2005

Riding toys, scooters: 78

Choking, asphyxiation

Balloons: 69

Balls: 47

Toy or toy part: 45

Marbles: 5

Toy chests: 14

Strangulation: 14

Other: 20

Source: U.S. Consumer Product Safety Commission

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Resources

Los Angeles County’s lead poisoning prevention program: (800) LA-4-lead; (800) 524-5323

Center for Disease Control and Prevention’s lead poisoning prevention program: www.cdc.gov. Click on “Environmental Health,” then “Childhood Lead Poisoning Prevention Program.”

Department of Housing and Urban Development’s guide to protecting against lead exposure during repainting or remodeling: https://www.hud.gov/offices/lead/ outreach/remodel.pdf