Consumer rights for child safety products- European Child Safety Alliance

Transcription

Consumer rights for child safety productsEuropean Child Safety Alliance
European Consumer Safety Association
Final Report
Project Leader:
Joanne Vincenten
Consumer rights for child safety productsEuropean Child Safety Alliance
Final Report
The project ‘Consumer rights for child safety products’ was co-ordinated by the European Child Safety
Alliance of ECOSA, Amsterdam, the Netherlands, with financial support of the European Commission,
Agreement nº: B5-1000/02/000394.
September 2004
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Contents
Page
MAIN REPORT
Summary
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Adult beds
Baby walkers
Bath seats or rings
Bunk beds
Changing tables
Child car seats
Child gates/ safety barriers
Child sleep wear
Cots
Fireworks
Goals for soccer or handball
High chairs
Lighters non-child-resistant
Pacifiers
Plastic bags
Playground equipment
Playpens: mesh-sided
Rattles
Small parts (marbles, small balls, strings, toys sold in food etc.)
Strings, cords and necklaces
Strollers
Toy chests
Toys
Trampolines
Window blind or drapery cords
References
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FINANCIAL REPORT
ANNEXES
Annex A
Annex B
Annex C
Annex D
Annex E
Literature review
Product safety organisations
Data tables
EU and related reports
Expert groups
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Summary
Project title: Consumer rights for child safety products
Project duration: November 2002 till June 30, 2004
Introduction
All Europeans consumers and especially our most vulnerable in society, children, have the right to
safety as outlined in the United Nations charter of rights for children. This particularly needs to include
products available on the market place that are promoted as safety devices giving consumers the
expectation that it meets a ‘safety standard’ and will provide protection to their children. Consumers
need education to increase their awareness and knowledge of being informed shoppers and their
rights to attain safe products for children. Consumers also need to be aware of hazards that can occur
while specific products are in use. Currently consumers make the assumption that if a product is
available for purchase that it is safe to buy and use. Many consumers as reported by ANEC
(European Association for the Co-ordination of Consumer Representation in Standardisation) assume
the CE mark is a safety seal, yet at this time there is no universal European mark that approves a
product for safe use. Therefore the need for consumer product safety information that is consistent
across the European market is essential and products are available at a global level.
Deaths and serious injuries related to various children’s childcare products have been reported in
many Member States’ national data systems and through the European Home and Leisure Accident
Surveillance System (EHLASS) data registry in Europe. This has also been reinforced with detailed
data reports from the Consumer Product Safety Council (CPSC) in the United States with products for
children. Deaths and serious injuries related to childcare products and toys do not need to occur.
Raising the awareness of the potential risks before purchasing and using products with children is one
strategy to reduce unnecessary accidents from happening by enhancing the knowledge of consumers
to buy products wisely and use them safely.
Project purpose and objectives
Purpose:
To increase awareness and knowledge of European Consumers of their rights to safe childcare
articles and toys as well as their ability to purchase and use safe equipment for their children.
Objectives:
To research and prepare a recommended list of consumer products that pose injury risks to children.
To launch a communications plan to inform consumers of the researched risks and recommended
actions to take to reduce child injury risks from specific products.
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Project partners
This project was conducted by the European Child Safety Alliance of the European Consumer Safety
Association (ECOSA). The Alliance has an active and established network of 22 countries and 3
international associations that work co-operatively to advance child safety in Europe. A complete list of
Alliance Members can be located on our website under the contact section and annex E of this report.
The project leader was Joanne Vincenten, Director of the European Child Safety Alliance and
research support provided by Mathilde Sector, research associate for the Alliance. Justin Cooper of
the European Consumer Safety Association and Henk Zantvoord of the Consumer Safety Institute of
the Netherlands completed Website development and design.
Expert review and technical support was also provided by the following individuals:
Dirk van Aken
Yvonne Lievens
Morag Mackay
Joe Sibert
Perry Chan
Lotten Strindberg
Wanda Geisendorf
Helena Menezes
Fernanda Polacon
Robert Bell
Ian Scott
Wim Rogmans
Consumer Safety Institute
Cardiff University Wales
Ram Consulting
Konsumentverket
Konsumentverket
Portuguese Association for Child Safety
and Injury Control
Portuguese Association for Child Safety
and Injury Control
Nursery Group Sweden
World Health Organisation
Target group and geographical coverage
The audience for this project are European Consumers in the EU Member States. In particularly the
information and communication pieces focus on parent consumers of young children whom are the most
vulnerable in our society and deals with their leading cause of death, injury.
Approach and methods
A series of steps were undertaken to conduct the work on this project.
First a review of relevant literature was conducted to determine what has already been studied and
reported in a formal method regarding hazards and child related products. This information provided
indications world wide of products that have been reported as potentially dangerous for children and
the specific problems encounter with these products. The literature in this area is not large and
therefore reinforced the need in this project to not only rely on published journal articles regarding
potentially dangerous products, but other forms of information and evidence that certain childcare
products or toys could be a problem for families. Samples of the most relevant articles are available in
annex A of this report. A comprehensive listing of related literature is available on the new Alliance
website (www.childsafetyeurope.org)
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Second a review of key organisations in Europe that are involved with product safety were reviewed
for scope of work and information provided for background and information for this project as well as
the European population in general. Summaries of these organisations can be found in annex B.
Limited information was provided by these organisations for both this project as well as consumer
information in general. No one organisation provides a ‘complete overview’ of products that can be
viewed as dangerous to families, agencies tended to focus on only one or two categories. No one
agency also existed that provided consumers with information on recalled products (the Rapid Alert
System for Non-Food Products (RAPEX system) of the European Commission is for the exchange
between Member States and the Commission, but not targeted to alert consumers, only the
authorities). As well, no reports are produced from RAPEX stating product recalls or safety alerts. It is
not transparent, who and how the Commission deals with the products reported to RAPEX. Therefore
further inquires were made to organisations based outside Europe, including the Consumer Product
Safety Commission (CPSC) in the United States, which currently provides the most specific
information by product. Yet it still was not possible in this organisation to get statistics on which
products were the most dangerous, or a ranking of dangerous products.
Available data was then reviewed to determine which child related products were involved in accidents
with children in the previous 15 Member States of the EU. Data available was very limited in Europe
and currently does not provide a complete or accurate account of the relationship of deaths or injury
hospitalisations that are product related for children or adults. No information was found concerning
the number of deaths, injuries and or property damage resulting from consumer product incidents in
the EU annually. Also no toll free hotline exists for consumers to report product related injuries or
potentially hazardous products to use as a data source.
Through the current European Home and Leisure Accident Surveillance System (EHLASS) an inquiry
of hospitalisations to children due to product related incidents was investigated. This data provides
only a sample of hospitals in some EU Member States that participate and is not representative data
at a national level or for Europe, but this is the currently available data. The injury hospitalisations
provided by this sample of hospitals is detailed in annex C and are used in each of the product
summary sheets that follow in this report. To supplement this data sample, National data was sought
where available to provide a more concrete example of the level of deaths and injuries some products
have caused. These have been also included on the product summary sheets that follow and are
referenced. It should be noted that the CPSC offices in the United States receives product-related
injuries within 24 hours from the hospital via electronic transmission while the EHLASS data takes 1.5
years in some countries and longer in others, to clean and make available to the public.
-
A series of EU and related reports were also collected and reviewed to assist in determining a list of
potentially dangerous child related products along with the previous information described in this
section. The Consumer Product Safety Commission (CPSC), a leader in international product safety,
identified for example the following products as child hazardous products:
Adult Bed/Water Bed Hazards for Children
Age Labeling Issues
Baby Bath Seats/Rings
Baby Back Carriers/Carrier Seats
Baby Gates/Enclosures
Balloons
Booster Seats
Chest Freezers
Children's Toys
High Chairs
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-
Infant Suffocation Issues
Juvenile Furniture
Pacifiers
Rattles
School/Day Care Safety Issues
Shopping Carts
Storage Chests
Strollers/Carriages
Teethers
Walkers
Water Toys
In Europe, home and leisure data was examined concerning injuries caused by falls to a lower level
among 0-4-year-olds from Austria, Denmark, Greece, the Netherlands and Sweden.
It was found that children’s use of several product categories was closely related to age. Children’s
furniture account for between 21 percent (Netherlands) and 34 percent (Sweden) of the injuries from
falls to a lower level in the first living year, but decreased with increasing age in all countries. The
same pattern applied to strollers.
In contrast, injuries due to falls involving playground equipment increased with age to reach between
13 (Greece) and 34 (Netherlands) percent of injuries following falls to a lower level among 4-year-olds.
Bicycles also increase with age, reaching between 4 (Netherlands) and 17 (Denmark) percent among
4-year-olds.
Stairs, chairs and sofas were most frequently involved in falls to a lower level at ages 1 to 3 in all
countries.
Type of injury:
Contusions and concussions were the result of injuries involving children’s furniture, in particular
changing tables, high chairs and baby walkers.
Fractures were strongly associated with injuries involving playground equipment. Wounds were
frequent in connection with bicycles and chairs. The researcher concluded that the majority of the
furniture causing injuries were of low height, such as ordinary beds, chairs and sofas, and products
intended especially for children (such as playground equipment, children’s furniture incl. high chairs,
changing tables, baby walkers and strollers) continue to account for several thousand injuries each
year in the five European countries. (Reference: Falls among Young Children in Five European
Countries -Injuries requiring medical attention following falls to a lower level among 0-4-year-olds - A
study of EHLASS data from Austria, Denmark, Greece, the Netherlands and Sweden. Henrik Nordin,
Swedish Consumer Agency, June 6, 2004 World Conference, available in annex D).
Research in Sweden examined the safety of childcare products from 1998 to 1999. The researcher
analyzed the causes of mild brain injuries at home and during leisure time and the relation to childcare
products, defined as child and baby furniture, nursing tables, baby walkers, toys, baby carriages, sport
equipment for children, playground equipment and security equipment for children.
In 1998 46% of mild brain injuries were due to childcare products, and 48% in 1999. Nursery furniture
caused the most accidents, and baby walkers were the most dangerous childcare products, followed
by playground equipment. (Reference: Emanuelson, I. How safe are childcare products, toys and
playground equipment? A Swedish analysis of mild brain injuries at home and during leisure time
1998-1999. Injury Control and Safety Promotion, 2003, 10(3):139-144.)
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These reports also contributed to information for the product summary sheets that follow on 25 child
related products. The sections of the most relevant reports have been placed in annex D.
With the assistance of all the information describe above, Alliance members made the opportunity
available during their biannual meetings and online communication to discuss the issues of product
safety and those potentially dangerous to children and the outputs to be developed. Meeting minutes
that include references to product safety discussions for this work are enclosed in annex E. Members
provided input into planning the project work, providing research and evidence for developing the list
of products and contents for the product summary sheets, national data examples, review of technical
and promotional materials which includes 25 product summary sheets, a TV and radio spot (which
focuses on one product to be targeted to parents and caregivers of young children as a starting pointbaby walkers, which was viewed by the Alliance as potentially the most dangerous for children) and
new website to make all this information available. A final large group discussion on potentially
dangerous products occurred in Stockholm on September 20, 2004. Discussions regarding dangerous
products and child safety concluded with the drafting of a manifesto representing 21 countries that
participated in the discussions and can also be found in annex E.
Project results
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2
The completion of this project has resulted in the following outputs:
A broad listing of 25 potentially dangerous child related products in Europe (this does not include fad
toy items that appear for short timeframes such as yo yo balls). Standard communication pieces that
can be adapted for use by Member States available for use in various mediums (electronic- television,
radio, video, websites and printed-newspapers, magazines, journals, flyers, poster and press
releases) with 25 product summary sheets, a 30-second TV and radio spot and new Alliance website
to launch these materials.
A position statement in the form of the ‘Stockholm Manifesto’ that addresses product risks and
prevention actions to take at the level of the World Health Organisation, European Commission,
Member States, Business and Non Governmental Organisations.
These outputs are available to the Member States to use for communication with parents to alert them
of potential dangers of child related products currently available in the market place. This completes
the communication plan outlined in the project objectives. The 22 Member States of the Alliance have
made a commitment to launch their next European level campaign on home injuries for children that
will include potentially dangerous products. The Alliance has prepared a new website for these
materials that allows for easy access by all interested parties and professionals in the field of child
safety as well as parents and caregivers.
Conclusions
A wide variety of child related products have been implicated in deaths and serious injuries for children
in the European Union. Consumers and in particular, parent consumers of young children who are the
most vulnerable to injuries have the right to be well informed about potential risks of child related
products when deciding to purchase a product and before it is used. Awareness and knowledge based
materials providing consistent information across Europe for child related products that are readily
available on the European market place is a valuable tool and one method to assist in the reduction of
child deaths and injuries.
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Through the support of the European Commission a small start has begun with this project by
identifying 25 child-related products that pose potential danger to children and making educational
information available for parents across Europe in a consistent manner. As well as creating initial
promotion material to begin to address these potentially dangerous products, such as for baby
walkers. The formal statement of the Stockholm Manifesto will serve as an advocacy tool over the next
year as a call to action for Member States, Business, NGO’s, WHO and the European Commission to
reduce chid injuries including those related to products.
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Further work is needed to enhance the level of communication to parents to make them aware of
product related risks. Some recommendations to consider for this area of work include:
Make transparent at the EU Consumer Affairs how dangerous products are recalled.
Establish a hotline for consumers to call in unsafe products and have follow-up to the concern.
Establish a clearing house of product safety information for consumers
Establish a ‘Fast Track Recall’ system similar to that of the CPSC in the USA
Make available injury records due to products on a population level.
Conduct an annual child safety campaign to increase the parents’ awareness and knowledge of
actions to reduce child accidents.
The European Child Safety Alliance will continue its work to make Europe safer for children and build
from the information and resources gained through the work in this project. As the Alliance is an
established and ongoing platform for child safety work in Europe this issue of child-related product
safety will continue to be addressed in the agenda of work and will work cooperatively with all partners
to achieve gains in this area.
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Adult beds
Why are adult beds a problem?
In Austria for example there were an estimated 935 injuries involving adult beds in children 0-18 years
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of age in 2003 .
In a sample of hospitals in the 15 Member States of Europe in 1998 (latest standardised data
available) there were 4321 hospitalisations of children 0-18 years of age due to an injury involving an
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adult bed .
The United States Consumer Product Safety Commission has reports of more than 100 deaths of
children under age 2, most from suffocation, associated with adult beds. In 2001 these deaths
involved an entrapment, a fall, or a situation in which bedding or the position of the child was related to
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the death. Nearly all of the children, 98%, were babies under 1 year old .
-
How are adult beds dangerous?
Many parents and caregivers are unaware that there are hidden hazards when placing babies on adult
beds. Consumers often think that if an adult bed is pushed against a wall, or pillows are placed along
the sides of the bed, small babies will be safe as they sleep. However, data shows hidden hazards for
babies on adult beds:
Entrapment between the bed and the wall, or between the bed and another object.
Entrapment involving the bed frame, headboard or footboard.
Falls from adult beds onto piles of clothing, plastic bags, or other soft materials resulting in suffocation.
Suffocation in soft bedding (such as pillows or thick quilts and comforters).
Figure 1: Adult bed and child
1 Austrian EHLASS 2003 data, Institute Sicher Leben.
2 Fifteen Member States EHLASS 1998 data, European Commission.
3 Consumer Product Safety Commission, The United States Consumer Product Safety Commission Cautions Caregivers about
Hidden Hazards for Babies on Adult Beds, # 5091, http://www.theunitedstatesconsumerproductsafetycommission.gov/theunited
statesconsumerproductsafetycommissionpub/pubs/5091.htm.
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When buying/ prior to using, what to look for:
- Check that the bed has a firm tight-fitting mattress.
- Buy a bed with the head and footboards as one solid piece rather than ones with gaps/spaces or bars.
- Buy a bed with one mattress rather than a bed with two separate mattresses.
How to use adult beds safely:
- Never let a child sleep alone in an adult bed and always place the baby to sleep on his or her back,
not on the stomach.
- Remove soft blankets and pillows as they may cause suffocation.
- Place a mattress on each side of the bed in case the child falls off.
Alternative:
Place your baby to sleep in a cot next to the adult bed.
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2
Baby walkers
Why are baby walkers a problem?
The Child Accident Prevention Trust in the United Kingdom estimates that more children are injured in
baby walkers than with any other nursery product. The accidents happen even when a caregiver is
nearby. Baby walker accidents typically happen very quickly and there may be little that parents can
do to prevent them. An American study has shown that in nearly 70 per cent of baby walker injuries
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the child was being supervised at the time .
In 2002 in the United Kingdom over 2,350 babies were taken to hospital after being injured while in a
baby walker, almost 70% of them aged less than 1 year. Research has shown that at least a third of
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babies using baby walkers will be injured .
Many parents believe that baby walkers help to teach children to walk. Paediatricians have repeatedly
stressed that this is not true. In fact there is increasing evidence to suggest that baby walkers may
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delay normal child development .
How are baby walkers dangerous?
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Some parents believe that a baby walker is a safe place for their child. But data shows hazards :
Baby walkers are a fall hazard. In a baby walker a child has increased speed, mobility, and reach. This
can lead to a fall down a flight of stairs, a crash into a hot stove, against a table edge or into a glass
door. They offer limited balance to a child not yet completely able to stand or walk. If unstable, walkers
can easily tip over. Most of the injuries are caused by:
•
•
•
Falling down stairs: children in baby walkers can quickly move to the edge of the stairs and fall.
This kind of accident frequently happens when someone forgets to close a basement door or
safety gate.
Tipping over: baby walkers can tip over when children try to cross uneven surfaces such as door
thresholds or carpet edges.
Burns: children in baby walkers can be burned when they touch hot surfaces such as oven doors,
radiators, heaters, and fireplaces. Children can also be burned when they reach and spill hot
liquids such as soup, coffee, or cooking oil. Research in Welsh burns unit revealed that a quarter
of babies aged 6-12 months who were in the hospital with burns and scalds had been in a baby
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walker when the injury occurred . The baby’s upright position in the walker also means that many
of these scalds are on the face and head.
4 Smith, G. et al (1997) Baby walker related injuries continue despite warning labels and public education. Pediatrics, 100 (2),
E1.
5 NSW Health (1998) Baby walkers, stairs and nursery furniture as potential factors for head injuries in infants. A case control
study. State Health Publication (HP) 980064, North Sydney.
6 Petridou, E. et al (1996) Hazards of baby walkers in a European context. Injury Prevention, 2(2), 118-120).
7 Child Accident Prevention Trust Fact Sheets Baby Walkers, January 2004, http://www.capt.org.uk/FAQ/default.htm.
8 Cassells, O. C. S. et al (1997) Baby walkers – still a major cause of infant burns. Burns, 23: 451-3.
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The European Child Safety Alliance does not recommend buying or using a baby walker due to the
high risk. If you decide to still buy a baby walker, it is important to buy one that has safety features to
help prevent falls down stairs:
- Check that the baby walker is too wide to fit through a standard doorway, or
- Check that it has a gripping mechanism to stop the walker at the edge of a step.
- Look for standard EN1273: 2001 to ensure that it meets European standards.
How to use safely:
Voluntary standards have been introduced as well as injury prevention strategies including parent
education and warning labels. In many countries design modifications have been introduced to try to
make baby walkers “safer”. There is however no evidence so far that British and European Standards,
education, warning labels or design modifications have led to any reduction in the number or severity
of baby walker injuries.
-
Buy a gate and make certain it is in use at the top of the stairs. Close all doors.
Keep children away from hot surfaces and containers. Keep hot containers away from the edge.
Beware of dangling appliance cords.
Keep your child in a walker away from toilets, swimming pools and other sources of water.
Stay with the child when he or she is in the walker, and use a walker only on smooth surfaces. Assist
the child over thresholds or carpeting.
Figure 2: Baby walkers
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3
Bath seats or rings
Why are baths seats/rings a problem?
In the United Kingdom for example it is reported that at least six fatal drownings involved the use of
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bath seats for children one year and under .
How are baths seats/rings dangerous to children?
The bath seats/rings usually contain three or four legs with suction cups that attach to the bottom of
the tub. However, the suction cups may suddenly release allowing the bath ring and baby to tip over.
A baby may also slip between the legs of the bath ring and become trapped under it or submerged
below the water. There are numerous cases of the caretaker turning away for a moment or leaving the
child unsupervised to answer the doorbell or telephone that has resulted in the drowning and death of
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children .
Make sure the suction cups grip well.
How to use baths seats/rings safely:
- NEVER, even for a moment, leave your child alone or under another child’s supervision in the bathtub,
even when the child is in a bath ring or seat. Always be at arm’s distance from your baby at all times. If
you must leave the room to answer the phone or the door, take your baby with you.
- Check periodically that the suction cups are gripping well as suction cups will NOT stick to textured,
ridged, appliquéd, or factory designed non-skid bathtub surfaces. Suction cups will not stick to
scratched, chipped, or repainted tub surfaces. After repeated use, the suction cups can become
ineffective.
- Bath rings are intended for use as bath aids while washing your child, they are NOT SAFETY
DEVICES!
Figure 3: Supervision of child in bathseat
9 Jenkins, David. Product safety: Bath seats for babies can give a false sense of security with fatal outcomes, The Royal
Society for the Prevention of Accidents (RoSPA), 2003, http://www.rospa.co.uk/product/pdfs/bathseats2003a.pdf.
10 The United States Consumer Product Safety Commission, Report Bath Seats, CPSC-R-93-5839, 2002,
http://www.cpsc.gov/LIBRARY/FOIA/Foia99/os/bathseat.pdf - 1200.3KB.
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4
Bunk beds
Why are bunk beds a problem?
2
available) there were 379 hospitalisations of children due to an injury involving a bunk bed .
Each year in the United States thousands of children under age 15 receive hospital emergency
room treatment for injuries associated with bunk beds. Most of these injuries are minor and
occur when children fall from the beds. Play wrestling frequently contributes to these
accidents. There are other less obvious yet potentially very serious hazards associated with
bunk bed structures that have entrapped children and resulted in suffocation or strangulation
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deaths .
How are bunk beds dangerous?
Bunk beds are a strangulation/suffocation/collapse hazard. Children have died from strangulation
when entrapped in the guard-rail and from collapse of the mattress foundation. Guard-rails that are
attached to the bed by hooks and remain in place by their own weight can dislodge, allowing a child to
become entrapped under the guard-rail or fall. Deaths have occurred when very young children rolled
off the bed and became entrapped between the wall and the side of the bed not having a guard-rail.
This hazard is not unique to bunk beds. Regular beds can present the same hazard. Suffocation
deaths have occurred when mattress foundations fell on children playing on the floor or occupying the
lowerbunk. Also, children have been hung when playing with ropes on the upperbunk.
- Look for the standard EN 747:1993 to ensure that it meets European standards.
- Guard-rails: Make sure guard-rails are on both sides of the top bunk. Most bunk beds are used with
one side located against a wall and are sold with only one guard-rail for the upper bunk to prevent falls
from the side away from the wall.
- Mattress foundation - The mattress foundation on some bunk beds merely rests on small ledges
attached to the bedframe. They can dislodge, particularly if a child, underneath the bunk, pushes or
kicks upwards on the mattress. Check that the mattress foundation is secure.
- Wrong size mattress - Make sure there is no opening between the mattress and headboard or
footboard. Strangulation deaths have occurred when children fell through openings created between
the mattress and headboard or footboard when a regular length mattress was used in an extra long
bed frame.
11 Consumer Product Safety Commission, Just The Facts, The United States Consumer Product Safety Commission Document
#071,
http://www.theunitedstatessconsumerproductsafetycommission.gov/theunitedstatesconsumerpProductsafetycommissionpub/pu
bs/071.html.
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•
•
•
•
•
•
•
-
-
-
Choose bunk beds that have:
Guard-rails on all sides that are screwed, bolted or otherwise firmly attached to the bed structure
to prevent falls.
Spacing between bed frame and bottom of guard-rails that is no greater than 75 mm.
Guard-rails that extend at least 160 mm above the mattress surface to prevent a child from rolling
off.
Cross ties under the mattress foundation that can be securely attached.
A ladder that is secured to the bed frame and will not slip when a child climbs on it.
A feature which permits the beds to be separated to form two single beds if you have children too
young to sleep safely on the upper bunk.
Choose a mattress that correctly fits your bed so no space exists between the mattress and the
head- or footboard.
How to use bunk beds safely:
Use
Always use two side guardrails on the upper bunk. Keep guardrails securely in place at all times no
matter what the age of the child. Children move about during sleep and may roll out of bed.
Do not permit children less than 6 years of age to sleep in the upper bunk. This is because the safety
standards for bunk beds are based on average measurements of children of this age. The spaces
between the bars and around the mattress have been tested to make sure that a six-year-old could
not get trapped in any part of the bed.
Be sure cross ties are under the mattress foundation of each bed and that they are secured in place
even if bunks are used as twin beds.
Emphasise to children to use the ladder and not chairs or other pieces of furniture to climb into or out
of the top bunk.
Teach children that rough play is unsafe around and on beds and other furniture.
Consider using a night-light so that children will be able to see the ladder if they get up during the
night.
Maintenance or Safety Repair
If spacing between guard-rails and bed frames is more than 75 mm, nail or screw another rail to close
the space to prevent head entrapment.
Keep guard-rails in good repair and securely in place.
Replace loose or missing ladder rungs immediately.
Repair or replace loose or missing hardware, including cross ties immediately.
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5
Changing tables
Why are changing tables a problem?
In Austria for example there were an estimated 715 injuries involving changing tables in children in
1
2003 .
2
available) there were 249 hospitalisations of children due to an injury involving a changing table .
How are changing tables dangerous for children?
Most injuries associated with changing tables occur when children fall from the changing table to the
floor. This occurs when a child is not strapped on the changing table and when a child is unattended
because the caregiver has turned away for a brief moment, or is answering the telephone or the
doorbell.
- Look for standard EN12221: 1999 to ensure the changing table has met European safety standards.
- Look for a table with a wide base for stability and one that has safety straps that are easy to use.
- Check that the changing table will allow you to have all needed supplies nearby.
How to use changing tables safely:
- Always use safety straps on a changing table. But know that children in secured straps can wiggle out
of the straps over time. So have all supplies within arm’s reach prior to changing your baby.
- Be an arm’s length away from your baby on the changing table.
- Take your baby with you when having to leave the room, even for a phone call or to answer the door.
- Never leave your child strapped to the table unattended.
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6
Child car seats
Why are child car seats a problem?
Data from the Royal Society for the Prevention of Accidents (RoSPA) show that every year in the
United Kingdom around 40 children between the ages of 0 and 11 years are killed while travelling in
cars, about 500 are seriously injured and up to 9,000 slightly injured. The Royal Society for the
Prevention of Accidents (RoSPA) states that the proper use of child car restraints would prevent many
12
of these deaths and injuries .
Road safety officers in Scotland found that in 52% of vehicles checked, 28% of children were secured
incorrectly. The commonest errors were loose seat belts and restraint devices not adequately secured
to the seat. Rates of incorrect use were highest in child seat restraints, reaching 60% with two-way
13
seats and 44% with rear facing infant seats .
How can child car seats be dangerous?
In a 50-km/h crash, a child who is not properly restrained would be thrown forward with a force 30 to
60 times their body weight. They would be thrown about inside the vehicle, injuring themselves and
quite possibly seriously injuring (or even killing) anyone else inside the vehicle. They are also likely to
be ejected from the car through one of the windows.
-
-
-
Look for standard ECE/R44/03 to ensure the car seats meets European safety standards.
Choose a seat that is suitable for your child's weight and height. Try to find a retailer who will let you
(or even better, help you) try the seat in your car before you buy it. If this is not possible, make sure
that you can return the seat if it is not suitable, and replace it or get a refund.
Avoid buying a child seat by mail order, unless you are sure that it will fit your car. Do not buy a
second-hand seat, you cannot be certain of its history (it may have been involved in an accident and
been seriously weakened - the damage may not be visible) and often the instructions are missing.
Second-hand seats are likely to be older and not designed to current standards.
Only accept a child seat from a family member or friend, if you are absolutely certain that you know its
history, it comes with the original instructions and it is not too old.
It's safer to fit child seats in the rear of the car, but if necessary they can be fitted in the front. But,
NEVER fit a rearward-facing baby seat in the front if there is an airbag on the passenger side of the
car. If the airbag went off it would strike the seat with considerable force, and could severely injure or
kill your baby.
12 Choosing and Using Child Seats, 2003, http://www.rospa.co.uk/road/factsheets/pdf/carseats/choosing_using_factsheet.pdf.
13 Campbell H, Macdonald S, Richardson P. High levels of incorrect use of car seat belts and child restraints in Fife--an
important and under-recognised road safety issue. Inj Prev. 1997 Mar; 3(1):17-22.
20
How to use child car seats safely:
Rearward facing seats:
• Babies should be in rearward facing baby seats as the injury-reducing effect of these seats was
14
found to be superior to all other child restraints in cars .
• Do not move your child to a forward-facing seat until they weigh at least 9 KGs and can sit up
unaided, but keep them in a rearward-facing seat for as long as possible. Once your child is above
the maximum weight of 13 kilos for a rearward-facing seat or the top of their head is above the top
of the seat, they should be moved into a forward-facing seat. It is not important if their knees are
bent in the seat, provided they are still within the seats weight range.
• National regulations in some member states, Sweden for example, require children as old as three
15
years to travel rearward facing in the back seat .
Also:
• Make sure the seatbelt passes through all the correct guides on the child seat. Some seats have
an alternative routing if the seat belt is too short to go around the main route.
• Push your weight into the child seat as you tighten the seat belt to make sure the child seat is
securely held. There should be no slack in the seat belt. The child seat should rest firmly on the
car seat, with hardly any forwards or sideways movement.
• Never modify the seat or adult seatbelt to make it fit.
• The seat belt buckle should not rest on the frame of the child seat.
• Do not place the child in a car seat on top of a table or couch as the child may rock in the car seat
and cause it to fall over, causing a head injury, or tip on the couch, causing the child to suffocate.
You can also obtain information about the safety performance of some seats from the European New
Car Assessment Programme (EURO NCAP, www.euroncap.com). When possible choose a child seat
that has scored well in their tests.
Use the checklist below from RoSPA to select the child seat that is most suitable for your child and
16
your vehicle .
Is the Child Seat suitable for my car(s)?
The shape of car seats, the length of seat belts and the position of seat belt anchor points differ
between cars. So, not all child seats fit all cars. For instance, the seat belt in a particular car may be
too short to go around a certain child seat. It is essential to check that the child seat you purchase will
fit in your car and that it will fit in all the seat positions you intend to use it. The manufacturer and
retailer should advise you.
Does the child seat fit on the rear side seats? Yes
Does the child seat fit on the rear middle seat? Yes
No
No
14 Carlsson G, Norin H, Ysander L. Rearward-facing child seats--the safest car restraint for children? Accid Anal Prev. 1991
Apr-Jun; 23(2-3): 175-82.
15 A Guide to Child Safety Regulations and Standards in Europe, European Child Safety Alliance, March 2003.
16 RoSPA. Buying a Child Seat: Checklist, http://www.childcarseats.org.uk/choosing/checklist.htm.
21
How helpful is the Retailer?
Some retailers are very knowledgeable about child restraints, others are not. Try to find a retailer who
will let you try the seat in your car first and who will demonstrate how it should be fitted. If this is not
possible, make sure you can return the seat, if it is not suitable.
Will the retailer help me fit the seat? Yes
No
Will the retailer let me try the seat before I buy it? Yes
No
Will the retailer let me return seat if it is not suitable? Yes
Does the retailer provide good advice? Yes
No
No
Does the seat meet the latest safety Standard?
Check that the seat you are buying meets the latest European safety standard: ECE R44.03
Does the seat conform to the European safety standard R44.03? Yes
No
Does my car have airbags?
If your car has an airbag in the front on the passenger's side, you must not use a rearward-facing seat
in the front seat. So make sure, the seat will fit in the rear of your car.
Does my car have a passenger airbag? Yes
No
If so, will the rearward-facing seat fit in the rear of my car? Yes
No
Are the instructions easy to understand and follow?
Many people find fitting child seats difficult. The most important thing is to read and follow the
manufacturer's instructions. Some instruction booklets are clearly written and well illustrated. Others
are difficult to understand and use. Ask to see the instruction booklet before you buy.
Are the instructions easy to read and follow? Yes
No
ISOFIX
A child restraint system called ISOFIX is being introduced. ISOFIX points are fixed connectors in a
car's structure into which an ISOFIX child seat can simply be attached. Many new vehicles have
ISOFIX points built in when they are manufactured, and child seat manufacturers are beginning to
produce ISOFIX child seats which have been approved for use in specific car models.
Does my car have ISOFIX Points? Yes
No
Has the ISOFIX child seat been approved for my specific car model?
Yes
No
22
7
Child gates / safety barriers
Why are child gates a problem?
Baby gates are used at the top and bottom of stairs or in open doorways to prevent toddlers from
falling or entering unsafe areas. But some baby gates themselves are dangerous, or can be misused.
2
available) there were five hospitalisations of children due to an injury involving entrapment in the gate .
How are child gates dangerous for children?
An entrapment and strangulation hazard exists with accordion-style baby gates that have large Vshaped openings along the top edge and diamond-shaped openings between the slats. There are
deaths that occurred when children's heads were entrapped in the V-shaped or diamond-shaped
openings when they attempted to crawl through or over the gates. There are also a number of
incidents where pressure gates have popped out of openings at the top of stairs resulting in children
17
falling down stairs .
-
-
Look for standard EN 1930:2000 to ensure that the baby gate meets European standards.
Do not buy accordion-style child safety gates. Choose a gate with a straight top edge and rigid bars or
mesh screen.
Do not buy a pressure gate to use at the top of the stairs. This type of gate is not bolted to the wall so
it has a higher risk of popping loose and tipping over when a child pushes against it, causing the child
to fall down the stairs.
Be sure the child safety gate is securely anchored in the doorway or stairway it is blocking. Children
have pushed gates over and fallen down stairs.
Follow installation instructions carefully to ensure proper fit. If installed too high from the floor a child
can get trapped in the space underneath.
How to use child gates safely?
- Check to make sure that gates are closed when the child is in the home.
- Each time you use the gate, check that it is securely anchored in the doorway or stairway it is
blocking. Children have pushed gates over and fallen down stairs.
17 The United States Consumer Product Safety Commission, Report 5085, 2001,
http://www.cpsc.gov/CPSCPUB/PUBS/5085.pdf.
23
8
Child sleepwear
Why is children’s sleepwear a problem?
The Department of Trade and Industry reported that 28% of clothing flammability accidents in the
United Kingdom are due to nightwear. Nightdresses and dressing gowns, followed by pyjamas are the
three nightwear garments most frequently involved.
Above average levels of minor accidents occur among all children under 18, the highest being boys
aged 14-17. Above average numbers of severe accidents is highest amongst girls under 18. Overall,
burns account for 99% of all injuries. That is why since 1984 the United Kingdom has set a national
safety standard for children's sleepwear flammability designed to protect children from burn injuries if
they come in contact with an open flame, such as a match or stove burner. A flame resistant garment
does not continue burning when removed from an ignition source in the Netherlands, legislation has
been proposed, but recently it has been decided to maintain voluntary labelling (Convenant between
the ministry and the industry), and to take action against very flammable clothing on the basis of the
18
GPSD only .
In the Netherlands, about 10 children (0-9 years) are submitted to hospitals each year after their
clothing caught fire. About the same number are treated at accident and emergency departments of
hospitals (30 persons in the age group 0-24 years). The portion of sleepwear in these figures is
19
unknown .
A European standard is available for testing the flammability of clothing textiles (EN 1103). In addition,
a standard has been proposed for classification of nightwear according to the burning behaviour (prEN
14878). The latter standard, if adopted, will require children’s nightwear to be relatively slowburning.
However, it is important to realise that all consumer clothing will burn in the end if exposed to flames.
How are children’s sleepwear dangerous?
Children are most at risk from burn injuries that result from playing with fire (matches, lighters,
candles, burners on stoves) while in their sleepwear, just before bedtime and just after rising in the
morning. One reason for the increased proportion of severe of accidents amongst children is that they
are prone to panic rather than attempting to put the flames out. Instead they scream for help, and
continue to burn until an adult (who is usually not too far away) comes to extinguish the fire.
- Buy children's sleepwear that is either flame-resistant or snugfitting.
- Flame-resistant garments are made from inherently flame-resistant fabrics or are treated with flame
retardants and do not continue to burn when removed from a small flame. However, there are health
and environment issues with some flame retardant chemicals.
- Snug-fitting sleepwear is made of stretchy cotton or cotton blends that fit closely against a child's
body. Snug-fitting sleepwear is less likely than loose T-shirts to come into contact with a flame and
does not ignite as easily or burn as rapidly because there is little air under the garment to feed a fire.
18 United Kingdom Department of Trade and Industry. Clothing flammability accidents study. June 1994 URN 94/549.
http://www.dti.gov.uk/homesafetynetwork/cf_raccs.htm.
19 The Netherlands EHLASS data 2003, Consumer Safety Institute.
24
How to use children’s sleepwear safely:
- Loose-fitting T-shirts and other loose-fitting clothing made of cotton or cotton blends should not be
used for children's sleepwear as they catch on fire easily. Only use child sleepwear that is flameresistant or snug fitting.
- Supervise children carefully just before bedtime and just after rising in the morning as this is when
children are at most risk from burn injuries that result from playing with a candle, a lighter, etc. while in
sleepwear.
25
9
Cots
Why are cots a problem?
1
In Austria for example there were an estimated 165 injuries involving children in cots in 2003 .
The United States Consumer Product Safety Commission reports that in the United States
more infants die every year in accidents involving cots than with any other nursery product.
Thousands of infants are injured seriously enough to require treatment in hospital emergency
rooms. Decorative knobs or cornerposts have been implicated in two cases of brain damage
20
and 48 deaths due to strangulation .
How are cots dangerous?
Cot cornerposts: cot cornerposts are a strangulation hazard as children's clothing or other items can
catch on cornerposts or knobs, especially if the child is trying to climb out.
Cot design: cot design may be a strangulation/suffocation hazard as it can create openings that can
entrap a child. If there is more than two fingers’ width between the mattress and the side of the cot, an
infant’s head could get caught in between and the infant could suffocate. If the slats are more than 4.5
cm to 6.5 cm apart, the baby’s body can slide between the slats and the baby can suffocate.
Cot Toys: cot toys are also a strangulation hazard. Remove all cot toys which are strung across cot or
playpen area when your child is beginning to push up on hands or knees or is 5 months of age,
whichever occurs first.
Never hang toys with long strings, cords, loops or ribbons in cots or playpens. Pacifiers should never
be attached by string or ribbon around a baby’s neck.
21
-
-
-
When buying/ prior to using, what to look for :
Look for the standard EN 1130:1996. A crib with this standard will have been designed to make sure
that your baby cannot easily fall out or get his or her head trapped between the bars.
If you buy a second-hand cot or are given one from a friend or family member, you can check the
important measurements yourself: the cot should be at least 50 cm deep to make sure your baby
cannot climb out and bars should be vertical with spacing of 4.5 cm to 6.5 cm between them.
Cots should be on a firm stand and any swinging mechanism should be lockable.
Look for a cot mattress that is smooth, firm and fits the cot –there should not be a gap of more than 4
cm anywhere between the edge of the mattress and the bars of the cot. If the gap is bigger than this
your baby’s head may become trapped causing suffocation.
Remove cornerpost extensions and discard them to prevent suffocation by hanging. Some may be
removed merely by unscrewing, while others may have to be sawed off and sanded smooth.
20 Consumer Product Safety Commission, Some Cot Cornerposts May Be Dangerous, Document #5027,
http://www.cpsc.gov/cpscpub/pubs/5027.html.
21 Child Accident Prevention Trust. Keep Your Baby Safe, 2003, information leaflet,
http://www.capt.org.uk/pdfs/Sample%20keep%20your%20baby%20safe.pdf.
26
22
-
-
-
-
-
-
-
-
-
How to use cots safely :
Remove all soft bedding and pillow-like items, quilts, comforters, sheepskin blankets, etc. from the cot
as they may cause suffocation. Cot bumpers should be used with caution. They can cause your baby
to over-heat because they trap air in the cot. They can also be used to climb on once your baby is
crawling and so can increase the risk of your baby falling from the cot.
Check the cot and replace any missing parts, such as screws, bolts or mattress support hangers,
before placing your child in it. Make sure all screws or bolts are securely tightened. Any screw inserted
into a wood component that cannot be tightened securely should be replaced by one that fits. On cots
where the mattress support is suspended by hangers attached to hooks on the end panels, check
frequently to be sure they have not become disconnected. Check the hooks regularly to be sure none
are broken or bent. Open hooks may allow the mattress to fall. Never use a cot with broken or missing
parts.
Use a mattress that fits tightly. If you can fit more than two fingers between the edge of the mattress
and cot side, the mattress is too small. An infant can suffocate if its head or body becomes wedged
between the mattress and the cot sides. Check the mattress support frequently to make sure it hasn’t
become unhooked from the end panels.
Avoid older cots with headboard and footboard designs that may allow an infant's head to become
caught in the openings between the corner post and the top rail, or in other openings in the top edge
of the headboard structure. These openings may lead to strangulation.
Do not use a cot that has decorative knobs on corner posts. If you already have a cot with such knobs,
the knobs should be unscrewed or sawed off flush with the headboard or footboard. Sand off splinters
and sharp corners, to avoid strangulation.
Never use a cot that has loose or missing slats. Be sure that all slats are securely fastened in place
and the space between slats is no more than 4.5cm to 6.5cm to avoid head
entrapment /strangulation.
