At a recent baby shower, a pregnant colleague received a pacifier with an attached fuzzy lamb — easier to find and keep in the infants’ mouth. We all oohed and ahhed. But perhaps this darling little sucking device should have come with a black box warning: a new study found that every four hours a child is treated in the emergency department for injuries related to her pacifier, sippy cup or baby bottle.

In what’s being called the first study of its kind, researchers estimate that on average 2,270 injuries per year in the U.S. are related to mishaps involving these ostensibly soothing devices. Most of the accidents examined here involved falls with the product in the child’s mouth.

The study, published in the journal Pediatrics, and conducted by researchers at the Center for Biobehavioral Health and the Center for Injury Research and Policy at Nationwide Children’s Hospital also found (according to the news release):

…that from 1991 to 2010, an estimated 45,398 children younger than three years of age were treated in U.S. emergency departments for injuries related to the use of these products. This equates to an average of 2,270 injuries per year, or one child treated in a hospital emergency department every four hours for these injuries.

The study [released online May 14 and published in the June print issue of Pediatrics] found that baby bottles accounted for 66 percent of injuries, followed by pacifiers at 20 percent and sippy cups at 14 percent. Body regions most commonly injured were the mouth (71 percent) and the head, face or neck (20 percent).

Most injuries were the result of falls while using the product (86 percent), which suggests that children were walking or running with the product in their mouth at the time of the injury.

“Two-thirds of injuries examined in our study were to one-year-old children who are just learning to walk and more prone to falls,” said the study’s co-author Sarah Keim PhD, MA, MS, principal investigator in the Center for Biobehavioral Health at Nationwide Children’s Hospital. “Having children sit down while drinking from baby bottles or sippy cups can help reduce the occurrences of these injuries.”

Both the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) recommend that children be transitioned to regular, lidless cups at 12 months of age. The AAP also suggests that parents try to limit pacifier use after six months of age as use after that age may increase the risk of ear infections.

“These are products that almost everyone uses,” noted study co-author, Lara McKenzie, PhD, principal investigator in the Center for Injury Research and Policy at Nationwide Children’s Hospital. “Educating parents and caregivers about the importance of transitioning their children away from these products at the ages recommended by the AAP and AAPD could prevent up to 80 percent of the injuries related to baby bottles, pacifiers and sippy cups.”

This is the first study to use a nationally representative sample to examine injuries associated with bottles, pacifiers and sippy cups that were treated in U.S. emergency departments. Data for this study were obtained from the National Electronic Injury Surveillance System (NEISS), which is operated by the U.S. Consumer Product Safety Commission. The NEISS provides information on consumer product-related and sports and recreation-related injuries treated in hospital emergency departments across the country.

Both Drs. Keim and McKenzie are faculty members at The Ohio State University College of Medicine.

But Karen Weintraub, writing the Daily Dose blog today reports that tax day can be very bad for your physical health — and life — particularly when driving.

Looking at 30-years of car accident data, a University of Toronto professor has found that April 15 (or whatever weekday taxes were due that year) is substantially more dangerous than the same weekday a week earlier or later.

Roughly 13 more people die in road crashes on tax day than other days, according to the research published in the April 11 issue of the Journal of the American Medical Association.

Deadline stress was probably a key factor in these extra deaths, said Dr. Donald A. Redelmeier, who led the study and whose research was the first to reveal the dangers of driving while talking on a cell phone.

“Our main finding is that stressful deadlines can contribute to driving errors that can contribute to fatal crashes,” he said. “We use tax day to learn something about stress that may be relevant 365 days a year.”

Passengers and pedestrians are also more likely to die on tax day, Redelmeier said, though it’s not clear whether – for pedestrians – that’s because they were in the wrong place at the wrong time, or – for passengers – because the car they were in was driven or struck by someone distracted by stress.

“We believe that almost every fatal crash could have been avoided by a small change in driver behavior,” said Redelmeier, who also practices medicine at Sunnybrook Health Sciences Centre in Toronto. More than 93 percent of accidents are caused by human error, rather than mechanical failure or roadway problems, he said.

Basic safety practices like wearing a seatbelt, obeying the speed limit, restricting alcohol use, minimizing distractions, and driving with care, save lives, he said.

On March 19, 1991, Larry Brennan broke his neck.

He was 18 years old and suddenly paralyzed. He’s had to use a wheelchair ever since.

At the time of the accident, Larry was a freshman at the University of Massachusetts Amherst; he was in the Bahamas with friends on spring break. The details of the accident are fuzzy, he says, because he was intoxicated at the time, having been on a “booze cruise” all day. He remembers running down the beach, then nothing else. According to his friends, Larry dove into the water. The impact broke his cervical spine.

