Research In Action

Moderator's note: This post is part of our ongoing series highlighting articles from the "Preventing Unintentional Injuries among Children and Youth" issue of Pediatric Clinics of North America. Today’s entry, written by Dr. Leah K. Middelberg, features the article “Pediatric Injuries from Consumer Products and Strategies for Prevention.” Dr. Middelberg is an attending physician in Pediatric Emergency Medicine at Nationwide Children's Hospital. 

In our recent article, “Pediatric Injuries from Consumer Products and Strategies for Prevention”, Dr. Jonathan Midgett and I explore the scope and prevention of pediatric injuries related to consumer products—an often underrecognized but substantial contributor to childhood morbidity and mortality.

We begin with a tragic but illustrative case of a recalled crib that remained in circulation and led to a child’s death, underscoring a central theme: hazardous products persist in real-world environments long after risks are identified. This reflects a broader challenge—consumer product safety in the United States is largely reactive rather than proactive. Unlike the rigorous safety testing of new medications by the FDA prior to public availability, most products enter the market without premarket safety evaluation. If the product meets existing regulations, it can be sold.

Consumer products are implicated in tens of millions of injuries annually, spanning everyday environments such as homes, childcare settings, and recreational spaces. We categorize pediatric hazards into three groups: perennial hazards (e.g., infant sleep products, ATVs, household cleaners), hidden hazards (e.g., furniture tip-overs, window blind cords), and emerging hazards (e.g., water beads, button batteries, high-powered magnets). Each category highlights different mechanisms of injury and evolving risk patterns that clinicians should recognize.

A key concept we emphasize is the hierarchy of prevention: eliminate, guard, and warn. Eliminating hazards—through recalls, bans, or product redesign—is the most effective strategy, while guarding (e.g., safety features or barriers) provides intermediate protection. In contrast, warnings and education alone are the least effective, given issues such as message fatigue and inconsistent uptake by caregivers.

We also examine how injury prevention is operationalized at a systems level. Surveillance systems like the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System and public reporting platforms such as SaferProducts.gov play a critical role in identifying hazards. Regulatory approaches include recalls, voluntary consensus standards, and, when necessary, federal legislation. However, because much of the system relies on manufacturer compliance and post-market data, there are inherent delays between hazard identification and meaningful intervention.

Clinicians have a critical role within this ecosystem. Beyond providing anticipatory guidance, pediatric providers can contribute to surveillance through reporting injuries, participate in standards development, and advocate for stronger safety regulations. Clinical encounters offer repeated opportunities to deliver targeted, developmentally appropriate safety counseling—for example, discussing choking hazards in toddlers or safe sleep environments for infants.

Finally, we highlight an important reframing: the presence of a product on the market does not equate to safety. Families should be counseled to approach products—particularly secondhand or novel items—with caution, check recall databases, and prioritize products from reputable manufacturers.

Pediatric clinicians are uniquely positioned to bridge these domains and play a central role in advancing safer product environments for children. For instance, when I see a child in the emergency department for a foreign body ingestion, I take that opportunity to counsel the family on the dangers of button batteries or high-powered magnets. While most foreign body ingestions are benign and require no intervention, there are some products that are innately dangerous and pose a risk the public may not know about. Additionally, if I see a child with an injury from a product like an electric scooter, I report that injury on SaferProducts.gov to allow improved identification and tracking of emerging risks. Overall, reducing pediatric consumer product injuries requires a coordinated approach that integrates surveillance, regulation, clinician engagement, and caregiver education.