If you paint or refinish the cot, use only high quality household lead-free enamel paint and let it dry
thoroughly so there are no residual fumes. Check the label on the paint can to
make sure the manufacturer does not recommend against using the paint on items such as cots.
Whenever the cot is moved, be sure all mattress support hangers are secure.
Always lock the side rail in its raised position whenever you place your child in the cot. As soon as
your child can stand up, adjust the mattress to its lowest position and remove the bumper pads. Also,
remove any large toys-an active toddler will use anything for climbing out of the cot.
When your child reaches 90 cm in height, or can sit without assistance, he/she has outgrown the cot
and should sleep in a bed.
22 Consumer Product Safety Commission, The United States Consumer Product Safety Commission Warns Parents About
Infant Strangulations Caused by Failure of Crib Hardware, Document #5025,
http://www.theunitedstatesconsumerproductsafetycommission.gov/the
unitedstatesconsumerproductsafetycommissionpub/pubs/5025.html.
27
Figure 4 and 5: Cot hazards
28
29
10
Fireworks
Why are fireworks a problem?
In Great Britain in the four weeks surrounding Bonfire Night 2001, 685 children under 16 were treated
in hospital for injuries caused by fireworks - over half of all firework injuries in Great Britain. Many more
boys than girls were injured by fireworks - particularly in the 12 to 15 age group. The number of
23
children injured by fireworks increased by just over 35 per cent between 2000 and 2001 .
In Greece during a 5-year period 91 children came to the emergency department due to a fireworkrelated injury. The estimated annual incidence of childhood firework injuries treated in the emergency
departments of hospitals countrywide was 7 per 100 000 children. A sharp peak in spring was noted
24
when the Greek Orthodox Easter is celebrated .
In the Netherlands about 600-700 injuries due to fireworks are treated at accident and emergency
departments each year. The peak is around New Years Eve, the only period that it is allowed for
consumers to use fireworks. The majority of the victims are male, and the age groups 0-9 years and
19
10-19 years account for 11% and 48% of the injuries .
15
There are no European-wide regulations governing the sale of fireworks .
The Netherlands has forbidden the sale of fireworks to children less than 16 years of age, and since
2002 it is forbidden to use firecrackers/bangers (fireworks without illumination, just a cracking/banging
noise). Only persons over 18 years of age are allowed to buy fireworks in Sweden, and the United
Kingdom has a similar rule.
How are fireworks dangerous?
In the United Kingdom in 2001, as in previous years, rockets caused more accidents than any other
type of firework and young children are at high risk of injuries caused by sparklers. In 2001 sparklers
caused nearly one in ten firework accidents. Nearly seven in ten sparkler accidents happened at a
23
family or private party .
In Greece 70 % of injuries concerned older children (10–14 years), mostly boys with self-inflicted
injuries - they had the firework in their hands as it exploded, whereas girls suffered injuries as
bystanders. Illicitly sold fireworks caused most injuries, but in eight instances home-made firecrackers
24
were responsible .
23 Child Accident Prevention Trust, Factsheets: Firework accidents, 2002, http://www.capt.org.uk/FAQ/default.htm.
24 Konte Vassilia, Petridou Eleni, Trichopoulos Dimitrios. Firework-related childhood injuries in Greece: a national problem.
Burns. 30(2004)2:151-153.
30
25
- If fireworks are legal where you live, only purchase those in a commercial store.
- Fireworks made illegally may not be properly constructed and may explode improperly, resulting in a
higher risk of injury.
25
How to use fireworks safely :
If fireworks are legal where you live and you decide to set them off on your own, be sure to follow
these important safety tips:
• Never allow children to play with or ignite fireworks.
• Read and follow all warnings and instructions.
• Be sure other people are out of range before lighting fireworks.
• Only light fireworks on a smooth, flat surface away from the house, dry leaves, and flammable
materials.
• Never try to relight fireworks that have not fully functioned.
• Keep a bucket of water handy in case of a malfunction or fire.
• Do not keep fireworks in the hand unless the instructions specifically allow this.
25 Consumer Product Safety Commission, Fireworks Safety Tips
http://www.theunitedstatesconsumerproductsafetycommission.gov/theunitedstatesconsumerproductsafetycommissionpub/pubs/j
uly4/millin.pdf.
31
11
Goals for soccer or handball
Why are soccer goals a problem?
available) there were 483 hospitalisations of children 0-18 years of age due to an injury involving a
2
soccer goal .
In Portugal there were a few deaths and some very serious injuries resulting in permanent disability,
mostly to boys from 8 to 16 years old from a handball goal. The injuries took place when children were
26
playing by themselves in public access playing fields or school playgrounds .
The United States Consumer Product Safety Commission knows of four deaths in 1990 alone and at
least 21 deaths during the past 16 years (1979-1994) associated with movable soccer goals. In
addition, an estimated 120 injuries involving falling goals were treated each year in United States’
27
hospital emergency rooms during the period 1989 through 1993 .
There are European standards for handball goals (EN 748) and soccer goals (EN 749), but they only
deal with organised training and competition and not school and leisure use. There are no technical
requirements at present contained in the standards to properly address the fixation and stability for
15
goals .
27
How are soccer goals dangerous to children?
The serious injuries and deaths are a result of blunt force trauma to the head, neck, chest, and limbs
of the victims against the goal. In most cases this occurred when the goal tipped or was accidentally
tipped onto the victim. In one case an 8-year-old child was fatally injured when the movable soccer
goal he was climbing tipped over and struck him on the head. In another case, a male died from a
massive head trauma when he pulled a goal down on himself while attempting to do chin-ups. In a
third case, while attempting to tighten a net to its goal post, the victim’s father lifted the back base of
the goal causing it to tip over striking his 3-year-old child on the head, causing a fatal injury.
27
- Buy a soccer goal that is professionally made. The common dimensions of a full-size goal are
approximately 7.3 m in width by 2.4 m in height and 1.8 m in depth. Check that the soccer goal is easy
to anchor firmly in place.
26 Interview with Helena Menezes, Director of the Portuguese Association for Child Safety and Injury Control (APSI),
September 7, 2004.
27 Consumer Product Safety Commission, Guidelines for Movable Soccer Goal Safety, 1995,
http://www.cpsc.gov/CPSCPUB/PUBS/Soccer.pdf.
32
- Buy a stable soccer goal:
•
•
•
One effective design alternative uses a counterbalancing strategy by lengthening the overall depth
of the goal to effectively place more weight further from the goal’s front posts (more weight at the
back of the goal).
A second design selects lightweight materials for the goal’s front posts and crossbar and provides
much heavier materials for the rear ground bar and frame members. This tends to counterbalance
the forces working to tip the goal forward.
Another design uses a heavy rear framework and folds flat when not in use, making the goal much
less likely to tip over.
How to use soccer goals safely:
- Store goals properly when not in use. The majority of the incidents investigated did not occur during a
soccer match. Most of the incidents occurred when the goals were unattended. Therefore, it is
imperative that all goals are stored properly when not being used.
When goals are not being used always:
• Remove the net.
• Place the goal frames face to face and secure them at each goal post with a lock and chain.
• Lock and chain to a suitable fixed structure such as a permanent fence.
• Lock unused goals in a secure storage room after each use.
• If applicable, fully disassemble the goals for seasonal storage, or
27
• if applicable, fold the face of the goal down and lock it to its base .
- Securely anchor or counterweight movable soccer goals at ALL times.
- Check for structural integrity and proper connecting hardware before every use. Replace damaged or
missing parts or fasteners immediately.
- NEVER allow anyone to climb on the net or goal framework.
- Always exercise extreme caution when moving goals and allow adequate manpower to move goals of
varied sizes and weights. Movable soccer goals should only be moved by authorised and trained
personnel.
- Always instruct players on the safe handling of and potential dangers associated with movable soccer
goals.
- Movable soccer goals should only be used on LEVEL (flat) fields. Movable soccer goals can fall over
and kill children who climb on them or hang from the crossbar.
33
12
High chairs
Why are high chairs a problem?
1
In Austria for example there were an estimated 550 injuries involving high chairs in children in 2003 .
2
high chair .
How are high chairs dangerous?
- High chairs are a fall hazard. The majority of the injuries result from falls when restraining straps are
not used and when children are not closely supervised. Babies can slip out of a high chair in an instant
if not properly strapped in.
- Deaths also occur. The majority of deaths occurred when children slipped down under the tray and
were strangled. Most often, these children were either unrestrained or were restrained only by a waist
belt.
- An unstable high chair can tip over with the baby in it. High chairs may tip if an active child pushes off
from a table or wall, stands up in the high chair, or rocks it back and forth, leading to head injuries from
falls. Fingers can also be injured when putting the tray in place.
- Look for standard EN 1178:1994 to ensure the high chair meets European safety standards.
- Select one that has a wide base for stability.
- To help prevent injuries and deaths, high chairs should have a waist strap and a strap that runs
between the legs. Examine the straps to ensure that the waist belt has a buckle that cannot be
fastened unless the crotch strap is also used.
- Since the restraining straps must be used every time a child is placed in the chair, look for straps that
are easy to use. If the straps are difficult to use or take too much time to fasten, you might not use
them.
- Consider a high chair that has a post between the child's legs to prevent the child from slipping down
and becoming trapped under the tray.
- Make sure there are no sharp edges on the tray and check regularly to see that there are no loose
nuts or other small parts. Do not use a chair if the plastic has split and any foam is exposed.
- If you are using a table mounted chair look for one that is made to the national or European standards
(EN 1272:1998) and is for use on a solid table. It cannot be used on glass or single pedestal tables.
How to use high chairs safely:
- High chairs should have a waist strap and a strap that runs between the legs. If you have a high chair
without built in five-point harness, you can fit one yourself. When buying a separate harness look for
one made to national or European standards. Use the harness every time you use the chair.
- The crotch strap alone will not be sufficient to hold your baby securely. Without two straps, children
can stand in the chair seat and topple from the chair, or slide under the tray and strangle on the waist
strap or when their heads become trapped between the tray and the chair seat. Some high chairs also
come with shoulder straps.
34
- Make sure that all safety belts or straps on the high chair are adjusted to the size of your child and
securely fastened and that the tray is properly secured. The tray should not be used as a restraining
device in place of the straps.
- Check the condition of straps and their attachments often to make sure they are securely attached and
work properly. Only safety straps keep the child from climbing out or sliding down and strangling.
- Be sure that the locking device on a folding high chair is locked each time you set up the chair.
- Never allow a child to stand up in a high chair as this can cause tipping.
- Stay close to your child while they are in the high chair - especially if the child has shown an ability to
unfasten safety straps.
- Keep the chair away from “traffic lanes,” doorways, refrigerator and stove, and far enough away from a
table, counter, wall, or other surface so that a child can't use them to push off or reach hot or sharp
items from surfaces.
- Don't let a child climb into it unassisted.
- Don't let older children hang on to a high chair or climb on it while a baby is in it. The high chair could
tip over.
35
13
Lighters: non-child-resistant
Why are non-child-resistant lighters a problem?
A study completed in the United States showed that 71% of cigarette lighter fires were started by
children younger than age five. In 1994 the United States passed a safety standard for child resistant
cigarette lighters. From 1994 to 1998 there was a 58% reduction in fires started by children younger
28
than age five, resulting in $566.8 million saved .
15
There exists the European standard EN 13869 that deals with child resistance for lighters .
29
How are non-child-resistant lighters dangerous to children?
Children as young as 2 years old are capable of operating lighters, but the majority of the children who
start fires by playing with lighters are ages 3 and 4. At these ages, children are curious about fire but
don't understand the danger. Typically, when children start a fire, they will leave the room without
telling anyone about the fire.
Purchase a lighter that says on the packaging that the lighter is child-resistant. Remember, these
lighters are child resistant, not childproof.
How to use child-resistant lighters safely:
- Keep lighters and matches out of the reach of children.
- Never use a lighter as a source of amusement for children. This may encourage children to think of
lighters as a toy and try to light one on their own.
28 Smith, L.E., Greene, M.A., Singh, H.A. Study of the effectiveness of the U.S. safety standard for child resistant cigarette
lighters. Inj Prev 2002. 8(3):192-196.
29 Consumer Product Safety Commission, Child-Resistant Lighters Protect Young Children, Report #5021,
36
14
Pacifiers
Why are pacifiers a problem?
Pacifiers have caused injury and death in children due to strangulation and suffocation.
How are pacifiers dangerous to children?
Pacifiers are a suffocation hazard. There are reports of infants strangling on pacifiers and pacifier
cords, ribbons, keycords, lanyards tied around their necks. Children have caught pacifier cords on cot
30
corner posts, cot toys and gyms, pieces of furniture, and even doorknobs .
- Pacifiers must be strong enough to not separate into small pieces on which a baby could choke or
suffocate.
- Pacifier guards or shields must be large enough and firm enough to prevent the pacifier from being
drawn entirely into a baby's mouth.
- Pacifier guards or shields must have ventilation holes.
- Do not buy a pacifier with a ribbon, string, cord, or yarn attached as it presents a
- strangulation danger.
How to use pacifiers safely:
- Remember, NEVER HANG a pacifier AROUND YOUR child’s NECK. Use pacifiers that have a short
string and clip it to the child’s clothing.
- Pacifiers may deteriorate with age, exposure to food, sunlight, etc. Inspect them frequently and
discard immediately if you notice a change in texture, tears, holes or weakening.
Figure 6: Pacifier hazard
30 Consumer Product Safety Commission, Document # 202, The Safe Nursery, http://www.cpsc.gov/cpscpub/pubs/202.pdf.
37
15
Plastic bags
Why are plastic bags a problem?
The Consumer Product Safety Commission in the United States regularly receives data on injuries
involving products. It reports an average of about 25 reports a year in the United States of deaths to
31
children who suffocated due to plastic bags. Almost 90 percent of them were under one year of age .
31
How are plastic bags dangerous for children?
Plastic bags are a suffocation hazard. Children have suffocated when plastic bags (dry-cleaning,
garbage or trash bags, bags from packaging of toys or produce shopping) have blocked the nose and
mouth and prevented breathing.
Cases reported were:
• Child pulled plastic dry-cleaning bag over face while lying on adult bed.
• Plastic garbage bag (filled with clothes) fell over child’s face and mouth while child was on adult
bed.
• Child crawled into plastic garbage bag.
• Child rolled off mattress onto plastic bag filled with clothes.
• Child slept on mattress covered by plastic bag.
-
How to use plastic bags safely:
Store plastic bags out of the reach of children in a secure storage area or discard them immediately.
Use cloth or paper bags to make it safer for children and better for the environment.
Do not allow children to play with plastic bags.
Do NOT use a plastic mattress cover.
Never put children to sleep on or near plastic bags.
31 Consumer Product Safety Commission, Children Still Suffocating with Plastic Bags, Document #5064, 2001,
http://www.cpsc.gov/cpscpub/pubs/5064.pdf.
38
16
Playground equipment
How is playground equipment a problem?
A study in Athens, Greece identified 777 injuries in public and private playgrounds in Athens in 1999.
The annual incidence of playground injuries in was about 7 in 1000 among boys and 4 in 1000 among
girls, with two times higher risk for an injury to occur in a public playground compared to a private
playground. It was found that approximately 50% of playground injuries could be prevented by
structural and equipment changes, while further reduction could be accomplished through simple
32
measures including closer supervision, and encouraging children to wear proper shoes .
In the Netherlands, about 12,000 injuries are treated at accident and emergency departments each
year associated with playground equipment. Children (0-9 years) are involved in about 75% of these
injuries. The highest incidence is in the age group 5-9 years: about 6 per 1,000. There are about 840
19
hospitalisations each year .
How can playground equipment be dangerous?
Most playground injuries occur when a child falls from the equipment onto the ground. Death can
occur when a child’s head is caught in an opening in playground equipment and strangles, or when
clothing gets caught on the equipment, such as a clothing drawstring and the child strangles.
When buying/prior to using, what to look for:
- There are no European regulations on playgrounds, but there are voluntary European standards
dealing with playground equipment and impact absorbing surfaces. Look for the following voluntary
15
European standards EN 1176:1998 and EN 1177:1998 for impact absorbing surfaces .
- Buy playground equipment that is professionally made and have it installed by professionals.
- Check that the playground equipment you want to buy is age-appropriate and that you have enough
space for in.
- Make sure play structures higher than 60 cm have a falling space of at least 1.5 m; for equipment
higher than 1.5 m, this space increases gradually up to 2.5 m.
- Check for dangerous hardware, like open "S" hooks or protruding bolt ends.
- Make sure spaces that could trap children, such as openings in guard-rails or between ladder rungs,
measure less than 9 cm or more than 23 cm to prevent possibles head entrapment.
- Check for sharp points or edges in equipment.
33
How to use playground equipment safely :
- Install and maintain a shock-absorbing surface around the play equipment.
- Use at least 30 cm of wood chips, mulch, or shredded rubber for play equipment. Or, use surfacing
mats made of safety-tested rubber or rubber-like materials.
32 Petridou E, Sibert J, Dedoukou X, Skalkidis I, Trichopoulos D. Injuries in public and private playgrounds: the relative
contribution of structural, equipment and human factors. Acta Paediatr. 2002;91(6):691-7.
33 Consumer Product Safety Commission, Handbook for Public Playground Safety, #325,
http://www.theunitedstatesconsumerproductsafetycommission.gov/theunitedstatesconsumerproductsafetycommissionpub/pubs/
325.pdf.
39
- Install protective surfacing at least 2 m in all directions from play equipment. For swings, be sure
surfacing extends, in back and front, twice the height of the suspending bar.
- Never attach - or allow children to attach-ropes, jump ropes, clotheslines, or pet leashes to
- Play equipment; children can strangle on these.
- Check for hardware such as open "S" hooks or protruding bolt ends, which can be hazardous.
- Check for spaces that could trap children, such as openings in guard-rails or between ladder rungs;
these spaces should measure less than 9 cm or more than 23 cm.
- Make sure platforms and ramps have guard-rails to prevent falls.
- Check for sharp points or edges in equipment.
- Remove tripping hazards, like exposed concrete footings, tree stumps, and rocks.
- Regularly check play equipment and surfacing to make sure both are in good condition.
- Carefully supervise children on play equipment to make sure they are safe.
• Check the safety netting for tears or frays. Torn netting could allow a child to climb onto the outer
portions of the equipment and fall onto a hard surface.
Check floor surfacing for tears. Floor surfacing should not be torn, in order to prevent trips or ankle
sprains. If mats are used they should be placed tightly together and should not be torn, in order to
prevent trips or ankle sprains.
• Remove clothing strings, necklaces, earrings and all loose items in pockets before the child enters
the playground. Loose hanging strings and jewellery can get caught in play equipment.
• Do not allow children to play or linger at the base of slides or climbing equipment. A child playing
at the base of the equipment could be struck by a child above.
- Put all outdoor climbing equipment on surfaces such as sand or mulch to prevent children's head
injuries. Children's plastic climbing equipment should not be used indoors on wood or cement floors,
even if covered with carpet, such as indoor/out-door, shag or other types of carpet. Carpet does not
provide adequate protection to prevent injuries. There are reports of two children killed and hundreds
injured at home and at day-care centres when they fell from climbing equipment placed indoors on
cement, wood or carpeted floors.
- On a hot day check for hot surfaces on metal playground equipment before allowing young children to
play on it. A child may be burned by touching such a surface.
40
17
Playpens: mesh-sided
Why are mesh-sided playpens a problem?
Playpens that are mesh-sided have been reported to cause injury and death due to head injury or
suffocation.
How are mesh-sided playpens dangerous for children?
Mesh-sided playpens are a suffocation hazard. A child’s head can be trapped if the playpen collapses.
Deaths have also occurred in playpens or travel cots that have a rotating hinge in the centre of each
top rail to enable the product to be folded into a compact package. These deaths resulted when the
top rails collapsed and formed an acute 'V' shape that entrapped the child's neck. In the entrapment
incidents, the hinges were either not turned inward and down or they somehow rotated during use to
the unlocked position.
Some playpens have a hinge at the centre of each top rail with a latching mechanism that locks
automatically when the rail is lifted into the normal use position. To fold these products, a
button or other release mechanism must be used to release the latch. Such products, while
similar in appearance to those with rotating hinges, are not known to have been involved in
34
any fatal entrapment incidents .
-
Look for standard EN 12227:1999 to ensure the playpen meets European standards.
For playpens with a hinge in the centre of each of the four top rails, look for a playpen or travel cot that
has top rails that automatically lock when lifted into the normal use position.
Look for mesh netting with a very small weave (less than 7 mm)-smaller than the tiny buttons on a
baby's clothing.
Slat spaces on a wooden playpen should be no more than 65 mm in width.
Check to see if the playpen has a hinge at the centre of each top rail that must be turned toward the
inside of the cot and down to prevent folding. Use of this type of product is not recommended.
34
-
-
How to use playpens safely :
Always show babysitter/caregiver how to properly set up playpen according to the manufacturer's
instructions. Improper set-up can cause the playpen to collapse, resulting in injury or death to the
child. Check prior to each use that the playpen is securely locked into the open position so it cannot
collapse.
Never leave an infant in a mesh playpen with the drop-side down. Infants can roll into the space
between the mattress and loose mesh side and suffocate. Even when a child is
Not in a playpen, leave the drop-side up. Children may try to climb back into a playpen and cut or
pinch their fingers on the unlocked hinge mechanism.
Remove large toys, bumper pads, or boxes from inside the playpen. They can be used for climbing
out.
Avoid tying any items across the top or corner of the playpen; they can be a strangulation hazard.
34 Consumer Product Safety Commission, Infants Can Suffocate In Mesh Drop-Sided Playpens, The United States Consumer
Product Safety Commission Document #5058,
5058.pdf.
41
- Toys should not be hung from the sides with strings or cords because they could wrap around a child's
neck. Use another method for attaching the toys to the playpen.
- Children may use the top rail of the playpen for teething. Check vinyl or fabric-covered rails frequently
for holes and tears. A teething child can chew off pieces and choke.
- If staples are used to attach the mesh side to the floor plate, make sure none are loose or missing.
- Examine the mesh and its attachment to the top rail and floor frequently for loose threads. There have
been reports of entanglements in threads (stitching) that unravelled.
- Never use a playpen with holes in the mesh sides. These could entrap a child's head and cause
strangulation.
- Never use a playpen with a hinge in the centre of each of the four top rails that fold if each top rail
does not automatically lock when the rail is lifted into the normal use position.
- Never use a pad that does not fit snugly and never add a second pad or mattress. Babies have
suffocated when trapped between mattresses or between the playpen side and mattress that was too
small.
Figure 7 and 8: Mesh-sided playpen hazard
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18
Rattles
Why are rattles a problem?
Rattles have been reported to cause suffocation in children.
How are rattles dangerous for children?
Rattles can be a choking/suffocation hazard. To date, the largest rattle known to have lodged in an
infant's mouth/throat had an end about the size of a golf ball. Squeeze toys and teethers have been
involved in similar choking incidents. Rattles, squeeze toys and teethers involved in incidents had
handles or ends small enough to enter a baby's mouth and lodge in the throat, blocking the airway.
Because children have choked to death on baby rattles, the United States Consumer Product Safety
35
Commission issued a regulation in 1978 requiring:
that rattles be large enough to prevent them from becoming lodged in an infant's throat and
that they be sturdily constructed to prevent them from separating into small pieces that can be
swallowed or inhaled.
1
2
Do not buy rattles, squeeze toys, teethers and other toys with ball-shaped ends. Choose handles too
large to lodge in a baby's throat. To test this, place the end of the handle into an empty toilet paper
roll, and if it fits into the roll then it is too small and could be a choking hazard.
-
-
How to use rattles safely:
Check that the rattle is large enough so that it cannot enter the infant's mouth using the toilet paper roll
test, to prevent the rattle from becoming lodged in the back of the throat.
Check all rattles, squeeze toys and teethers for small ends that could extend into the back of the
baby's mouth, be swallowed or inhaled. If you feel that the toy may be too small for safety, throw it
away.
Take rattles, squeeze toys, teethers, and other small objects out of the cot or playpen when the baby
sleeps.
Teethers, like pacifiers, should never be fastened around a baby's neck.
Avoid rattles and squeeze toys with ball-shaped ends.
35 Consumer Product Safety Commission, CPSC Warns Consumers of Dangers With Infant Rattles, CPSC Document #086,
http://www.cpsc.gov/cpscpub/pubs/5070.html.
43
19
Small parts (marbles, small balls, toys sold in foods, etc.)
Why are small parts a problem?
Small parts such as marbles, small balls, and toys sold in foods are known to cause injury and death
in children. In a sample of hospitals in the 15 Member States of Europe in 1998 (latest standardised
data available) there were 52 hospitalisations of children 0-18 years of age due to an injury involving a
2
marble .
A study regarding accidents due to suffocation from small parts carried out by the Centre for Research
and Prevention of Injuries among the Young (CEREPRI) identified 8 cases of deaths throughout
Europe during a three-month period due to suffocation from small parts. CEREPRI estimated that the
annual number of injuries due to such products would be 117 cases per year in Greece alone and
36
about 2000 cases in the EU as a whole .
A study carried out in Germany reported there might be as many as 84 accidents a year from such
products requiring medical treatment. Over 90% of accidents involved children under 5 years of age,
therefore this age group has the greatest risk of injury. The most common causes of injury were the
result of children ingesting the small toy or its parts that lodge in the stomach, lung or ear. Toys in
chocolate eggs were identified as the most common source of accidents, being cited in the vast
36
majority of cases .
15
Draft legislation exists in Portugal and Greece to ban toys sold in foods or warning labels .
How are small parts dangerous?
Small parts are a choking/suffocation hazard. Smooth round objects present the highest risk of
choking. Children between the ages of 4 and 36 months are at risk from suffocation by hollow, cylinder
objects through suction formation and complete airway obstruction. Shallow containers with
dimensions ranging from approximately 6.0 to 11.0 cm have been reported to be especially hazardous
37
as they increase the risk of suction-type suffocation .
Uninflated balloons and balloon pieces lying on the ground after the balloon has exploded can easily
be inhaled into the lungs and are extremely difficult for medical personnel to remove.
- Check the size of any surprise toys in food packages for children as these toys may cause suffocation.
- Look for age appropriate labels when purchasing items.
- Check that the small part is large enough so that it cannot enter the infant's mouth by using the toilet
roll test: try to place the part inside an empty toilet roll. If it passes through the roll, then it is too small
and can become lodged in the back of the throat.
36 Presentation by Antiopi Sotiriou, Edibles commingled with inedibles: an example of good practice that has been advocated
successfully?, Berlin, Germany, European Child Safety Alliance Business Meeting, November 2003.
37 Nakamura, S.W., Pollack-Nelson, C., Chidekel, A.S. Suction-type suffocation incidents in infants and toddlers /. Pediatrics
11(2003)1(Jan)e12-e16.
44
How to use small parts safely:
- Do NOT allow children under the age of six to play with uninflated balloons without supervision.
Immediately collect the pieces of broken balloons and dispose of them out of the reach of young
children.
- Keep small balls and other smooth round objects away from those who have a tendency to put such
objects in their mouths.
- Separate toys that are for younger children, less than 3 years old from those for older children, more
than 3 years old, and store them apart.
45
20
Strings, cords and necklaces
Why are strings/cords/necklaces a problem?
2
available) there were 117 hospitalisations of children due to an injury involving a clothing drawstring .
In recent years the United States Consumer Product Safety Commission (which collects data on
unsafe products regularly) has received reports of two to three deaths annually to children under two
years old who were strangled by strings, cords, ribbons, or necklaces around their necks. Most of the
deaths involved pacifiers tied around the child’s neck. Many of the others involved necklaces. From
1985 to1999 the United States Consumer Product Safety Commission received reports of 22 deaths
38
and 48 non-fatal incidents involving the entanglement of children’s clothing drawstrings .
38
-
-
-
-
How are strings/cords/necklaces dangerous?
Strings, cords, necklaces are a strangulation hazard. Usually, the string, cord, or necklace caught on
some product such as a cot or playpen. In other cases, the string or cord became tightly wrapped or
twisted around the child’s neck.
Over two-thirds of the deaths and non-fatal incidents involved hood/neck drawstrings on upper
outerwear. The majority of these cases involved playground slides. Typically, as the child descended
the slide, the toggle or knot on the drawstring got caught in a small space or gap at the top of the slide.
Examples of catch points include a protruding bolt or a tiny space between the guard-rail and the slide
platform. As the child hung by the drawstring, suspended part way down the slide, the drawstring
pulled the garment taut around the neck, strangling the child. Victims of these cases ranged in age
from 2 through 8 years old.
In one case, a 5-year-old girl strangled after the drawstring on her jacket hood caught on the slide at
her school.
One incident involved a fence. A 4-year-old girl strangled after the hood drawstring on her coat
became entangled on a fence as she attempted to climb over it.
Two strangulations occurred in cots. In one case, an 18-month-old child was found hanging from a
corner post of his cot by the tied cord of the hooded sweatshirt he was wearing.
Another little girl was hanged by the drawstring of her sweatshirt in her cot the first time she wore the
sweatshirt.
It is recommend that consumers purchase children's outerwear with alternative closures, such as
snaps, buttons, or Velcro, instead of long, loose drawstrings.
38 Consumer Product Safety Commission, Guidelines for Drawstrings on Children's Outerwear, Document # 208,
46
How to use strings/cords/necklaces safely:
- Never tie pacifiers or other items around your child's neck. Use a pacifier that is hung on a short string
and clip it to your child’s clothing.
- Never leave cords of any kind near an infant. If a piece of clothing has cords, remove the cords before
dressing the child in this clothing. Take off bibs, necklaces or other clothing tied around a child’s neck
before putting the child in a cot or playpen.
- Necklaces are not recommended for use under 2 years of age.
Figure 9: Clothing drawstring hazard
47
21
Strollers
Why strollers can be a problem?
2
available) there were 204 hospitalisations of children due to an injury involving a stroller .
In a recent one-year period, an estimated 14,400 children under age 5 in the United States were
treated in hospital emergency rooms for injuries associated with strollers. Most of the injuries resulted
from falls, and almost 90 percent of the fall injuries were to the head. On average, about two children
die each year in the United States from stroller-related incidents. Many of these deaths happen when
39
children are left unattended to sleep in strollers reclined to the "carriage" position .
How are strollers dangerous?
- Strollers are a strangulation/suffocation hazard. A child may slip feet first through a leg opening and
become entrapped by the head between the seat and restraint bar. Deaths have resulted when infants
were left to sleep in strollers with the backrest reclined to the carriage position. The infants moved
(wriggled) feet first towards the front of the stroller and, when their bodies passed through the opening
between the handrest (grab bar) and front edge of the seat, they became trapped by the head and
strangled.
- Strollers are a fall hazard. The stroller may also fall backwards when the handles are overloaded with
parcels, or when a child stands in the stroller.
- Also, children's fingers have been amputated in parts of the folding mechanism.
21
-
-
Look for the standard EN1888: 2003 when you are buying a new stroller to ensure it meets European
safety standards.
All new strollers come with a five-point harness. Check the harness to make sure it is strong and
durable, fits snugly around your child, and can be easily fastened and unfastened. If you have a
second-hand stroller you may need to buy a harness separately. If so, look for the standard in your
country.
Make sure that there is a brake and that it is convenient to operate and actually locks the wheels.
Brakes on two wheels are required.
Check that the stroller cannot fold up when your baby is in it – there should be a safety-locking device
to prevent it from doing this.
Make sure your baby’s feet cannot trail on the ground. Guards or shopping trays below the footrest
can help prevent this.
If a stroller has a shopping basket for carrying packages, it should be low on the back of the stroller
and in front of (or directly over) the rear wheels for appropriate stability.
If you are buying a second-hand stroller check the fabric areas to make sure that no sharp pieces of
metal or plastic have worn through.
39 The United States Consumer Product Safety Commission, Infants Can Die When Their Heads Become Trapped in Strollers,
2001, http://www.cpsc.gov/CPSCPUB/PUBS/5096.pdf.
48
How to use strollers safely:
- Check the overall condition of your stroller every few months.
- Do not overload your stroller, in particular avoid hanging bags on the handles. This can unbalance the
pushchair and cause it to tip backwards even when your child is sitting in it.
- Use the harness each time you place the baby in the stroller.
- Test the brakes on a slope as well as on a flat surface regularly and make sure they work well with the
weight of your baby in the stroller.
- To avoid incidents of entrapment in stroller leg openings, never leave a child unattended in a stroller.
This is especially important if the stroller seat's backrest is in the flat ‘carriage’ position. And be aware
that infants only a few weeks old can creep or move when asleep. The youngest victim was an infant
just seven weeks old.
- When folding or unfolding a stroller, keep your child away from it. Children's fingers have been
amputated in parts of the folding mechanism.
- A stroller is not a toy. Never allow children to use one as a plaything and do not allow young children
to stand in the stroller as this can cause tipping and result in serious head injuries.
- Never use a pillow, folded quilt, or blanket as a mattress in a stroller or carriage as they can cause
suffocation.
Figure 10: Stroller hazard
49
22
Toy chests
Why are toy chests a problem?
available) there were 5 hospitalisations of children due to trapped fingers, injury while inside, and
2
injury with the lid of a toy chest .
In the United Kingdom for example, toy boxes cause nearly 4,000 accidental injuries each year. Over
40
70 % of these accidents involve children between one and four years old .
In France for example, from 1986 to 1992, home and leisure data in eight hospitals in France recorded
50 accidents associated with the use of toy chests among children aged 0 to 14 years. Two accidents
concerned children less than one year old, 33 accidents affected children aged 1 to 4 years, 13
children aged 5 to 9 years and two children aged 10 to 14 years. Many accidents were caused by a
child falling onto or off the toy chest (33 cases). The other accidents are caused by the toy chest lid
closing suddenly and causing finger injuries (cuts, crushing, etc.) or injuries to the child’s head.
As a result of this study the Commission asked the authorities in charge of standardisation to draw up
41
a specific toy chest standard to improve the safety of toy chests on the market as soon as possible .
The U.S. Consumer Product Safety Commission knows of 45 children in the United States who
died when lids of containers used for toy storage fell on their heads or necks. There have been
at least three incidents of permanent brain damage. These chests include those specifically
manufactured for toy storage, as well as trunks, wicker chests, wooden storage chests, and
42
other similar items which are also available in Europe .
How are toy chests dangerous?
- Toy chests are a strangulation/suffocation hazard as the child or child’s head is trapped within the
chest. Fatal suffocation incidents have also happened when children climbed into storage containers
such as cedar chests to play, sleep or hide and became trapped. Because the toy chests were not
adequately ventilated, the children suffocated in the enclosed space.
40 Child Accident Prevention Trust, Factsheets: Toys and Accidents, 2002, http://www.capt.org.uk/FAQ/default.htm.
41 Commission de la Securite Des Consommateurs/Consumer Safety Commission, Paris, France, 6 January 2000, Opinion
Regarding The Safety Of Toy Chests.
42 Consumer Product Safety Commission, The United States Consumer Product Safety Commission Warns Consumers of
Dangers With Toy Chest Lids, Document #5099,
http://www.theunitedstatesconsumerproductsafetyvcommission.gov/theunitedstatesconsumerproductsafetycommissionpub/pubs
/5099.html.
50
- Toy chests are also a head/neck injury hazard. Typically, accidents occurred when children used the
chest to pull themselves up, causing the lid to fall from the upright, open position, and when young
children attempted to open the lids themselves. Children were reaching over and into the chest when
the lid dropped and either fell on their heads or trapped them at the neck between the lid and the edge
42
of the toy chest. Most of the children were under two years of age .
- Also, children’s fingers can be injured from heavy lids dropping on their fingers while opening or
closing the lid.
It is recommended to avoid any toy chest or other container which has a hinged lid that can fall freely.
- Look for standard EN 71:1998 to ensure that the toy chest meets European safety standards.
- Look for one that has a support that will hold the hinged lid open in any position in which it is placed or
buy one with a detached lid or doors.
- Look for a toy chest with ventilation holes that will not be blocked if the chest is placed against the
wall, or a chest which, when closed, has a gap between the lid and the sides of the chest. Many
chests are ventilated by a space between the underside of the lid and sides or front of the box.
- Make certain that the lid of the toy chest does not have a latch.
- Look for a lid that is lightweight and if intended for children then one that is easy to open for children.
42
How to use toy chests safely :
If you already own a toy chest or trunk with a freely falling lid, it is recommended that you REMOVE
THE LID to avoid possible tragedy.
Otherwise, you may wish to install a lid support device designed to hold the lid open in any position
(see Figure 11). Buy a spring-loaded lid support that will not require periodic adjustment. A springloaded lid-support device can keep a lid from falling on a child's neck or from closing and trapping a
child playing inside the chest. This device should be used on all chests. Once a support is installed, it
is important to check it frequently to make certain that it is working properly. Some supports may need
to be adjusted or tightened periodically so that they continue to hold the lid open.
Figure 11: Spring-loaded lid support
51
23
Toys
Why can toys be a problem?
The rapid alert system of the European Commission reported that the category of products most often
43
notified in 2003 was toys, followed by other types of products for children .
2
toy .
The Child Accident Prevention Trust reports that every year in the United Kingdom over 35,000
44
children less than 15 years old go to hospital after an accident involving a toy . The majority of these
accidents happen to toddlers between one and three years old.
The following toys are associated with particularly high numbers of accidental injures in the United
44
Kingdom :
•
•
•
•
•
Toys that children ride on such as cars or rocking horses can cause cuts, bruises or fractures if
children fall from them. Each year there are over 5,500 injuries caused by this type of toy.
Toy boxes cause nearly 4,000 accidental injuries each year. Over 70 per cent of these accidents
involve children between one and four years old.
Model cars, planes and trains are also responsible for nearly 4,000 visits to emergency
departments each year. Many of these accidents involve children under three and are choking
related, by small parts in these toys.
Soft toys such as teddies, dolls or action figures cause more than 1,500 accidents each year. As
with other toys, it is the children under three that are most at risk and small parts such as eyes,
buttons or pieces of stuffing that cause many of these accidents.
Toys that fire objects, such as toy guns or bows and arrows, water pistols, or catapults, cause
over 1,000 accidents each year.
Also, each year 5,500 children in the Netherlands are admitted to emergency rooms because of
45
accidents involving toys .
How can toys be dangerous?
As well as accidents associated with the toys themselves, injuries also happen when children - and
adults - trip on toys. The most serious of these accidents occur when toys are left on stairs or steps.
44
When buying/prior to using, look for :
It is very important to choose the right toy for the age of child. Most toys have a suggested age range
on the packaging. These are mostly for guidance only and reflect what age groups the manufacturer
43 RAPEX - Rapid Alert System for Non-Food Products,
http://europa.eu.int/comm/consumers/cons_safe/prod_safe/gpsd/rapex_en.htm.
44 Child Accident Prevention Trust, Fact Sheets Toys and Accidents, 2002, http://www.capt.org.uk/FAQ/default.htm.
45 Consumer Safety Institute, Report Speelgoed, 1998.
52
believes will find the toy most appealing. A warning symbol telling you that a toy is not suitable for
children under 36 months is important because it means that the toy may contain parts that could
choke a very young child. Other safety marks can also help identify safe toys.
- Toys should conform to the European Standard EN 71. If this number is shown anywhere on the toy or
the packaging it shows that it has been tested to agreed safety standards. Toys may also carry a CE
mark. This is a legal requirement for all toys sold in the European Union and is not a guarantee of
quality or safety.
- If the toy is for a child under three years old you will need to check for choking hazards. Be aware that
small objects such as buttons or beads are not suitable for young children. Toys intended for children
under eight years of age should be free of sharp glass and metal edges.
In addition to these basic requirements you will also need to think about the following:
- Does the toy have moving parts? If so you need to make sure fingers will not be trapped in the
mechanism.
- Are you using wood? If so you must make sure it is smooth, will not cause splinters and bear a child’s
weight?
- Are you using paint, varnish or other coatings? If so, make sure anything you use is non-toxic lead
free and designed for use with children.
- Does the toy have strings or straps? If so, think about whether the toy could pose a strangulation
hazard for a young child.
- Check all toys periodically for breakage and potential hazards. A damaged or dangerous toy should be
repaired immediately or thrown away.
- Teach children to put their toys safely away on shelves or in a toy chest after playing to prevent trips
and falls. Teach older children to help keep their toys away from younger brothers and sisters
- Store toys away that are used outdoors and after play - rain or dew can rust or damage a variety of
toys and toy parts creating hazards.
- Toy caps and some noisemaking guns and other toys can produce sounds at noise levels that can
damage hearing. These toys should not be used within close reach of the ear and certain ones should
not be used indoors (check packaging instructions). These toys can injure a child's hearing.
- Toys with long strings or cords may be dangerous for infants and very young children. The cords may
become wrapped around an infant's neck, causing strangulation. Never hang toys with long strings,
cords, loops, or ribbons in cots or playpens where children can become entangled.
- Check the toys regularly. Toys that have been broken may have dangerous points or prongs. Stuffed
toys may have wires inside the toy which could cut or stab if exposed
- Projectiles - guided missiles and similar flying toys - can be turned into weapons and can injure eyes
in particular. Children should never be permitted to play with adult lawn darts or other hobby or
sporting equipment that has sharp points. Arrows or darts used by children should have soft cork tips,
rubber suction cups or other protective tips intended to prevent injury. Check to be sure the tips are
secure. Avoid those dart guns or other toys that might be capable of firing articles not intended for use
in the toy, such as pencils or nails.
