Tuesday, October 25, 2011

Surviving Fright Night

  Who's the most likely to get hit by a car?

Check your children's candy before they eat it.  Can they can see through their eye holes?  Better yet, don't let them wear a mask at all.  Make sure that costume isn't flammable.  Now, make sure it isn't inflammable.

We get the same advice from  so-called experts every year on Halloween safety.  How much of it, though, is evidence-based?  Let's run through the potential dangers of Fright Night, and see which ones you should really be worried about:

Tampered treats.  FALSE (mostly).  I think this one has been thoroughly debunked, but for those of you who have never wasted an afternoon on Snopes: A criminal justice professor concluded in a 2008 review of Halloween sadism that no child has ever been killed or seriously injured by a contaminated trick-or-treat sweet.  Only 1 child has died of Halloween candy poisoning, and he was poisoned by his own father. 

That’s not to say that sharp objects haven’t found their way into candy bars and apples.  There is exactly one published case report of an adult whose stomach was perforated by a needle thought to be hidden in a Halloween caramel apple.  Most tamperings end up being hoaxes, though, perpetrated by kids who want to freak out their parents.  Some hospitals go so far as to offer free x-rays of Halloween treats, but two published studies discovered no cases of tampered treats in over a thousand bags of candy.  Alarmingly, the authors of one study hid a needle in an apple as a quality control measure, and one out of the five hospitals tested missed the needle.
Drunken teenagers in costume.  TRUE.  I always feel like I’m being shaken down when surly, Goth teenagers appear at my door on Halloween night, thrusting empty pillowcases into my face.  Assuming the Goth get-up isn’t a costume, I should really be thankful that they’re not wearing disguises.  One survey of Halloween behavior in college students found that wearing a costume is significantly associated with alcohol use.  Not only that, but Halloween is one of the hardest drinking times of the year for college freshmen, outstripping even spring break.
Sex offenders lying in wait.  FALSE.  Many states have laws against registered sex offenders passing out treats on Halloween night.  There’s no evidence, though, that molesters use this holiday as an opportunity to prey on kids.  One analysis of over 67,000 nonfamilial child sex crimes found that there was no increase on Halloween, even before the advent of these restrictive policies. These sickos are just as likely to strike on Arbor Day as they are on Halloween.

Getting hit by a car.  TRUE.  The Centers for Disease Control reported in 1997 that pedestrian deaths quadruple on Halloween night.  It’s a good idea to have your kid carry a flashlight or glow stick.  Just beware of….

Glow stick injuries.  TRUE (but minor).  My husband experienced this firsthand when my daughter’s glow stick exploded in his face.  He ran screaming to the sink to rinse out his eyes, which were red and painful for the next eight hours. Witnessing their dad’s chemical burn didn’t traumatize my kids in the least.  On the contrary, they were mesmerized by the glowing splatter on the rug, which resembled an alien crime scene.

The number of glow product exposures reported to poison control centers has been increasing over the years, and the largest spike always occurs around Halloween.  Fortunately, no one has ever been seriously injured, including the twelve misguided individuals who swallowed intact glow sticks.

Sporotrichosis from hay bales.  TRUE.  Sporotric--what?  It’s a rare but ugly fungal skin infection transmitted from contaminated plant material. 

                                                Source: Dermatlas.org
One outbreak of sporotrichosis was traced to hay bales from a Halloween haunted house.  And you thought it was just the scratchy hay from the wagon ride making your butt itch!

Pumpkin carving injuries.  TRUE – unless you use Pumpkin MastersTM tools.    While there aren’t any epidemiologic reports related to these injuries, there was a controlled study of kitchen knives vs. specially designed pumpkin carving tools, performed on cadavers who raised their hands to volunteer:

Kitchen knives caused tendon lacerations in 4 out of the 6 fingers tested, while Pumpkin MastersTM caused none.  (Pumpkin KutterTM severed one finger tendon, much to the company’s dismay, as it had donated its tools for the study.)

Pumpkin seed bezoars.  TRUE.  A bezoar is a collection of ingested, undigested material that causes gastrointestinal obstruction.  Bezoars are most commonly made of hair (usually the patient’s own), but come October, these poor disturbed souls switch to pumpkin seeds.  There are multiple case reports of unshelled seeds getting stuck in traffic somewhere along the GI tract, including the rectum.*  I'll spare you the photo, but for those of you who get a kick out of that sort of thing, you can purchase the article itself.

The undead.  TRUE.  You think I’m kidding?  Then why would the CDC post guidelines on how to survive a zombie attack? Some of their tips include, “Make a list of local contacts like the police, fire department and local zombie response team.”  They also recommend having a first aid kit on hand, though they concede that “you’re a goner if a zombie bites you.”  Reassuringly, the CDC has a plan to investigate and contain any outbreak of what they term “Ataxic Neurodegenerative Satiety Deficiency Disorder.”

Now if only they could teach us how to handle drunken, costumed teenagers.

Stay safe, everyone.

*There are also case reports of rectal bezoars due to watermelon seeds, sunflower seeds, popcorn and prickly pear cactus.  No glow stick bezoars, thankfully.

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