Initially, when his friends saw him lying face down in the water, they assumed he was snorkeling, and it was several minutes before they realized he was in trouble. He wasn’t breathing when they pulled him out. One of his friends knew CPR, and working with the others, tried to resuscitate him until the ambulance came. Larry coughed up sea water and started to breathe again, but his heart stopped and restarted numerous times before help arrived.

Larry was raised in Wakefield, Massachusetts. In high school, he was a popular, 6-foot-4-inch athlete. He played football and tennis, became an accomplished skier and had many friends. As a freshman at UMass, he was flourishing, and his spring break trip was a highlight.

The accident damaged his spinal cord at the C 5-6 level, basically his lower neck, leaving him a quadriplegic (meaning he has weakness in all four limbs). He can move his shoulders and his upper arms, but not his fingers, and he’s completely paralyzed from the upper chest down, with total weakness in his core trunk muscles and legs. However, Larry’s injury is considered “incomplete” in that his sensory nerve fibers were spared and his sensation is intact. For this, he feels lucky.

Here, Larry talks about coming to terms with his injury and learning to live a productive, happy life — though one he says he wouldn’t wish upon anyone else. He finished college at UMass Boston six years after his injury. Now, he lives alone with his service dog Emmie, and gets help from a home aide. He works full time as a Senior Development Officer at Massachusetts General Hospital; goes on dates, skis and sails, and still hangs out with his high school buddies. As Larry puts it, “the biggest thing for me is that I live a full and active life — similar to how my life would have been had I not been injured. Now, I can’t walk, but this is not so important to me anymore. I care most about my relationships with friends and family, staying active and having fun.”

In meeting Larry, I realized how little I understood about quadriplegia before our interaction. I never really stopped to consider the day-to-day challenges that someone in this situation faces, and the tremendous strength that it takes to overcome these obstacles. Moreover, meeting Larry has made me think about how our fears of the unknown can hinder true and genuine connection in life. When I first met Larry, I was nervous, checking myself, wondering how to be. Should I try to shake his hand or will this make him uncomfortable? Should I offer him food and drink during our meeting or will that be too hard? And so on. Larry has taught me that it is better to just ask, to be direct, and not to let these mundane, functional issues get in the way. Larry has no hang ups about these things, so why should I? We just do some things differently, and that’s all.

(Dr. Annie Brewster is a Boston internist who became interested in storytelling as a way to promote healing among patients. You can hear more of her stories here, here and here, as part of our Listening To Patients series.)

1. Slow down, be safe and embrace an attitude of we’ll-get-there-when-we-get-there (the grill will still be hot when you arrive).

2. Things are far worse elsewhere. For example, here’s a public health professor living in Bangladesh, Tracey Koehlmoos, who’s been blogging for BMJ about the massive number of road traffic deaths where she lives and in poor countries around the world. After writing about the terrible things that happen to others on the treacherous, pothole-laden roads around her, something terrible happened to Koehlmoos: her husband, a U.S. Army colonel, died in a traffic accident last month.

On 27 August 2011, my husband, Colonel Randall L. Koehlmoos, US Army, died in a road traffic accident in Jakarta, Indonesia. The irony of a soldier who has served in every major war and peace action for the past three decades meeting his demise on the streets of Jakarta is not wasted on me, even now in the depths of my grief. It highlights that we are all at risk and that this issue must be addressed before more lives are lost and more families suffer.

Although I write frequently about the boys, I have safeguarded my husband’s privacy with the exception of discussing our commitment to physical activity and the occasional détente over my refusal to provide a salt shaker on the table during family meals. I will tell you now that he was a consummate soldier-statesman who felt passionately about South and South East Asia: the issues, the languages, the culture, and the people.

In December 2010, I wrote about the scourge of road traffic accidents in developing countries. At that time I noted that it was predicted that by 2030, road traffic injuries will be the fifth leading cause of death globally. Already each year approximately 1.3 million people die due to road traffic accidents and an additional 20 to 50 million are injured or disabled in accidents. Despite being home to less than 50% of the world’s motor vehicles, low and middle income countries have 90% of the mortality burden for road traffic accidents.

Drive carefully this weekend, and enjoy the end of summer.

I don’t even want to think about the kinds of sledding injuries that the trauma doctors at Children’s Hospital Boston see. I don’t want to picture them. Let’s just assume that they know what they’re talking about when they beg parents to take some basic precautions as they head to the hill with their children on crusty, white evenings like this one.

This new video featuring Dr. David Mooney, director of the trauma program at Children’s, breaks their wisdom down neatly into six S’s:
Slope — watch out for obstacles
Snow — Not too icy
Sled — should be steerable
Sun — is best, poor visibility increases risk
Sit — the safest position
Snowsuit — hypothermia begins with bad judgment

Helmets of the type used for skiing are recommended, but not as important as these other six, Dr. Mooney said. My own family is just back from the hill with tales of some big kids who showed up with heavy snowboards and almost plowed into several little kids. Maybe we need a seventh S: Sanity.