- Certain toys, such as balloons, marbles, small parts can cause suffocation. Balloons, when uninflated
or broken, can choke or suffocate if young children try to swallow them. Infant toys, such as rattles,
squeeze toys, and teethers, should be large enough so that they cannot enter and become lodged in
an infant's throat.
- Electric toys that are improperly constructed, wired or misused can shock or burn. Electric toys with
heating elements are recommended only for children over eight years old. Children should be taught
to use electric toys properly, cautiously and under adult supervision.
53
Remember also that children are likely to play with your toy in ways you had not expected. Watch
children playing and see how they use the toys they have
54
24
Trampolines
Why are trampolines dangerous?
2
available) there were 495 hospitalisations of children due to an injury involving a trampoline .
The United States Consumer Product Safety Commission regularly collects data on unsafe products
and estimates that in 2001 there were 91,870 hospital emergency room-treated injuries associated
with trampolines. About 93 percent of the victims were under 15 years of age, and 11 percent were
less than 5 years of age. Since 1990, The United States Consumer Product Safety Commission has
46
received reports of 6 deaths of children under age 15 involving trampolines .
How are trampolines dangerous for children?
Injuries and deaths due to trampoline use are caused by:
• Colliding with another person on the trampoline.
• Landing improperly while jumping or doing stunts on the trampoline.
• Falling or jumping off the trampoline.
• Falling on the trampoline springs or frame.
Most of the trampolines associated with injuries were at private homes.
- Look for standard EN 13219:2001 to ensure the trampoline meets European standards.
- Look for an enclosed-netted trampoline as they can help prevent falls off trampolines.
- Check that hard metal frames and poles are padded and that there are no spaces or webbing in the
mat where toes or fingers can get caught.
46
-
How to use a trampoline safely :
Here are the steps you can take to help prevent serious trampoline injuries, especially paralysis,
fractures, sprains, and bruises:
The trampoline should be placed on a solid, stable surface. Springs or spaces should be covered so
they do not pinch fingers, toes, skin.
Access to a trampoline should be via a fenced gate that is locked when no adult is present to
supervise in order to preventing children using the trampoline unattended.
Allowing only one person on the trampoline at a time reduces the risk of injuries.
Do not attempt or allow somersaults because landing on the head or neck can cause paralysis.
Do not use the trampoline without shock-absorbing pads that completely cover its springs, hooks, and
frame.
Place the trampoline away from structures, trees, concrete surfaces and other play areas.
Do not use a ladder to get on the trampoline because it provides unsupervised access by small
children.
Always supervise children using a trampoline by spotting at the side of the trampoline.
Use trampolines with enclosures as they can help prevent injuries from falls off trampolines.
46 Consumer Product Safety Commission, Consumer Product Safety Alert – Trampoline Alert, 2003
,http://www.cpsc.gov/cpscpub/pubs/085.html.
55
Window blind or drapery cords
Why are window blinds/drapery cords a problem?
available) there were 129 hospitalisations of children due to an injury involving a window blind loop or
2
drapery cord .
It is estimated that if loops are eliminated from all new and existing window coverings, children’s lives
47
will be saved every year .
15
There is now a regulation in the United States to avoid closed loops that could result in strangulation .
How are window blinds/drapery cords dangerous?
Window blinds/drapery cords are a strangulation hazard. Children become entangled in the pull cords
or in the inner cords that are used to raise the slats of blinds. These entrapments occur when a young
child pulls on an inner cord and it forms a loop that a child can hang in. The reported deaths involved
children in cots or playpens placed next to windows. In most cases, the outer pull cords were placed
out of reach, but the children still strangled when they pulled on the inner cords of the blinds. Children
were found hanging by the neck in the loop of the cords.
48
When buying/prior to using, what to look for :
Look for blinds or draperies with no loops or cords. If these are unavailable then change them to make
them safer:
Horizontal Blinds
Cut the cord above the tassel, remove the equaliser buckle, and add a separate tassel at the end of
each cord, or cut the cord above the tassel, remove the equaliser buckle, and add a breakaway tassel
which will separate if a child becomes entangled in the loop. To prevent inner cords from being pulled
into a loop, install cord stops as shown below:
1
2
Eliminate looped pull cords
Cut the looped pull cord just above the tassel, and remove equaliser buckle (if any).
Insert cord through tassel and tie cord ends to secure the tassel. Be sure pull cords are short.
47 Consumer Product Safety Commission Report: The United States Consumer Product Safety Commission Works With
Industry to Save Lives: Window Pull-Cords and Strangulations,
success/cords.html.
48 Consumer Product Safety Commission, Children Can Strangle in Window Covering Cords,
http://www.cpsc.gov/theunitedstatesconsumerproductsafetycommissionpub/pubs/cords.html.
56
Figure 12: Window cord hazard
Install cord stops
1
2
3
Lower the blind to its proper length and lock cords into position at head rail. Be sure pull cords are
short.
Pinch together a portion of the pull cord to create a loop near the head rail, then slide the cord stop
over the loop end.
Slip the free end of the pull cord through the loop to loosely knot the cord stop onto the pull cord.
Tighten the knot to secure the cord stop 2.5 – 5 cm below the head rail.
Install tie-downs
Insert cord or chain into tie-down device. Attach the tie-down device to the floor or wall so that the cord
is fully extended and securely fastened.
Pleated or cellular shades
Leave the cord stop near the headrail in place. Cut the cord above the tassel and add a separate
tassel at the end of each cord. Warning: When shades are raised, a loop will appear above the
cord stop. Keep cord out of the reach of children.
Vertical blinds, continuous loop systems, and drapery cords
- Install a cord tie-down device. Permanently attach and use the tie-down to floor, wall or window jamp.
How to use window blinds/draper cords safely:
- Keep all cords out of the reach of children. Do not have furniture near the cords as children can climb
on top and reach the cords.
57
References
1.
Austrian EHLASS 2003 data, Institute Sicher Leben.
2.
Fifteen Member States EHLASS 1998 data, European Commission.
3.
Consumer Product Safety Commission, The United States Consumer Product Safety
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http://www.theunitedstatesconsumerproductsafetycommission.gov/theunited
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Smith, G. et al (1997) Baby walker related injuries continue despite warning labels and public
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5.
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Petridou, E. et al (1996) Hazards of baby walkers in a European context. Injury Prevention,
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Child Accident Prevention Trust Fact Sheets Baby Walkers, January 2004,
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Cassells, O. C. S. et al (1997) Baby walkers – still a major cause of infant burns. Burns, 23:
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Jenkins, David. Product safety: Bath seats for babies can give a false sense of security with
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http://www.rospa.co.uk/product/pdfs/bathseats2003a.pdf.
10.
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Consumer Product Safety Commission, Just The Facts, The United States Consumer Product
Safety Commission Document #071,
http://www.theunitedstatessconsumerproductsafetycommission.gov/theunitedstatesconsumerp
Productsafetycommissionpub/pubs/071.html.
12.
Choosing and Using Child Seats, 2003,
http://www.rospa.co.uk/road/factsheets/pdf/carseats/choosing_using_factsheet.pdf.
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Campbell H, Macdonald S, Richardson P. High levels of incorrect use of car seat belts and
child restraints in Fife--an important and under-recognised road safety issue. Inj Prev. 1997
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RoSPA. Buying a Child Seat: Checklist,
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58
17.
The United States Consumer Product Safety Commission, Report 5085, 2001,
18.
United Kingdom Department of Trade and Industry. Clothing flammability accidents study. J
une 1994 URN 94/549. http://www.dti.gov.uk/homesafetynetwork/cf_raccs.htm.
19.
The Netherlands EHLASS data 2003, Consumer Safety Institute.
20.
Consumer Product Safety Commission, Some Cot Cornerposts May Be Dangerous,
Document #5027, http://www.cpsc.gov/cpscpub/pubs/5027.html.
21.
Child Accident Prevention Trust. Keep Your Baby Safe, 2003, information leaflet,
http://www.capt.org.uk/pdfs/Sample%20keep%20your%20baby%20safe.pdf.
22.
Commission Warns Parents About Infant Strangulations Caused by Failure of Crib Hardware,
Document #5025, http://www.theunitedstatesconsumerproductsafetycommission.gov/the
unitedstatesconsumerproductsafetycommissionpub/pubs/5025.html.
23.
Child Accident Prevention Trust, Factsheets: Firework accidents, 2002,
24.
Konte Vassilia, Petridou Eleni, Trichopoulos Dimitrios. Firework-related childhood injuries in
Greece: a national problem. Burns. 30(2004)2:151-153.
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http://www.theunitedstatesconsumerproductsafetycommission.gov/theunitedstatesconsumerpr
oductsafetycommissionpub/pubs/july4/millin.pdf.
26.
Interview with Helena Menezes, Director of the Portuguese Association for Child Safety and
Injury Control (APSI), September 7, 2004.
27.
Consumer Product Safety Commission, Guidelines for Movable Soccer Goal Safety, 1995,
http://www.cpsc.gov/CPSCPUB/PUBS/Soccer.pdf.
28.
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for child resistant cigarette lighters. Inj Prev 2002. 8(3):192-196.
29.
Consumer Product Safety Commission, Child-Resistant Lighters Protect Young Children,
Report #5021, http://www.cpsc.gov/CPSCPUB/PUBS/5021.pdf.
30.
Consumer Product Safety Commission, Document # 202, The Safe Nursery,
31.
Consumer Product Safety Commission, Children Still Suffocating with Plastic Bags,
Document #5064, 2001, http://www.cpsc.gov/cpscpub/pubs/5064.pdf.
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playgrounds: the relative contribution of structural, equipment and human factors. Acta
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oductsafetycommissionpub/pubs/325.pdf.
34.
Consumer Product Safety Commission, Infants Can Suffocate In Mesh Drop-Sided Playpens,
The United States Consumer Product Safety Commission Document #5058,
59
oductsafetycommissionpub/pubs/5058.pdf.
35.
Consumer Product Safety Commission, CPSC Warns Consumers of Dangers With Infant
Rattles, CPSC Document #086, http://www.cpsc.gov/cpscpub/pubs/5070.html.
36.
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practice that has been advocated successfully?, Berlin, Germany, European Child Safety
Alliance Business Meeting, November 2003.
37.
Nakamura, S.W., Pollack-Nelson, C., Chidekel, A.S. Suction-type suffocation incidents in
infants and toddlers /. Pediatrics 11(2003)1(Jan)e12-e16.
38.
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Document # 208, http://www.cpsc.gov/cpscpub/pubs/208.pdf.
39.
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Become Trapped in Strollers, 2001, http://www.cpsc.gov/CPSCPUB/PUBS/5096.pdf.
40.
Child Accident Prevention Trust, Factsheets: Toys and Accidents, 2002,
41.
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France, 6 January 2000, Opinion Regarding The Safety Of Toy Chests.
42.
Commission Warns Consumers of Dangers With Toy Chest Lids, Document #5099,
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43.
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44.
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45.
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46.
Consumer Product Safety Commission, Consumer Product Safety Alert – Trampoline Alert,
2003 ,http://www.cpsc.gov/cpscpub/pubs/085.html.
47.
Consumer Product Safety Commission Report: The United States Consumer Product Safety
Commission Works With Industry to Save Lives: Window Pull-Cords and Strangulations,
oductsafetycommissionpub/pubs/success/cords.html.
48.
Consumer Product Safety Commission, Children Can Strangle in Window Covering Cords,
http://www.cpsc.gov/theunitedstatesconsumerproductsafetycommissionpub/pubs/cords.html.
60
Annex A: Literature review
(of these articles it is unauthorized to reproduce)
Annex B: Product safety organisations
- ANEC
- The Association of Play Industries - United Kingdom
- British Association of Toy Retailers
- Child Accident Prevention Trust
- Consumer Product Safety Commission
- European Child Safety Alliance/ European Consumer
Safety Association
- Harborview Injury Prevention and research Center
- Konsumentverket
- PROSAFE
- Räddningsverket
- The Royal Society for the Prevention of Accidents
ANEC
ANEC stands for "European Association for the Co-ordination of Consumer Representation in
Standardisation", in short the European consumer voice in standardisation. ANEC was established in
1995 as an international non-profit association under Belgian law. It is funded by the European
Commission and EFTA. Its Secretariat is based in Brussels.
ANEC provides technical expertise based on a network of more than 170 consumer representatives
across Europe. Our experts directly participate in the work of more than 60 Technical Committees and
New Deliverables of the European Standards Bodies. It is full member of ETSI, Associate of CEN and
observer to CENELEC.
ANEC states having the following challenges:
• New sectors for standardisation and the extension of the New Approach principles.
• Non-formal standard setting.
• International standardisation.
The areas of priority for ANEC are: child safety, design for all, domestic appliances, environment,
information society, services and traffic safety.
ANEC commissions research and testing projects to underpin activities at the technical level. The
research supports the work of the ANEC Working Groups and assists in developing European
consumer positions in the field of European and international standardisation.
In the field of child safety, ANEC has achieved success with baby walkers: Most parents in Europe
consider baby walkers as a safe place to put their small children. Research undertaken by European
consumer organisations, however, showed that baby walkers on sale in the EU might seriously harm
young children. The European standard on baby walkers did not take into account that a young child
in a baby walker has an increased mobility and reach, causing severe accidents. On the initiative of
ANEC, the standard on baby walkers was changed to include the stair fall hazard and the increased
mobility of the child.
Relevant literature:
Workshop on Notification of dangerous products, Brussels, 8 October 2003
Joint statement by ANEC and BEUC
Written by Tania Vandenberghe, ANEC and Charlotte De Roo, BEUC
When work on the revision of the General Product Safety Directive started about five years ago,
ANEC and BEUC in their comments stressed the need for transparency in support of consumer
safety. In line with our thinking on the need for greater transparency, we particularly highlighted the
need for:
• A requirement on manufacturers to notify voluntary corrective action.
• The establishment of a European wide recall system.
• A requirement on Member States to notify voluntary corrective action.
As the GPSD of 1992 did not include requirements for ensuring the information of the competent
authorities by producers and distributors in case of dangerous products, we asked the Commission to
introduce in the revised version of the Directive a requirement on manufacturers, retailers and
importers to notify to the responsible authorities all cases where they have found the existence or
likelihood of a risk.
In our comments we also mentioned that withdrawal and recall should not be used on their own, but
that maybe some guidance documents or standards should deal with it.
We were very pleased to see that most of our comments were taken into account and that the
important gap concerning the obligation to inform national authorities has been filled in the new
version of the GPSD. This obligation to notify is an important element for improved market surveillance
and risk management.
It was clear from the past experience that greater efforts needed to be made to improve enforcement
collaboration. Enforcement authorities are no longer simply safeguarding their own consumers but
have a responsibility Europe-wide.
Coming back to the need for transparency in support of consumer safety, we feel there needs to be
greater sharing of information and collaboration in general.
- First of all, we would argue for the earliest and widest possible dissemination of information relating to
dangerous products, to ensure a maximum possible flow of information. The results of a notification
should be available or published for consumers to have confidence in the single market. When
national authorities find a product that is problematic due to safety concerns and negotiate a voluntary
agreement with the producer to take the product of the market or to change it in some way, we think
this should be notified to other member states.
We believe consumers have the right all over Europe for equal protection and certainly the right to
know about inconsistencies among member states. We are a bit concerned that the information from
notifications may not be publicly available until an action such as a recall is the result. Past experience
has shown that even if the product has been notified, the Commission and national administrations do
not systematically inform consumers or consumer groups on notifications of dangerous products. An
exception to this is the information and statistics on the Low Voltage Directive safeguard clause
notifications, which we regularly receive from the Commission and from the LVD-Administrative Cooperation Group. The success of any recall is amongst others dependent on the communication of the
information to consumers. However, requirements should be laid down for the content of recall notices
(some recall notices in newspapers as you know can on occasion read more like advertising for the
product).
- Secondly, any notification system should be open to countries outside of Europe and needs to also
work with the US notification system. There is a moral responsibility to share information on defective
or unsafe products with non-EU countries, such as the US and third world countries
- Thirdly, the strategy for greater sharing of information and collaboration should contain the following
elements: common guidelines for how risks should be identified and dealt with, particularly those
considered to be immediate and serious; common criteria for risk evaluation; training activities for
public servants concerning risk evaluation.
We welcome the obligation of notification in the new version of the Directive, but we are also
wondering how this will be implemented in practice. As we know from the past and from enforcement
in general, Member States are using different approaches so that consumers may experience different
levels of safety in different countries. During the revision process of the General Product Safety
Directive, ANEC and BEUC have been supportive of a product safety network and we hope that this
network will soon become operational.
We hope that the discussions from today and the issues under consideration will be used for wider
application. The requirements in the General Product Safety Directive should be reflected in the New
Approach Directives. As it is clear that a lot of products fall under more than one directive, there needs
to be a consistent, coherent and co-ordinated approach. Therefore we recommend to the Commission
to establish open and transparent structures. After all, we should not lose sight of the overall objective,
which is to put safe products on the market for all consumers, no matter which administrative
arrangements there are in place and no matter under which directive a consumer product falls.
-
-
-
To end our statement, we would like to make some comments on the consultation paper from the
Commission:
On page 12, terms are used like normal adults and if the product is likely to be used by vulnerable
people. We would ask for more clarification of normal adults and vulnerable people.
On page 13 (5.3.1 issue concerning criteria for non-notification), it is said that if the information
available to a company does not reasonably support the conclusion that a dangerous product exists,
the company need not inform the competent authority. This sentence leaves the door open for
manufacturers to argue e.g. that it was a question of misuse, giving them an argument not to notify.
If a manufacturer gets a complaint, which is safety-related, we think the manufacturer should ALWAYS
notify this to the authorities, so that a discussion can be held between the manufacturers and the
authorities to see which action needs to be taken. It should not be left up to the manufacturer to decide
if the problem is serious enough to notify it to the authorities or not.
In Annex I, point 3 (details of products involved), we wonder if the exact product can be identified with
these details. Some products are identical, but have another model name.
It is not clear in the guide how notification of long-term effects from chemicals is to be ensured. The
guide should be clear on how to handle this and take corrective action.
The safety requirements only mention risks assessment, how does the guide envisage the use of the
precautionary principle?
The Association of Play Industries - United Kingdom
The Association of Play Industries is the lead trade body within the play sector, representing the
interests of the manufacturers, installers, designers and distributors of both outdoor and indoor play
equipment and safer surfacing.
The four working groups of the API are the Outdoor, Indoor, Surfacing and Construction sections.
Associate membership is also available.
Founded in 1984 it represents approximately 80% of the market with over 60 members. Its aims are:
• To improve the quality of play and play equipment.
• To promote safer play.
• To assist with the creation of British and European Standards.
• To improve the image of the Industry.
• To establish dialogue with other relevant organisations in the UK and abroad.
• To ensure all member companies comply with the relevant standards.
• To act as a spokesman for the industry.
• To improve the standing, strength and influence of the API in all areas of the play industry.
In accordance with its aims, the Association works closely with all agencies involved in the play
sector and has close links with the Department for Culture Media and Sport.
British Association of Toy Retailers (BATR)
BATR is the only official voice of toy retailers in the UK and is represented on government, safety and
other organisations in the UK.
BATR assists those who want to start up in toy retailing, for those already retailing and to help the
public in tracking down their nearest BATR member.
BATR has the following safety information for toy retailers:
• Guidance on toys for children under 3 years old
If you can prevent a customer buying an unsuitable toy for a young child, you may well be preventing
that child injuring himself or herself. You will also be demonstrating to your customer the principles
behind the Approved Lion Mark Retailer scheme - safety is not only offering safe toys for sale, but also
making sure that an inappropriate toy doesn't become an unsafe toy in the wrong hands.
• Age labelling
Check age guidance instructions on the package. Age labelling is the manufacturer's guide to the
consumer as to the suitability of the product for a particular age group. So often, parents (and more
often, proud grandparents) overestimate the ability of young children to cope with toys which were not
made for their age group. No manufacturer wants to limit his sales and it is safe to assume that a toy
marked 'age 4-6' is pitched for those ages where awareness and interest begins at the younger end
and tails off at the higher end.
• Why are some toys not suitable for children under 3 years?
Beside obvious reasons such as the size or mental abilities of the young child, the toy safety
standards also give other reasons why some toys are unsuitable for young children. For example,
components of toys for children under 3 years must be sufficiently large to prevent choking. A special
gauge has been specifically designed to reflect the size of the throat in a child of 3 years and under.
Items that do not fit entirely into the gauge are considered too large to cause this hazard. This test has
dramatically reduced the incidence of choking on small items.
• 'Under Supervision'
This phrase is often used on toys (for example, those played with in water) which need some form of
adult involvement. It implies that while the manufacturer has made the product to the required safety
standards, the product should not be used without adult supervision as children might misuse it in play
and therefore transform a safe toy into a dangerous one. Again, you should inform your customer that
the toy requires adult supervision.
Child Accident Prevention Trust (capt)
Concerned about the number of children they treated as a result of accidents, two paediatricians, Dr
Hugh Jackson and Professor Donald Court, formed a committee in the late 1970s to focus on child
accident prevention. In 1981 it gained charitable status and became the Child Accident Prevention
Trust (capt).
Child Accident Prevention Trust is a national charity committed to reducing the number of children and
young people who are killed, disabled or seriously injured as a result of accidents.
The Trust understands that experimenting and risk-taking are part of growing up. It works to secure
lower injury rates without compromising children's health or quality of life.
Child Accident Prevention Trust aims to reduce serious accidental injuries, especially those with longterm consequences by:
• raising the profile of childhood accidental injury among decision-makers, practitioners and parents;
•
increasing knowledge of what works in preventing childhood accidental injury;
• reducing inequalities in accidental injury.
The Trust works to achieve these aims through:
• publicity directed at practitioners and parents through safety campaigns and its annual awarenessraising Week - Child Safety Week;
• information and advice to practitioners and parents through publications and videos, and via a
telephone information service;
• close contact with decision-makers in government and other organisations participation in the
development of standards, both British and International;
• Professional and community development through training courses, conferences and seminars;
• community-based projects particularly targeting disadvantaged families.
Capt has many factsheets and publications for consumer education on the website.
Consumer Product Safety Commission - USA
The Consumer Product Safety Commission (CPSC) is charged with protecting the public from
unreasonable risks of serious injury or death from more than 15,000 types of consumer products
under the agency's jurisdiction. Deaths, injuries and property damage from consumer product
incidents cost the nation more than $700 billion annually. The CPSC is committed to protecting
consumers and families from products that pose a fire, electrical, chemical, or mechanical hazard or
can injure children. The CPSC's work to ensure the safety of consumer products - such as toys, cribs,
power tools, cigarette lighters, and household chemicals - contributed significantly to the 30 percent
decline in the rate of deaths and injuries associated with consumer products over the past 30 years.
CPSC currently has about 480 employees, who are responsible for monitoring the safety of over
15,000 kinds of consumer products.
CPSC is an Independent Federal Regulatory Agency. CPSC works to save lives and keep families
safe by reducing the risk of injuries and deaths associated with consumer products. This is done by:
developing voluntary standards with industry issuing and enforcing mandatory standards or banning
consumer products if no feasible standard would adequately protect the public obtaining the recall of
products or arranging for their repair conducting research on potential product hazards informing and
educating consumers through the media, state and local governments, private organizations, and by
responding to consumer inquiries CPSC announces recalls of products that present a significant risk
to consumers either because the product may be defective or violates a mandatory standard issued by
CPSC.
There are three ways that CPSC alerts the consumers about recalls. One is to via the CPSC web site
home page, where new recalls are posted as soon as they are issued, another is the Recalls section
of the website, where one can search by product type or description, company, and date of recall. Or
one can use the ‘Search’ function on the website to search by product type (e.g., toys) or product
name. Another way is to join the recalls e-mail subscription list to get CPSC's recall notices
automatically the same day they are issued.
Consumer Recall Report of the CPSC
The term ‘Victim’ covers any individual killed, injured
or exposed to a possible product-related hazard and
does not imply that the product caused an incident.
Your name:
Name of victim:
Your address:
Victim's address:
City:
Victim's city:
State:
Please Select
Victim's state:
Please Select
Zip code:
Victim's zip code:
Your email address:
Victim's telephone:
Your telephone:
Victim's age:
(at time of incident)
Date of Incident:
Victim's sex:
Female
Please describe the incident or hazard, including description of injuries:
Describe product involved:
Product Brand Name/Manufacturer:
Place where manufactured (city and state or country):
Male
Product model, serial #, & date of manufacture or date code if available:
When was the product purchased?
Do you still have the product?
Yes
No
May we use your name
with this report?
I request that you do not release my name
You may release my name to the manufacturer but I request that you do not release it to the general public
You may release my name to the manufacturer and to the public
Clear Form
This information is collected by authority of 15 U.S.C. 2054 and will be entered into a database by a
Consumer Product Safety Commission contractor. The information is not retrievable by name. The
information may be shared with product manufacturers, distributors, or retailers. However, no names
or other personal information will be disclosed without explicit permission.
Consumer Safety Institute - The Netherlands / no English website available
Denmark National Consumer Agency / no English website available
Ministère de l' Économie, des Finances en de l' Industrie
Commission de la Sécurité des Consommateurs - France / No English website available
ECSA/ECOSA, European Child Safety Alliance, European Consumer Safety Association
ECOSA promotes an exchange of knowledge and good practice among experts and institutes in the
field of consumer safety. A priority area is product safety where a wealth of information exists on
product safety recommendations, events, links and news.
Relevant Literature:
Child Protective Products: Requirements and test methods.
This report builds on the research and findings of previous studies and represents a big step forward
in defining test methods and requirements for groups of protective products. It demonstrates how
these (horizontal) requirements and test methods can be used to draft a (vertical) product standard
(i.e. locks and locking devices). The report targets not only people associated with the preparation of
standards but is also helpful for manufacturers, distributors and retailers of child protective products.
Child Safety Products: An assessment of their effectiveness.
The aim of this report was to define an assessment procedure that could be used to check the
effectiveness of child safety products. The basic principles for child safety were considered, from
which an assessment framework, defining a categorisation, target group(s), and the level of protection
provided by the product was established. A decision tree was designed where the decisions for the
steps could be taken after considering the information given in this report. A selection of child safety
products was assessed using the decision tree. An assessment matrix was outlined with the aim of
defining the requirements, and test methods, for each combination of level of protection and category
of child safety protection. The full development of this matrix will be undertaken as a separate project.
Computer models of children 0 to 4 years: Predicting accessibility of product parts with computer
simulation.
When formulating safety criteria and testing methods dummies are needed for simulating certain
characteristics of children. It's evident that for several characteristics different dummies exist that are
not in conformity. Also these dummies are not always based on scientific data. The purpose of this
project is to develop children's test dummies and probes for the purpose of safety criteria.
Child-proof articles: Using child-proof articles is a good precautionary measure.
Small children are responsible for many accidents in the home. Babies, toddlers and pre-schoolers are
very adventurous. They love to scramble over and into everything and grab anything within reach. This
can create dangerous situations. 60,000 children are admitted to the emergency room every year
because of accidents that occurred at home. Using child-proof articles is a good precautionary
measure. More information on child-proof products can be found in this pamphlet.
Products for children: Development and evaluation of symbols for warnings.
The aim of the project was to develop one or more comprehensible symbols for each of the following
warnings that are frequently used on childcare and use articles.
A
B
C
a child may suffocate in the wrapping of this product.
this product is not suited for children above a certain age, weight or height.
never leave a child unattended with this product.
A linear and iterative procedure is used to develop the warning symbols. The selection of suitable
symbols is based on the consecutive use of two ways of testing/evaluating symbol proposals. The
following three phases can be distinguished in the project: design phase (design of symbol proposals),
estimation testing phase and comprehension testing phase. When necessary the test results have
been used as input to adapt the design of symbols or to develop new designs. The iterative aspect of
the procedure is that whenever the result of a particular phase is not satisfactory, this phase is
repeated with adapted or new symbol designs. The final results indicate the expected usability of
symbols expressed as the comprehension level of samples of average users of the products. The
tests have results in symbols with a sufficiently high level of comprehension for the referents
'suffocation' (92%), 'not unattended' (84%) and 'not above a certain weight (98%). No symbols with an
acceptable level of comprehension have been found for the categories 'not above a certain age' and
'not above a certain height'. The main reason why these symbols are not acceptable is the percentage
of contradictory interpretations (well suited for children above a certain age, or height).
Products for Children: Testing Warning Sentences and Symbols in Europe
The aim of this study was to test the comprehensibility of warning symbols and text for child-care
products in a number of European countries (France, Sweden, the UK and the Netherlands). Symbols
and texts for the following warnings were investigated:
1
2
3
Keep this (plastic) cover away from your child to avoid suffocation.
Never leave your child unattended in/with this (product name). Your child may be hurt.
Do not use this (product name) once your child is larger than x cm/ weighs more than x kg.
they (product name) may collapse/fall over. Your child may be hurt.
In the first part of the study, potential consumers of child-care products were interviewed in shops that
sell these products. They were asked to describe the meaning of the symbols. In the second part, a
sample of parents-to-be and a sample of students were presented with product manuals of child-care
products (a safety gate, a highchair and a baby walker). The manuals contained no safety information,
only warning text (non-explicit or explicit), a symbol, or a combination of both text and symbol.
Comprehension of the safety information was investigated, as was the influence of safety information
on people's perceptions. Intended compliance was also measured.
The results indicated that a combination of a warning symbol and explicit text leads to the best
understanding of the complete warning message (what to do/avoid, product-related hazards and the
consequences of unsafe use). The suffocation symbol was understood by almost everyone in both the
first and second part of the study. The symbols for unattended, weight, and height met the IS/DIVES
9186 acceptance and rejection criteria in the second part of the study, but failed the first. Further
research is needed to explain this.
Harborview Injury Prevention and Research Center
Cochrane Review
Finding out "what works" in injury control is of tremendous public health importance. Systematic
literature reviews and meta-analyses are invaluable methods of synthesizing the existing evidence
from evaluation studies. Health care providers, policy makers and injury control professionals are
faced with large amounts of information, distributed in a large number of sources, and need systematic
reviews to provide a basis for rational decision making. It is quite likely that when currently available
evidence on the efficacy of injury prevention interventions is thoroughly synthesized, many
interventions believed to be effective will be shown to be ineffective and vice versa. In addition,
systematic reviews are likely to show that some proposals for future research are redundant because
intervention efficacy can already be established from existing evidence. Most importantly, such
reviews will clarify which programs are appropriate to implement on a broader scale.
It is unreasonable to expect clinicians, policy makers and program directors who want reliable
information about interventions to unearth all the relevant evidence from reports of original research.
Particularly in the injury field, these reports are far too dispersed to make this practical. Many reports
are not indexed in MEDLINE and cannot be easily found in computer searches. Reviews occupy a key
position in the chain which should link results of research at one end to programs and decreased
injuries at the other.
-
Hundreds of childhood injury prevention programs have been implemented; many have been
evaluated, and many have been evaluated in controlled trials. Injury prevention professionals in health
departments, community agencies and other organizations need to have data on which interventions
are effective and which make sense to replicate in their community. Investigators need to know what
has been done in the past so as to not duplicate these efforts, and instead build on them. Hopefully,
the information in this database will make the work of many people easier. Most importantly, our hope
is that it will reduce morbidity and mortality from injuries to children and adolescents.
The intervention strategies reviewed by Harborview on product modification interventions are the
following:
Choking product and environment modification
Footwear and falls
Playgrounds and falls
Window bars and falls
Gun buy-backs and firearms
Vehicle modifications and pedestrians
Child-resistant packaging and poisoning
Knee braces in sports
Mouth guards in sports
Taping in sports
Physical conditioning in sports
Equipment modification in sports
Konsumentverket The Swedish Consumer Agency
Konsumentverket is a state agency whose task is to help the Swedish general public with consumer
affairs. The Agency, with a staff of around 180, works on a wide variety of consumer issues. Its fields
mainly relate to advertising and contract terms, consumer information and education, domestic
finances, product safety, product quality and environmental impact. The Government and the Swedish
Parliament set consumer policy objectives.
The Consumer Agency is headed by a Director General, Karin Lindell, who is also the Consumer
Ombudsman, Konsumentombudsman. The Konsumentombudsman represents consumer interests to
the business world and pursues legal action on behalf of these interests.
The general policy goals are:
• to strengthen the position and influence of consumers in the market;
• to help households make the best possible use of their money and other resources;
• to strengthen the protection of consumer health and safety;
• to promote patterns of production and consumption which contribute to long-term sustainable
development;
• to increase consumer access to good advice and assistance, information and education.
The Consumer Ombudsman is responsible for ensuring that companies abide by the laws and rules in
the consumer field and ensures that consumer rights are respected.
PROSAFE
PROSAFE (the Product Safety Enforcement Forum of Europe) is an organisation established entirely
by enforcement officers. The first formal meeting of the group was in 1990. Since that time, most
Member States and EFTA (the European Free Trade Association) countries have been represented at
meetings. Interest has now been expressed by enforcement officers from Central and Eastern
European States and organisations such as ANEC and CEN.
The group was established by common recognition of the need to build links in operational
understanding and trust between enforcement officials charged with the task of working together to
enforce community law.
PROSAFE has been supported by the European Commission Health & Consumer Protection
Directorate General (DG), Internal Market DG, Enterprise DG and EFTA. It is an organisation
established entirely by enforcement officers throughout Europe who deal with the safety of consumer
products. PROSAFE online enables these officers to overcome some of the physical barriers that
separate colleagues throughout the European economic area. It allows efficient and effective
communication and provides an opportunity to raise awareness of enforcement structures and
practices. Although systems of enforcement vary considerably throughout Europe, information is
presented using a standard format.
The main aim of PROSAFE online is to enable co-ordination of community wide enforcement activities
in high risk areas. The development of this web site has been part funded by the Commission of the
European Communities Health & Consumer Protection Directorate General.
The main operational objectives of PROSAFE are summarised below :
• Encouraging liaison between enforcement practitioners by providing, collecting and exchanging
information of value to them.
• Enabling discussion and exchange of ideas on the improvement of the enforcement function.
• Developing a closer understanding of common problems, mutual confidence and more effective
working relations contributing to a wide range of European Product Safety Law enforcement
matters including the methodology of market control/inspection and co-operative procedures;
risk assessment; sampling and testing; information exchange.
• Developing solutions to known enforcement problems.
PROSAFE supports the internal market and contributes to its good operation by:
• considering and commenting on proposals for legislation, guidelines for implementation, etc.;
• alerting both European and national authorities on issues that require action;
• providing on request independent professional advice to both European and national authorities.
Räddningsverket - The Swedish Rescue Services Agency
This Agency promotes practice that improves emergency prevention and response, and in the event of
an incident/accident limits injury and damage. This is achieved by imparting information, by running
training courses and holding exercises, and through supervision etc.
The objective of the municipal fire & rescue services is to ensure that the general public is provided
with a reasonable degree of safety in relation to local risks.
The Swedish Rescue Services Agency is the central supervisory government authority for the rescue
services.
Its tasks include examining co-ordination between the various branches of the national rescue
services, as well as contingency planning by the county administrative boards for the rescue services
in the event of a release of radioactive substances. The agency also collates observations and
lessons learned from serious emergencies that have occurred at home and abroad.
It also develops methods and equipment for use by the rescue services; and is responsible for the
training of all personnel in the municipal fire & rescue services and in the chimney sweeping service.
In addition, the agency implements regulations for safety in relation to the road and rail transport of
dangerous goods, and co-ordinates the work of the supervisory authorities in this field.
RoSPA - The Royal Society for the Prevention of Accidents
This Society is a registered charity which was established over 80 years ago. Providing information,
advice, resources and training, RoSPA is actively involved in the promotion of safety in all areas of life:
at work, in the home, and on the roads, in schools, at leisure and on or near water. RoSPA aims to
campaign for change, influence opinion, contribute to debate, educate and inform - for the good of all.
RoSPA believes that many people suffer injury or death as a result of poor product design or manufacture.
RoSPA’s Product Safety Adviser help designers and manufacturers to meet obligations requiring their products to
be legally ‘safe’, thereby reducing the threat of legal action. RoSPA has the expertise to advise, preferably at the
design stage, or after manufacture with detailed unbiased reporting, making RoSPA the first port of call for
designers, manufacturers - in fact everyone with an interest in safe product design. RoSPA generally does not
advise on the safety of motor vehicles or food, and RoSPA does not endorse specific products.
RoSPA believes the following issues must be addressed:
- The need to develop safer products
An estimated 0.75 million accidental injuries each year are caused by unsafe products. Despite
product safety legislation and standards, many products still present unacceptable risks.
RoSPA is working to promote a coherent product safety culture, including a stronger emphasis on
using risk assessment at the design stage, going beyond minimum standards and encouraging the
integration of product safety management systems with other systems dealing with health and safety,
quality and the environment.
- Better information on product safety, including product recalls
There is no comprehensive and accessible source of case data on product-related accidental injuries,
safety-related product recalls or enforcement action. Similarly, there is no mandatory requirement for
manufacturers to report product safety failures. RoSPA is developing proposals to address these
issues.
The role of RoSPA’s Product Safety Adviser is to promote safe products and encourage their safe
use. Product safety is important to all RoSPA’s departments of course, but much of my work relates to
ordinary, everyday, household products.
RoSPA has warned about baby walkers, bath seats, table-mounted chairs, candles, lighters, plugs
and many other dangerous products and helped many Trading Standards Officers around the country
with their inquiries into unsafe products.
The primary issue in product safety, seen from our vantage point, is the need for better product safety
management. This applies across the product safety system including manufacturing and the training
of designers for example, right through to the role of government and to local authority Trading
Standards Officers who have the onerous duty of ensuring that the products we buy meet the level of
safety required by law.
Key Issues:
In addition to the fundamental management problem, the Key Issues which currently concern RoSPA
and on which action can be taken now, are the need to develop safer products and the need for better
information on unsafe products (including product recalls). Developing safer products has to start with
the producer but they can be encouraged by the effective enforcement of the law and powers do exist
to stimulate such action.
Relevant Literature:
Product safety
David Jenkins
Fall in unsafe product prosecutions – A success story?
Report to Parliament
The Secretary of State for Trade and Industry recently reported to Parliament on work
carried out over the past five years in relation to the safety provisions, as required by
the Consumer Protection Act 19871. The figures show a further reduction in
prosecutions brought by local authority Trading Standards Services.
This is the fourth in a series of reports showing that prosecutions for marketing unsafe
products in the UK have fallen from an average of 600 cases a year up to 31.03.932
(300 cases a year up to 31.03.983) to only 100 cases a year in the five year period to
31.03.034.
A report by the Minister in 19885 recorded just 897 prosecutions under the safety
regulations but that was shortly after the introduction of the Consumer Protection Act
on 1 October 1987. Officers previously reported selected cases in a confidential
bulletin published by the Institute of Trading Standards Administration (ITSA) now
the Trading Standards Institute (TSI). These records showed a fall in the prosecution
rate from 95 cases in 1988 to only 48 in 19946.
5yr to 31.03.93
5yr to 31.03.98
5yr to 31.03.03
4000
3000
2000
1000
0
3155
1638
544
Prosecutions 1988 - 2003
The latest report concedes that data are incomplete partly because there is no
requirement under Section 70 of the Weights and Measures Act for local authorities to
make returns of legal proceedings to the DTI. Returns of legal proceedings can also
be made to the Office of Fair Trading, but this again is voluntary.
1
Section 42(1)
DTI (1993), “Consumer Safety”, Report by the Secretary of State for Trade and Industry for the
period 1 April 1988 – 31 March 1993, HMSO.
3
4
period 1 April 1993 – 31 March 1998, HMSO HC411.
5
6
D.Jenkins, personal files.
2
PRGM
1
Product safety
David Jenkins
Comment
It would appear from the dramatic fall in prosecution cases that either a. consumer products have become much safer,
b. alternative methods have been found to combat the risks presented, or
c. official action in this area of local authority work has declined.
Enforcement of the product safety regulations under the Consumer Protection Act
1987, is the duty of local weights and measures authorities usually through their
Trading Standards Services. Officers can make test purchases of products and take
appropriate action if they find they fail any safety provision. This occasionally, and
usually as a last resort, means bringing a prosecution against those who have
marketed dangerous products and put the public at risk of injury.
Ideally, such surveillance work should be based on statistical methods, be uniform
throughout the European Union and records of formal action should be published.
The official notification system, RAPEX7 enables authorities to report the most
dangerous products found on sale in the EU to their colleagues.
Official surveillance work is the last line of defence consumers have against the
dangerous products which I estimate cause up to 100 deaths each year8.
Failure of a surveillance system permits dangerous products onto the market and puts
consumers at risk. An effective surveillance system forms the basis of a pro-active
approach to accident prevention but it must be supported with adequate resources.
Consumers need to be better informed about suspect products and the risks they are
exposed to in order to decide on their own level of exposure and that of their families.
Such information is required under the revised General Product Safety Directive.
It is accepted that prosecutions are only one measure of the effectiveness of the
Trading Standards Service and that voluntary compliance is better than going to court.
The latter course of action is time consuming, costly and clearly not taken lightly.
The level of risk presented by suspect consumer products needs to be assessed as
objectively as possible by officers to determine the most appropriate course of action
and to prioritise investigations. The new CoPRA9 method may help in this.
Adequate records should be kept of official action taken by local authority Trading
Standards Services, and Environmental Health Departments in Northern Ireland. This
is necessary to demonstrate the work of enforcement authorities and its effectiveness.
