Emergency-department review describes severe, preventable lacerations; prompts call for safety standards

Many households harbor a threat to young children that safety regulations, surprisingly, have overlooked: glass-topped tables and tables with glass panels. A review by Children’s Hospital Boston, in collaboration with Consumers Union, nonprofit publisher of Consumer Reports, finds that glass-table injuries aren’t as rare as one might think, and that many could have been avoided had tempered glass been used.

The report appears in the March issue of Pediatric Emergency Care. Consumer tips and information on other safety-related issues are available in the Consumer Reports safety blog (https://blogs.consumerreports.org/safety).

Although glass doors and windshields are mandated to contain tempered glass, which is four to five times stronger than standard glass and breaks into small fragments that are unlikely to cause injury, no such standards apply to glass tables, neither patio nor indoor furniture. Injuries are typically caused when children jump, sit or fall on glass tables or knock them over. The shattered glass – or jagged edges of broken tables -- can cause severe lacerations, leaving disfiguring scars and damaging tendons and nerves.

“Huge shards of glass are basically like knives. If they sever an artery, they can cause uncontrolled bleeding, and the injury can be fatal,” says Amir Kimia, MD, of the Division of Emergency Medicine at Children’s Hospital Boston, who led the study.

Last December, a Rhode Island girl died from a severe puncture wound to her leg; see https://www.projo.com/ri/providence/content/girl_Dies_12-13-08_9QCKAJG_v19.375420b.html.) After earlier media reports about children seen at Children’s Hospital Boston with severe lacerations (see: https://www3.whdh.com/features/articles/specialreport/BO52162/), Consumers Union collaborated with Kimia on a systematic study.

“This is a serious safety hazard with a simple remedy,” says Donald Mays, Senior Director of Product Safety and Technical Policy for Consumers Union.  “The use of tempered glass can significantly reduce the more than 20,000 serious injuries incurred each year from the use of common annealed glass in furniture.”  

Using a computer algorithm to search electronic records, Kimia and colleagues identified 174 glass-table injuries logged by Children’s emergency department between 1995 and 2007. On reviewing the patients’ charts, they concluded that half of the injuries would have been preventable or less severe with safety glass. Almost two-thirds of patients were boys, and the median age was 3.4 years. Cuts were most often on the face, especially in young children, followed by feet, legs, hands and arms. Forty percent of patients needed imaging to find buried pieces of glass, and 80 percent needed surgical repair.

Kimia notes that although some glass furniture uses tempered glass, there’s no way to tell by simply looking at it.  Promulgation of mandatory standards can ensure that all glass furniture manufactured in the future will enhance the safety of furniture with glass.

Lois Lee, MD, MPH of Children’s Division of Emergency Medicine was senior author of the study, which was conducted without outside funding.  The team is now investigating two other glass-related safety threats: glass thermometers and Christmas ornaments.

Children's Hospital Boston is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 500 scientists, including eight members of the National Academy of Sciences, 11 members of the Institute of Medicine and 12 members of the Howard Hughes Medical Institute comprise Children's research community. Founded as a 20-bed hospital for children, Children's Hospital Boston today is a 396-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children's also is the primary pediatric teaching affiliate of Harvard Medical School. For more information about the hospital and its research visit: www.childrenshospital.org/newsroom.