Having been subjected to many changes over recent years and the imposition of
additional demands including food standards, the Trading Standards Service is
entitled to a period of stability and perhaps some good news. If there are far fewer
unsafe products on the market, it is to be welcomed. This large fall in prosecution
cases must not mean a reduction in commitment by the Service to safe products.
djenkins@rospa.com
7
RAPid EXchange of information on dangerous products
Based on Nottingham University study of 11,721 home accidents (2.8% product fault fatalities)
9
Consumer Product Risk Assessment (see author)
8
PRGM
2
Annex C: Data tables
Data tables
-
Explanatory note to the Data Tables:
The five-digit code is the product code*
‘Kennummer' is the case number
Sex is 1 for male, 2 for female
Age is based in months
Product 1 is defined as the product involved in the accident
Product 2 is defined as the product causing the injury
Product 3 is defined as other product
‘Haufigkeit' is frequency
*Codes analysed from the European Commission Home and Leisure Database:
F0000 = crib
F0012 = Playpen
F0020 = high chair
F1200 = bunk beds
F12 = adult bed
G3110/G3112 = cigarette lighter, petrol and gas
K0705 =
K2028 = bike child carrier
L = Toys
N0900 = soccer goal
N2022 /N2024 = trampoline
P0146 = pyjama
P3020 /F0010 = changing table
P3005 = soothers/teethers and baby bottle
P4010 = stroller
P4020 = baby walker
R0510 = Fireworks
S0404 = chest (for toy chests)
S0932 = clothing drawstring
S0932/F4298 = Loop on window blind cords
C. Data Tables
Data comes from the European Commission Home and Leisure Data Database titled the Injury
Surveillance System, 1998 data from the 15 Member States, compiled by the Injury Prevention
Program of the DG SANCO.
P4020
Kennummer Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
8975DK
1
2
P4020
1
17161DK
1
207
P4020
1
49629DK
1
32K0100
P4020
1
17871DK
1
2P4020
B1009
1
39195DK
1
216P4020
B1009
1
1523DK
1
215P4020
B1099
1
36648DK
1
212P4020
B1099
1
39004DK
1
210P4020
B1099
1
50329DK
1
3P4020
B1099
1
29485DK
1
216P4020
C0299
1
59846DK
1
216P4020
V9940
1
61004DK
1
212P4020
V9940
1
6162DK
2
30
P4020
1
13389DK
2
211
P4020
1
13777DK
2
212
P4020
1
23517DK
2
2
P4020
1
59842DK
2
5
P4020
1
17977DK
2
6E0056
P4020
34210DK
2
2P4020
A1000
1
11693DK
2
202P4020
B1009
1
34754DK
2
2P4020
B1099
1
39285DK
2
43P4020
B1099
1
39786DK
2
210P4020
B1099
1
31219DK
2
35P4020
C0299
1
37966DK
2
216P4020
C0299
1
11991DK
2
2P4020
T0000
1
4709FI
1
203C0920
C0920
P4020
1
3576FI
1
210P4020
B2998
V9998
1
3848FI
1
2P4020
B2998
V9998
1
3927FI
1
205P4020
C0098
V9999
1
2741FI
1
211P4020
C0212
V9998
1
4979FI
1
2P4020
C0299
V9998
1
6462FI
1
206P4020
C0299
V9998
1
1813FI
1
210V9999
C0098
P4020
1
1605FI
2
2P4020
B2998
V9998
1
3739FI
2
214P4020
B2998
V9998
1
1965FI
2
2P4020
P4020
V9998
1
T1000
1
5025FR
1
205P4020
A0060
V9999
1
15780FR
1
209P4020
B2998
V9999
1
8449FR
1
215P4020
B2999
V9999
1
8972FR
1
213P4020
B2999
V9999
1
11146FR
1
216P4020
B2999
V9999
1
11473FR
1
2P4020
B2999
V9999
1
11832FR
1
203P4020
C0098
V9999
1
11842FR
1
210P4020
C0098
V9999
1
10552FR
1
2P4020
C0210
V9999
1
11383FR
1
216P4020
C0210
V9999
1
16441FR
1
208P4020
C0210
V9999
1
16529FR
1
215P4020
C0210
V9999
1
4567FR
1
201P4020
C0299
V9999
1
7128FR
1
215P4020
C0299
V9999
1
8642FR
1
211P4020
C0299
V9999
1
10612FR
1
207P4020
C0299
V9999
1
10891FR
1
213P4020
C0299
V9999
1
11738FR
1
207P4020
C0299
V9999
1
26208FR
1
214P4020
P4020
V9999
1
10536FR
1
207P4020
R0920
V9999
1
11665FR
1
210P4020
R0920
V9999
1
4180FR
2
209P4020
B2998
V9999
1
11718FR
2
210P4020
B2998
V9999
1
5895FR
2
2P4020
B2999
V9999
1
6724FR
2
210P4020
B2999
V9999
1
8496FR
2
208P4020
B2999
V9999
1
10281FR
2
214P4020
C0210
V9999
1
11126FR
2
215P4020
C0210
V9999
1
13957FR
2
206P4020
C0210
V9999
1
12812FR
2
208P4020
C0299
V9999
1
15654FR
2
211P4020
C0299
V9999
1
26728FR
2
2P4020
P4020
V9999
1
10781FR
2
213P4020
R0920
V9999
1
3912FR
2
205P4020
V9999
V9999
1
5741IE
1
2P4020
P4020
V9999
1
5796IT
1
212P4020
C0210
V9999
1
5042IT
1
3P4020
C0299
V9999
1
6669IT
2
212P4020
B2999
V9999
1
4159IT
2
74P4020
C0210
V9999
1
5750IT
2
212P4020
C0210
V9999
1
2468UK
1
1P4020
P4020
P4020
1
5061UK
1
1P4020
P4020
P4020
1
7541UK
1
1P4020
P4020
P4020
1
44093UK
1
0P4020
P4020
P4020
1
48161UK
1
1P4020
P4020
P4020
1
80358UK
1
0P4020
P4020
P4020
1
80640UK
1
0P4020
P4020
P4020
1
85699UK
1
2P4020
P4020
P4020
1
85700UK
1
2P4020
P4020
P4020
1
87825UK
1
1P4020
P4020
P4020
1
87926UK
1
2P4020
P4020
P4020
1
87927UK
1
2P4020
P4020
P4020
1
90601UK
1
0P4020
P4020
P4020
1
94831UK
1
0P4020
P4020
P4020
1
118984UK
1
1P4020
P4020
P4020
1
136035UK
1
1P4020
P4020
P4020
1
146433UK
1
2P4020
P4020
P4020
1
147123UK
1
0P4020
P4020
P4020
1
147697UK
1
4P4020
P4020
P4020
1
147698UK
1
4P4020
P4020
P4020
1
148250UK
1
1P4020
P4020
P4020
1
148423UK
1
1P4020
P4020
P4020
1
148424UK
1
1P4020
P4020
P4020
1
164162UK
1
1P4020
P4020
P4020
1
187890UK
1
0P4020
P4020
P4020
1
4018UK
2
18P4020
P4020
P4020
1
4019UK
2
18P4020
P4020
P4020
1
27141UK
2
0P4020
P4020
P4020
1
73115UK
2
1P4020
P4020
P4020
1
81340UK
2
26P4020
P4020
P4020
1
82590UK
2
2P4020
P4020
P4020
1
84479UK
2
88P4020
P4020
P4020
1
88444UK
2
37P4020
P4020
P4020
1
88445UK
2
37P4020
P4020
P4020
1
90854UK
2
1P4020
P4020
P4020
1
91304UK
2
30P4020
P4020
P4020
1
92060UK
2
26P4020
P4020
P4020
1
92749UK
2
1P4020
P4020
P4020
1
103250UK
2
39P4020
P4020
P4020
1
103251UK
2
39P4020
P4020
P4020
1
117810UK
2
1P4020
P4020
P4020
1
122986UK
2
3P4020
P4020
P4020
1
122987UK
2
3P4020
P4020
P4020
1
125874UK
2
25P4020
P4020
P4020
1
145988UK
2
5P4020
P4020
P4020
1
152732UK
2
50P4020
P4020
P4020
1
159506UK
2
64P4020
P4020
P4020
1
159507UK
2
64P4020
P4020
P4020
1
162242UK
2
13P4020
P4020
P4020
1
163454UK
2
3P4020
P4020
P4020
1
163455UK
2
3P4020
P4020
P4020
1
163456UK
2
3P4020
P4020
P4020
1
168283UK
2
75P4020
P4020
P4020
1
168284UK
2
75P4020
P4020
P4020
1
190972UK
2
48P4020
P4020
P4020
1
190973UK
2
48P4020
P4020
P4020
1
192441UK
2
1P4020
P4020
P4020
1
194201UK
2
4P4020
P4020
P4020
1
194202UK
2
4P4020
P4020
P4020
1
200340UK
2
32P4020
P4020
P4020
1
206420UK
2
60P4020
P4020
P4020
1
138
Data Table con’t
F0000
Kennummer
Country
Sex
Age
Product1
Product2
Product3
V9999
Häufigkeit
3384 BE
1
21 F0000
F0000
30005 DK
1
212 F0000
C0299
1
9406 IT
2
28 V9999
F0000
V9999
1
2871 PT
1
209 F0000
C0299
V9999
1
4890 PT
2
212 F0000
F0000
V9999
1
4918 PT
1
207 F0000
C0200
V9999
1
5170 PT
1
3 F0000
C0200
V9999
1
5346 PT
1
2 F0000
C0200
V9999
1
6348 PT
1
211 F0000
F0000
V9999
1
6488 PT
1
3 F0000
F1299
C0299
1
7039 PT
2
213 F0000
C0200
V9999
1
7618 PT
1
2 F0000
F0000
V9999
1
9897 PT
2
212 F0000
F0000
V9999
1
9949 PT
1
212 F0000
C0200
V9999
1
10648 PT
2
3 F0000
C0200
F4305
1
10817 PT
1
212 F0000
C0299
V9999
1
13877 PT
1
215 F0000
C0298
V9999
1
15711 PT
1
209 F0000
F0000
V9999
1
17005 PT
1
212 F0000
C0299
V9999
1
17545 PT
1
212 F0000
C0200
P2935
1
18118 PT
2
212 F0000
C0299
V9999
1
19131 PT
1
210 F0000
C0210
V9999
1
22656 PT
1
212 F0000
C0200
V9999
1
26252 PT
2
214 F0000
F0000
V9999
1
26429 PT
1
213 F0000
F0000
V9999
1
26561 PT
2
213 F0000
F0000
V9999
1
26685 PT
1
211 F0000
C0299
V9999
1
27588 PT
1
212 F0000
C0200
V9999
1
29511 PT
2
212 F0000
C0200
V9999
1
29638 PT
2
2 F0000
C0200
V9999
1
33449 PT
2
211 F0000
C0210
V9999
1
35258 PT
1
213 F0000
C0299
V9999
1
35404 PT
1
2 F0000
C0200
V9999
1
36146 PT
1
2 F0000
C0200
V9999
1
36148 PT
2
2 F0000
C0200
V9999
1
36594 PT
1
204 F0000
C0210
V9999
1
36602 PT
1
210 F0000
F4305
V9999
1
36873 PT
2
204 F0000
F0000
V9999
1
37251 PT
2
2 F0000
F1299
V9999
1
37336 PT
1
216 F0000
F0000
V9999
1
27096 SE
1
202 F0000
C0299
F4305
1
1
94807 UK
1
1 F0000
F0000
F0000
1
42
Data Table con’t
F1200
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
177 AT
2
7 F1200
F4305
V9999
1
226 AT
2
7 F1200
F4305
V9999
1
419 AT
1
4 F1200
F1100
C0200
1
1132 AT
1
4 F1200
F1005
V9999
1
1511 AT
2
39 F1200
F4398
V9999
1
2503 AT
2
13 F1200
F1098
V9999
1
2559 AT
2
13 F1200
F1005
V9999
1
2789 AT
1
3 F1200
F4398
V9999
1
2987 AT
2
9 F1200
F4398
V9999
1
3187 AT
2
6 F1200
C0200
V9999
1
3692 AT
2
13 F1200
C0200
V9999
1
4530 AT
2
42 L9098
F1200
V9999
1
5097 AT
1
5 F1200
F4305
V9999
1
6822 AT
2
8 F1200
F1200
V9999
1
6883 AT
1
23 F4398
F1200
P2200
1
4393 BE
1
48 F1200
C0299
V9999
1
4413 BE
1
4 F1200
C0299
V9999
1
5973 BE
2
7 F1200
C0299
V9999
1
8950 BE
1
7 F1200
C0299
V9999
1
9132 BE
1
17 F1200
C0299
V9999
1
372 DK
1
9 F1200
F4010
1
656 DK
1
5 F1200
C0299
1
817 DK
2
2 F1200
C0299
1
1401 DK
2
6 F1200
C0299
1
1607 DK
1
8 F1200
C0299
1
2171 DK
1
13 F1200
C0299
1
2443 DK
1
6 F1200
C0299
1
2444 DK
2
4 F1200
F1800
1
2516 DK
2
2 F1200
C0299
1
2704 DK
1
7 F1200
C0299
1
3388 DK
1
208 F1200
C0299
1
4742 DK
1
4 F1200
C0299
1
5753 DK
2
4
F1200
1
5841 DK
1
4 F1200
C0299
1
6013 DK
1
12 F1200
C0299
1
6134 DK
2
3 F1200
C0299
1
8194 DK
2
5 F1200
C0299
1
8702 DK
2
5 F1200
C0299
1
9194 DK
2
6 F1200
C0299
1
10628 DK
2
F1200
1
10724 DK
1
7 F1200
C0299
1
10756 DK
1
214 F1200
C0299
1
11209 DK
2
3 F1200
C0299
1
11310 DK
1
3 F1200
C0299
1
11989 DK
2
10 F1200
C0299
1
15592 DK
2
6 F1200
C0299
1
15868 DK
1
5 F1200
C0299
1
16771 DK
2
6 F1200
C0299
1
17016 DK
2
5 F1200
C0299
1
17322 DK
1
4 F1200
C0299
1
17339 DK
1
31 F1200
C0299
1
17887 DK
1
2 F1200
C0299
1
17990 DK
1
3 F1200
C0299
1
18223 DK
1
3 F1200
C0299
1
18353 DK
1
214 F1200
C0299
1
18471 DK
2
9 F1200
C0299
1
19754 DK
2
3 F1200
C0299
1
22157 DK
2
6 F1200
C0299
1
22433 DK
1
9 F1200
C0299
1
22443 DK
1
2 F1298
C0299
22616 DK
1
4 F1200
C0299
1
23655 DK
1
9 F1200
C0299
1
24044 DK
1
3 F1200
C0299
1
24124 DK
2
8 F1200
C0299
1
25164 DK
2
6 F1200
C0220
1
26071 DK
2
7 F1200
F1280
1
26236 DK
2
2 F1200
C0299
1
26647 DK
1
4 F1200
C0299
1
30497 DK
1
5 F1200
C0299
1
31409 DK
2
6 F1200
L9072
1
31855 DK
1
3 C0299
F1200
1
32847 DK
2
6 F1200
C0299
1
34171 DK
1
8 F1200
F4010
1
34588 DK
2
2 F1200
C0299
1
35373 DK
1
36 F1200
C0299
1
36091 DK
2
31 F1200
F1288
1
36937 DK
1
12 F1200
C0299
1
36995 DK
2
3 F1200
C0299
1
36
F1200
1
38069 DK
1
6 F1200
C0299
1
38153 DK
1
16 F1200
C0299
1
38601 DK
2
F1200
1
39057 DK
2
10 F1099
F1200
1
39604 DK
2
2 F1200
C0299
1
39671 DK
2
10 F1200
C0299
1
40229 DK
1
9 F1200
C0299
1
42972 DK
2
6 F1200
C0299
1
43023 DK
2
7 F1200
A8000
1
43171 DK
1
6 F1200
C0299
1
43253 DK
2
3 F1200
C0299
1
44475 DK
1
2 F1200
C0299
1
45586 DK
1
F1200
1
45644 DK
2
2 F1200
C0299
1
45723 DK
2
2 F1200
C0299
1
45823 DK
1
3 F1200
C0299
1
46030 DK
1
7 F1200
C0299
1
46222 DK
2
2 F1200
C0299
1
48876 DK
1
3 F1200
C0299
1
48910 DK
1
10 F1200
C0299
1
49182 DK
1
4 F1200
C0299
1
49358 DK
1
3 F1200
C0299
1
49434 DK
1
7 F1200
C0299
1
53171 DK
1
206 F1200
C0299
1
53775 DK
1
6 F1200
C0299
1
55407 DK
2
3 F1200
C0299
1
56508 DK
2
3 F1200
C0299
1
56676 DK
2
3 F1200
C0299
1
58635 DK
1
3
F1200
1
59284 DK
1
2 F1200
C0299
1
59640 DK
2
3 F1200
C0299
1
61476 DK
2
6 F1200
C0299
1
61555 DK
1
3 F1200
C0299
1
62931 DK
2
20 Q3299
F1200
63794 DK
2
9 F1200
C0299
1
64875 DK
1
5 F1200
C0299
1
64989 DK
1
8 F1200
C0299
1
65426 DK
1
2 F1200
C0299
1
65538 DK
2
5 F1200
C0299
1
458 FI
2
2 F1200
C0299
V9998
1
502 FI
1
3 F1200
C0299
V9998
1
957 FI
2
8 F1200
C0299
V9998
1
1048 FI
2
7 F1200
C0299
V9998
1
1150 FI
1
5 F1200
C0299
V9998
1
1170 FI
1
6 F1200
C0299
F1998
1
3
26
C0299
1
1296 FI
2
6 F1200
C0200
V9998
1
1722 FI
1
8 F1200
C0299
S0499
1
1772 FI
1
11 F1200
C0299
V9998
1
1806 FI
1
30 F1288
F4399
F1200
1
1825 FI
1
3 F1200
C0299
V9998
1
1902 FI
2
2 F1200
C0299
F4010
1
1967 FI
2
13 F1200
C0299
V9998
1
2009 FI
2
2 V9998
F4399
F1200
1
2056 FI
2
7 V9999
F1200
C0299
1
2387 FI
2
9 F1200
C0299
V9998
1
2814 FI
2
6 F1200
C0299
V9998
1
2838 FI
2
3 F1200
C0299
V9998
1
2966 FI
1
2 F1200
C0299
V9998
1
3065 FI
2
4 F1200
C0299
V9998
1
3130 FI
1
4 F1200
C0299
V9999
1
3171 FI
2
3 F1200
C0299
V9998
1
3644 FI
1
4 F1200
C0299
V9999
1
3778 FI
1
3 F1200
C0299
V9998
1
3968 FI
2
6 F1200
F4399
V9998
1
4100 FI
1
7 F1200
C0299
V9998
1
5036 FI
1
2 F1200
C0299
V9998
1
5279 FI
2
11 V9999
V9999
F1200
1
5378 FI
2
7 F1200
C0299
V9998
1
5476 FI
2
7 F1200
F1800
V9998
1
5528 FI
1
4 F1200
F1200
V9998
1
5565 FI
1
21 V9998
C0298
F1200
1
5591 FI
1
12 V9998
C0298
F1200
1
5617 FI
1
6 F1200
C0299
V9998
1
5824 FI
1
4 F1200
C0299
V9998
1
6392 FI
1
4 F1200
C0299
V9998
1
6476 FI
1
216 F1200
C0299
V9998
1
6477 FI
2
2 F1200
C0299
V9998
1
6671 FI
1
4 F1200
C0299
F4005
1
6673 FI
1
4 F1200
C0299
V9998
1
6885 FI
2
4 F1200
C0299
V9998
1
6978 FI
1
3 F1200
C0299
V9998
1
12806 FR
1
5 F1200
F1200
V9999
1
12842 FR
2
3 F1200
C0299
V9999
1
13175 FR
2
206 F1200
C0299
V9999
1
13443 FR
2
3 F1200
C0299
V9999
1
13504 FR
1
15 F1200
C0299
V9999
1
13953 FR
1
5 F1200
C0200
V9999
1
14547 FR
1
7 F1200
C0299
V9999
1
14914 FR
1
13 F1200
C0299
V9999
1
15039 FR
1
4 F1200
C0299
V9999
1
15937 FR
1
8 F1200
C0299
V9999
1
16180 FR
1
6 F1200
C0299
V9999
1
16195 FR
2
2 F1200
C0299
V9999
1
16209 FR
2
2 F1200
C0299
V9999
1
17719 FR
1
4 F1200
F4305
V9999
1
18061 FR
1
7 F1200
F4305
V9999
1
19561 FR
2
13 F1200
F4305
V9999
1
19754 FR
1
4 F1200
C0210
V9999
1
20585 FR
1
10 F1200
C0299
V9999
1
20640 FR
1
12 F1200
F1005
V9999
1
20926 FR
1
3 F1200
C0299
V9999
1
20960 FR
1
3 F1200
C0299
V9999
1
21633 FR
1
3 F1200
C0299
V9999
1
35085 FR
1
13 V9998
F1200
V9998
1
35328 FR
2
3 B2999
F1200
V9998
1
63 IE
1
4 F1200
V9999
V9999
1
1089 IE
2
10 F1200
F1200
V9999
1
1781 IE
1
8 F1200
V9999
V9999
1
1923 IE
2
6 F1200
F1200
V9999
1
1929 IE
1
13 F1200
F1200
V9999
1
2172 IE
1
30 F1200
V9999
V9999
1
2252 IE
1
5 F1200
F1200
V9999
1
2312 IE
1
18 F1200
V9999
V9999
1
2428 IE
2
12 F1200
V9999
V9999
1
3327 IE
1
14 F1200
F1200
V9999
1
3487 IE
1
6 F1200
F1200
V9999
1
3991 IE
1
7 F1200
F1200
V9999
1
4529 IE
2
2 F1200
V9999
V9999
1
4968 IE
1
58 F1200
F1200
V9999
1
4971 IE
2
13 F1200
F1200
V9999
1
5114 IE
1
11 F1200
V9999
V9999
1
5159 IE
1
6 F1200
V9999
V9999
1
5596 IE
1
16 F1200
F1200
V9999
1
4247 IT
1
11 F1200
F1200
V9999
1
4626 IT
1
5 F1200
C0210
V9999
1
4838 IT
1
22 F1200
C0299
V9999
1
4880 IT
1
22 F1200
C0210
V9999
1
4934 IT
1
21 F1200
C0210
V9999
1
5050 IT
2
37 F1200
C0210
V9999
1
5213 IT
1
44 F1200
F1200
V9999
1
5219 IT
1
10 F1200
C0210
V9999
1
5290 IT
2
65 F1200
F1200
V9999
1
5310 IT
1
8 F1200
C0210
V9999
1
5743 IT
2
14 F1200
C0210
V9999
1
5807 IT
1
8 F1200
F1200
V9999
1
6433 IT
2
47 F1200
C0210
V9999
1
6717 IT
2
5 F1200
C0210
V9999
1
6802 IT
1
4 F1200
C0210
V9999
1
6839 IT
1
13 F1200
C0210
V9999
1
1192 PT
1
3 C0299
F1200
V9999
1
1917 PT
1
213 F1200
C0299
F4305
1
5251 PT
1
2 F1200
F1200
V9999
1
5895 PT
2
208 F1200
F4305
V9999
1
10187 PT
2
35 C0299
C0299
F1200
1
11625 PT
2
9 F1200
F4305
V9999
1
11792 PT
1
3 F1200
F4305
V9999
1
13149 PT
2
6 F1200
C0200
V9999
1
14429 PT
2
4 F1200
C0200
V9999
1
17240 PT
1
4 F1200
F1030
V9999
1
17911 PT
1
4 F1200
F1200
V9999
1
22666 PT
2
12 F1200
F1200
V9999
1
23240 PT
2
12 F1200
C0200
V9999
1
23918 PT
2
16 F1200
G0210
V9999
1
24425 PT
2
3 F1200
F1399
V9999
1
25057 PT
2
208 F1200
C0212
V9999
1
29133 PT
2
11 F1200
C0299
V9999
1
32279 PT
1
9 F1200
C0200
V9999
1
36861 PT
1
4 F1200
F1298
V9999
1
1120 SE
2
6 F1200
C0200
V0000
1
1632 SE
1
4 F1200
F4010
V0000
1
4094 SE
1
5 F1200
C0299
V0000
1
5051 SE
1
5 G0010
A8010
F1200
1
5199 SE
1
10 F1200
V9999
V0000
1
5691 SE
2
3 F1200
C0012
V0000
1
6551 SE
2
8 F1200
C0299
V0000
1
7255 SE
1
9 F1200
C0299
V0000
1
7271 SE
2
4 F1200
C0299
V0000
1
8553 SE
2
7 F1200
F1320
V0000
1
9032 SE
2
216 F1200
C0299
V0000
1
9197 SE
1
8 F1200
T0000
V0000
1
9342 SE
1
4 F1200
L9098
V0000
1
9696 SE
1
31 F1200
F1999
V0000
1
10115 SE
2
36 F1200
C0299
V0000
1
10331 SE
1
2 F1200
C0299
V0000
1
10552 SE
2
6 F1200
V9998
V0000
1
11610 SE
2
8 F1200
F1399
V0000
1
11786 SE
1
8 F1200
C0299
V0000
1
12004 SE
2
8 F1200
C0299
V0000
1
12352 SE
2
7 F1200
F1200
V0000
1
14426 SE
1
3 F1200
C0299
V0000
1
14650 SE
2
2 F1200
C0299
V0000
1
15878 SE
2
6 F1200
C0299
V0000
1
16751 SE
2
37 F1200
F1200
C0299
1
17369 SE
1
33 H6098
C0212
F1200
1
17409 SE
2
6 F1200
V9999
V0000
1
17760 SE
2
13 F1200
C0299
V0000
1
17916 SE
2
10 F1200
C0200
V0000
1
17960 SE
1
2 F1200
C0299
V0000
1
17975 SE
1
9 F1200
F1320
V0000
1
18608 SE
1
3 F1200
C0299
L9098
1
20534 SE
1
2 F1200
C0205
V0000
1
20535 SE
1
5 F1200
C0212
V0000
1
20536 SE
2
2 F1200
C0299
V0000
1
20537 SE
2
2 F1200
C0299
V0000
1
20538 SE
2
63 F1200
C0299
V0000
1
20539 SE
1
11 F1200
F1030
V0000
1
20540 SE
2
4 F1200
F1200
V0000
1
20541 SE
2
6 F1200
V9999
V0000
1
25085 SE
1
2 F1200
C0299
V0000
1
25464 SE
1
8 F1200
C0299
V0000
1
25818 SE
2
11 F1200
C0299
V0000
1
26191 SE
2
6 F1200
C0299
V0000
1
27268 SE
2
4 F1200
C0299
V0000
1
27285 SE
2
8 F1200
C0299
V0000
1
27711 SE
1
5 F1200
C0299
T0000
1
770 UK
1
3 F1200
F1200
F1200
1
4434 UK
1
2 F1200
F1200
F1200
1
4636 UK
2
10 F1200
F1200
F1200
1
4644 UK
1
5 F1200
F1200
F1200
1
5359 UK
2
2 F1200
F1200
F1200
1
5694 UK
1
3 F1200
F1200
F1200
1
6902 UK
1
6 F1200
F1200
F1200
1
7620 UK
1
4 F1200
F1200
F1200
1
8189 UK
2
2 F1200
F1200
F1200
1
8190 UK
2
2 F1200
F1200
F1200
1
8540 UK
2
3 F1200
F1200
F1200
1
8858 UK
1
5 F1200
F1200
F1200
1
9101 UK
1
21 F1200
F1200
F1200
1
9377 UK
1
7 F1200
F1200
F1200
1
9401 UK
1
2 F1200
F1200
F1200
1
10328 UK
1
8 F1200
F1200
F1200
1
10647 UK
1
13 F1200
F1200
F1200
1
11385 UK
2
10 F1200
F1200
F1200
1
11784 UK
1
8 F1200
F1200
F1200
1
12753 UK
2
3 F1200
F1200
F1200
1
14513 UK
2
40 F1200
F1200
F1200
1
16876 UK
1
31 F1200
F1200
F1200
1
16877 UK
1
31 F1200
F1200
F1200
1
19426 UK
2
9 F1200
F1200
F1200
1
20075 UK
1
6 F1200
F1200
F1200
1
21931 UK
2
4 F1200
F1200
F1200
1
23945 UK
2
11 F1200
F1200
F1200
1
24881 UK
1
7 F1200
F1200
F1200
1
25224 UK
2
9 F1200
F1200
F1200
1
25417 UK
1
5 F1200
F1200
F1200
1
25424 UK
1
12 F1200
F1200
F1200
1
25464 UK
1
14 F1200
F1200
F1200
1
25656 UK
2
7 F1200
F1200
F1200
1
26478 UK
2
15 F1200
F1200
F1200
1
26822 UK
2
12 F1200
F1200
F1200
1
27056 UK
2
30 F1200
F1200
F1200
1
28132 UK
2
2 F1200
F1200
F1200
1
28358 UK
1
16 F1200
F1200
F1200
1
28962 UK
2
32 F1200
F1200
F1200
1
29369 UK
2
3 F1200
F1200
F1200
1
29450 UK
2
2 F1200
F1200
F1200
1
29626 UK
1
10 F1200
F1200
F1200
1
29627 UK
1
10 F1200
F1200
F1200
1
29743 UK
2
2 F1200
F1200
F1200
1
30023 UK
2
2 F1200
F1200
F1200
1
30160 UK
1
5 F1200
F1200
F1200
1
30420 UK
1
3 F1200
F1200
F1200
1
32134 UK
1
15 F1200
F1200
F1200
1
32931 UK
1
5 F1200
F1200
F1200
1
33487 UK
2
5 F1200
F1200
F1200
1
33678 UK
2
14 F1200
F1200
F1200
1
34006 UK
2
21 F1200
F1200
F1200
1
34718 UK
1
5 F1200
F1200
F1200
1
34877 UK
1
3 F1200
F1200
F1200
1
34998 UK
2
2 F1200
F1200
F1200
1
35414 UK
1
3 F1200
F1200
F1200
1
35512 UK
2
16 F1200
F1200
F1200
1
36075 UK
2
8 F1200
F1200
F1200
1
36112 UK
2
7 F1200
F1200
F1200
1
37458 UK
2
10 F1200
F1200
F1200
1
63414 UK
1
18 F1200
F1200
F1200
1
78155 UK
2
60 F1200
F1200
F1200
1
78156 UK
2
60 F1200
F1200
F1200
1
85720 UK
2
32 F1200
F1200
F1200
1
85837 UK
2
13 F1200
F1200
F1200
1
88863 UK
2
6 F1200
F1200
F1200
1
89823 UK
2
6 F1200
F1200
F1200
1
91451 UK
1
5 F1200
F1200
F1200
1
91911 UK
2
14 F1200
F1200
F1200
1
93585 UK
2
8 F1200
F1200
F1200
1
94338 UK
1
5 F1200
F1200
F1200
1
94521 UK
1
12 F1200
F1200
F1200
1
96562 UK
2
6 F1200
F1200
F1200
1
98343 UK
2
5 F1200
F1200
F1200
1
98344 UK
2
5 F1200
F1200
F1200
1
104141 UK
2
3 F1200
F1200
F1200
1
104142 UK
2
3 F1200
F1200
F1200
1
107000 UK
1
7 F1200
F1200
F1200
1
107001 UK
1
7 F1200
F1200
F1200
1
109116 UK
1
10 F1200
F1200
F1200
1
110275 UK
1
13 F1200
F1200
F1200
1
110276 UK
1
13 F1200
F1200
F1200
1
110889 UK
1
12 F1200
F1200
F1200
1
111266 UK
2
9 F1200
F1200
F1200
1
112811 UK
1
3 F1200
F1200
F1200
1
112812 UK
1
3 F1200
F1200
F1200
1
123569 UK
1
16 F1200
F1200
F1200
1
125477 UK
2
8 F1200
F1200
F1200
1
126055 UK
2
7 F1200
F1200
F1200
1
126056 UK
2
7 F1200
F1200
F1200
1
126057 UK
2
7 F1200
F1200
F1200
1
127070 UK
1
12 F1200
F1200
F1200
1
127071 UK
1
12 F1200
F1200
F1200
1
127675 UK
1
1 F1200
F1200
F1200
1
127676 UK
1
1 F1200
F1200
F1200
1
128405 UK
2
6 F1200
F1200
F1200
1
128526 UK
1
2 F1200
F1200
F1200
1
128527 UK
1
2 F1200
F1200
F1200
1
129646 UK
1
10 F1200
F1200
F1200
1
130717 UK
2
9 F1200
F1200
F1200
1
131093 UK
2
9 F1200
F1200
F1200
1
131219 UK
1
11 F1200
F1200
F1200
1
131220 UK
1
11 F1200
F1200
F1200
1
135904 UK
1
10 F1200
F1200
F1200
1
135905 UK
1
10 F1200
F1200
F1200
1
136513 UK
2
5 F1200
F1200
F1200
1
137372 UK
1
13 F1200
F1200
F1200
1
139163 UK
2
7 F1200
F1200
F1200
1
139256 UK
2
10 F1200
F1200
F1200
1
139585 UK
1
12 F1200
F1200
F1200
1
140431 UK
1
9 F1200
F1200
F1200
1
140933 UK
2
5 F1200
F1200
F1200
1
140934 UK
2
5 F1200
F1200
F1200
1
146164 UK
2
39 F1200
F1200
F1200
1
397
Data Table con’t
R0510
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
251 AT
1
22 G0210
G0210
R0510
1
8583 BE
1
13 R0510
R0510
V9999
1
2 DK
1
32
R0510
1
4 DK
1
20
R0510
1
6 DK
1
37
R0510
1
8 DK
1
47
R0510
1
10 DK
1
32
R0510
1
12 DK
1
13
R0510
1
14 DK
1
24
R0510
1
16 DK
1
20
R0510
1
18 DK
1
39
R0510
1
20 DK
2
24 R0510
A7098
1
22 DK
2
51
R0510
1
24 DK
1
15 P2999
R0510
1
26 DK
1
13
R0510
1
28 DK
1
9
R0510
1
30 DK
1
7 G3199
R0510
1
47 DK
1
10
R0510
1
49 DK
2
10
R0510
1
51 DK
1
10
R0510
1
53 DK
2
34
R0510
1
55 DK
1
33
R0510
1
57 DK
1
50
R0510
1
59 DK
1
16
R0510
1
61 DK
1
35
R0510
1
63 DK
1
25
R0510
1
65 DK
1
48
R0510
1
67 DK
1
17
R0510
1
69 DK
1
64
R0510
71 DK
1
32
R0510
1
73 DK
1
8
R0510
1
75 DK
1
12
R0510
1
77 DK
2
42
R0510
1
79 DK
1
10
R0510
1
81 DK
1
12
R0510
1
151 DK
1
28
R0510
1
200 DK
1
11
R0510
1
237 DK
1
14
R0510
1
331 DK
2
64
R0510
1
531 DK
1
12
R0510
1
1001 DK
1
9
R0510
1
P6110
1
1257 DK
1
39
R0510
1
2517 DK
1
12
R0510
1
5161 DK
1
16
R0510
1
7123 DK
1
37
R0510
1
8383 DK
1
36
R0510
1
15717 DK
1
10
R0510
1
19439 DK
2
8
R0510
1
19576 DK
1
13
R0510
1
19630 DK
1
11
R0510
1
19691 DK
1
11 R0510
S0000
1
19771 DK
1
7
R0510
1
19772 DK
1
11
R0510
1
19951 DK
2
19
R0510
1
19952 DK
1
10
R0510
1
19953 DK
1
7 R0510
P0118
1
19981 DK
1
6
R0510
1
19982 DK
1
9
R0510
1
20020 DK
2
16
R0510
1
31012 DK
1
13
R0510
1
31120 DK
1
14
R0510
1
31179 DK
2
R0510
1
31207 DK
1
14
R0510
1
31428 DK
1
14
R0510
1
31429 DK
1
44
R0510
1
31485 DK
1
28
R0510
1
31498 DK
1
37
R0510
1
31499 DK
1
35
R0510
1
31500 DK
1
15
R0510
1
31501 DK
1
13
R0510
1
31502 DK
1
32
R0510
1
31503 DK
1
45
R0510
1
31504 DK
2
23
R0510
1
31505 DK
1
32
R0510
1
31506 DK
1
31
R0510
1
31507 DK
1
61
R0510
1
31509 DK
1
11
R0510
1
31510 DK
1
26
R0510
1
31511 DK
1
19
R0510
1
31569 DK
1
9
R0510
1
35417 DK
2
29 R0510
A7099
1
45547 DK
1
22 Q3299
R0510
1
45553 DK
1
19
R0510
1
45690 DK
1
16
R0510
1
45691 DK
1
9
R0510
1
45692 DK
1
20
R0510
1
4 Y0199
45693 DK
2
14 R0510
B1099
1
45694 DK
1
20
R0510
1
45695 DK
1
13
R0510
1
45696 DK
1
13 P0118
R0510
1
45697 DK
1
46
R0510
1
45698 DK
1
30
R0510
1
45699 DK
1
34
R0510
1
45700 DK
2
21
R0510
1
45701 DK
1
2
R0510
1
45769 DK
1
12 R0510
U1200
1
45820 DK
2
19
R0510
1
45884 DK
1
15
R0510
1
46094 DK
1
31
R0510
1
46477 DK
1
11
R0510
1
46986 DK
1
41 T0000
R0510
49872 DK
1
15
R0510
1
51422 DK
1
45
R0510
1
57046 DK
2
7
R0510
1
57048 DK
1
20
R0510
1
57049 DK
1
38
R0510
1
57050 DK
1
24
R0510
1
57051 DK
1
18
R0510
1
57053 DK
1
13
R0510
1
57054 DK
2
11 R0510
R0510
1
57055 DK
1
21 R0510
R0510
1
57058 DK
1
39 R0510
U1200
1
57076 DK
1
20 Q3299
R0510
1
57077 DK
1
38 Q3299
R0510
1
63595 DK
1
14
R0510
1
65409 DK
1
14
R0510
1
65507 DK
1
13
R0510
1
65549 DK
1
14
R0510
1
65596 DK
1
30
R0510
1
7068 FI
1
8 V9999
R0510
V9998
1
2292 FR
1
13 R0510
R0510
V9999
1
2891 FR
1
32 R0510
R0510
V9999
1
3016 FR
1
12 T1000
T1000
R0510
1
10290 FR
1
38 R0510
R0510
V9999
1
11343 FR
1
43 R0510
R0510
V9999
1
15488 FR
1
20 R0510
R0510
V9999
1
15489 FR
1
17 R0510
R0510
V9999
1
22845 FR
2
26 R0510
R0510
V9999
1
22855 FR
1
11 R0510
R0510
V9999
1
25202 FR
1
14 R0510
R0510
V9999
1
41408 FR
2
22 R0510
R0510
V9999
1
Q3299
1
3 IT
1
11 R0510
R0510
V9999
1
7045 IT
1
13 R0510
R0510
V9999
1
7046 IT
2
20 R0510
V9999
V9999
1
7051 IT
1
19 R0510
R0510
V9999
1
7066 IT
1
13 R0510
R0510
V9999
1
7298 IT
1
12 R0510
R0510
V9999
1
8116 IT
1
8 E0009
R0510
V9999
1
9655 IT
1
13 R0510
R0510
V9999
1
10243 IT
1
13 R0510
R0510
V9999
1
4 NL
1
20 V9999
V9999
R0510
1
6 NL
1
14 V9999
V9999
R0510
1
7 NL
1
10 V9999
V9999
R0510
1
10 NL
1
12 V9999
V9999
R0510
1
11 NL
1
10 V9999
V9999
R0510
1
13 NL
1
13 V9999
R0510
V9999
1
18 NL
1
43 V9999
V9999
R0510
1
21 NL
2
25 V9999
V9999
R0510
1
26 NL
1
29 V9999
R0510
V9999
1
27 NL
2
9 V9999
V9999
R0510
1
33 NL
1
19 V9999
V9999
R0510
1
45 NL
1
17 R0510
V9999
S0000
1
49 NL
1
21 V9999
V9999
R0510
1
57 NL
1
9 V9999
V9999
R0510
1
59 NL
1
8 V9999
R0510
A7099
1
61 NL
2
46 V9999
V9999
R0510
1
63 NL
1
27 V9999
V9999
R0510
1
68 NL
1
24 V9999
V9999
R0510
1
79 NL
1
11 V9999
V9999
R0510
1
248 NL
1
11 R0510
V9999
V9999
1
257 NL
2
74 R0510
V9999
V9999
1
300 NL
1
7 V9999
V9999
R0510
1
363 NL
1
9 V9999
V9999
R0510
1
437 NL
1
11 V9999
V9999
R0510
1
466 NL
1
16 V9999
V9999
R0510
1
567 NL
1
27 S0000
R0510
A8099
1
636 NL
1
12 V9999
V9999
R0510
1
2265 NL
1
28 V9999
V9999
R0510
1
2585 NL
2
16 V9999
V9999
R0510
1
3501 NL
1
23 V9999
V9999
R0510
1
5374 NL
1
48 V9999
V9999
R0510
1
6054 NL
1
10 V9999
V9999
R0510
1
6602 NL
1
13 V9999
R0510
V9999
1
7098 NL
1
35 V9999
V9999
R0510
1
7293 NL
1
37 V9999
V9999
R0510
1
7498 NL
1
33 V9999
V9999
R0510
1
7619 NL
1
10 R0510
V9999
V9999
1
7669 NL
1
30 V9999
V9999
R0510
1
7672 NL
1
13 V9999
V9999
R0510
1
7675 NL
1
37 V9999
V9999
R0510
1
7687 NL
2
26 V9999
R0510
B1099
1
9465 NL
1
27 V9999
V9999
R0510
1
9643 NL
1
7 V9999
V9999
R0510
1
10635 NL
2
8 V9999
V9999
R0510
1
10989 NL
1
22 V9999
V9999
R0510
1
12672 NL
2
33 V9999
V9999
R0510
1
13159 NL
1
13 V9999
V9999
R0510
1
13233 NL
1
18 V9999
V9999
R0510
1
13457 NL
1
10 V9999
V9999
R0510
1
13655 NL
1
28 V9999
V9999
R0510
1
13675 NL
1
20 V9999
V9999
R0510
1
36225 NL
1
23 V9999
V9999
R0510
1
45735 NL
1
30 V9999
V9999
R0510
1
47346 NL
1
7 V9999
V9999
R0510
1
48095 NL
1
2 V9999
V9999
R0510
1
51962 NL
1
20 V9999
R0510
V9999
1
51965 NL
1
15 V9999
V9999
R0510
1
51974 NL
1
6 V9999
V9999
R0510
1
52652 NL
2
25 V9999
V9999
R0510
1
53113 NL
1
14 V9999
V9999
R0510
1
53510 NL
1
22 V9999
V9999
R0510
1
54773 NL
1
7 V9999
V9999
R0510
1
56398 NL
1
30 V9999
V9999
R0510
1
57761 NL
1
20 V9999
A1899
R0510
1
57775 NL
1
17 V9999
V9999
R0510
1
57960 NL
1
11 V9999
V9999
R0510
1
58254 NL
2
13 V9999
V9999
R0510
1
58343 NL
1
15 V9999
V9999
R0510
1
58395 NL
1
25 V9999
R0510
V9999
1
58714 NL
1
14 V9999
V9999
R0510
1
60289 NL
1
13 V9999
V9999
R0510
1
4287 PT
2
58 R0510
V9999
V9999
1
6248 PT
1
10 R0510
R0510
V9999
1
7126 PT
1
13 R0510
R0510
V9999
1
7592 PT
1
15 R0510
R0510
V9999
1
25573 PT
1
11 R0510
R0510
V9999
1
593 SE
1
31 V0000
R0510
V0000
1
2289 SE
2
20 V0000
R0510
V0000
1
2392 SE
1
8 R0510
A7099
T0000
1
7194 SE
1
18 V0000
R0510
V0000
1
7220 SE
1
41 R0510
U1920
V0000
1
9933 SE
1
15 R0510
R0510
G3112
1
9963 SE
1
21 R0510
R0510
V0000
1
9971 SE
1
12 R0510
R0510
V0000
1
9972 SE
1
12 R0510
R0510
V0000
1
11612 SE
1
13 R0510
R0500
G3199
1
15777 SE
1
12 R0510
R0510
V0000
1
16083 SE
2
40 R0510
U0950
V0000
1
17764 SE
1
29 R0510
R0510
V0000
1
18178 SE
1
28 R0510
S0005
A1400
1
19045 SE
2
12 R0510
R0510
T0000
1
19046 SE
1
5 R0510
R0510
T0000
1
19118 SE
1
6 N1300
R0510
U0098
1
22129 SE
1
23 R0510
R0510
V0000
1
22130 SE
1
56 R0510
V9999
V0000
1
25496 SE
1
12 V0000
R0510
V0000
1
3460 UK
1
45 R0510
R0510
R0510
1
23046 UK
1
14 R0510
R0510
R0510
1
23577 UK
1
11 R0510
R0510
R0510
1
23578 UK
1
11 R0510
R0510
R0510
1
36559 UK
1
18 R0510
R0510
R0510
1
41256 UK
2
37 R0510
R0510
R0510
1
41257 UK
2
37 R0510
R0510
R0510
1
47799 UK
1
18 R0510
R0510
R0510
1
47884 UK
1
0 R0510
R0510
R0510
1
47885 UK
2
28 R0510
R0510
R0510
1
47892 UK
1
15 R0510
R0510
R0510
1
56344 UK
2
28 R0510
R0510
R0510
1
67076 UK
1
9 R0510
R0510
R0510
1
67077 UK
1
10 R0510
R0510
R0510
1
67078 UK
1
10 R0510
R0510
R0510
1
67331 UK
1
13 R0510
R0510
R0510
1
67332 UK
1
13 R0510
R0510
R0510
1
67527 UK
1
15 R0510
R0510
R0510
1
67528 UK
1
15 R0510
R0510
R0510
1
67543 UK
1
13 R0510
R0510
R0510
1
67544 UK
1
13 R0510
R0510
R0510
1
67824 UK
1
11 R0510
R0510
R0510
1
67825 UK
1
11 R0510
R0510
R0510
1
83840 UK
1
11 R0510
R0510
R0510
1
93373 UK
1
14 R0510
R0510
R0510
1
105675 UK
1
15 R0510
R0510
R0510
1
105676 UK
1
15 R0510
R0510
R0510
1
106971 UK
1
9 R0510
R0510
R0510
1
106972 UK
1
9 R0510
R0510
R0510
1
139841 UK
2
32 R0510
R0510
R0510
1
139854 UK
1
26 R0510
R0510
R0510
1
151977 UK
1
12 R0510
R0510
R0510
1
164135 UK
1
9 R0510
R0510
R0510
1
164136 UK
1
9 R0510
R0510
R0510
1
164722 UK
1
13 R0510
R0510
R0510
1
164723 UK
1
13 R0510
R0510
R0510
1
164724 UK
1
13 R0510
R0510
R0510
1
179378 UK
1
43 R0510
R0510
R0510
1
179379 UK
1
43 R0510
R0510
R0510
1
205755 UK
1
10 R0510
R0510
R0510
1
205756 UK
1
10 R0510
R0510
R0510
1
277
Data Table con’t
G3110/G3112
Kennummer
Country
Sex
Age
Product1
Product2
Product3
V9999
Häufigkeit
7236 AT
2
16 G3110
F1399
16874 DK
1
18 G3110
U0950
1
35104 DK
1
18
G3110
1
35120 DK
2
2 G3110
U0950
35124 DK
2
16 G3110
U0950
1
39162 DK
1
12 G3110
U0950
1
45732 DK
1
29
G3110
1
60990 DK
1
37 G3110
A7050
1
4019 FI
1
12 G3110
U0950
P0118
1
4250 FI
1
12 G3110
U0950
V9998
1
3169 FR
1
23 R0105
R0105
G3110
1
6842 FR
1
30 G3110
G3110
V9999
1
7849 FR
1
16 G3110
R0105
V9999
1
11319 FR
1
36 G3110
R0500
V9999
1
11494 FR
1
18 G3110
R0105
V9999
1
13784 FR
1
27 G3110
G3110
V9999
1
14362 FR
1
20 G3110
R0105
V9999
1
16121 FR
2
28 P5115
G3110
Q7005
1
21711 FR
1
20 V9999
G3110
V9999
1
30703 FR
1
18 V9998
G3110
V9998
1
41725 FR
1
8 G3110
G3110
V9999
1
970 GR
1
6 C0212
C0212
G3110
1
3665 GR
2
3 G3110
C0212
C0212
1
6534 GR
1
6 G3110
C0212
E0215
1
6786 GR
2
3 G3110
C0212
E0215
1
6890 GR
2
2 G3110
C0212
E0215
1
7099 GR
1
12 G3110
C0212
E0215
1
7113 GR
2
3 G3110
C0212
E0215
1
7185 GR
1
8 E0215
G3110
E0215
1
7258 GR
2
3 G3110
C0212
E0215
1
7435 GR
1
5 G3110
P2205
E0215
1
7440 GR
1
5 E0215
G3110
E0215
1
7834 GR
1
10 G3110
C0212
E0215
1
7844 GR
1
7 G3110
C0212
E0215
1
7854 GR
1
216 G3110
C0212
E0215
1
7891 GR
2
6 G3110
C0212
E0215
1
8049 GR
1
12 C0212
C0212
G3110
1
8369 GR
1
7 G3110
C0212
E0215
1
8393 GR
2
10 G3110
C0212
E0215
1
8465 GR
1
4 C0212
C0212
G3110
1
8485 GR
1
2 G3110
C0212
E0215
1
T0000
1
1
8886 GR
1
7 G3110
E0215
E0215
1
9283 GR
2
3 G3110
C0212
E0215
1
9418 GR
2
5 G3110
C0212
E0215
1
13803 GR
1
49 G3110
C0212
E0215
1
13973 GR
1
92 G3110
C0212
F1198
1
14223 GR
2
65 G3110
C0212
E0215
1
14335 GR
2
22 G3110
C0212
E0215
1
14533 GR
1
73 C0212
C0212
G3110
1
14542 GR
1
30 G3110
B0155
E0215
1
14733 GR
1
30 G3110
A1410
E0215
1
15158 GR
1
52 G3110
C0212
E0215
1
15475 GR
1
33 B0155
B0155
G3110
1
17173 GR
1
65 G3110
C0212
E0215
1
19080 GR
2
53 C0212
C0212
G3110
1
19981 GR
2
75 G3110
B0155
E0215
1
28336 GR
1
27 E0215
G3110
E0215
1
29027 GR
2
23 E0215
G3110
E0215
1
29186 GR
1
42 E0215
G3110
E0215
1
29223 GR
2
21 E0215
G3110
E0215
1
29454 GR
2
20 E0215
G3110
E0215
1
29456 GR
1
57 G3110
C0212
E0215
1
29497 GR
2
29 E0215
G3110
E0215
1
29731 GR
2
17 E0215
G3110
E0215
1
29751 GR
1
67 E0215
G3110
E0215
1
30460 GR
2
35 K4200
G3110
E0215
1
31251 GR
1
32 G3110
C0212
E0215
1
7817 IT
1
51 G3110
U0950
V9999
1
9805 IT
1
37 G3110
U0950
V9999
1
3969 PT
2
22 G3110
G3110
V9999
1
14291 PT
1
11 G3110
E0009
V9999
1
18073 PT
1
7 G3110
G3110
V9999
1
31166 PT
1
28 G3110
K0398
V9999
1
31918 PT
1
29 G3110
G3110
V9999
1
9933 SE
1
15 R0510
R0510
G3112
1
10684 SE
1
12 G3112
G3112
T0000
1
18468 SE
1
12 G3112
U0950
G3000
1
1400 UK
2
35 G3110
G3110
G3110
1
1401 UK
2
35 G3110
G3110
G3110
1
2979 UK
1
34 G3110
G3110
G3110
1
2980 UK
1
34 G3110
G3110
G3110
1
7576 UK
1
7 G3112
G3112
G3112
1
8555 UK
2
5 G3112
G3112
G3112
1
30877 UK
1
35 G3110
G3110
G3110
1
93416 UK
2
17 G3112
G3112
G3112
1
93885 UK
1
4 G3112
G3112
G3112
1
107918 UK
1
25 G3112
G3112
G3112
1
108786 UK
1
14 G3112
G3112
G3112
1
138306 UK
2
23 G3112
G3112
G3112
1
138307 UK
2
23 G3112
G3112
G3112
1
90
Data Table con’t
F0012
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
7148 BE
1
0 F0012
Q7005
V9999
1
15066 FR
1
213 V9999
F0012
V9999
1
16040 FR
1
210 V9999
F0012
V9999
1
22810 FR
1
213 F0012
C0299
V9999
1
41594 FR
2
210 F0012
F0012
V9999
1
2261 IE
2
9 F0012
V9999
V9999
1
4937 IT
1
3 F0012
C0210
V9999
1
8609 IT
2
29 V9999
F0012
V9999
1
3973 PT
2
209 F0012
C0298
V9999
1
9854 PT
2
210 F0012
F0012
V9999
1
33509 PT
2
26 V9999
V9999
F0012
1
10773 UK
2
4 F0012
F0012
F0012
1
92260 UK
2
3 F0012
F0012
F0012
1
13
Data Table con’t
K0705
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
1899 DK
2
214
K0705
1
8153 DK
1
203 K0705
C0212
1
13366 DK
1
203 K0705
C0299
1
15307 DK
2
K0705
1
19430 DK
2
2 K0705
K0398
1
25380 DK
1
2 K0705
T0000
1
28718 DK
2
208 K0705
C0299
1
48628 DK
2
208 K0705
V9940
1
49108 DK
1
21 K0100
K0705
1
50358 DK
1
7 K0705
V9940
1
58905 DK
1
205 K0705
C0299
1
538 SE
1
203 K0705
K0398
T0000
1
7411 SE
1
201 K0705
C0299
V0000
1
9400 SE
2
2 K0705
T0000
K0199
1
10783 SE
2
205 K0705
C0299
F1320
1
18568 SE
2
203 T0000
B1000
K0705
1
18569 SE
1
2 T0000
K0300
K0705
1
1756 UK
2
1 K0705
K0705
K0705
1
2871 UK
2
24 K0705
K0705
K0705
1
3239 UK
1
1 K0705
K0705
K0705
1
3373 UK
1
28 K0705
K0705
K0705
1
5779 UK
2
1 K0705
K0705
K0705
1
15542 UK
1
36 K0705
K0705
K0705
1
16366 UK
2
41 K0705
K0705
K0705
1
17801 UK
2
48 K0705
K0705
K0705
1
23934 UK
2
1 K0705
K0705
K0705
1
28362 UK
1
34 K0705
K0705
K0705
1
31619 UK
1
0 K0705
K0705
K0705
1
31735 UK
1
19 K0705
K0705
K0705
1
44370 UK
1
1 K0705
K0705
K0705
1
47280 UK
2
2 K0705
K0705
K0705
1
47589 UK
1
13 K0705
K0705
K0705
1
49409 UK
2
81 K0705
K0705
K0705
1
54873 UK
2
3 K0705
K0705
K0705
1
63489 UK
1
4 K0705
K0705
K0705
1
69028 UK
1
22 K0705
K0705
K0705
1
70808 UK
2
21 K0705
K0705
K0705
1
70809 UK
2
21 K0705
K0705
K0705
1
70834 UK
2
2 K0705
K0705
K0705
1
70945 UK
1
2 K0705
K0705
K0705
1
72761 UK
1
26 K0705
K0705
K0705
1
30
84478 UK
2
52 K0705
K0705
K0705
1
87492 UK
2
39 K0705
K0705
K0705
1
95612 UK
1
44 K0705
K0705
K0705
1
95613 UK
1
44 K0705
K0705
K0705
1
95689 UK
2
2 K0705
K0705
K0705
1
97089 UK
2
57 K0705
K0705
K0705
1
122439 UK
1
38 K0705
K0705
K0705
1
125347 UK
2
2 K0705
K0705
K0705
1
125455 UK
1
22 K0705
K0705
K0705
1
134157 UK
2
0 K0705
K0705
K0705
1
134158 UK
2
0 K0705
K0705
K0705
1
135888 UK
2
0 K0705
K0705
K0705
1
136320 UK
2
20 K0705
K0705
K0705
1
141802 UK
1
42 K0705
K0705
K0705
1
141803 UK
1
42 K0705
K0705
K0705
1
143733 UK
1
4 K0705
K0705
K0705
1
143911 UK
1
1 K0705
K0705
K0705
1
144083 UK
1
2 K0705
K0705
K0705
1
145965 UK
2
1 K0705
K0705
K0705
1
153043 UK
2
26 K0705
K0705
K0705
1
157034 UK
1
11 K0705
K0705
K0705
1
158793 UK
1
21 K0705
K0705
K0705
1
162268 UK
2
93 K0705
K0705
K0705
1
169360 UK
1
3 K0705
K0705
K0705
1
179361 UK
2
0 K0705
K0705
K0705
1
179362 UK
2
0 K0705
K0705
K0705
1
182642 UK
1
30 K0705
K0705
K0705
1
182643 UK
1
30 K0705
K0705
K0705
1
182644 UK
1
30 K0705
K0705
K0705
1
182645 UK
1
30 K0705
K0705
K0705
1
188639 UK
2
77 K0705
K0705
K0705
1
189774 UK
1
2 K0705
K0705
K0705
1
191823 UK
2
36 K0705
K0705
K0705
1
197961 UK
1
30 K0705
K0705
K0705
1
198897 UK
2
60 K0705
K0705
K0705
1
198898 UK
2
60 K0705
K0705
K0705
1
203236 UK
2
2 K0705
K0705
K0705
1
205391 UK
1
2 K0705
K0705
K0705
1
79
Data Table con’t
N2022 /N2024
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
2892AT
2
8N2022
V9999
V9999
1
2899AT
1
17N2022
N2022
V9999
1
2944AT
1
15V9999
N2022
V9999
1
3381AT
2
11N2022
N2022
V9999
1
4928AT
2
16N2022
N2022
V9999
1
4945AT
2
4N2022
N2022
V9999
1
5037AT
1
31N2024
V9999
V9999
1
6258AT
2
15N2022
B2998
V9999
1
7213AT
1
7N2022
N2016
V9999
1
7393AT
1
13V9999
N2022
V9999
1
390BE
1
21N2022
N2022
V9999
1
558BE
2
17N2022
N2022
V9999
1
607BE
1
3N2098
N2022
V9999
1
753BE
1
14N2098
N2022
V9999
1
1055BE
2
7N2022
B2999
V9999
1
1689BE
1
7N2022
B2999
V9999
1
2218BE
2
8N2022
V9999
V9999
1
2975BE
2
12N2022
B2999
V9999
1
3724BE
2
10N2098
N2022
V9999
1
3830BE
1
16N2098
N2022
V9999
1
4485BE
2
13N2022
N2022
V9999
1
4617BE
1
15N2022
N2016
V9999
1
4657BE
2
12N2022
N2022
V9999
1
4760BE
1
15N2022
N2022
V9999
1
5010BE
2
8N2022
N2022
V9999
1
5150BE
1
8N2022
N2016
V9999
1
5471BE
1
17N2022
C0298
V9999
1
6357BE
2
14N2022
N2016
C0210
1
8241BE
2
6N2022
C0299
V9999
1
8884BE
2
19N2022
N2022
V9999
1
9815BE
1
22N2022
C0299
V9999
1
10991BE
1
15N2022
N2022
V9999
1
11006BE
2
9N2099
N2022
V9999
1
12155BE
2
14N2099
N2022
V9999
1
12342BE
2
10N2098
C0299
N2022
1
14646BE
2
20N2024
N2024
V9999
1
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11N2022
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11N2099
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13N2098
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15
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13
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1
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36
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11
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11N2022
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1
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5
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14
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18N2022
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6
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15
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8
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2
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20
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1
41
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1
25
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38
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1
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1
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30
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24
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18
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35
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32
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10N2024
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C0112
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20N2022
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13N2098
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12N2022
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31959FR
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32583FR
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15N2022
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12N2022
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33268FR
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13N2098
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11N2022
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2
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20N2022
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35640FR
2
16N2098
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36159FR
1
10N2022
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16V9998
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36634FR
2
11V9998
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21N2022
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1
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2N2022
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16N2022
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12N2022
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6N2022
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18N2099
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1
32N2099
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1
24N2098
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1
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2
15N2198
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1
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1
18N2024
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1
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1
28V9999
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1
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1
15N2024
C0212
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1
21N2024
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1
12N2024
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2
12N2024
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1
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1
7N2024
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2
33N2024
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1
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1
14V9999
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1
11074IT
1
18V9999
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11128IT
1
17N2022
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1
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1
16V9999
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1
7ES
2
11V9999
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1
519PT
2
49N2022
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1
1018PT
1
14N2022
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1
13N2022
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1
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2
12N2022
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1
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13N2022
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1
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1
16N2022
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1
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2
17N2022
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1
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1
13N2022
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1
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2
20N2022
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1
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2
12N2022
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1
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1
15N2022
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1
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1
16N2022
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1
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2
17N2022
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1
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2
18N2022
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1
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2
12N2022
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1
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1
11N2022
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1
17103PT
1
11N2022
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1
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2
15N2022
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1
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2
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1
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2
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1
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1
10N2022
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1
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2
13N2022
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1
35275PT
1
12N2022
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1
35812PT
1
11N2022
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1
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1
10N2022
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1
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1
11N2022
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1
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2
9N2022
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1
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2
8V0000
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1
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1
12N2022
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1
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1
15N2022
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1
13769SE
2
10N2022
C0299
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1
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2
17N2024
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1
15228SE
1
23N2022
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1
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2
14N2016
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1
21792SE
1
9N2022
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V0000
1
21793SE
2
13N2022
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1
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6N2024
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52N2022
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1
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1
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1
7N2022
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1
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22N2022
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1
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5N2022
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1
30004UK
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10N2022
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1
13N2022
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1
31733UK
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72N2022
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1
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1
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1
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1
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15N2022
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1
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16N2022
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1
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2
16N2022
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1
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18N2022
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1
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2
15N2022
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1
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2
15N2022
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1
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23N2022
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1
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1
7N2022
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1
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1
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1
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2
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1
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1
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1
3N2022
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1
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26N2022
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1
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13N2022
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1
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1
13N2022
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19N2022
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1
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1
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1
11N2022
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13N2022
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1
76693UK
2
13N2022
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1
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2
13N2024
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1
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1
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14N2022
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1
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14N2022
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1
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1
12N2022
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15N2022
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1
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2
14N2022
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1
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2
12N2022
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1
81522UK
2
29N2022
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N2022
1
81945UK
2
6N2022
N2022
N2022
1
82959UK
2
15N2022
N2022
N2022
1
83309UK
1
14N2022
N2022
N2022
1
85156UK
2
25N2022
N2022
N2022
1
86771UK
1
11N2024
N2024
N2024
1
87399UK
2
4N2024
N2024
N2024
1
90216UK
2
9N2022
N2022
N2022
1
90689UK
1
10N2022
N2022
N2022
1
97767UK
1
7N2022
N2022
N2022
1
99768UK
2
5N2024
N2024
N2024
1
100664UK
2
5N2022
N2022
N2022
1
102263UK
1
12N2022
N2022
N2022
1
102264UK
1
12N2022
N2022
N2022
1
102265UK
1
12N2022
N2022
N2022
1
110499UK
2
9N2022
N2022
N2022
1
112119UK
1
28N2022
N2022
N2022
1
112120UK
1
28N2022
N2022
N2022
1
115107UK
1
7N2022
N2022
N2022
1
116143UK
1
7N2022
N2022
N2022
1
116144UK
1
7N2022
N2022
N2022
1
117050UK
2
12N2022
N2022
N2022
1
117051UK
2
12N2022
N2022
N2022
1
121519UK
2
22N2022
N2022
N2022
1
121520UK
2
22N2022
N2022
N2022
1
122747UK
1
4N2022
N2022
N2022
1
128610UK
2
7N2022
N2022
N2022
1
128611UK
2
7N2022
N2022
N2022
1
128748UK
1
4N2022
N2022
N2022
1
132788UK
2
7N2022
N2022
N2022
1
136646UK
2
46N2024
N2024
N2024
1
137446UK
1
5N2022
N2022
N2022
1
141905UK
2
13N2022
N2022
N2022
1
143243UK
2
22N2022
N2022
N2022
1
143738UK
1
13N2022
N2022
N2022
1
144069UK
1
15N2022
N2022
N2022
1
144658UK
2
11N2022
N2022
N2022
1
147978UK
1
10N2022
N2022
N2022
1
150312UK
1
2N2024
N2024
N2024
1
151902UK
2
14N2022
N2022
N2022
1
152187UK
2
14N2022
N2022
N2022
1
152211UK
2
11N2022
N2022
N2022
1
153505UK
2
16N2022
N2022
N2022
1
153575UK
2
11N2022
N2022
N2022
1
153835UK
2
18N2022
N2022
N2022
1
154025UK
2
14N2022
N2022
N2022
1
154599UK
2
13N2022
N2022
N2022
1
155163UK
2
14N2022
N2022
N2022
1
156590UK
1
17N2022
N2022
N2022
1
157077UK
2
21N2022
N2022
N2022
1
157442UK
2
13N2022
N2022
N2022
1
158324UK
2
12N2022
N2022
N2022
1
158631UK
1
21N2022
N2022
N2022
1
158960UK
2
19N2022
N2022
N2022
1
162884UK
2
12N2024
N2024
N2024
1
163162UK
2
11N2022
N2022
N2022
1
163394UK
1
14N2022
N2022
N2022
1
165513UK
2
15N2022
N2022
N2022
1
165770UK
2
19N2022
N2022
N2022
1
166119UK
2
11N2022
N2022
N2022
1
167232UK
2
13N2022
N2022
N2022
1
167233UK
2
13N2022
N2022
N2022
1
167250UK
2
15N2022
N2022
N2022
1
167251UK
2
15N2022
N2022
N2022
1
167738UK
1
10N2022
N2022
N2022
1
167739UK
1
10N2022
N2022
N2022
1
167822UK
1
10N2022
N2022
N2022
1
167823UK
1
10N2022
N2022
N2022
1
171297UK
1
15N2022
N2022
N2022
1
172936UK
2
29N2022
N2022
N2022
1
172937UK
2
29N2022
N2022
N2022
1
173446UK
2
16N2022
N2022
N2022
1
173447UK
2
16N2022
N2022
N2022
1
173929UK
2
28N2022
N2022
N2022
1
177898UK
2
6N2022
N2022
N2022
1
177899UK
2
6N2022
N2022
N2022
1
178922UK
2
13N2022
N2022
N2022
1
178974UK
2
13N2024
N2024
N2024
1
178975UK
2
13N2024
N2024
N2024
1
178976UK
2
13N2024
N2024
N2024
1
180719UK
1
2N2022
N2022
N2022
1
180875UK
2
9N2022
N2022
N2022
1
182122UK
1
23N2022
N2022
N2022
1
183275UK
2
36N2022
N2022
N2022
1
183276UK
2
36N2022
N2022
N2022
1
186776UK
2
7N2022
N2022
N2022
1
186777UK
2
7N2022
N2022
N2022
1
187662UK
2
14N2022
N2022
N2022
1
187663UK
2
14N2022
N2022
N2022
1
188296UK
1
9N2022
N2022
N2022
1
188372UK
1
15N2022
N2022
N2022
1
188645UK
2
13N2022
N2022
N2022
1
188646UK
2
13N2022
N2022
N2022
1
188681UK
2
18N2022
N2022
N2022
1
189480UK
2
14N2022
N2022
N2022
1
189481UK
2
14N2022
N2022
N2022
1
190149UK
2
15N2022
N2022
N2022
1
190186UK
2
14N2022
N2022
N2022
1
190856UK
2
16N2022
N2022
N2022
1
191248UK
1
27N2022
N2022
N2022
1
191249UK
1
27N2022
N2022
N2022
1
191628UK
2
9N2022
N2022
N2022
1
191629UK
2
9N2022
N2022
N2022
1
192265UK
1
12N2022
N2022
N2022
1
195340UK
2
10N2022
N2022
N2022
1
196016UK
2
14N2022
N2022
N2022
1
196017UK
2
14N2022
N2022
N2022
1
196018UK
2
14N2022
N2022
N2022
1
197668UK
2
13N2022
N2022
N2022
1
197669UK
2
13N2022
N2022
N2022
1
201931UK
2
9N2022
N2022
N2022
1
202688UK
1
6N2022
N2022
N2022
1
203334UK
2
7N2022
N2022
N2022
1
204497UK
2
12N2022
N2022
N2022
1
205256UK
2
14N2022
N2022
N2022
1
208385UK
2
11N2022
N2022
N2022
1
208402UK
1
15N2022
N2022
N2022
1
495
Data Table con’t
S0404
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
3681 SE
2
45 S0406
S0404
V0000
1
14072 SE
1
59 S0404
U0199
V0000
1
17793 SE
1
6 S0404
V9999
V0000
1
26016 SE
1
9 T0000
S0404
V0000
1
4
P0146
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
9890 BE
2
35 C0644
P0148
P0146
1
16062 SE
2
2 C0200
C0405
P0146
1
16299 SE
1
81 P0146
S0420
C5098
1
2346 UK
2
2 P0146
P0146
P0146
1
93651 UK
1
3 P0146
P0146
P0146
1
5
K2028
Kennummer
Country
Sex
Age
Product1
Product2
56330 DK
2
2 K2028
B1009
60016 DK
1
2 K2000
V9940
Product3
Häufigkeit
1
K2028
1
2
Data Table con’t
P4010
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
435AT
2
48 B2020
B1040
P4010
1
6328AT
2
85 K3010
P4010
V9999
1
8479BE
1
2 P4010
C0299
V9999
1
1242DK
2
202
P4010
1
1695DK
2
214
P4010
1
2799DK
2
202 P4010
B1009
1
5562DK
1
2 P4010
V9940
1
5577DK
2
214 P4010
V9940
1
5704DK
1
211 P4010
B1099
1
7091DK
2
203 P4010
V9940
1
8567DK
2
209
P4010
1
9068DK
1
213 P4010
V9940
1
10115DK
1
209 P4010
V9940
1
10892DK
1
207 P4010
C0220
1
11287DK
1
202 P4010
C0299
1
18222DK
1
211 P4010
C0299
1
18427DK
1
13
P4010
1
20909DK
2
212
P4010
1
21570DK
2
211 P4010
C0210
1
22626DK
1
2 P4010
V9940
1
22648DK
1
212 P4098
P4010
1
23061DK
1
202 P4010
V9940
1
27026DK
2
207 P4010
V9940
1
29866DK
2
206 P4010
B1000
31255DK
2
2 P4010
B1099
35958DK
1
213
P4010
37143DK
1
207 P4010
B1099
1
37840DK
2
210 P4010
B1099
1
37860DK
1
3 P4010
B1099
1
37948DK
1
2 P4010
B1099
1
38058DK
2
38 P4010
C0299
1
41040DK
2
25
P4010
1
41524DK
2
C0210
1
46375DK
2
P4010
1
49749DK
2
209 P4010
C0299
1
51382DK
2
2 P4010
B1099
1
52670DK
1
211 P4010
B1099
59636DK
2
P4010
1
60146DK
2
210 P4010
V9940
1
61367DK
1
216 P4010
V9940
1
64287DK
2
216 P4010
V9940
1
65098DK
1
42 P4010
B1040
1
210 P4010
3
26
T1000
1
1
B1009
P4098
1
1
2316FI
2
215 K9998
B2998
P4010
1
2648FI
1
2 P4010
B2998
V9998
1
3092FI
2
210 P4010
B2998
V9998
1
3366FI
1
202 P4010
B2999
V9998
1
3651FI
2
2 V9999
B2999
P4010
1
5028FI
1
2 P4098
P4098
P4010
1
6658FI
2
2 P4010
B2999
V9998
1
124FR
1
202 P4010
B2999
V9999
1
1050FR
1
215 P4010
B2999
V9999
1
1485FR
2
10 P4010
B2999
V9999
1
1747FR
1
202 P4010
B2999
V9999
1
2688FR
1
207 P4010
V9998
V9999
1
7252FR
2
202 P4010
C0299
V9999
1
11384FR
2
210 P4010
R0920
V9999
1
17058FR
2
206 P4010
P4010
V9999
1
18494FR
1
211 P4010
R0920
V9999
1
18497FR
1
210 P4010
V9998
V9999
1
21557FR
1
214 P4010
C0299
V9999
1
21652FR
1
205 P4010
B2999
V9999
1
21804FR
2
29 P4010
B2999
V9999
1
22312FR
1
209 P4010
B2999
V9999
1
22835FR
2
2 F0005
P4010
V9999
1
23080FR
1
2 P4010
F4305
V9999
1
23104FR
1
2 P4010
C0210
V9999
1
23638FR
1
2 P4010
B1098
V9999
1
23977FR
1
3 P4010
B1098
V9999
1
24347FR
2
2 P4010
C0210
V9999
1
24499FR
2
209 P4010
B1098
V9999
1
24741FR
1
208 P4010
C0210
V9999
1
24913FR
2
2 P4010
C0212
V9999
1
25354FR
2
207 P4010
C0210
V9999
1
25816FR
2
7 P4010
C0210
V9999
1
29276FR
1
9 P4010
V9999
V9999
1
36330FR
2
31 P4010
K0100
K0398
1
36415FR
2
211 V9998
P4010
V9998
1
37032FR
1
215 V9998
P4010
V9998
1
37225FR
1
2 P4010
B2999
V9999
1
38043FR
1
2 P4010
P4010
V9999
1
38928FR
1
208 P4010
B2999
V9999
1
40459FR
1
203 P4010
B2999
V9999
1
40478FR
1
2 P4010
B2999
V9999
1
40504FR
2
213 P4010
P4010
V9999
1
40533FR
1
4 P4010
P4010
V9999
1
40625FR
1
210 P4010
B2999
V9999
1
41157FR
2
214 P4010
B2999
V9999
1
41230FR
1
214 C0098
C0098
P4010
1
96IE
1
205 P4010
P4010
V9999
1
568IE
1
2 P4010
C0098
V9999
1
2643IE
2
207 P4010
V9999
V9999
1
5908IE
2
212 P4010
P4010
V9999
1
2282IT
1
4 P4010
B2999
V9999
1
3044IT
1
2 P4010
B2999
V9999
1
3530IT
1
212 P4010
B2999
V9999
1
4188IT
2
11 P4010
P4010
V9999
1
4556IT
2
2 P4010
P4010
V9999
1
5878IT
1
216 P4010
C0210
V9999
1
6534IT
2
209 P4010
C0210
V9999
1
6716IT
2
212 P4010
P4010
V9999
1
6822IT
2
212 P4010
C0210
V9999
1
7136IT
1
216 P4010
P4010
V9999
1
7405IT
1
216 P4010
P4010
V9999
1
9553IT
1
2 P4010
V9999
V9999
1
12466IT
2
212 V9999
P4010
V9999
1
1155PT
1
211 P4010
B1098
V9999
1
7135PT
1
2 P4010
C0210
V9999
1
8853PT
1
206 P4010
C0210
V9999
1
9711PT
1
210 V9999
B1098
P4010
1
12085PT
2
12 P4010
C0212
V9999
1
12811PT
2
205 P4010
C0200
V9999
1
14297PT
2
212 P4010
P4010
V9999
1
15284PT
2
201 P4010
B1098
V9999
1
15403PT
2
25 P4010
B1002
V9999
1
15404PT
1
215 P4010
B1002
V9999
1
17761PT
2
5 P4010
P4010
V9999
1
19541PT
1
214 P4010
C0210
V9999
1
21733PT
2
212 P4010
F1399
C0299
1
22598PT
1
212 P4010
A1998
V9999
1
23359PT
1
2 P4010
B1098
V9999
1
23631PT
2
204 P4010
C0098
V9999
1
23872PT
2
216 P4010
C0210
V9999
1
23914PT
1
214 P4010
B1098
V9999
1
26921PT
1
202 P4010
C0210
V9999
1
27503PT
2
213 P4010
B1098
V9999
1
27898PT
1
212 P4010
B1098
V9999
1
28491PT
2
207 P4010
B1098
V9999
1
29014PT
2
203 P4010
C0299
V9999
1
29029PT
1
40 P4010
F1005
V9999
1
31829PT
1
3 P4010
B1099
V9999
1
34546PT
1
208 P4010
C0298
V9999
1
34564PT
1
208 P4010
F4305
V9999
1
35825PT
2
213 P4010
B1098
V9999
1
37304PT
1
11 P4010
B1098
V9999
1
37311PT
2
207 P4010
B1099
V9999
1
1291SE
2
40 B1040
B1040
P4010
1
3612SE
1
4 V0000
P4010
V0000
1
3780SE
1
32 P4010
H4400
V0000
1
3994SE
1
4 P4010
B1004
V0000
1
3996SE
1
211 V0000
P4010
V0000
1
4893SE
1
204 P4010
A1310
V0000
1
9459SE
2
63 P4010
V9999
V0000
1
10566SE
1
202 P4010
B1000
T0000
1
10634SE
2
206 P4010
V9999
V0000
1
11370SE
1
212 P4010
C0299
V0000
1
15992SE
2
3 P4010
P4010
V0000
1
17761SE
2
2 P4010
C0299
V0000
1
18107SE
1
212 P4010
P4010
V0000
1
18208SE
2
213 P4010
P4010
B1099
1
18779SE
1
2 T1404
T1404
P4010
1
18780SE
2
28 U0002
B1040
P4010
1
21911SE
1
2 P4010
B1000
V0000
1
21912SE
2
78 P4010
B1009
V0000
1
21915SE
2
2 P4010
B1099
V0000
1
21916SE
2
2 P4010
C0212
V0000
1
21918SE
2
216 P4010
P4010
V0000
1
21919SE
2
213 P4010
P4010
V0000
1
21920SE
2
79 P4010
V9999
V0000
1
25755SE
2
203 C0099
P4010
T0000
1
26388SE
2
216 P4010
V9930
V0000
1
402UK
1
0 P4010
P4010
P4010
1
6076UK
1
33 P4010
P4010
P4010
1
7633UK
2
1 P4010
P4010
P4010
1
12328UK
1
5 P4010
P4010
P4010
1
19746UK
1
9 P4010
P4010
P4010
1
19747UK
1
9 P4010
P4010
P4010
1
21585UK
1
0 P4010
P4010
P4010
1
24858UK
2
70 P4010
P4010
P4010
1
26259UK
1
0 P4010
P4010
P4010
1
28722UK
2
38 P4010
P4010
P4010
1
45129UK
2
2 P4010
P4010
P4010
1
57211UK
2
9 P4010
P4010
P4010
1
72825UK
2
6 P4010
P4010
P4010
1
75194UK
1
0 P4010
P4010
P4010
1
75426UK
2
1 P4010
P4010
P4010
1
81102UK
2
85 P4010
P4010
P4010
1
82269UK
2
85 P4010
P4010
P4010
1
84974UK
2
25 P4010
P4010
P4010
1
86838UK
2
0 P4010
P4010
P4010
1
87704UK
1
0 P4010
P4010
P4010
1
91358UK
2
23 P4010
P4010
P4010
1
91871UK
1
0 P4010
P4010
P4010
1
129994UK
2
1 P4010
P4010
P4010
1
129995UK
2
1 P4010
P4010
P4010
1
130709UK
2
7 P4010
P4010
P4010
1
131730UK
1
2 P4010
P4010
P4010
1
131731UK
1
2 P4010
P4010
P4010
1
135619UK
2
0 P4010
P4010
P4010
1
135878UK
2
1 P4010
P4010
P4010
1
136189UK
2
2 P4010
P4010
P4010
1
139377UK
1
11 P4010
P4010
P4010
1
139872UK
2
0 P4010
P4010
P4010
1
142428UK
2
1 P4010
P4010
P4010
1
150845UK
1
0 P4010
P4010
P4010
1
180278UK
2
25 P4010
P4010
P4010
1
194952UK
2
33 P4010
P4010
P4010
1
194953UK
2
33 P4010
P4010
P4010
1
195030UK
1
0 P4010
P4010
P4010
1
200737UK
1
1 P4010
P4010
P4010
1
201684UK
2
1 P4010
P4010
P4010
1
203836UK
1
11 P4010
P4010
P4010
1
204608UK
2
0 P4010
P4010
P4010
1
204609UK
2
0 P4010
P4010
P4010
1
207501UK
2
48 P4010
P4010
P4010
1
204
Data Table con’t
S0932
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
5782 DK
2
56 S0932
K0110
1
7545 DK
1
33
S0932
1
17274 DK
2
49 S0932
V9940
1
21558 DK
1
2 S0932
V9940
1
23546 DK
1
50 H7020
S0932
1
23928 DK
2
64 S0932
B1099
1
30297 DK
2
4 T0000
S0932
1
32436 DK
1
62 S0932
A1810
1
33187 DK
1
33
S0932
1
33203 DK
2
8 S0932
B1999
1
33879 DK
1
63 Y1299
B1999
35091 DK
2
5
S0932
1
35920 DK
2
4 S0932
C0299
1
36347 DK
2
11 S0932
V9940
1
37837 DK
2
10 S0932
C0299
1
38408 DK
1
6 S0932
C0299
1
39763 DK
2
29 S0932
B2020
1
39948 DK
2
10 S0932
N2022
1
40234 DK
2
10 S0932
C0299
1
43351 DK
2
50 S0932
S0932
1
59731 DK
2
70 S0932
C0205
1
61031 DK
2
43 S0932
V9940
1
64566 DK
1
43 S0932
V9940
1
65262 DK
2
35 S0932
V9940
4623 SE
2
6 S0932
B1998
B0212
1
4639 SE
2
47 B1198
S0932
V0000
1
6237 SE
1
50 S0932
V0000
V0000
1
7592 SE
1
46 T1098
S0932
V0000
1
7626 SE
2
76 S0932
S0932
S0310
1
8757 SE
1
38 S0932
S0932
A1400
1
10249 SE
1
64 U1299
B1099
S0932
1
11342 SE
2
11 S0932
S0932
V0000
1
11706 SE
2
78 S0932
V9998
V0000
1
12356 SE
2
8 S0932
H4110
V0000
1
13397 SE
1
9 B0205
V9999
S0932
1
14386 SE
2
22 S0932
A0011
V0000
1
14387 SE
1
47 S0932
V9998
V0000
1
15697 SE
2
83 S0932
B2020
U1200
1
16511 SE
1
19 S0932
S0932
D0900
1
18917 SE
1
10 T0000
V9930
S0932
1
S0932
1
1
22195 SE
2
38 S0932
A0011
V0000
1
22196 SE
1
11 S0932
H4300
V0000
1
2431 UK
2
45 S0932
S0932
S0932
1
2518 UK
1
62 S0932
S0932
S0932
1
16097 UK
1
42 S0932
S0932
S0932
1
18751 UK
1
33 S0932
S0932
S0932
1
26464 UK
2
35 S0932
S0932
S0932
1
39344 UK
1
35 S0932
S0932
S0932
1
39574 UK
2
26 S0932
S0932
S0932
1
45333 UK
2
5 S0932
S0932
S0932
1
49262 UK
2
25 S0932
S0932
S0932
1
50377 UK
1
58 S0932
S0932
S0932
1
57722 UK
1
30 S0932
S0932
S0932
1
61005 UK
2
31 S0932
S0932
S0932
1
63044 UK
1
13 S0932
S0932
S0932
1
65879 UK
1
19 S0932
S0932
S0932
1
69952 UK
2
11 S0932
S0932
S0932
1
75111 UK
2
4 S0932
S0932
S0932
1
86212 UK
1
20 S0932
S0932
S0932
1
99424 UK
1
37 S0932
S0932
S0932
1
113254 UK
2
72 S0932
S0932
S0932
1
113255 UK
2
72 S0932
S0932
S0932
1
113256 UK
2
72 S0932
S0932
S0932
1
140792 UK
2
10 S0932
S0932
S0932
1
147871 UK
2
29 S0932
S0932
S0932
1
149429 UK
1
22 S0932
S0932
S0932
1
149450 UK
2
13 S0932
S0932
S0932
1
149460 UK
1
53 S0932
S0932
S0932
1
149496 UK
1
35 S0932
S0932
S0932
1
157335 UK
2
11 S0932
S0932
S0932
1
158624 UK
2
49 S0932
S0932
S0932
1
163967 UK
2
46 S0932
S0932
S0932
1
165474 UK
1
6 S0932
S0932
S0932
1
165576 UK
2
14 S0932
S0932
S0932
1
166007 UK
2
9 S0932
S0932
S0932
1
166008 UK
2
9 S0932
S0932
S0932
1
169040 UK
2
21 S0932
S0932
S0932
1
170337 UK
2
23 S0932
S0932
S0932
1
171973 UK
2
42 S0932
S0932
S0932
1
174444 UK
2
16 S0932
S0932
S0932
1
174445 UK
2
16 S0932
S0932
S0932
1
174446 UK
2
16 S0932
S0932
S0932
1
176448 UK
2
5 S0932
S0932
S0932
1
176449 UK
2
5 S0932
S0932
S0932
1
177515 UK
2
7 S0932
S0932
S0932
1
177516 UK
2
7 S0932
S0932
S0932
1
177636 UK
1
8 S0932
S0932
S0932
1
177637 UK
1
8 S0932
S0932
S0932
1
178537 UK
1
39 S0932
S0932
S0932
1
178538 UK
1
39 S0932
S0932
S0932
1
180137 UK
2
60 S0932
S0932
S0932
1
180138 UK
2
60 S0932
S0932
S0932
1
181359 UK
2
33 S0932
S0932
S0932
1
181786 UK
1
15 S0932
S0932
S0932
1
182869 UK
1
45 S0932
S0932
S0932
1
182870 UK
1
45 S0932
S0932
S0932
1
182871 UK
1
45 S0932
S0932
S0932
1
184083 UK
2
34 S0932
S0932
S0932
1
184084 UK
2
34 S0932
S0932
S0932
1
184609 UK
2
27 S0932
S0932
S0932
1
185088 UK
1
11 S0932
S0932
S0932
1
188518 UK
1
31 S0932
S0932
S0932
1
188519 UK
1
31 S0932
S0932
S0932
1
188520 UK
1
31 S0932
S0932
S0932
1
190747 UK
2
34 S0932
S0932
S0932
1
190748 UK
2
34 S0932
S0932
S0932
1
190965 UK
2
23 S0932
S0932
S0932
1
190966 UK
2
23 S0932
S0932
S0932
1
193043 UK
2
8 S0932
S0932
S0932
1
198562 UK
2
33 S0932
S0932
S0932
1
200994 UK
2
27 S0932
S0932
S0932
1
200995 UK
2
27 S0932
S0932
S0932
1
200996 UK
2
27 S0932
S0932
S0932
1
201641 UK
1
8 S0932
S0932
S0932
1
201642 UK
1
8 S0932
S0932
S0932
1
201901 UK
1
27 S0932
S0932
S0932
1
204070 UK
1
38 S0932
S0932
S0932
1
117
Data Table con’t
N0900
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
1211 AT
1
25 V9999
N0900
V9999
1
1548 AT
1
10 N8998
N0900
V9999
1
1827 AT
1
17 N0099
N0900
V9999
1
6097 AT
1
15 N0099
N0900
V9999
1
6299 AT
1
10 N0099
N0900
V9999
1
6351 AT
2
33 Q0199
N0900
V9999
1
296 BE
2
14 N8998
N0900
V9999
1
493 BE
2
9 N0900
N0900
V9999
1
1565 BE
2
10 N0900
N0900
V9999
1
2154 BE
2
12 N8998
N0900
B2999
1
3057 BE
1
14 N0900
N8998
V9999
1
3081 BE
1
9 N8998
N0900
V9999
1
3295 BE
1
18 V9999
N0900
B2999
1
3949 BE
1
7 N8998
N0900
V9999
1
4074 BE
1
9 N0900
N0900
V9999
1
4196 BE
1
18 N8998
N0900
V9999
1
5271 BE
1
15 N8998
N0900
V9999
1
6233 BE
1
14 N8998
N0900
V9999
1
6297 BE
1
32 N8998
N0900
V9999
1
6792 BE
1
8 N8998
N0900
V9999
1
7039 BE
2
6 N0900
N0900
V9999
1
7077 BE
1
13 N0900
N0900
V9999
1
7268 BE
1
9 N0900
B2020
V9999
1
8516 BE
1
10 N0900
C0210
V9999
1
592 DK
1
25
N0900
1
845 DK
1
29
N0900
1
3010 DK
1
10
N0900
1
4997 DK
1
20
N0900
1
5300 DK
1
35
N0900
1
6544 DK
1
8 N0900
C0299
1
8061 DK
1
8
N0900
1
8216 DK
1
9 N0900
B2099
1
8290 DK
1
4
N0900
1
8296 DK
1
10
N0900
1
9731 DK
1
22
N0900
1
10146 DK
1
10
N0900
1
10353 DK
1
19
N0900
1
10496 DK
1
11 F1005
N0900
1
11625 DK
1
5
N0900
1
11817 DK
2
6
N0900
1
12160 DK
1
16
N0900
1
12289 DK
1
26
N0900
1
13892 DK
1
9
N0900
1
14459 DK
1
11
N0900
1
15104 DK
1
5
N0900
1
15531 DK
1
12
N0900
1
15862 DK
2
B2020
1
16082 DK
1
11
N0900
1
16592 DK
1
9
N0900
1
17109 DK
1
14
N0900
1
17861 DK
2
14
N0900
1
18416 DK
1
22
N0900
1
20794 DK
1
6
N0900
1
22388 DK
1
8
N0900
1
22931 DK
1
6
N0900
1
23287 DK
2
4
N0900
1
23597 DK
1
8
N0900
1
23729 DK
1
8
N0900
1
24644 DK
1
12
N0900
1
24786 DK
1
13
N0900
1
24936 DK
1
14
N0900
1
25576 DK
1
14
N0900
1
25657 DK
1
12
N0900
26231 DK
1
10
N0900
1
26267 DK
2
38
N0900
1
26548 DK
2
B2020
1
26765 DK
2
12
N0900
1
27047 DK
1
18
N0900
1
27620 DK
1
2
N0900
1
28370 DK
2
14 N0002
N0900
1
29189 DK
1
16
N0900
1
29346 DK
2
23 N0900
C0299
1
29857 DK
2
6
N0900
1
31926 DK
1
18
N0900
1
32331 DK
1
24
N0900
1
32464 DK
1
2 N0900
C0299
1
33006 DK
1
12 N0900
B1999
1
33291 DK
1
14
N0900
1
33341 DK
1
13
N0900
1
33382 DK
1
23
N0900
1
33757 DK
1
9
N0900
1
34200 DK
1
7
N0900
1
35109 DK
1
27
N0900
1
35442 DK
1
25
N0900
1
9 N0900
7 N0900
H1600
1
35512 DK
1
10
N0900
1
35566 DK
1
4
N0900
1
35730 DK
1
14
N0900
1
36704 DK
1
8
N0900
1
37793 DK
1
13 N0900
B2020
1
37826 DK
2
12
N0900
1
38043 DK
1
6
N0900
1
39073 DK
1
18
N0900
1
39874 DK
1
23
N0900
1
40317 DK
1
11
N0900
1
41220 DK
1
14
N0900
1
41609 DK
1
54
N0900
1
42117 DK
1
18
N0900
1
42193 DK
1
13
N0900
1
43234 DK
1
4
N0900
1
50352 DK
1
6
N0900
1
50568 DK
1
8
N0900
1
50934 DK
1
8
N0900
1
51017 DK
1
14 N0900
V9940
1
51389 DK
2
13
N0900
1
51582 DK
1
10 N0900
C0299
1
54137 DK
1
25
N0900
1
54243 DK
1
10
N0900
1
54464 DK
1
33
N0900
1
54588 DK
1
6
N0900
1
54757 DK
2
6
N0900
1
54794 DK
1
7
N0900
1
55137 DK
1
31
N0900
1
55487 DK
1
9
N0900
1
56096 DK
2
14
N0900
1
56172 DK
1
30
N0900
1
57868 DK
1
14
N0900
1
59720 DK
1
N0900
1
59961 DK
1
11
N0900
1
60050 DK
1
23
N0900
1
60259 DK
1
V9940
1
60354 DK
1
10
N0900
1
60533 DK
1
5
N0900
1
60828 DK
2
8
N0900
1
63222 DK
1
9 N0900
B1009
1
575 FI
1
14 V9999
N0900
N0099
1
2604 FI
2
3 N0900
N0900
V9998
1
3372 FI
1
3 N0099
N0900
V9998
1
3693 FI
1
12 N0099
N0900
V9998
1
9 B1020
9 N0900
4426 FI
1
8 N0900
B2999
V9998
1
4624 FI
1
13 N0099
N0900
V9998
1
5089 FI
1
11 N0099
N0900
V9998
1
5383 FI
2
8 N0900
B2002
V9998
1
5818 FI
1
10 N0099
N0900
V9998
1
2155 FR
1
10 N0900
N0900
V9999
1
2600 FR
1
9 N0900
N0900
V9999
1
2676 FR
1
14 N0900
N0900
N8998
1
3126 FR
1
9 N0900
N0900
V9999
1
3520 FR
1
37 N0998
N0900
V9999
1
5370 FR
1
8 N8998
N0900
V9999
1
6433 FR
1
4 N0900
N0900
V9999
1
7031 FR
1
9 N0900
N0900
V9999
1
7900 FR
1
22 N0900
F4398
V9999
1
8616 FR
1
9 N8998
N0900
V9999
1
8821 FR
1
23 N0900
N0900
V9999
1
9345 FR
1
11 N0900
N0900
V9999
1
11727 FR
1
11 N0900
N0900
V9999
1
12425 FR
1
9 N0900
B2999
V9999
1
12786 FR
2
9 N0900
N0900
V9999
1
13346 FR
1
15 N0900
N0900
V9999
1
14633 FR
1
15 N0900
N0900
V9999
1
16191 FR
1
10 N0900
N0900
V9999
1
16343 FR
1
31 N0900
N0900
V9999
1
20720 FR
1
13 V9999
N0900
V9999
1
21852 FR
1
12 V9999
N0900
V9999
1
22504 FR
1
14 N0900
N0099
V9999
1
22944 FR
1
12 N8998
N0900
V9999
1
23894 FR
1
13 N8998
N0900
V9999
1
25909 FR
1
7 N0900
N0900
V9999
1
26659 FR
1
17 N0998
N0900
V9999
1
33091 FR
1
13 N8998
N0900
V9998
1
39246 FR
2
13 N0900
N0900
V9999
1
5 IE
1
20 N0900
N0900
V9999
1
474 IE
1
27 N0900
V9999
V9999
1
2340 IE
1
15 N0900
N0900
V9999
1
2554 IE
1
34 N0900
N0900
V9999
1
2733 IE
1
15 N0900
N0900
V9999
1
2800 IE
2
11 N0900
V9999
V9999
1
2896 IE
2
39 N0900
V9999
V9999
1
2941 IE
1
12 N0900
V9999
V9999
1
3387 IE
1
5 N0900
V9999
V9999
1
4679 IE
1
24 N0900
N0900
V9999
1
5123 IE
1
27 N0900
V9999
V9999
1
1222 IT
1
10 N0900
N0900
V9999
1
1762 IT
1
17 N0900
N0900
V9999
1
1923 IT
1
20 N0900
N0900
V9999
1
2012 IT
1
15 V9999
N0900
V9999
1
2102 IT
1
15 N0900
N0900
V9999
1
3120 IT
1
22 N8998
N0900
V9999
1
3186 IT
1
16 N8998
N0900
V9999
1
5231 IT
1
15 N8998
N0900
V9999
1
6762 IT
1
15 N0900
N0900
V9999
1
6826 IT
1
17 N0900
N0900
V9999
1
7101 IT
1
11 N0900
N0900
V9999
1
7656 IT
1
21 V9999
N0900
V9999
1
7777 IT
1
23 N8998
N0900
V9999
1
7846 IT
1
19 N8998
N0900
V9999
1
7861 IT
1
32 V9999
N0900
V9999
1
8504 IT
1
13 N8998
N0900
V9999
1
8554 IT
1
13 V9999
N0900
V9999
1
8650 IT
1
16 V9999
N0900
V9999
1
8730 IT
1
12 V9999
N0900
V9999
1
9270 IT
1
29 N8998
N0900
V9999
1
9774 IT
1
22 V9999
N0900
V9999
1
9833 IT
1
29 V9999
N0900
V9999
1
10291 IT
1
16 N8998
N0900
V9999
1
10461 IT
1
24 L9074
N0900
V9999
1
10494 IT
1
20 N8998
N0900
V9999
1
10929 IT
1
11 N8998
N0900
V9999
1
11009 IT
1
17 N8998
N0900
V9999
1
11027 IT
1
17 N8998
N0900
V9999
1
11140 IT
1
16 N8998
N0900
V9999
1
11501 IT
1
16 L9074
N0900
V9999
1
566 ES
2
5 V9999
N0900
V9999
1
1140 PT
1
20 N0099
N0900
V9999
1
2023 PT
1
16 N0900
N0900
V9999
1
4281 PT
1
25 N0900
B2998
N0099
1
4351 PT
1
14 N0099
N0900
V9999
1
4411 PT
1
11 N0099
N0900
C0299
1
6331 PT
1
10 B1099
N0900
V9999
1
8541 PT
1
15 N0900
N0900
V9999
1
8799 PT
1
13 C0200
C0200
N0900
1
9689 PT
1
12 N0900
N0900
V9999
1
9730 PT
1
6 N0900
N0900
V9999
1
10262 PT
1
9 N0099
N0900
V9999
1
10820 PT
1
40 N0099
N0900
V9999
1
13071 PT
2
15 N0900
N0900
V9999
1
14548 PT
1
13 N0900
N0900
V9999
1
14610 PT
1
35 N0900
N0900
V9999
1
15272 PT
1
8 N0900
B1098
V9999
1
15288 PT
1
9 N0900
N0900
V9999
1
16993 PT
1
25 N0900
N0900
V9999
1
17242 PT
2
10 N0900
N0900
V9999
1
17495 PT
1
22 N0900
N0900
V9999
1
18490 PT
2
12 N0900
N0900
V9999
1
19526 PT
1
32 N0099
N0900
V9999
1
19704 PT
1
10 N0900
N0900
V9999
1
19789 PT
1
31 N0900
N0900
V9999
1
20696 PT
1
11 N0900
N0900
V9999
1
23695 PT
1
16 N0099
N0900
P2099
1
23765 PT
1
25 N0099
N0900
V9999
1
23823 PT
1
31 N0099
N0900
B1099
1
24555 PT
1
12 N0900
N0900
V9999
1
24562 PT
2
7 N0900
B1099
V9999
1
29787 PT
2
3 N0900
N0900
V9999
1
33074 PT
1
16 N0900
N0900
V9999
1
33401 PT
1
10 N0099
N0900
V9999
1
33728 PT
1
16 N0900
N0900
V9999
1
33731 PT
2
12 N0900
B1098
V9999
1
35805 PT
1
10 N0900
N0900
V9999
1
37349 PT
1
10 N0900
B1099
V9999
1
37369 PT
1
23 N0900
N0900
V9999
1
186 SE
1
16 N0900
T0000
V0000
1
367 SE
1
14 N1620
N0900
V0000
1
522 SE
1
42 N0900
N0235
V0000
1
802 SE
1
6 N1499
N0900
V0000
1
2222 SE
1
9 V0000
N0900
V0000
1
4763 SE
1
7 V0000
N0900
V0000
1
5128 SE
1
10 N0900
V9998
V0000
1
5172 SE
1
18 V9999
N0900
V0000
1
8878 SE
2
38 T0000
N0900
V0000
1
9714 SE
1
25 V0000
N0900
V0000
1
10298 SE
1
11 N0000
N0900
V0000
1
10726 SE
2
7 P6199
N0900
V0000
1
10868 SE
1
9 N0000
N0900
V0000
1
11134 SE
1
9 T0000
N0900
N0000
1
11523 SE
1
19 N0000
N0900
V0000
1
11603 SE
1
48 T0000
N0000
N0900
1
11679 SE
1
32 T0000
T0000
N0900
1
11914 SE
1
8 V0000
N0900
V0000
1
12460 SE
2
7 N0900
C0299
N0099
1
12854 SE
1
9 T0000
N0900
N0000
1
13155 SE
1
8 N0900
N0900
V0000
1
13984 SE
1
14 N0050
N0900
V0000
1
15219 SE
1
12 T0000
N0000
N0900
1
15287 SE
2
8 N0900
V9999
V0000
1
15567 SE
1
15 N0000
N0900
V0000
1
15899 SE
1
9 N0900
B1000
N0002
1
16169 SE
1
9 N0000
N0900
V0000
1
16330 SE
1
17 N0000
N0900
V0000
1
16394 SE
2
5 B2020
N0900
V0000
1
17067 SE
1
38 N0000
N0900
V0000
1
18049 SE
1
19 N0900
N0900
V0000
1
18660 SE
2
22 N0900
C0299
N0055
1
18677 SE
1
24 N0000
V9999
N0900
1
18678 SE
1
12 N0002
C0299
N0900
1
18679 SE
1
28 T0000
N0000
N0900
1
18680 SE
1
29 T0000
N0235
N0900
1
18691 SE
2
89 T0000
N0900
N1410
1
21592 SE
1
6 N0900
B1099
V0000
1
21593 SE
1
6 N0900
N0900
V0000
1
21594 SE
1
39 N0900
N0900
V0000
1
22457 SE
2
46 T0000
N0900
V0000
1
22458 SE
1
19 T0000
N0900
V0000
1
23703 SE
2
3 V9999
N0900
V0000
1
23704 SE
1
17 V9999
N0900
V0000
1
24957 SE
1
6 V0000
N0900
V0000
1
25315 SE
1
16 V0000
N0900
V0000
1
25340 SE
1
14 V0000
N0900
V0000
1
25668 SE
2
5 N0900
B1000
V0000
1
25843 SE
1
12 V0000
N0900
V0000
1
26949 SE
1
21 V0000
N0900
V0000
1
27925 SE
1
17 N1499
N0900
V0000
1
37159 UK
1
9 N0900
N0900
N0900
1
37834 UK
1
13 N0900
N0900
N0900
1
39746 UK
1
12 N0900
N0900
N0900
1
40517 UK
1
8 N0900
N0900
N0900
1
40767 UK
1
13 N0900
N0900
N0900
1
40809 UK
1
14 N0900
N0900
N0900
1
43429 UK
1
9 N0900
N0900
N0900
1
43712 UK
1
16 N0900
N0900
N0900
1
44258 UK
1
16 N0900
N0900
N0900
1
44712 UK
1
12 N0900
N0900
N0900
1
45465 UK
1
21 N0900
N0900
N0900
1
46019 UK
1
11 N0900
N0900
N0900
1
46942 UK
1
10 N0900
N0900
N0900
1
47601 UK
1
31 N0900
N0900
N0900
1
47602 UK
1
31 N0900
N0900
N0900
1
47603 UK
1
31 N0900
N0900
N0900
1
48128 UK
1
7 N0900
N0900
N0900
1
48498 UK
1
15 N0900
N0900
N0900
1
48698 UK
1
22 N0900
N0900
N0900
1
48863 UK
2
13 N0900
N0900
N0900
1
49065 UK
1
11 N0900
N0900
N0900
1
49551 UK
1
21 N0900
N0900
N0900
1
49967 UK
1
10 N0900
N0900
N0900
1
51437 UK
1
1 N0900
N0900
N0900
1
51870 UK
1
19 N0900
N0900
N0900
1
51871 UK
1
19 N0900
N0900
N0900
1
52120 UK
1
11 N0900
N0900
N0900
1
54803 UK
1
17 N0900
N0900
N0900
1
54804 UK
1
17 N0900
N0900
N0900
1
55084 UK
1
29 N0900
N0900
N0900
1
55214 UK
1
13 N0900
N0900
N0900
1
55452 UK
2
9 N0900
N0900
N0900
1
56051 UK
1
28 N0900
N0900
N0900
1
58612 UK
1
24 N0900
N0900
N0900
1
58682 UK
1
7 N0900
N0900
N0900
1
59129 UK
1
8 N0900
N0900
N0900
1
59130 UK
1
8 N0900
N0900
N0900
1
59461 UK
1
12 N0900
N0900
N0900
1
60359 UK
1
17 N0900
N0900
N0900
1
60360 UK
1
17 N0900
N0900
N0900
1
61785 UK
1
16 N0900
N0900
N0900
1
63147 UK
1
9 N0900
N0900
N0900
1
63148 UK
1
9 N0900
N0900
N0900
1
64529 UK
1
16 N0900
N0900
N0900
1
64591 UK
1
10 N0900
N0900
N0900
1
65045 UK
1
10 N0900
N0900
N0900
1
65413 UK
1
9 N0900
N0900
N0900
1
66851 UK
1
12 N0900
N0900
N0900
1
66858 UK
1
16 N0900
N0900
N0900
1
66980 UK
1
17 N0900
N0900
N0900
1
66981 UK
1
17 N0900
N0900
N0900
1
67401 UK
1
11 N0900
N0900
N0900
1
68181 UK
1
17 N0900
N0900
N0900
1
68259 UK
1
17 N0900
N0900
N0900
1
68853 UK
1
13 N0900
N0900
N0900
1
69081 UK
1
25 N0900
N0900
N0900
1
69361 UK
1
16 N0900
N0900
N0900
1
69362 UK
1
16 N0900
N0900
N0900
1
70781 UK
1
13 N0900
N0900
N0900
1
70923 UK
1
14 N0900
N0900
N0900
1
70944 UK
1
7 N0900
N0900
N0900
1
70965 UK
1
11 N0900
N0900
N0900
1
71212 UK
1
7 N0900
N0900
N0900
1
71277 UK
1
12 N0900
N0900
N0900
1
71956 UK
1
15 N0900
N0900
N0900
1
73418 UK
1
39 N0900
N0900
N0900
1
73419 UK
1
39 N0900
N0900
N0900
1
74442 UK
1
27 N0900
N0900
N0900
1
75778 UK
1
43 N0900
N0900
N0900
1
75817 UK
1
14 N0900
N0900
N0900
1
76338 UK
1
14 N0900
N0900
N0900
1
77337 UK
2
14 N0900
N0900
N0900
1
77535 UK
1
6 N0900
N0900
N0900
1
79126 UK
1
7 N0900
N0900
N0900
1
79814 UK
1
11 N0900
N0900
N0900
1
81585 UK
2
13 N0900
N0900
N0900
1
83721 UK
1
14 N0900
N0900
N0900
1
83722 UK
1
14 N0900
N0900
N0900
1
84539 UK
1
21 N0900
N0900
N0900
1
142080 UK
1
11 N0900
N0900
N0900
1
143293 UK
2
14 N0900
N0900
N0900
1
143324 UK
1
14 N0900
N0900
N0900
1
143471 UK
1
16 N0900
N0900
N0900
1
143510 UK
1
13 N0900
N0900
N0900
1
144772 UK
1
25 N0900
N0900
N0900
1
145067 UK
1
23 N0900
N0900
N0900
1
145312 UK
1
15 N0900
N0900
N0900
1
145378 UK
1
13 N0900
N0900
N0900
1
145379 UK
1
13 N0900
N0900
N0900
1
147222 UK
2
21 N0900
N0900
N0900
1
147578 UK
1
17 N0900
N0900
N0900
1
148226 UK
2
7 N0900
N0900
N0900
1
148456 UK
1
10 N0900
N0900
N0900
1
148457 UK
1
10 N0900
N0900
N0900
1
149462 UK
1
9 N0900
N0900
N0900
1
149463 UK
1
9 N0900
N0900
N0900
1
149464 UK
1
9 N0900
N0900
N0900
1
149465 UK
1
9 N0900
N0900
N0900
1
150158 UK
1
30 N0900
N0900
N0900
1
150267 UK
1
11 N0900
N0900
N0900
1
151510 UK
1
14 N0900
N0900
N0900
1
151670 UK
1
14 N0900
N0900
N0900
1
151718 UK
1
15 N0900
N0900
N0900
1
153749 UK
1
40 N0900
N0900
N0900
1
154868 UK
1
12 N0900
N0900
N0900
1
154869 UK
1
12 N0900
N0900
N0900
1
155835 UK
1
19 N0900
N0900
N0900
1
155975 UK
1
20 N0900
N0900
N0900
1
157588 UK
1
20 N0900
N0900
N0900
1
158263 UK
1
21 N0900
N0900
N0900
1
160069 UK
1
17 N0900
N0900
N0900
1
161249 UK
1
11 N0900
N0900
N0900
1
162625 UK
1
12 N0900
N0900
N0900
1
162626 UK
1
12 N0900
N0900
N0900
1
163545 UK
1
14 N0900
N0900
N0900
1
163746 UK
1
21 N0900
N0900
N0900
1
164678 UK
1
19 N0900
N0900
N0900
1
165352 UK
2
15 N0900
N0900
N0900
1
165591 UK
2
11 N0900
N0900
N0900
1
166422 UK
1
14 N0900
N0900
N0900
1
166610 UK
1
17 N0900
N0900
N0900
1
167742 UK
2
12 N0900
N0900
N0900
1
167743 UK
2
12 N0900
N0900
N0900
1
168277 UK
1
13 N0900
N0900
N0900
1
168278 UK
1
13 N0900
N0900
N0900
1
168494 UK
1
19 N0900
N0900
N0900
1
168495 UK
1
19 N0900
N0900
N0900
1
169450 UK
1
12 N0900
N0900
N0900
1
169451 UK
1
12 N0900
N0900
N0900
1
172239 UK
1
9 N0900
N0900
N0900
1
174227 UK
1
27 N0900
N0900
N0900
1
174401 UK
1
18 N0900
N0900
N0900
1
174402 UK
1
18 N0900
N0900
N0900
1
174481 UK
1
48 N0900
N0900
N0900
1
175202 UK
1
14 N0900
N0900
N0900
1
175203 UK
1
14 N0900
N0900
N0900
1
178804 UK
1
20 N0900
N0900
N0900
1
179531 UK
1
14 N0900
N0900
N0900
1
179532 UK
1
14 N0900
N0900
N0900
1
179694 UK
1
12 N0900
N0900
N0900
1
179695 UK
1
12 N0900
N0900
N0900
1
181884 UK
1
10 N0900
N0900
N0900
1
181885 UK
1
10 N0900
N0900
N0900
1
183313 UK
1
19 N0900
N0900
N0900
1
183314 UK
1
19 N0900
N0900
N0900
1
183315 UK
1
19 N0900
N0900
N0900
1
184192 UK
1
17 N0900
N0900
N0900
1
185775 UK
1
26 N0900
N0900
N0900
1
185776 UK
1
26 N0900
N0900
N0900
1
186038 UK
1
11 N0900
N0900
N0900
1
186039 UK
1
11 N0900
N0900
N0900
1
186040 UK
1
11 N0900
N0900
N0900
1
186217 UK
1
25 N0900
N0900
N0900
1
186218 UK
1
25 N0900
N0900
N0900
1
186219 UK
1
25 N0900
N0900
N0900
1
186524 UK
1
12 N0900
N0900
N0900
1
186525 UK
1
12 N0900
N0900
N0900
1
186708 UK
1
8 N0900
N0900
N0900
1
186888 UK
1
16 N0900
N0900
N0900
1
186889 UK
1
16 N0900
N0900
N0900
1
187095 UK
1
15 N0900
N0900
N0900
1
187096 UK
1
15 N0900
N0900
N0900
1
188220 UK
1
24 N0900
N0900
N0900
1
188221 UK
1
24 N0900
N0900
N0900
1
188292 UK
1
3 N0900
N0900
N0900
1
188293 UK
1
3 N0900
N0900
N0900
1
189890 UK
1
10 N0900
N0900
N0900
1
190361 UK
1
29 N0900
N0900
N0900
1
193032 UK
1
8 N0900
N0900
N0900
1
195874 UK
1
10 N0900
N0900
N0900
1
196083 UK
1
12 N0900
N0900
N0900
1
196157 UK
1
8 N0900
N0900
N0900
1
197099 UK
1
25 N0900
N0900
N0900
1
198496 UK
1
16 N0900
N0900
N0900
1
199231 UK
1
24 N0900
N0900
N0900
1
199605 UK
1
22 N0900
N0900
N0900
1
200600 UK
1
13 N0900
N0900
N0900
1
200648 UK
1
13 N0900
N0900
N0900
1
200649 UK
1
13 N0900
N0900
N0900
1
201560 UK
1
7 N0900
N0900
N0900
1
202804 UK
1
27 N0900
N0900
N0900
1
203700 UK
1
38 N0900
N0900
N0900
1
204022 UK
1
24 N0900
N0900
N0900
1
204120 UK
1
27 N0900
N0900
N0900
1
204998 UK
1
15 N0900
N0900
N0900
1
205134 UK
1
23 N0900
N0900
N0900
1
206416 UK
1
18 N0900
N0900
N0900
1
206616 UK
1
12 N0900
N0900
N0900
1
206617 UK
1
12 N0900
N0900
N0900
1
208404 UK
1
18 N0900
N0900
N0900
1
208528 UK
1
20 N0900
N0900
N0900
1
483
Data Table con’t
S0932/F4298
Kennummer
Country
Sex
Age
Product1
Product2
Product3
F4298
Häufigkeit
3116 AT
1
40 F1030
F1499
5782 DK
2
56 S0932
K0110
1
7545 DK
1
33
S0932
1
17274 DK
2
49 S0932
V9940
1
21558 DK
1
2 S0932
V9940
1
23546 DK
1
50 H7020
S0932
1
23928 DK
2
64 S0932
B1099
1
30297 DK
2
4 T0000
S0932
1
32436 DK
1
62 S0932
A1810
1
33187 DK
1
33
S0932
1
33203 DK
2
8 S0932
B1999
1
33879 DK
1
63 Y1299
B1999
35091 DK
2
5
S0932
1
35920 DK
2
4 S0932
C0299
1
36347 DK
2
11 S0932
V9940
1
37837 DK
2
10 S0932
C0299
1
38408 DK
1
6 S0932
C0299
1
39763 DK
2
29 S0932
B2020
1
39948 DK
2
10 S0932
N2022
1
40234 DK
2
10 S0932
C0299
1
43351 DK
2
50 S0932
S0932
1
53123 DK
1
47
F4298
1
59731 DK
2
70 S0932
C0205
1
61031 DK
2
43 S0932
V9940
1
64566 DK
1
43 S0932
V9940
1
65262 DK
2
35 S0932
V9940
1
33016 FR
2
75 V9998
F4298
V9998
1
38342 FR
1
4 F4298
B2998
V9999
1
17991 PT
2
15 F4298
C0109
V9999
1
22653 PT
1
26 F4298
F4298
V9999
1
23270 PT
2
51 F4298
H7122
V9999
1
25049 PT
2
58 F1840
F4298
V9999
1
1644 SE
2
54 F4298
V0000
V9998
1
4623 SE
2
6 S0932
B1998
B0212
1
4639 SE
2
47 B1198
S0932
V0000
1
5841 SE
2
86 V9999
V9999
F4298
1
6237 SE
1
50 S0932
V0000
V0000
1
7592 SE
1
46 T1098
S0932
V0000
1
7626 SE
2
76 S0932
S0932
S0310
1
8757 SE
1
38 S0932
S0932
A1400
1
S0932
1
1
10249 SE
1
64 U1299
B1099
S0932
1
10927 SE
2
64 F4298
F1030
C5050
1
11342 SE
2
11 S0932
S0932
V0000
1
11706 SE
2
78 S0932
V9998
V0000
1
12356 SE
2
8 S0932
H4110
V0000
1
13397 SE
1
9 B0205
V9999
S0932
1
14386 SE
2
22 S0932
A0011
V0000
1
14387 SE
1
47 S0932
V9998
V0000
1
15398 SE
2
31 F4298
F4298
F4199
1
15697 SE
2
83 S0932
B2020
U1200
1
16511 SE
1
19 S0932
S0932
D0900
1
18917 SE
1
10 T0000
V9930
S0932
1
22195 SE
2
38 S0932
A0011
V0000
1
22196 SE
1
11 S0932
H4300
V0000
1
2431 UK
2
45 S0932
S0932
S0932
1
2518 UK
1
62 S0932
S0932
S0932
1
16097 UK
1
42 S0932
S0932
S0932
1
18751 UK
1
33 S0932
S0932
S0932
1
26464 UK
2
35 S0932
S0932
S0932
1
39344 UK
1
35 S0932
S0932
S0932
1
39574 UK
2
26 S0932
S0932
S0932
1
45333 UK
2
5 S0932
S0932
S0932
1
49262 UK
2
25 S0932
S0932
S0932
1
50377 UK
1
58 S0932
S0932
S0932
1
57722 UK
1
30 S0932
S0932
S0932
1
61005 UK
2
31 S0932
S0932
S0932
1
63044 UK
1
13 S0932
S0932
S0932
1
65879 UK
1
19 S0932
S0932
S0932
1
69952 UK
2
11 S0932
S0932
S0932
1
75111 UK
2
4 S0932
S0932
S0932
1
86212 UK
1
20 S0932
S0932
S0932
1
99424 UK
1
37 S0932
S0932
S0932
1
113254 UK
2
72 S0932
S0932
S0932
1
113255 UK
2
72 S0932
S0932
S0932
1
113256 UK
2
72 S0932
S0932
S0932
1
140792 UK
2
10 S0932
S0932
S0932
1
147871 UK
2
29 S0932
S0932
S0932
1
149429 UK
1
22 S0932
S0932
S0932
1
149450 UK
2
13 S0932
S0932
S0932
1
149460 UK
1
53 S0932
S0932
S0932
1
149496 UK
1
35 S0932
S0932
S0932
1
157335 UK
2
11 S0932
S0932
S0932
1
158624 UK
2
49 S0932
S0932
S0932
1
163967 UK
2
46 S0932
S0932
S0932
1
165474 UK
1
6 S0932
S0932
S0932
1
165576 UK
2
14 S0932
S0932
S0932
1
166007 UK
2
9 S0932
S0932
S0932
1
166008 UK
2
9 S0932
S0932
S0932
1
169040 UK
2
21 S0932
S0932
S0932
1
170337 UK
2
23 S0932
S0932
S0932
1
171973 UK
2
42 S0932
S0932
S0932
1
174444 UK
2
16 S0932
S0932
S0932
1
174445 UK
2
16 S0932
S0932
S0932
1
174446 UK
2
16 S0932
S0932
S0932
1
176448 UK
2
5 S0932
S0932
S0932
1
176449 UK
2
5 S0932
S0932
S0932
1
177515 UK
2
7 S0932
S0932
S0932
1
177516 UK
2
7 S0932
S0932
S0932
1
177636 UK
1
8 S0932
S0932
S0932
1
177637 UK
1
8 S0932
S0932
S0932
1
178537 UK
1
39 S0932
S0932
S0932
1
178538 UK
1
39 S0932
S0932
S0932
1
180137 UK
2
60 S0932
S0932
S0932
1
180138 UK
2
60 S0932
S0932
S0932
1
181359 UK
2
33 S0932
S0932
S0932
1
181786 UK
1
15 S0932
S0932
S0932
1
182869 UK
1
45 S0932
S0932
S0932
1
182870 UK
1
45 S0932
S0932
S0932
1
182871 UK
1
45 S0932
S0932
S0932
1
184083 UK
2
34 S0932
S0932
S0932
1
184084 UK
2
34 S0932
S0932
S0932
1
184609 UK
2
27 S0932
S0932
S0932
1
185088 UK
1
11 S0932
S0932
S0932
1
188518 UK
1
31 S0932
S0932
S0932
1
188519 UK
1
31 S0932
S0932
S0932
1
188520 UK
1
31 S0932
S0932
S0932
1
190747 UK
2
34 S0932
S0932
S0932
1
190748 UK
2
34 S0932
S0932
S0932
1
190965 UK
2
23 S0932
S0932
S0932
1
190966 UK
2
23 S0932
S0932
S0932
1
193043 UK
2
8 S0932
S0932
S0932
1
198562 UK
2
33 S0932
S0932
S0932
1
200994 UK
2
27 S0932
S0932
S0932
1
200995 UK
2
27 S0932
S0932
S0932
1
200996 UK
2
27 S0932
S0932
S0932
1
201641 UK
1
8 S0932
S0932
S0932
1
201642 UK
1
8 S0932
S0932
S0932
1
201901 UK
1
27 S0932
S0932
S0932
1
204070 UK
1
38 S0932
S0932
S0932
1
129
Data Table con’t
F0020
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
5358 AT
1
22 F0020
F4398
V9999
1
2476 BE
2
0 F0020
B2999
V9999
1
4438 BE
2
75 F0020
E0028
C0210
1
4934 BE
2
2 F0020
C0299
V9999
1
8332 BE
2
2 F0020
C0299
V9999
1
9383 BE
2
2 F0020
C0299
V9999
1
9547 BE
1
0 F0020
C0644
V9999
1
9745 BE
2
2 F0020
C0210
V9999
1
15156 BE
1
0 F0020
F1399
V9999
1
3319 DK
1
211 F0020
C0299
1
5374 DK
1
2 F0020
C0299
1
6348 DK
2
F0020
1
7269 DK
1
206 F0020
C0299
1
12441 DK
1
210 F0020
C0299
1
14520 DK
2
211 F0020
C0299
1
17707 DK
2
215
F0020
1
17744 DK
1
210 F0020
C0220
1
17953 DK
1
2 F0020
C0299
1
18785 DK
1
210 F0020
C0299
1
21685 DK
1
214 F0020
C0299
1
21713 DK
1
209 F0020
C0299
1
22652 DK
1
213 F0020
C0299
1
27366 DK
1
2 F0020
C0299
1
28087 DK
1
214 F0020
F1399
1
29459 DK
1
2
F0020
1
29767 DK
1
2 F0020
C0299
1
30582 DK
1
216 F0020
F1340
1
31408 DK
2
3 F0020
C0299
1
33716 DK
1
2 F0020
C0299
1
46965 DK
1
216 F0020
C5030
1
47745 DK
2
210 F0020
F0020
48168 DK
2
2 F0020
C0299
1
52003 DK
2
2 F0020
C0299
1
53028 DK
2
208 F0020
C0299
1
57085 DK
1
207 F0020
C0298
1
63188 DK
1
2 F0020
C0299
1
63867 DK
1
208 F0020
C0299
1
64244 DK
1
2 F0020
C0299
1
1
215 F0020
C0299
36 FI
31
C0299
V9998
1
1
64 FI
1
2 V9999
C0299
F0020
1
220 FI
2
209 F0020
C0299
V9998
1
321 FI
2
209 F0020
E0062
V9999
1
941 FI
1
212 F0020
F1499
V9998
1
1007 FI
1
2 F0020
C0299
V9998
1
1047 FI
2
209 F0020
C0299
V9998
1
1471 FI
1
2 F0020
D6048
V9998
1
2029 FI
1
210 F0020
F4399
V9998
1
2099 FI
2
3 F0020
C0299
V9998
1
2639 FI
2
2 F0020
C0299
V9998
1
2877 FI
2
214 F0020
C0299
V9998
1
2918 FI
2
208 F0020
C0299
F1399
1
4184 FI
1
2 F0020
E0055
V9998
1
4243 FI
2
211 F1098
F0020
F1399
1
4534 FI
1
208 F0020
C0299
V9998
1
4872 FI
1
209 F0020
C0299
V9998
1
5261 FI
1
4 F0020
C0299
V9998
1
6534 FI
2
213 F0020
F0020
V9998
1
6940 FI
2
2 F0020
C0299
V9998
1
7027 FI
1
214 F0020
C0299
V9998
1
2431 FR
1
2 F0020
G0010
V9999
1
2450 FR
1
208 F0020
C0299
V9999
1
3026 FR
1
212 F0020
F0020
V9999
1
3061 FR
1
216 F0020
C0299
V9999
1
3240 FR
1
2 F0020
C0299
V9999
1
3896 FR
2
208 F0020
C0299
V9999
1
4444 FR
2
215 F0020
C0299
V9999
1
4746 FR
1
210 F0020
C0299
V9999
1
4931 FR
1
2 F0020
C0299
V9999
1
4990 FR
1
208 F0020
C0299
V9999
1
5263 FR
2
212 F0020
C0299
V9999
1
5311 FR
1
207 F0020
C0299
V9999
1
5371 FR
2
212 F0020
C0299
V9999
1
6046 FR
2
3 F0020
F0020
V9999
1
6834 FR
2
210 F0020
C0299
V9999
1
6882 FR
2
214 F0020
C0299
V9999
1
7664 FR
2
2 F0020
C0299
V9999
1
7966 FR
1
215 F0020
C0299
V9999
1
8435 FR
1
210 F0020
F1399
V9999
1
8874 FR
2
209 F0020
C0299
V9999
1
8944 FR
1
214 F0020
C0299
V9999
1
9151 FR
1
201 F0020
F1399
V9999
1
9512 FR
1
212 F0020
C0299
V9999
1
9884 FR
1
211 F0020
C0299
V9999
1
10016 FR
1
209 F0020
C0210
V9999
1
11000 FR
1
212 F0020
C0299
V9999
1
11183 FR
2
2 F0020
C0299
V9999
1
11372 FR
1
212 F0020
C0299
V9999
1
11721 FR
2
2 F0020
C0299
V9999
1
11811 FR
1
214 F0020
C0299
V9999
1
11972 FR
1
214 F0020
C0299
V9999
1
12166 FR
1
208 F0020
C0299
V9999
1
12171 FR
2
209 F0020
C0299
V9999
1
12356 FR
1
211 F0020
C0299
V9999
1
12498 FR
2
3 F0020
C0299
V9999
1
12800 FR
2
212 F0020
C0299
V9999
1
12824 FR
1
209 F0020
C0299
V9999
1
13154 FR
2
206 F0020
C0210
V9999
1
13315 FR
1
216 F0020
C0299
V9999
1
13369 FR
2
3 F0020
C0299
V9999
1
14189 FR
1
207 F0020
C0299
V9999
1
14407 FR
1
206 F0020
C0299
V9999
1
14700 FR
2
207 F0020
F0020
V9999
1
15041 FR
1
211 F0020
C0299
V9999
1
15083 FR
2
2 F0020
C0299
V9999
1
15255 FR
1
213 F0020
F1830
V9999
1
15272 FR
1
2 F0020
C0210
V9999
1
15497 FR
1
214 F0020
C0299
V9999
1
15501 FR
1
213 F0020
C0210
V9999
1
15849 FR
1
2 F0020
C0299
V9999
1
16223 FR
1
214 F0020
C0210
V9999
1
16634 FR
1
213 F0020
F4398
V9999
1
17073 FR
2
2 F0020
C0210
V9999
1
17939 FR
2
2 F0020
C0210
V9999
1
19563 FR
1
208 F0020
F1399
V9999
1
20663 FR
1
208 F0020
C0299
V9999
1
21553 FR
2
208 F0020
C0299
V9999
1
22412 FR
2
209 F0020
C0299
V9999
1
23066 FR
1
208 F0020
C0210
V9999
1
23073 FR
2
213 F0020
C0210
V9999
1
23611 FR
1
213 F0020
C0210
V9999
1
23705 FR
1
212 F0020
C0210
V9999
1
23729 FR
1
208 F0020
F4305
V9999
1
23750 FR
1
210 F0020
C0210
V9999
1
23757 FR
1
11 F0020
F4310
V9999
1
23811 FR
1
3 F0020
C0210
V9999
1
23832 FR
2
208 F0020
F4305
V9999
1
23844 FR
2
211 F0020
F4310
V9999
1
23856 FR
2
11 F0020
F4305
V9999
1
23875 FR
1
208 F0020
F4305
V9999
1
23889 FR
1
204 F0020
F4305
V9999
1
23944 FR
1
210 F0020
C0210
V9999
1
24030 FR
1
215 F0020
C0210
V9999
1
24052 FR
2
2 F0020
C0210
V9999
1
24284 FR
1
216 F0020
C0210
V9999
1
24320 FR
1
208 F0020
C0210
V9999
1
24370 FR
1
213 F0020
C0210
V9999
1
24818 FR
2
207 F0020
C0210
V9999
1
24992 FR
1
214 F0020
C0210
V9999
1
25030 FR
1
211 F0020
C0210
V9999
1
25031 FR
1
210 F0020
C0210
V9999
1
26080 FR
1
216 F0020
C0210
V9999
1
26114 FR
1
2 F0020
C0210
V9999
1
26127 FR
1
2 F0020
C0210
V9999
1
26242 FR
2
215 F0020
C0210
V9999
1
26269 FR
1
207 F0020
C0210
V9999
1
26555 FR
2
211 F0020
C0210
V9999
1
26616 FR
1
2 F0020
C0210
V9999
1
27011 FR
1
212 F0020
C0210
V9999
1
27073 FR
1
2 F0020
V9999
V9999
1
28952 FR
2
5 F0020
V9999
V9999
1
30245 FR
1
215 V9998
F0020
V9998
1
37221 FR
1
10 F0020
B2999
V9999
1
37304 FR
2
216 F0020
B2999
V9999
1
38154 FR
2
207 F0020
B2999
V9999
1
38183 FR
1
210 F0020
B2999
V9999
1
38240 FR
1
2 F0020
F0020
V9999
1
38381 FR
2
213 F0020
B2999
V9999
1
39282 FR
1
208 F0020
B2999
V9999
1
39983 FR
1
212 F0020
B2999
V9999
1
40126 FR
2
213 F0020
C0210
V9999
1
40450 FR
2
21 F0020
B2999
V9999
1
41551 FR
2
213 F0020
B2999
V9999
1
130 IE
1
209 F0020
F0020
V9999
1
280 IE
1
212 F0020
V9999
V9999
1
775 IE
2
2 F0020
C0210
V9999
1
1971 IE
1
215 F0020
C0212
V9999
1
1979 IE
1
215 F0020
V9999
V9999
1
2321 IE
1
206 F0020
V9999
V9999
1
2568 IE
1
2 F0020
C0210
V9999
1
4828 IE
1
206 F0020
F1399
C0299
1
1059 IT
2
2 F0020
C0210
V9999
1
1872 IT
2
2 F0020
C0210
V9999
1
2921 IT
2
3 F0020
C0210
V9999
1
4925 IT
1
13 F0020
C0210
V9999
1
5007 IT
1
2 F0020
C0210
V9999
1
5008 IT
1
3 F0020
C0210
V9999
1
5046 IT
1
3 F0020
C0210
V9999
1
5240 IT
2
212 F0020
C0210
V9999
1
5332 IT
1
212 F0020
C0210
V9999
1
5363 IT
2
212 F0020
C0210
V9999
1
5399 IT
1
212 F0020
C0210
V9999
1
5403 IT
1
212 F0020
C0210
V9999
1
5410 IT
2
212 F0020
C0210
V9999
1
5737 IT
1
212 F0020
C0210
V9999
1
6343 IT
1
212 F0020
C0210
V9999
1
6591 IT
2
212 F0020
C0210
V9999
1
6648 IT
1
3 F0020
C0210
V9999
1
6809 IT
1
212 F0020
C0210
V9999
1
7071 IT
1
216 F0020
C0210
V9999
1
7898 IT
1
216 F0020
V9999
V9999
1
8955 PT
2
214 F0020
C0210
V9999
1
8998 PT
1
3 F0020
C0299
V9999
1
22053 PT
1
215 F0020
C0299
V9999
1
32298 PT
1
210 F0020
B1099
V9999
1
33734 PT
2
215 F0020
C0210
V9999
1
1955 SE
2
215 F0020
T0000
V0000
1
3120 SE
2
215 F0020
C0299
V0000
1
5695 SE
2
211 F0020
C0299
V0000
1
12670 SE
2
2 F0020
C0299
V0000
1
14412 SE
1
208 F0020
C0299
V0000
1
15647 SE
2
216 F0020
C0299
V0000
1
17201 SE
2
211 V9999
F0020
V0000
1
18277 SE
1
2 F0020
L9098
C0299
1
20434 SE
1
207 F0020
F0020
V0000
1
20435 SE
2
3 F0020
V9999
V0000
1
4267 UK
1
1 F0020
F0020
F0020
1
7719 UK
2
0 F0020
F0020
F0020
1
8111 UK
1
0 F0020
F0020
F0020
1
8192 UK
2
66 F0020
F0020
F0020
1
9134 UK
2
1 F0020
F0020
F0020
1
10975 UK
2
34 F0020
F0020
F0020
1
12136 UK
2
30 F0020
F0020
F0020
1
14136 UK
2
23 F0020
F0020
F0020
1
24518 UK
1
36 F0020
F0020
F0020
1
34427 UK
1
0 F0020
F0020
F0020
1
36650 UK
1
1 F0020
F0020
F0020
1
37382 UK
1
6 F0020
F0020
F0020
1
76732 UK
1
3 F0020
F0020
F0020
1
84806 UK
2
1 F0020
F0020
F0020
1
86626 UK
1
7 F0020
F0020
F0020
1
86797 UK
1
1 F0020
F0020
F0020
1
86874 UK
1
1 F0020
F0020
F0020
1
88491 UK
1
1 F0020
F0020
F0020
1
88707 UK
1
0 F0020
F0020
F0020
1
90275 UK
2
1 F0020
F0020
F0020
1
92139 UK
2
1 F0020
F0020
F0020
1
92323 UK
2
1 F0020
F0020
F0020
1
94883 UK
1
1 F0020
F0020
F0020
1
95183 UK
1
0 F0020
F0020
F0020
1
97577 UK
2
27 F0020
F0020
F0020
1
97578 UK
2
27 F0020
F0020
F0020
1
97579 UK
2
27 F0020
F0020
F0020
1
100332 UK
1
1 F0020
F0020
F0020
1
101585 UK
1
2 F0020
F0020
F0020
1
113971 UK
1
0 F0020
F0020
F0020
1
113972 UK
1
0 F0020
F0020
F0020
1
113973 UK
1
0 F0020
F0020
F0020
1
114766 UK
2
32 F0020
F0020
F0020
1
119019 UK
2
26 F0020
F0020
F0020
1
119020 UK
2
26 F0020
F0020
F0020
1
125165 UK
1
0 F0020
F0020
F0020
1
127833 UK
2
33 F0020
F0020
F0020
1
133853 UK
2
4 F0020
F0020
F0020
1
135044 UK
1
2 F0020
F0020
F0020
1
137681 UK
2
1 F0020
F0020
F0020
1
141019 UK
1
0 F0020
F0020
F0020
1
200165 UK
2
1 F0020
F0020
F0020
1
247
Data Table con’t
P3020 /F0010
Kennummer
Country
Sex
Age
Product1
Product2
Product3
Häufigkeit
3560 AT
1
207 P3020
F4305
V9999
1
7539 BE
2
0 P3020
U1920
C0200
1
7542 BE
1
0 P3020
C0299
V9999
1
8823 BE
2
1 P3020
C0299
V9999
1
10033 BE
1
0 P3020
F1800
V9999
1
12995 BE
1
1 P3020
C0299
V9999
1
13068 BE
1
1 P3020
C0299
V9999
1
15020 BE
2
0 P3020
C0299
V9999
1
15844 BE
1
0 P3020
C0299
V9999
1
16045 BE
1
1 P3020
C0299
V9999
1
503 DK
1
202
F0010
1
667 DK
2
210 F0010
C0299
1
2622 DK
1
2 F0010
C0299
1
3318 DK
2
209 F0010
C0299
1
4675 DK
2
F0010
1
6043 DK
2
203 F0010
C0299
1
8161 DK
2
209 F0010
C0212
1
11106 DK
1
210 F0010
C0299
1
11712 DK
2
209 F0010
C0299
1
14262 DK
2
2 F0010
D6012
1
16178 DK
2
205 F0010
C0299
1
16290 DK
2
207 F0010
C0299
1
16400 DK
1
214 F0010
C0299
1
16636 DK
2
91 F0010
C0299
1
16890 DK
2
202 F0010
C0299
1
18196 DK
1
210 F0010
C0210
1
20905 DK
1
204 F0010
C0299
1
21565 DK
2
203 F0010
C0210
1
21698 DK
2
206 F0010
C0299
1
23940 DK
1
207 F0010
C0299
1
24190 DK
2
208 F0010
C0299
1
25465 DK
2
213 F0010
C0299
1
28616 DK
1
205 F0010
C0299
1
29687 DK
2
211 F0010
C0299
1
29848 DK
1
210 F0010
C0299
1
30411 DK
1
206 F0010
C0299
1
30781 DK
2
211 F0010
C0299
1
32504 DK
2
206 F0010
C0200
1
34086 DK
2
204 F0010
C0299
1
34999 DK
2
204 F0010
C0299
2
P0199
1
36492 DK
2
208 F0010
C0299
1
36511 DK
1
203 F0010
C0299
1
37876 DK
2
211 F0010
C0299
1
38179 DK
2
214 F0010
C0210
1
38524 DK
1
208 F0010
C0299
1
38859 DK
2
212 F0010
C0299
1
38868 DK
1
2 F0010
C0299
1
38963 DK
1
211 F0010
C0299
1
39600 DK
1
213 F0010
T0000
1
40094 DK
2
211 F0010
C0299
1
43200 DK
2
212 F0010
C0299
1
44174 DK
2
209 F0010
C0207
1
44389 DK
1
211 F0010
C0299
1
46798 DK
1
211 F0010
C0299
1
46880 DK
1
2 F0010
C0299
1
47220 DK
2
207 F0010
C0210
1
49566 DK
2
2 F0010
F0010
1
49969 DK
2
209 F0010
C0299
1
51634 DK
2
210 F0010
C0299
1
55093 DK
2
205 F0010
C0299
1
59210 DK
1
208 F0010
C0210
1
59555 DK
2
F0010
1
60527 DK
1
209 F0010
C0299
1
61730 DK
1
204 F0010
C0299
1
61822 DK
1
209 F0010
C0200
1
2052 FI
2
210 P3020
C0299
V9998
1
2267 FI
1
207 P3020
C0299
V9998
1
2548 FI
2
204 P3020
C0210
V9998
1
3498 FI
1
208 P3020
C0299
V9998
1
4080 FI
2
205 P3020
F4399
V9998
1
4584 FI
1
2 F1005
P3020
V9998
1
52 FR
1
206 P3020
F1030
V9999
1
107 FR
1
206 P3020
C0299
V9999
1
140 FR
2
2 P3020
C0210
V9999
1
162 FR
2
212 P3020
C0299
V9999
1
805 FR
1
204 P3020
C0299
V9999
1
841 FR
1
211 P3020
C0299
V9999
1
964 FR
2
210 P3020
B2999
V9999
1
1323 FR
1
211 P3020
C0299
V9999
1
1391 FR
1
213 P3020
C0299
V9999
1
1433 FR
1
204 P3020
C0299
V9999
1
1700 FR
2
212 P3020
C0210
V9999
1
1761 FR
1
204 P3020
C0299
V9999
1
2343 FR
2
201 P3020
C0299
V9999
1
31
2738 FR
2
205 P3020
C0299
V9999
1
3157 FR
1
205 P3020
C0299
V9999
1
3211 FR
2
214 P3020
C0299
V9999
1
3344 FR
2
215 P3020
C0299
V9999
1
3571 FR
2
210 P3020
C0299
V9999
1
3809 FR
2
215 P3020
C0299
V9999
1
4308 FR
1
2 P3020
C0299
V9999
1
4347 FR
1
207 P3020
C0299
V9999
1
4499 FR
2
209 P3020
C0299
V9999
1
4704 FR
2
211 P3020
C0299
V9999
1
4986 FR
2
211 P3020
C0299
V9999
1
5201 FR
2
203 P3020
C0299
V9999
1
5326 FR
1
216 P3020
C0299
V9999
1
5336 FR
1
215 P3020
C0299
V9999
1
5561 FR
1
212 P3020
C0210
V9999
1
5601 FR
2
3 P3020
C0299
V9999
1
5621 FR
2
212 P3020
C0109
V9999
1
5720 FR
2
209 P3020
C0299
V9999
1
6045 FR
2
206 P3020
C0299
V9999
1
6142 FR
2
210 P3020
C0299
V9999
1
6173 FR
1
209 P3020
C0299
V9999
1
6189 FR
2
202 P3020
C0299
V9999
1
6500 FR
1
211 P3020
C0299
V9999
1
6542 FR
1
216 P3020
C0299
V9999
1
6583 FR
2
206 P3020
C0299
V9999
1
6792 FR
1
210 P3020
F4305
V9999
1
7309 FR
1
209 P3020
C0299
V9999
1
7700 FR
1
209 P3020
C0299
V9999
1
8433 FR
1
213 P3020
C0299
V9999
1
8930 FR
2
213 P3020
C0299
V9999
1
8979 FR
2
208 P3020
C0299
V9999
1
9319 FR
1
204 P3020
C0299
V9999
1
9468 FR
1
206 P3020
F4398
V9999
1
9541 FR
2
2 P3020
F4305
V9999
1
9553 FR
1
210 P3020
F4398
V9999
1
9594 FR
1
210 P3020
F4398
V9999
1
9772 FR
2
209 P3020
C0299
V9999
1
10137 FR
2
212 P3020
C0299
V9999
1
10339 FR
2
207 P3020
C0299
V9999
1
10516 FR
1
212 P3020
C0299
V9999
1
10578 FR
2
209 P3020
C0299
V9999
1
10587 FR
1
216 P3020
C0299
V9999
1
10628 FR
2
209 P3020
C0299
V9999
1
10711 FR
1
213 P3020
C0299
V9999
1
11110 FR
1
207 P3020
F4398
V9999
1
11581 FR
1
205 P3020
C0299
V9999
1
11584 FR
1
215 P3020
C0299
V9999
1
11607 FR
1
213 P3020
C0299
V9999
1
12328 FR
2
206 P3020
C0299
V9999
1
12372 FR
2
206 P3020
C0299
V9999
1
12426 FR
2
214 P3020
C0299
V9999
1
12433 FR
1
209 P3020
C0299
V9999
1
12572 FR
2
207 P3020
F4305
V9999
1
12919 FR
1
201 P3020
C0299
V9999
1
13145 FR
1
2 P3020
F1288
V9999
1
14287 FR
2
211 P3020
C0299
V9999
1
14666 FR
1
209 P3020
C0299
V9999
1
14895 FR
1
201 P3020
C0299
V9999
1
14896 FR
2
215 P3020
C0299
V9999
1
14941 FR
1
203 P3020
C0299
V9999
1
15209 FR
2
210 P3020
C0299
V9999
1
15210 FR
2
208 P3020
C0299
V9999
1
15346 FR
1
207 P3020
C0299
V9999
1
15347 FR
1
210 P3020
C0299
V9999
1
15360 FR
1
208 P3020
F4305
V9999
1
15545 FR
1
210 P3020
C0299
V9999
1
16190 FR
2
209 P3020
C0299
V9999
1
16434 FR
1
213 P3020
C0299
V9999
1
16556 FR
1
212 P3020
C0299
V9999
1
16814 FR
2
2 P3020
A1098
V9999
1
17048 FR
1
3 P3020
A1098
L0978
1
17121 FR
2
203 P3020
F4305
V9999
1
17161 FR
1
9 P3020
A1098
V9999
1
17201 FR
1
3 F1100
P3020
L0978
1
17725 FR
1
6 L0978
P3020
A1098
1
19173 FR
2
3 P3020
A1098
V9999
1
19630 FR
2
4 P3020
A1098
V9999
1
19718 FR
1
2 P3020
A1098
V9999
1
20094 FR
1
2 P3020
A1098
V9999
1
20255 FR
2
205 D6012
P3020
V9999
1
20790 FR
2
202 P3020
C0299
V9999
1
20796 FR
1
207 P3020
C0299
V9999
1
20818 FR
1
209 P3020
C0299
V9999
1
21144 FR
2
206 P3020
C0299
V9999
1
21408 FR
2
212 P3020
C0299
V9999
1
21750 FR
1
211 P3020
C0299
V9999
1
21782 FR
2
211 P3020
C0299
V9999
1
22492 FR
2
210 P3020
C0299
V9999
1
23059 FR
2
210 P3020
F4310
V9999
1
23180 FR
2
208 P3020
F4310
V9999
1
23245 FR
1
212 P3020
F4310
V9999
1
23291 FR
1
209 P3020
F4305
V9999
1
23362 FR
2
213 P3020
F4310
V9999
1
23431 FR
1
211 P3020
F4305
V9999
1
23942 FR
1
212 P3020
F4305
V9999
1
23947 FR
1
206 P3020
F4310
V9999
1
24005 FR
1
206 P3020
F4305
V9999
1
24076 FR
1
202 P3020
F4305
V9999
1
24093 FR
2
212 P3020
F4310
V9999
1
24148 FR
2
209 P3020
F4310
V9999
1
24197 FR
2
209 P3020
F4305
V9999
1
24307 FR
2
209 P3020
F4310
V9999
1
24386 FR
2
209 P3020
F4310
V9999
1
24455 FR
1
210 P3020
F4305
V9999
1
24820 FR
2
208 P3020
F4310
V9999
1
25287 FR
1
209 P3020
F0098
F4305
1
25407 FR
1
208 P3020
F4305
V9999
1
25445 FR
2
206 P3020
F4305
F0098
1
25667 FR
1
210 P3020
F4310
V9999
1
25756 FR
1
207 P3020
F4305
V9999
1
25989 FR
2
210 P3020
F4310
V9999
1
26542 FR
2
205 P3020
F4305
V9999
1
26562 FR
2
211 P3020
F4305
V9999
1
26643 FR
1
207 P3020
F4305
V9999
1
26763 FR
1
210 P3020
F4305
V9999
1
26884 FR
1
203 P3020
F4305
V9999
1
27010 FR
2
208 P3020
F4305
V9999
1
27018 FR
1
209 P3020
F4310
V9999
1
30152 FR
2
214 V9998
P3020
V9998
1
35467 FR
1
212 V9998
P3020
V9998
1
37192 FR
1
207 P3020
B2999
V9999
1
37278 FR
1
213 P3020
B2999
V9999
1
37326 FR
2
208 P3020
B2999
V9999
1
38275 FR
1
201 P3020
B2999
V9999
1
38941 FR
2
208 P3020
B2999
V9999
1
39072 FR
2
214 P3020
B2999
V9999
1
40493 FR
2
203 P3020
B2999
V9999
1
40495 FR
1
208 P3020
B2999
V9999
1
41383 FR
1
211 P3020
V9998
F4305
1
41463 FR
2
212 P3020
B2999
V9999
1
669 IT
1
210 P3020
C0210
V9999
1
4656 IT
1
212 P3020
P3020
V9999
1
4894 IT
2
2 P3020
V9999
V9999
1
5149 IT
2
212 P3020
C0210
V9999
1
5252 IT
2
212 P3020
C0210
V9999
1
6124 IT
1
212 P3020
C0210
V9999
1
6275 IT
1
212 P3020
C0210
V9999
1
8234 IT
2
210 P3020
V9999
V9999
1
9080 IT
2
30 V9999
P3020
V9999
1
474 SE
2
215 V0000
F0010
V0000
1
1442 SE
1
207 F0010
C0299
V0000
1
1998 SE
2
208 F0010
C0299
V0000
1
3093 SE
2
207 F0010
C0210
V0000
1
5882 SE
1
201 F0010
C0299
V0000
1
8834 SE
1
203 F0010
V9999
V0000
1
9082 SE
1
209 F0010
C0299
V0000
1
9748 SE
1
205 F0010
C0299
V0000
1
10263 SE
1
216 F0010
V9999
V0000
1
10436 SE
1
209 F0010
C0200
V0000
1
10461 SE
1
208 F0010
C0299
V0000
1
10506 SE
2
206 F0010
C0298
V0000
1
10583 SE
1
203 F0010
C0299
V0000
1
10883 SE
2
208 F0010
C0205
V0000
1
12934 SE
2
36 F0010
F1410
F0010
1
14088 SE
1
209 F0010
V9999
V0000
1
17856 SE
1
2 F0010
C0210
V0000
1
18774 SE
1
212 F0010
V9999
P3000
1
18948 SE
2
204 F0010
C0299
T0000
1
20430 SE
1
206 F0010
C0205
V0000
1
20431 SE
1
203 F0010
C0299
V0000
1
20432 SE
2
203 F0010
P0199
V0000
1
25026 SE
2
209 F0010
C0299
V0000
1
27479 SE
1
205 F0010
C0299
V0000
1
31362 UK
1
0 P3020
P3020
P3020
1
89694 UK
2
0 P3020
P3020
P3020
1
249
Data Table con’t
P3005
Kennummer
Country
Sex
Age
Product1
Product2
Product3
V9999
Häufigkeit
16098 BE
2
44 P3005
P3005
3197 DK
2
33
P3005
1
1
4189 DK
1
2 F1005
P3005
1
9832 DK
1
211 C0299
P3005
1
12357 DK
1
209 C0299
P3005
1
13686 DK
2
2 C0299
P3005
1
18485 DK
2
30
P3005
1
29449 DK
2
24
P3005
1
31538 DK
1
203 P3005
U0198
1
37105 DK
2
213
P3005
348 FR
1
211 P3005
P3005
V9999
1
7098 FR
1
207 P3005
P3005
V9999
1
11722 FR
1
211 V9999
P3005
V9999
1
16224 FR
2
215 V9999
P3005
V9999
1
23717 FR
1
210 P3005
Q3999
V9999
1
24105 FR
1
205 P3005
R0400
V9999
1
25358 FR
1
2 P3005
P3005
V9999
1
26527 FR
1
207 P3005
R3020
V9999
1
26688 FR
2
216 P3005
P3005
V9999
1
26886 FR
1
206 P3005
R3098
V9999
1
32478 FR
1
2 V9998
P3005
V9998
1
36040 FR
1
7 V9998
P3005
V9998
1
37953 FR
2
5 P3005
P3005
V9999
1
7989 IT
2
26 P3005
P3005
V9999
1
20413 NL
1
35 V9999
V9999
P3005
1
21173 PT
2
2 B1098
P3005
V9999
1
23563 PT
2
51 E0098
Q0598
P3005
1
747 SE
1
216 C0299
P3005
V0000
1
10411 SE
1
214 C0400
P3005
V0000
1
18054 SE
2
209 P3005
P3005
V0000
1
18121 SE
2
3 B1099
P3005
V0000
1
18302 SE
1
209 V0000
P3005
C0299
1
18777 SE
2
2 F1320
C0299
P3005
1
20165 SE
1
209 C0299
P3005
V0000
1
27869 SE
1
3 T0000
C0299
P3005
1
4509 UK
2
1 P3005
P3005
P3005
1
4892 UK
1
0 P3005
P3005
P3005
1
6257 UK
2
2 P3005
P3005
P3005
1
15882 UK
1
0 P3005
P3005
P3005
1
17338 UK
1
2 P3005
P3005
P3005
1
26102 UK
1
1 P3005
P3005
P3005
1
1
31849 UK
1
0 P3005
P3005
P3005
1
33798 UK
1
24 P3005
P3005
P3005
1
35514 UK
2
11 P3005
P3005
P3005
1
86309 UK
2
2 P3005
P3005
P3005
1
103021 UK
2
37 P3005
P3005
P3005
1
110407 UK
1
1 P3005
P3005
P3005
1
121213 UK
2
1 P3005
P3005
P3005
1
126697 UK
2
1 P3005
P3005
P3005
1
137768 UK
1
0 P3005
P3005
P3005
1
50
Annex D: EU and related reports
- RAPEX - Rapid Alert system for non-food Products of the EC
- Preventative product safety analysis - hints on risk
minimisation in product design by explorative HLA (EHLASS)
data analysis.
- Falls among young children in five European countries,
Konsumentverket
- The actions and attitudes of Europeans on health, food and
alcohol and safety, The european Opinion Research Group
- Product related accidents in playgrounds and school grounds
in Sweden, Konsumentverket
- A guide to child safety regulations and standards in Europe,
European Child Safety Alliance*
* attached in front of the binder
RAPEX - Rapid Alert System for Non-Food Products of the European Commission, DG SANCO
RAPEX serves as a single rapid alert system for dangerous consumer products. All non-food products
intended for consumers or likely under reasonably foreseeable conditions to be used by consumers are
included within the scope of RAPEX, with the exception of pharmaceutical and medical products.
The legal basis of the RAPEX system is the General Product Safety Directive (2001/95/EC) laying down
procedures in matters of product safety.
The objective of RAPEX is to ensure the rapid exchange of information among Member States and the
Commission on measures taken in the Member States to prevent, restrict or impose specific conditions on the
marketing or use of consumer products by reason of serious risk to the health and safety of consumers.
This information is circulated among the competent authorities, through a network of national contact points.
However, the GPSD introduces specific provisions to ensure public access to the information available to the
authorities on product safety.
Some aggregated information on the functioning of RAPEX:
•
The number of notifications exchanged was 143 in 2001, 168 in 2002, and 139 in 2003.
•
Four categories of risks represent more than 60% of all notifications in 2003: the risks of choking and
suffocation, fire risk, presence of carcinogenic substances, electric shocks.
•
The category of products most often notified in 2003 was toys, followed by other types of products
for children.
Since the coming into force on 15 January 2004 of the revised General Product Safety Directive the
Commission is publishing weekly overviews of the RAPEX notifications providing the information deemed
most relevant for the general public.
EXECUTIVE SUMMARY
EHLASS, the European Home and Leisure Accident Surveillance System, was
originally meant for improving product safety by monitoring accidental injuries
related to consumer products. The main objective of this project was to evaluate the
potential of the current ISS, the EU Injury Surveillance Systems (formerly EHLASS)
to serve this purpose.
In particular, the project team consisting of product safety experts from France,
Greece, Netherlands, Sweden, and Austria conducted a comprehensive analysis and
interpretation of product information in the current EHLASS / ISS data. This
"Preventive Product Safety Analysis" consisted of:
1. a comparative review of product involvement or cause of accident classification in
injury surveillance systems
2. the development and pilot software implementation of an EHLASS / ISS specific
product involvement classification (Product Involvement Factor PIF and AUTOPIF software, which is based on multi-lingual keyword search in the free text
accident description of the EHLASS records)
3. the development and pilot application of a standard reporting scheme for
EHLASS / ISS product information based on indicators of frequency, severity and
product causality ("product safety priority table"; this table was complemented by
a literature review of product safety research and initiatives)
4. the assessment of preventability and possible safety solutions for a sample of
EHLASS case files produced by the PIF software ("product safety expert panel")
The proposed PIF classification (steps 1 to 2) consists of six distinct "factors" of
product involvement (PIF 1-7). These factors provide both an implicit product
definition and a qualification of product involvement; its automatic application to four
national EHLASS data sets yielded the following results (AT, FR, NL, SE):
• in 85 % of cases a "Manufactured product was involved" (PIF 3-7; range 66-94%)
• in 19 % of cases the "Product role was clearly identified" (PIF 3-6; range 16-24%)
• in 5 % of cases "Product causality was likely" (PIF 4-6; range 1-11%)
• in 2 % of cases the "Product was potentially defective" (PIF 4; range 0,4-4%)
Within manufactured products only (PIF 3-7), 17% are proximity products and 5%
are "causality products" (PIF 4-6: defective products, maladapted, high risk). In
comparison to manual product involvement classification (from step 1: international
review) the AUTO-PIF tends to underestimate the share of products "causality
products" by a factor of two.
The proposed "Product safety priority table" (step 3) was applied to the same four
EHLASS data sets and yielded the following top ten “priority product categories”:
Rank [1-24] *
Product Category
(top ten; EHLASS V.96 1. digit)
Other and unspecified product
Frequency
1
Severity
Electric equipment primarily for use in household
6
14
2
7
Human being, animals, animal articles
5
10
13
9
Part of building and stationary furniture
3
7
18
9
Food, beverages, tobacco
14
11
4
10
Chemicals, detergents, pharmaceutical products
16
4
10
10
Stationary equipm., processed and natural surface – outside
2
8
20
10
3
Product Average
Causality (Priority)
17
7
Medico-technical equipment, laboratory equipment
23
6
1
10
Natural element, plants and trees
15
9
8
11
Domestic appliances and equipment
12
15
6
11
* Rank 1 = highest, rank 24 = lowest; e.g.: Product Category “Electric equipment” has rank 6 in frequency, 14 in
severity, 2 in causality and 7 on the average of all three indicators; possible ranks are 24, corresponding to the no. of
product categories
After applying the PIF-intrinsic product definition to this table (excluding nonmanufactured products, basically) and adding the indicator on information need (no.
of publications) the following product categories und generic products have been
exemplified as "priorities" for product safety research:
• Machinery for industry, handicraft and hobby: Manual garden tool, Mechanical
Craft tool/implement, Chain saw
•
Electric household equipment: Major electric household machine, Cooker/oven,
Electric iron, Barbecue grill
•
Domestic appliances and equipment: Coffee pot, Unsp. non-fixtures, Pressure
cooker
•
Furniture and textile: Cot/cot bed. Baby bouncer (hanging), Carpet strip/grip
•
Industrial installations, stationary installations for water, sanitation and electricity:
Boiler, stationary electric installation
•
Packaging and containers: Aerosol spray, Container, Tins
•
Medico-technical equipment, laboratory equipment: Thermometer
•
Chemical products, detergents: Pharmaceutical products, Soap, polish and
detergent
The causality indicator was derived from the Product Involvement Factor (PIF);
products in accidents assigned to PIF categories 4 to 6 were considered to have a high
likelihood of causal involvement (summarized as "product causality likely“):
PIF categories
PIF 1 – No product involved
PIF 2 - Product non-manufactured
PIF 3 - Product related to proximity
PIF 4 - Product potentially defective
PIF 5 - Product potentially maladapted:
PIF 6 - Product with high intrinsic risk:
PIF 7 - Product identified but description
inadequate to enable a judgment
Most frequent products in sample
(% within PIF category)
27% Stairs, indoors; 19% Processed surface, outdoors; 11%
Floor, flooring, indoors, unsp.; 10% Pavement, snow/ice
covered
2% Bicycle; 2% Drinking glass; 1% Door with glass; 1% Bowl,
dish; 1% Sledge; 1% Fireworks; 0% Boiler; 0% Swing
3% Bicycle (adult); 2% Angle grinder; 3% Passenger car, Car
door; 1% Skate, unsp.; 1% Walking frame (with wheels); 1%
Rugs, mats; 1% Slicing machine; 1% Sewing machine
4% Knife; 3% Firewood; 3% Fats and oils; 2% Electric iron; 1%
Angle grinder; 1% Can; 1% Drinking glass
-
In step 4 of the analysis the "product safety expert panel" assessed preventability and
possible safety solutions in a sample of PIF case files (of four national EHLASS data
sets):
• the majority of accidents (56%) was attributed predominately to behavioural
causes
• 12% were considered to be preventable by a current technical safety solution,
• 4% by a potential technical safety solution
• the share of cases with "not enough information" was 16%
The highest share of accidents that were considered to have a "potential safety
solution" was found in the PIF categories 4, 5 and 6 (product involvement likely to be
causal). However, as the following examples show it was not possible to devise safety
recommendations for specific cases beyond a very general level (mainly because of
the limited information on product involvement in the accident description):
Product
Product unspecified
Circular saw
Moulding machine
Other sp. fixed machine
Electric heating blanket
El-grill, separate
Fireworks
Other sp. product
Product unspecified
Sawing tool, mechanical
Sledge
Slicing machine
Safety Recommendation (derived from free text description of cases in
PIF categories 4-6 "product causality likely“)
Use of safety glass in glass doors
Improve design of safety mechanism of saw
Redesign of milling cutter? Safety adjustment on milling cutter
Redesign of hydraulic wood cleaver; Redesign of wood cleaver
Prevent blanket from overheating
improve stableness of product
Highlight fireworks safety information
Risk assessment of Boiler for wood chips
Place limit on temperature of hot water boilers
Redesign of product or better maintenance
Manufacture all sledges with brakes and steering
Improve product design to include safety features
Based on the results of the PIF analysis (steps 1-3) the expert panel drew the
following conclusions:
• in general, the product information recorded in the current EHLASS / ISS data
sets can be extremely useful for monitoring product involvement on a generic
level. The "product safety priority table" is recommended as an indicator-based
reporting tool (indicators of frequency, severity and causality). Used as such, it
provides a broad empirical framework for product and consumer safety research.
However, the lack of an underlying product definition, inconsistent product
coding and little specific product information in the accident description impose
mayor restrictions even on this “high level” reporting functionality.
• technically, the key-word based PIF procedure (PIF classification and AUTO-PIF
software) is a practical and useful tool to preselect EHLASS / ISS cases by type of
product (simple product definition) and product involvement (causality indicator).
The rate of "false" PIF assignments is tolerable, and the accumulation rate of
"true" (product relevant) cases is considerable. The multi-lingual and flexible
design of the PIF software allows for easy adaptation to any national data set.
• product oriented assessment of preventability and specific safety solutions in
individual records proved to be very difficult. The safety expert panel concluded
that the EHLASS case files (free text description in combination with other data)
in their present form contain little information, and certainly no systematic
information, to classify the role of products unambiguously. Thus, in most cases
(with likely causal product involvement) only very general safety
recommendation could be given.
However, the literature review confirmed that EHLASS / ISS are the only available
instrument to provide an empirical background in injuries related to (consumer)
products on EU level. The following recommendations by the project team might help
to overcome the structural and quality-linked restrictions (mentioned above) that
currently keep EHLASS / ISS from being more widely used as a product safety tool
(the recommendations are put as “instructions” to the product safety part of the
EHLASS / ISS administration on EU level):
•
introduce a product concept and a product definition that is linked to the EU
product safety legislation
• reduce the number of products in the product list (e.g. to three digit level)
• instead, add a cause variable and/or product “flag” to the list of variables (e.g. like
the PIF classification)
• only in case of product causality (product flag on), ask for some specific and
standardized product information
• the “flagged” cases could immediately be forwarded to the scrutiny of the national
data centers (and also to EU level subsequently – allowing for rapid reaction)
• generally, structure and standardize accident description (“free text”) to allow for
better comparability and guarantee information additional to the codes
For the moment, also the tools developed by product safety expert panel might
enhance the utility of the current EHLASS / ISS data:
• implement and “enforce” common coding and quality standards (through
guidelines)
• provide all accident descriptions (free text) on HIEMS / ISS level in English
(the feasibility of machine translation for this purpose is shown in this report)
• implement the EHLASS-based indicators on severity (SSDR) and causality
(AUTO-PIF) on HIEMS/ISS level and use the "product safety priority table"
as a reporting tool
The AUTO-PIF software tool for the automatic categorisation of EHLASS cases
according to the PIF (Product Involvement Factor) will be available on the CIRCA
website of DG SANCO: http://forum.europa.eu.int/Members/irc/sanco/ehlass/home
(the current version features automatic PIF classification of EHLASS V.96 data,
choice of either EHLASS product fields 1, 2 or 3 for PIF-classification, dynamic
update of keywords, multi-lingual keyword search and output of case files for
preventive safety analysis; for Win95, 98, NT, 2000).
Keywords: product safety, epidemiology, prevention
This report was produced by a contractor for Health & Consumer Protection Directorate General and represents the views of the
contractor or author. These views have not been adopted or in any way approved by the Commission and do not necessarily
represent the view of the Commission or the Directorate General for Health and Consumer Protection. The European
Commission does not guarantee the accuracy of the data included in this study, nor does it accept responsibility for any use made
thereof.
2004-06-04
SW EDIS H C ON SU MER
AGENCY
CONSUMER OMBUDSMAN
Falls among Young Children in Five European Countries
Injuries requiring medical attention following falls to a lower level among 0-4-year-olds
1
A study of EHLASS data from Austria, Denmark, Greece, the Netherlands and Sweden
i
Mr Henrik Nordin, Swedish Consumer Agency
Falls are the most common cause of injuries among young children, as in most age groups. Children
have a natural urge for running, climbing and other challenging physical activities, that contribute to
creating risks for falls, particularly as children often move in environments and use products that are
designed primarily for adults, or otherwise with insufficient consideration for the risks created by children’s behaviour.
Objective
EHLASS, the European Home and Leisure Accident Surveillance System, has provided a possibility to
retrieve and analyse comparable injury data from several countries in the E.U. The main purpose of
this study is to look into and compare patterns in injuries caused by falls to a lower level among young
children in different European countries, with a particular regard to products involved, using EHLASS
data. A further step is to form an opinion as to the value for European standardisation of such an
analysis.
Material and method
EHLASS data concerning injuries caused by falls to a lower level among 0-4-year-olds from Austria,
Denmark, Greece, the Netherlands and Sweden has been analysed. (Technically, the Dutch data has
been taken from the national LIS system, as this has a broader basis, making it more representative.)
In all countries contributing data, the accident data is collected in hospital emergency departments,
using interviews or questionnaires, and complemented by medical data on the injury and its consequences. Data is collected at samples of hospitals. Population coverage and sample representativity
vary between countries, and are sufficient in Denmark, Greece and the Netherlands (10-15% coverage), less so in Sweden (5% coverage) and Austria (<1% coverage).
The registered cases serve as the basis for national estimates of total numbers of injuries and incidence rates, that have been calculated using official population data. The statistical reliability of the
national estimates varies with the number of cases on which they are based. The number of observations in the material are as follows: Austria 353; Denmark 6,827; Greece 8,728; the Netherlands
5,981; Sweden 2,534.
During the analysis it became clear that differing principles and practices of product registration tend
to create false differences between the countries in the injury data. To compensate for this, a freer use
of the data registered than a strict variable-by-variable approach was adopted. In particular, the variable mechanism of injury was used to complement product coding regarding injuries related to stairs
and steps: when no product was specified, and the mechanism was fall on or from stairs, the stairs
were assumed to be the product. This may have led to some overestimation of the involvement of
stairs and steps in accidents and injuries. Furthermore, falls from bicycles were always considered as
falls to a lower level, even if this was not the case in the original coding in one of the countries (Austria).
Results
Incidence rates
The incidence rate is highest in Greece, followed in descending order by Austria, Denmark, Sweden
and the Netherlands (figure 1). However, the low rate in the Netherlands could be explained partly by
the health care system: as patients normally turn to a general practitioner first, many cases which require no treatment or only minor treatment will not reach the emergency department. Contrary to this,
in Denmark, Greece and Sweden patients normally turn straight to the ED following an accident. Due
1
European Home and Leisure Accident Surveillance System
to this, excluding cases that received no treatment in the ED from the Danish, Greek and Swedish
data might provide a better comparison with the Dutch data. The Dutch registration does not inform
whether a patient received treatment in the ED or was sent home after examination, but cases not
receiving treatment are considered to be few.
Furthermore, it is worth noting that the rate of cases admitted to hospital is also lowest in the Netherlands. This could be a sign that conditions are in fact safer in the Netherlands concerning falls among
young children, but it could also be caused by differing health care practices.
Age
The age pattern is roughly the same: infants in their first living year have the lowest incidence rates
and two-year-olds have the highest rates in countries where age specific rates can be calculated, except Sweden.
Austria reports no cases that were sent home after examination, but still has the second highest incidence rate. To some extent, this is probably due to infants being underrepresented in the Austrian
sample; infants in their first living year represent only two per cent of the injuries due to falls to a lower
level, compared to 10 per cent in Denmark and the Netherlands, 16 in Sweden and 21 in Greece.
Also, the small sample makes national estimates particularly uncertain for Austria.
Gender
Boys have higher incidence rates than girls in all five countries. The difference is greatest in Greece,
where the boys’ rate (50/1000) is over 30 per cent higher than the girls’ (38/1000), and smallest in the
Netherlands, where the boys’ rate (17/1000) is less than 20 per cent higher compared to the girls’
(15/1000).
Products involved in falls
The eight product categories shown in figure 2 are the top eight in all countries with only two minor
exceptions: in Sweden and Austria, tabletops account for somewhat greater portions than the lowest
ranking categories in figure 2.
Stairs and steps is the product category most commonly involved in falls to a lower level in Denmark,
Sweden and the Netherlands, and a close second in Greece. Apart from that, the ranking among the
eight categories varies a great deal. Austria shows the greatest deviations, which partly reflect the
higher proportion of older children in the data (more accidents involving bikes and playground equipment, less involving prams/strollers and children’s furniture; see below). (Concerning stairs and steps,
mechanism of injury was used to complement product coding, having the strongest effect on the Danish and Greek data.)
The percentages remain largely the same if injuries that do not require treatment are excluded from
the Danish, Greek and Swedish data.
Regarding stationary playground equipment, slides, swings and climbing frames dominate in all
countries. Looking at each country, swings reach the highest percentage in Denmark and Sweden,
slides in the others. Children’s furniture include changing tables, high and low chairs, cots and cradles, baby sitters and also baby walkers. None of these categories reach more than 3 per cent of all
injuries due to falls to a lower level among 0-4-year-olds in any country.
Gender
Patterns are similar for boys and girls in all countries; with few exceptions, the percentages for boys
and girls concerning different product categories are within two points from each other.
Age
Children’s use of several product categories is closely related to age, which is reflected in the injury
data. Children’s furniture account for between 21 per cent (Netherlands) and 34 per cent (Sweden)
of the injuries from falls to a lower level in the first living year, but decrease their portion of the injuries
with increasing age in all countries. The same pattern applies to prams, strollers etc., which account
for between 9 (Sweden) and 18 (Denmark) per cent of falls to a lower level during the first year.
2
In contrast, injuries due to falls involving playground equipment increase with age to reach between
13 (Greece) and 34 (Netherlands) per cent of injuries following falls to a lower level among 4-yearolds. Bicycles also increase with age, reaching between 4 (Netherlands) and 17 (Denmark) per cent
among 4-year-olds.
Stairs, chairs and sofas tend to be most frequently involved in falls to a lower level at ages 1 to 3 in
all countries.
Looking at different types of children’s furniture, changing tables account for several falls among
infants in Denmark, Sweden and the Netherlands (19, 16 and 10 per cent, respectively of falls to a
lower level during the first year), though not in Greece (3 per cent). Falls involving baby walkers are
more common among Greek and Swedish infants (13 and 9 per cent, respectively) than among Dutch
or Danish (less than 2 per cent).
Types of injury
Four types of injuries are the most common consequences of falls to a lower level among young children in all five countries: contusions or bruises, wounds, fractures and concussions (figure 3).
Contusions are the most common injury in three of the countries, Denmark, the Netherlands and Sweden (in the Netherlands along with fractures). In Greece, wounds stand out in the injury panorama. In
Austria, fractures dominate, with more than half of all cases.
3
Part of body
Wounds in particular, but also contusions usually affect the head or face, whereas fractures most often
affect the upper extremities. The head or face is the part of the body injured from 46 per cent of the
cases (Netherlands) up to over 80 per cent (Greece).
Age
The major types of injury tend to vary with age in all countries. Contusions and concussions appear
more among the youngest children, wounds and fractures tend to increase their portion of the injuries
with age.
Products involved in accidents
Different product categories tend to be associated with different types of injuries. Contusions and concussions are over represented when the product involved in the accident is children’s furniture, in
particular changing tables, high chairs and baby walkers. When prams/strollers etc. are involved,
contusions and concussions also tend to be somewhat more frequent. Fractures are strongly over
represented in accidents involving playground equipment. Wounds appear much more frequently in
connection with bicycles, chairs and to some extent sofas, than with most other products. By and
large, these patterns are common to all five countries. (Obviously, these variations are in accordance
with the age patterns mentioned above.)
Products causing injury
The product causing the injury in a fall is generally the product or object against which the falling person struck, in most cases the floor or ground. In the current study, the floor or ground caused 88 per
cent of the injuries in the Austrian sample, and are estimated to have caused half of the injuries in the
Dutch sample. In the three remaining countries, the portion is about 60 per cent. Apart from floor or
ground, stairs/steps and furniture are the only product categories that cause significant numbers of
injuries following falls to a lower level. The percentage of injuries caused by stairs range from 3 percent in Austria to an estimated 23 per cent in the Netherlands. Furniture cause from 2 per cent (Austria) to an estimated 11 per cent (Netherlands) of the injuries. (Concerning stairs and steps in the
Dutch data, product coding has been complemented using mechanism of injury.)
Types of injury
Falls onto different types of objects or surfaces have been analysed with regard to the types of injuries
sustained. Concerning falls onto furniture or other objects, excluding floor or ground, wounds are
greatly over represented, with between 40 (Austria) and 59 (Greece) per cent of the injuries. Falls onto
stairs or steps also tend to lead to a greater proportion of wounds than average in all countries except the Netherlands.
A separate analysis of falls onto the floor or ground has been performed, attempting to investigate
the effects of different types of surface (figure 4). Cases have been categorized according to whether
the surface causing the injury had some (if not always significant) shock-absorbing qualities, or no
such qualities. In the former category were placed injuries caused by outdoor surfaces made up of e.g.
soil, grass, sand or gravel, or floors made of e.g. wood or linoleum or covered with a carpet. The latter
category consisted of injuries caused by solid paved surfaces, e.g. asphalt, cement, stone or tile, indoor or outdoor. In many cases (the majority in three of the countries) there had not been enough
information to specify the type of surface. These form a third category.
In the Dutch and Austrian data, the proportion of fractures is significantly larger for falls onto surfaces
with shock-absorbing qualities than for falls onto solid paved surfaces. There are some similar tendencies in the Greek and Swedish data, although much weaker. If this were a more consistent pattern, it
might have supported an assumption that a shock-absorbing surface serves to prevent most types of
injury, with the exception of fractures. Studying the safety of surfaces in playgrounds, Mott et al (1997)
concluded that bark surfaces, although showing a clearly lower overall injury rate, “were not significantly more protective against arm fractures than concrete”. However, the present data can not support these findings. (It need hardly be said that a proper assessment of the safety of different types of
surfacing would require a different approach than a database study, in order to take into account falls
that do not lead to injury as a result of the preventive qualities of the surface.)
4
Conclusions
The vast majority of falls to a lower level that cause injuries among young children are related to
manufactured products. In each of the countries studied, ordinary household furniture account for
thousands of falls leading to injuries which require medical attention and even admission to hospital. In
fact, the majority is furniture of seemingly insignificant height, such as ordinary beds, chairs and sofas.
Perhaps more seriously, products particularly intended for children, such as playground equipment,
children’s furniture incl. high chairs, changing tables, baby walkers and prams and strollers also continue to account for several thousand injuries in each country, annually.
The main product categories involved are generally the same throughout Europe. With this general
accordance, the injury data could provide a common basis for preventive efforts in product safety in
Europe, in standardisation and other areas of prevention.
However, to fulfil this possibility, the European countries need to reach greater accordance concerning
the principles of injury coding and registration. Particularly concerning product registration, different
models adopted by different countries leave many traps and difficulties for a joint analysis, such as the
one attempted here.
Furthermore, differing patterns in health care consumption and organisation lead to considerable differences in the injury data. One such important factor is whether the emergency department, where
data is collected, is the first point of contact with the health care organisation, or whether a portion of
the injuries have been sorted out before registration. To properly analyse injury data, you need knowledge of the circumstances under which they have been collected. Some such knowledge has been
possible to gather within this study, more would be needed for a complete and correct interpretation of
all aspects of the results.
Reference
Mott A, Rolfe K, James R, Evans R, Kemp A, Dunstan F, Kemp K, Sibert J. Safety of surfaces and
equipment for children in playgrounds. The Lancet 1997; 349: 1874-76.
i
Co-authors:
Dr Robert Bauer, Austrian Institute for Home and Leisure Time Safety, Vienna, Austria
Mr Nick Dessypris, Centre for Research and Prevention of Injuries, Athens Univ. Med. School, Athens, Greece
Ms Baukje Hemmes, Consumer Safety Institute, Amsterdam, the Netherlands
Ms Stellina Kiosse, Centre for Research and Prevention of Injuries, Athens Univ. Med. School, Athens, Greece
Ms Hanne Møller, National Institute of Public Health, Copenhagen, Denmark
Dr Saakje Mulder, Consumer Safety Institute, Amsterdam, the Netherlands
Prof Eleni Petridou, Centre for Research and Prevention of Injuries, Athens Univ. Med. School, Athens, Greece
Ms Monica Steiner, Austrian Institute for Home and Leisure Time Safety, Vienna, Austria
5
REPORT
:
Product related Accidents in
Playgrounds and
School grounds in Sweden
– an Analysis of EHLASS Data
1998–1999
Preface
Children of all ages spend a lot of time in playgrounds, where they develop physical coordination, attempt new experiences and learn that they can manage them. They also
need to be able to fail now and then, without the results being too serious. There are often many children playing together in a limited area, so it is easy for an accident to happen. We know from experience that a substantial proportion of the injuries suffered by
children occur in playgrounds.
The Swedish Consumer Agency contacted the Department of Caring and Public Health
Sciences at the Mälardalen University, to propose a joint project. We hoped, in this
way, to come into contact with students looking for a suitable subject to investigate
from the Swedish EHLASS register, which contains data from home and leisure accidents noted by the public health care services.
One of the students, Malin Johansson, chose playground accidents as the subject for her
Grade C public health science paper, and the Swedish Consumer Agency contributed to
her work through the provision of the data material. Her supervisor was university lecturer Elsvig Eilert-Petersson.
The paper provides an excellent analysis of those injured in playgrounds, and in what
way, covering the age group from 0 to 12 years. It also includes an appendix that briefly
describes the occurrence of injuries for other age groups.
We hope that Malin Johansson's work will assist the extensive preventive work required
all over the country in order to prevent serious playground accidents. Its introductory
chapter, which includes a review of the literature and provides some international views,
forms an excellent introduction to child safety work in Sweden. It can also be recommended to those who do not have a particular need to make a more in-depth analysis of
playground accident statistics.
Henrik Nordin, of the Swedish Consumer Agency, has contributed some additional input to the report.
Stockholm, December 2001
Lotten Strindberg
Project Manager
Summary
Accidents in playgrounds and in school grounds among children in the 0-12 age group,
as recorded in the Swedish EHLASS system for 1998-1999, have been analysed. Over
these two years 1,722 such accidents were registered. The incidence rate for playground
and school grounds accidents among 0-12-year-olds in the EHLASS communes is 11
cases per 1000 inhabitants per year, which indicates that some 16 000 probably occur
annually in Sweden as a whole. 57 per cent of those injured were boys.
Six out of ten accidents were falls. Fractures and bruises were the most common types
of injury, each comprising one fourth of the accidents. Upper limbs were injured in four
out of ten accidents, and the head in three out of ten. The individual equipment categories involved in the greatest number of accidents were swings, climbing frames, slides
and asphalt surfaces, and these were singled out for further analysis. The results indicate
that the most important preventive measure would be the use and maintenance of shockabsorbing ground surfaces.
CONTENTS
Page
1. INTRODUCTION
9
2. BACKGROUND
10
2.1
2.2
2.3
2.4
2.5
2.6
National studies
International studies
Safety on playgrounds in the city of Västerås
EHLASS (European Home and Leisure Accident Surveillance System)
Standards, legislation and regulations for playgrounds
Preventive measures
3. OBJECTIVES
3.1
3.2
11
12
13
14
15
16
18
Main objective
Sub-objectives
18
18
4. MATERIAL AND METHODS
19
4.1
4.2
4.3
4.4
The survey population
Dropout
Restriction
Variables
5. RESULTS
19
19
19
20
22
5.1
5.1.1
5.1.2
5.1.3
5.1.4
5.1.5
5.1.6
Occurrence of accidents on playgrounds or school outdoor premises
Sex and age distribution
Injuries by month of occurrence
Injuries by mechanism
Types of injuries
Injuries by body area
Products involved
22
22
23
23
24
24
25
5.2
5.2.1
5.2.2
5.2.3
5.2.4
Products most commonly involved
Swings
Climbing frames
Slides
Asphalt
29
29
30
31
32
6. DISCUSSION
33
6.1 Method discussion
6.1.1 Ethical aspects
6.1.2 Validity and reliability
33
33
33
6.2 Results discussion
6.2.1 Swings
6.2.2 Climbing frames
34
35
35
6.2.3 Slides
6.2.4 Asphalt
6.2.5 General measures
35
36
36
6.3
37
Proposal for further research
7. CONCLUSION
38
8. REFERENCES
39
APPENDIX
42
Incidence of playground injuries to persons over the age of 12
42
1. INTRODUCTION
Injuries caused by accidents are one of the major public health problems in Sweden, as
they are in the rest of the world. In Sweden, they constitute the commonest cause of
death among children, young persons and younger adults.
Accidents to children are largely associated with exposure to dangerous environments.
The most effective way of preventing injuries is to do so in the environment in which
they occur. Important principles of improving the safety of children are to make the environment safer - better suited to children - and to educate parents and professionals involved with children on why injuries from accidents occur and how they can be prevented.
It is a basic right of children to expect society to support them, through the creation of
an appropriate organisation in the form of legislation and regulations intended to ensure
their safety. Injuries to children and young persons reflect their society's ability to create
safe, secure environments suited to the needs and circumstances of children.
Injury statistics play an important part in safety work and that of preventing injuries.
Accident risks need to be monitored through up-to-date statistics, so that new risks or
new types of accidents can be revealed. In order to be able to prevent accidents, it is important to know where, when and under what circumstances they have occurred.
Against this background, the intention is to reveal and analyse the accidents that occur
on Swedish playgrounds, using statistics from the EHLASS register.
9
2. BACKGROUND
There is no dispute that, although children's environments should be safe, they should
also stimulate them to encourage appropriate and harmonious development, and to satisfy children's natural curiosity and urge to discover. Children's activities change with
age and environment. The pattern of accidents changes, too, following the different development stages of children: what can be safe for a child of nursery school age can be a
risk for a one-year-old. Prevention of accidents - which includes regulations and legislation on children's environments - must be carried out with an awareness of the accidents
that can occur at different ages. Legislation and other regulations concerning accident
prevention differ from other aspects of children's rights in that they are generally of preventive character. In other words, they are intended to create and arrange a safe physical
environment, and to check that equipment of various types is so designed as to avoid the
risk of accidents (Berfenstam & Söderqvist 1992).
As long ago as 1954, two paediatricians, Ragnar Berfenstam and Theodor Ehrenpreis,
took the initiative to bringing together several organisations in order to form a committee to prevent accidents among children. There was considerable support for this, and
the result was to establish the Joint Committee for the Prevention of Accidents to Children. It included representatives from public associations, public authorities and institutions and associations involved in work with children. The background to the Committee's action was that, by the 1950s, statistics were showing that it was accidents that
were the commonest cause of death among children in Sweden. The Committee's work
was based on an overall view of children and their environment, on the basis of a wide
knowledge of children. Its work was very successful, and many organisations were involved. The general public became aware of the risks in children's environments. Planners and decision-makers tackled problems. Public investigations looked at the question
of child accidents from various aspects, giving publicity to the problems and often resulting in new legislation, regulations or recommendations. In 1980, the newly-formed
Children's Environment Council took over the work of preventing accidents among
children (Berfenstam & Söderquist, 1992). In 1993, Sweden's children and young persons were given their own ombudsman, whose duties include taking the initiative in coordination of public work in the field of child safety. The objective of this is that various
public bodies should take their proper responsibility for ensuring that children and
young persons themselves are aware of risks, and are taught how to prevent them
(Swedish Institute of Public Health, 1996).
Child safety work in Sweden has been very successful, which has had the effect of reducing accident mortality to among the lowest in the world (Children's Ombudsman,
2000). The number of fatal accidents to children has fallen from about 400 per year during the 1950s to about 80 per year today. Nevertheless, injuries are still the commonest
cause of death among children, young persons and younger adults (National Public
Health Committee, 2000).
Enjoyable, exciting playgrounds play an important part in children's lives. If properly
and safely designed, they are a source of pleasure and togetherness. Playgrounds should
meet the various requirements that children have as they grow up: a 2-3-year-old has
different needs and wishes than does an 8-10-year-old. A good playground should encourage games involving movement and balance, social games and activities, games intended to develop children's various senses and those that stimulate their creativity, curiosity and joy of discovery (National Association of Local Authorities, 2000).
10
It is precisely children's urge to discover new experiences and curiosity that can often be
related to injuries. Children need to try out different activities in order to grow and develop but, if the environment is hazardous, the child cannot foresee the possible consequences of its action. Children have a right to a safe and stimulating growth environment, which encourages their development (National Institute of Public Health, 1996).
Since 1990, Sweden has been signed up to the UN Convention on Children's Rights.
The Convention states that children have a right to a safe environment. Some of the
clauses that particularly relate to the safety of children (0-17) are as follows:
Clause 24 e
Each child and those responsible for its care shall be entitled to information and education on the prevention of accidents.
Clause 31
Each child shall be entitled to relaxation, play and recreational activities as appropriate to its age (Helleberg, 1994).
Together with other member states in the WHO European region, Sweden has adopted a
21-objective health policy - Health 21. WHO's renewed objectives extend until 2020.
Objective 3 - 'A healthy start in life' - and Objective 4 - 'Young persons' health' - are
general health objectives for children and young persons. Their aim is to reduce mortality and disability as a result of violence or accidental injuries among young persons
by at least 50 %. Objective 9 is concerned with reduction of injuries caused by violence
of accidents. It, too, aims to reduce mortality and disability, resulting from all types of
accidents in workplaces, in the home and as a result of recreation, by at least 50 % (National Institute of Public Health and the National Board of Health and Welfare, 1999).
The National Public Health Committee has been charged by the Government with preparing proposals for national public health objectives and strategies for achieving them.
The Committee has produced its report, entitled 'Health on equal terms - the second step
towards national public health objectives'. The report represents the third stage in a
process that resulted in proposals for national public health objectives and strategies.
The Committee has issued challenges to various parties, against the background of the
respective objectives and sub-objectives. Objective 8 challenges local government to
improve its overview of playground environments, and to clarify property-owners' responsibility for safety in such environments. The recording of data on injuries is presented as a challenge to county councils. In addition, it is pointed out that all parties involved, whether public or private, should be responsible for measures and costs to
minimise the risk of injuries within their areas of responsibility (National Public Health
Committee, 2000).
2.1
National studies
Accident statistics from hospitals in Sweden estimate that there are up to 12 000 injuries
on playgrounds each year, representing about 6 % of the total number of injuries to
children. Previous regional and local statistics show that playground injuries are generally more serious than other accidents to children (Swedish Consumer Agency, 1999).
Statistics from the University Hospital in Umeå from 1995-1996 show that 7 % of all
injuries to children under twelve occurred in connection with playground equipment.
About two-thirds of these accidents had occurred on public authority playgrounds. More
than half of the injuries were fractures, dislocation of joints or concussion. 15 % of the
11
injuries were the result of poor design, unsuitable positioning or inadequate maintenance of equipment (excluding the ground surface). Over three-quarters of the accidents
occurred when children were using swings, climbing frames or slides. 80 % of the accidents occurred between May and October (inclusive). According to the investigation,
the best way of preventing the injuries would have been to ensure that the ground beneath the equipment was suitably shock-absorbing, and to ensure that it was maintained
in this condition (Boman & Björnstig, 1998).
In 1997, the Swedish Consumer Agency carried out a market surveillance inspection of
publicly owned playgrounds in Flen, Nynäshamn, Örebro, Motala and Sollefteå. The
playgrounds were sited in child day care centres, children's holiday homes and schools,
in residential areas and in public parks.
In the areas inspected, the local government consumer advisors were asked to nominate
3-5 playgrounds. Inspection showed that, on the whole, new playground equipment was
generally satisfactory from a safety point of view. However, the planning of the playgrounds, and the placing of the equipment in relation to other items, was not satisfactory. From a safety viewpoint, the most serious shortcomings were those relating to the
sizes of openings, safety distances and the condition of the ground surface. Most of the
shortcomings were due to a lack of maintenance and, in some cases, to incorrect maintenance. There was no maintenance plan at all for playgrounds in three of the five areas
(Swedish Consumer Agency, 1999).
Sellström & Bremberg (1994) investigated injuries among children in Swedish day care
centres. The results showed that injuries in connection with outdoor playground activities were common. Among the outdoor injuries, a third of them resulted from falls from
playground equipment. Playground equipment (climbing frames, swings, slides) was the
largest contributory cause to the injuries.
Schools are interesting from a public health point of view, as many of the injuries suffered by children and young persons of school age occur there. 'Working conditions for
pupils and injuries suffered by pupils' is a development project being carried out jointly
by the National Injury Programme at the Institute of Public Health, the National Institute of Working Life and the Department of Public Health Science at the Karolinska Institute. Injury statistics were kept at 76 schools in Sweden during the 1996/1997 academic year. According to the second report from the project, dealing with injuries to
pupils and with school environments, one in five injuries occurred on the school playground. Over 40 % of the injuries were reported as having occurred during organised
activities on the playground. Analysis of the pattern of injuries occurring during breaks
showed that the three main groups were head injuries caused by blows, collisions during
movement and falls during play (Laflamme & Menckel, 1998).
2.2
International studies
Several investigations in other countries show links between playground injuries and
unsuitable ground surfaces (Robitaille et al., 2000, Allen & Johnson 1995, Mowat et al.,
1998, Chalmers et al., 1996, Mott et al., 1997, Witheaneacki & Meehan 1997).
According to Allen & Johnson (1995), 19 % of the risks in playgrounds were associated
with the material of the ground surface. There was a close link between the seriousness
of head injuries caused by falls and the type of material used for surfacing the playground. Hard surfaces constituted a significant risk to the safety of children. The authors
state that materials such as concrete, asphalt and grass have been used for surfacing
playgrounds due to their minimum maintenance requirements. Nevertheless, despite
their wide use, they are unsuitable for use as surfacing materials. The investigation also
12
showed that maintenance of equipment represented a significant problem, with 61 % of
the investigated equipment being badly maintained.
The risk of injury from a fall on to a hard surface, such as asphalt or concrete, is 2.28
times higher than the risk associated with a fall on to a shock-absorbing surface
(Chalmers et al., 1996). Mowat et al. (1998) showed that only 59 % of playgrounds fulfilled requirements in respect of the surfacing material.
Children suffer from more injuries in playgrounds with concrete surfaces than they do
in playgrounds with bark or rubber surfaces. The safety of a playground is a complex
interaction between many different factors, with the type of surface, the type of equipment and the height of the equipment being the most important (Mott et al., 1997).
Many studies show that fractures are the commonest injury from playgrounds
(Chalmers et al., 1996, Mack et al., 1997, Macarthur et al., 2000). Mack et al. (1997)
claim in their investigation that injuries to the head and face were commonest in the 0-4
age group, while it was injuries to arms and hands that were most common among
5-14-year-olds. In addition, the height of the fall was a significant risk factor in serious
playground injuries. The most injuries occurred in the months of May, June and September.
Chalmers et al., (1996) and Macarthur et al., (2000) show in their reports that it was the
upper limbs that were the most liable to injury. The majority of accidents occurred on
local government-owned playgrounds (49 %) or on school playgrounds (42 %), with
most injuries being caused by falls from the equipment. Injuries resulting from falls
were more frequently associated with equipment intended for climbing (32 %) or for
hanging from (46 %), as compared with slides (13 %) or swings (10 %) (Macarthur et
al., 2000). Mowat et al. (1998) also point out that a high proportion (80 %) of injuries
were the result of falls.
Roseveare et al. (1999) noted a reduction in the playground risks at twelve selected
schools after a special preventive programme had been introduced. Among the features
of the programme were information on playground risks, a report from a technician/engineer with recommended measures, regular contact and encouragement to carry
out improvements in line with the recommendations in the report. The schools were also
encouraged to develop appropriate safety policies. After 19 months, the risks at the intervention schools had fallen significantly, in comparison with those at the control
schools, which had received only information on playground risks.
2.3
Safety in playgrounds in the city of Västerås
A number of articles on the safety of playgrounds were published in the newspaper,
Vestmanlands Läns Tidning, during 2000/2001. Västerås has about 200 playgrounds,
owned by the local authority in one form or another. 125 of them are open to anyone,
and are administered by the council's Technical Services and Sports department, while
the rest are on school or child day-care premises. Technical Services and Sports inspects
the public playgrounds, and about 60 % of the others on behalf of the schools. In the
remainder of the cases, the schools themselves look after inspection and care. During
2000, the Västerås City Council spent SEK 400,000 on care and maintenance of its
playgrounds. In addition, the council funds two or three larger renovations per annum:
In 2000, the budget for these amounted to SEK 500,000. Each playground is checked by
an inspector once a year: in addition, each must be 'looked at' once a week (Vestmanlands Läns Tidning, 2000). In October 1999, the council's Technical Services and
Sports department started to inspect the city's playgrounds, in order to check whether
they complied with EU standards and Swedish legislation. The results of this work
13
showed that about 40 % of all the schools and child day-care playgrounds had shortcomings that needed to be attended to. In some cases, these shortcomings were so serious, and would have been so expensive to put right, that the school or child day-care
centre managers elected to dispose of the equipment rather than attempt to repair or
renovate it (Vestmanlands Läns Tidning, 2001).
2.4
EHLASS (European Home and Leisure Accident
Surveillance System)
In order to obtain information from the public health care services, and get more detailed information on injuries, the National Board of Health and Welfare and the Swedish Consumer Agency, in conjunction with the Public Health Institute, have been running a project for a number of years, with a selection of hospitals and health care providers. The project is based in an EU initiative, EHLASS (European Home and Leisure
Accident Surveillance System), of which the objective is to provide information on
home and leisure accidents in order to create a basis for improving the efficiency of
consumer safety work, both at national and at international levels (National Board of
Health and Welfare and the Swedish Consumer Agency, 2000).
The Swedish EHLASS project started in 1995, collecting data from four hospitals that
recorded details of injuries, and which could be modified to bring them into line with
the European requirements. Since 1997, data has been collected from the Umeå University Hospital, Hälsinglands Hospital (with hospitals in Hudiksvall and a unit in Ljusdal) and the Skaraborg Hospital (with hospitals in Skövde, Lidköping, Falköping and
Mariestad). The category of 'home and leisure' accidents consists of all accidents that
are not road or traffic accidents or accidents at work. However, it does include all accidents occurring to pupils during school hours, as well as to children being looked after
in other forms of childcare, and which are not road traffic accidents (National Board of
Health and Welfare and the Swedish Consumer Agency, 2000).
The initiative for the development of EHLASS must be seen partly against the background of the fact that injuries resulting from various forms of accidents are one of
Europe's major public health problems, and partly against the background of an increasingly free flow of products and services within the Community, for which the producers themselves are responsible for safety. Today, EHLASS has been integrated into
the EU's Injury Prevention Programme (IPP), covering the period from 1999 to 2003. In
Sweden, the project has gradually acquired a broader base, so that it now covers the acquisition of data on all injuries, apart from those caused by suicide attempts (National
Board of Health and Welfare and the Swedish Consumer Agency, 2000).
EHLASS uses a special system of accident classification, which largely accords with
the Nordic Classification of External Causes of Injuries (National Board of Health and
Welfare and the Swedish Consumer Agency, 2000).
Each year, the National Board of Health and Welfare's Centre for Epidemiology (EpC)
and the Swedish Consumer Agency publish the EHLASS data in a report. For the time
being, EHLASS is still in a development phase, as far as both quality and quantity are
concerned. There is, for example, no information at all at present on injuries from the
major urban areas or their suburbs. In addition, the population of industrial towns and
larger towns is under-represented (National Board of Health and Welfare and the Swedish Consumer Agency, 2000).
During 1998 and 1999, a total of 55,659 home and leisure accidents, resulting in bodily
injuries, were reported from emergency departments and out-of-hours treatment centres
in participating hospitals (28,200 cases in 1998, 27,459 in 1999). These details relate to
14
emergency medical treatment, with the injured person filling in a questionnaire on
where and how the injury occurred. A total of 14,528 injuries among children in the
0-12 age group was reported. 1983 accidents occurred on playgrounds, of which 1722
occurred to children in the 0-12 age group. (Personal communication, Karlsson A., EpC,
National Board of Health and Welfare, 2001-05-17).
Dropout checks have been carried out at all the participating units, with the commonest
method being to check 10 % of the year's days, in the form of two weekdays and one
weekend day per month, selected at random, and using the reception records and notes
as reference material (National Board of Health and Welfare and the Swedish Consumer
Agency, 2000). During 1998, the calculated registration dropout in EHLASS amounted
to 15.2 %. During 1999, the dropout was estimated as being less (Personal communication, Karlsson A, EpC, National Board of Health and Welfare, 2001-05-17).
2.5
Standards, legislation and regulations for playgrounds
Swedish standards for toys, SS 991010 - SS 991017, were developed in the middle of
the 1980s, based on the German DIN 7926 standard. They came into force in 1989 (Swedish Consumer Agency, 1999).
European work on standardisation of toys etc. has been in progress for ten years. The
work was concluded at the end of 1998, at which time 19 European states, including
Sweden, withdrew their earlier national standards and replaced them by the new European standards (National Association of Local Authorities, 2000). The new joint European standards came into force on 1st January 1999. They are divided into seven parts,
covering general safety requirements and test methods, special requirements for swings,
slides, runways, roundabouts and seesaws, together with standards for erection, inspection, operation and maintenance. In addition, there is a special standard, EN 1177, for
shock-absorbing surfaces. The standards set out minimum requirements for safety, and
can be used as guidance for meeting the mandatory requirements in the Swedish Planning and Building Act. The new standard is much more extensive than the previous
Swedish standard, and therefore demands more in the way of knowledge from those responsible for playgrounds and from their inspectors (Swedish Consumer Agency,
1999).
The standard takes a strict view of assembly/erection, instructions for regular annual inspections, constant status inspection and continuous maintenance, not only of the
equipment itself, but also of the shock-absorbing ground surface. A standard is, in principle, a voluntary agreement between a group of parties in a particular market. Legislation and regulations are generally too much of the character of blunt instruments for discussions concerning the improvement or renovation of playgrounds. When all is said
and done, it is always the owner of the playground who is ultimately responsible for its
maintenance, and for the safety required by the Planning and Building Act (National
Association of Local Authorities, 2000).
The regulations concerning the outdoor environment are set out in Chapter 3:15 and 17
§§ of the Planning and Building Act. Requirements in respect of the provision and arrangement of areas for play and outdoor occupation, together with the requirement that
playgrounds and fixed equipment must be maintained in such a way as to limit the risk
of accidents, are set out under the heading of Plots, General Areas etc. (Swedish Consumer Agency, 1999).
The local authority is the responsible supervisory authority under the Planning and
Building Act, and also the first instance for dealing with questions relating to the Act.
15
This means that, in the event of any suspicion that playground safety is being neglected,
e.g. due to poor maintenance, it is the local authority who should first be contacted. If
necessary, the local authority can close a playground if it finds that there is a risk of injury to children. However, it is always the owner of the ground or property where the
playground is situated who is ultimately responsible for ensuring compliance with the
safety requirements in the Planning and Building Act (National Association of Local
Authorities, 2000).
The Building Regulations of the National Board of Housing, Building and Planning
contain not only regulations as such, but also general guidance concerning their implementation. Under the heading of 'Playground equipment on building land', Section 8,
'Safety in use' sets out the following requirements and guideline text:
'Fixed playground equipment shall be arranged so that any risk of injury is limited.
Guideline: Surfaces beneath swings, climbing frames and similar playground equipment should be shock-absorbing, and so arranged in general that any risk of injury is
limited. (Building Regulations, 1998:38).' (National Association of Local Authorities,
2000.)
During 1996, the requirements of the Product Safety Act were extended to apply also to
goods provided for public activities. Examples of this included equipment and devices
in sports facilities, certain equipment in old people's homes and playground equipment
on playgrounds. The Swedish Consumer Agency is the surveillance authority for the
Product Safety Act (National Board of Housing, Building and Planning et al., 1999).
2.6
Preventive measures
In an international perspective, Sweden has had considerable success in measures taken
to prevent injuries. This is due to long-term work, based on epidemiological data and
research into the mechanisms of injuries, as well as on research into prevention strategies (National Public Health Committee, 1999). The pattern of injuries is dominated by
those occurring in the home and leisure sector, where the trend has been unfavourable
over the last few decades. In these areas, work aimed at preventing injuries from occurring has been more limited (National Public Health Committee, 1998). Despite the fact
that, today, home and leisure injuries predominate, almost all research into greater
safety has been conducted in the field of traffic and the working environment. Research
and development are important forerunners and driving forces for practical measures,
and so a coordinated strategy for dealing with the hitherto most neglected area of home
and leisure injuries is required (Strindberg & Andersson, 1999).
The prevention of injuries among children requires a wide range of measures, including
legislation and regulations aimed at creating appropriate environments for them. It is
important that children should be constantly and sufficiently watched, so that they learn
to be aware of risks and how to avoid them. There needs to be a general understanding,
in families and in society, of what children can manage and understand, and how they
react - what difficulty they have in assessing risks (Berfenstam & Söderquist 1992).
Products must be safe for their users. This requires an input both from their manufacturers and from the authorities in order to reduce the risks of injury. It is particularly
important that toys, and other products with which children come into contact, should
be safe (National Public Health Committee, 2000).
The risks of accidents, and environmental aspects, must be monitored by up-to-date statistics so that, if new risks or types of accidents become apparent, an appropriate response can be drafted in order to prevent the risks (Berfenstam & Söderqvist, 1992).
The recording of accident and injury statistics is one of the foundation stones of safety
16
and injury prevention work, while the lack of such statistics presents a considerable obstacle in the way of efficient preventive work (National Public Health Committee,
1999).
The term 'supportive environments' was coined at the First World Conference on Health
Promotion in Ottawa, Canada in 1986. In the public health context, it is associated with
the physical and social aspects of our surroundings. Work on supportive environments
shifts the focus from the treatment of illness to health maintenance, as well as from preventive work based on the consideration of risks to health promotion opportunities in
the everyday environment (Haglund & Svanström, 1995).
Supportive environments should be provided wherever persons live or work. By considering the entire environment, and not just the individual's risk behaviour, any actions
acquire a greater benefit for the total well-being of the population (Shelp et al., 1996).
The most effective way of preventing injuries can be to modify the environment through
appropriate design, manufacture and marketing of safer products. Such changes can be
effected by legislation and standards, complemented by appropriate surveillance and
implementation thereof. Environmental changes require no specific action by an adult or
a child, but nevertheless help to improve protection in every situation in which a risk
arises (Child Accident Prevention Trust, 1991).
The work of injury prevention distinguishes between two main strategies. An 'active'
prevention strategy attempts to persuade children and adults actively to modify their behaviour, e.g. to teach traffic safety to children. 'Passive' strategy involves modifying
risk-filled environments or products. This means that safety is incorporated in the environment in which the child finds itself. It is not the intention that the child should modify its behaviour: instead, it is the environment that should be modified to meet the
child's needs and circumstances (Mølsted et al., 1999).
Laflamme & Eilert-Petterson (1998) say that prevention should be of passive character,
which can be done by considering child safety when designing environments, buildings,
equipment or products. It is very important to ensure that pre-school children should be
provided with safe play environments. This is the responsibility not only of parents, but
also of designers, manufacturers, marketers and retailers.
Design is of considerable importance in accident prevention work. However, it is neither possible nor desirable completely to design away accidents: some degree of risk, or
the opportunity to take risks, is a part of a child's normal development (Roberts 1996).
17
3. OBJECTIVES
3.1
Main objective
The main objective of this work is to interpret data from the Swedish EHLASS register
to describe playground injuries during 1998-1999 to children in the 0-12-year-old range,
and to analyse the products involved.
3.2
Sub-objectives
The sub-objectives are to:
•
•
•
describe the sex and age distribution
describe when during the year the injuries occurred
describe the injury mechanisms, the type of injuries and the parts of the body injured
• describe the most frequently involved products (product setting off the accident/product causing the injury - swings, climbing frames, slides, asphalt)
• analyse the most frequently involved products in relation to the injury mechanism and the type of injury, and
• analyse the most frequently involved products in relation to the type of injury
and the part of the body that was injured.
18
4. MATERIAL AND METHODS
The material used in this quantitative study consists of EHLASS statistics from 1998
and 1999, relating to children in the 0-12 age group who have suffered injury in playgrounds. In turn, the playgrounds considered are those in residential areas, on school
premises, on other 'public' premises, and also unspecified playgrounds. A total of 1,722
injuries among children in the 0-12 age group were reported from playgrounds or school
grounds, making up 12 %of the total number of injured children in this age range. (Note
that these figures are not for the whole country, but only for the hospitals that were providing statistics for the EHLASS records at the time.)The figures for the two years have
been merged, and are presented together. The material has been supplied by the Swedish Consumer Agency, and has been processed and analysed using the Excel program.
Identities have been removed from the material, so that it is not possible to identify any
individuals, or the source of the material.
4.1
The survey population
The hospitals from which the data has originated are the Umeå University Hospital,
Hälsinglands Hospital Group (the Hudiksvall Hospital and the treatment centre in Ljusdal) and the Skaraborg Hospital Group (hospitals in Skövde, Lidköping, Falköping and
Mariestad). In total, their catchment areas cover 24 local council districts, with a population of about 5 % of the country's total population.
4.2
Dropout
Dropout checks have been carried out at all participating units. During 1998, the calculated registration dropout in EHLASS was 15.2 %. The dropout varies widely between the various statistics sites, being greatest (38.7 %) at the Ljusdal out-of-hours
treatment centre and least (5.5 %) at the Umeå Hospital
4.3
Restriction
The analysis has been restricted to children who have injured themselves in playgrounds
and where the playground surface has been artificially prepared or created in some way.
The most commonly involved products of swings, slides, climbing frames and asphalt
have been analysed in greater depth. The three ways in which the products involved
have been registered (as the product setting off the accident, as that causing the injury
or as that which has been important in some other way) have been merged.
As more than 80 % of the accidents in playgrounds occurred to children up to age of 12,
the material has been restricted to those in the 0-12 age group. Sex and age distributions
are described only in the general presentation, and not in connection with analysis of the
products. Data for children and young persons over the age of 12 is given briefly in the
appendix.
The 'outdoor surface' group includes 'processed surface outdoors covered by ice and
snow'. However, the ice and snow group is not analysed here, as it can be regarded as a
natural element, and not as an artificial product.
19
4.4
Variables
When processing the material, certain groups of variables have been aggregated in order
to simplify processing and to arrive at a more easily comprehended material. The variables that have been used for analysis and processing are described below.
Sex
Sex is given only as part of the general presentation.
Age: (three categories)
0-4 years, 5-8 years, 9-12 years
Ages are given only as part of the general presentation.
Injury month – indicates in which month the injury occurred.
The injury month is given only as part of the general presentation.
Injury mechanism: (four categories) - describes how the injury occurred.
Fall
Blow/impact
Crushing (crushing, cutting, piercing)
Other (asphyxiation, chemical and/or thermal effect, foreign body in natural orifice).
When analysing the products, trapping has been included in the 'miscellaneous' category.
Type of injury: (six categories) – indicating the type of injury caused.
Concussions
Contusions (bruising, muscular and/or tendon injury, crushing injury)
Wounds (scrapes, open wounds, damaged blood vessels)
Fractures
Sprains (sprains, dislocations)
Miscellaneous (burns, frostbite, no injury diagnosed, other specified/unspecified
type of injury).
Part of the body injured: (four categories) - indicates to what part of the body the injury
occurred.
Head (head, neck, throat)
Upper limbs
Lower limbs
Other (thorax, abdomen, back, pelvis, multiple parts of the body/entire body affected).
Products involved
Stationary equipment in playground: (seven categories)
Swings (swings and seesaws)
Climbing frames
Slides
Sand pits
Play houses
Roundabouts
Other (suspension bridges, play bars, other specified or unspecified playground
equipment).
20
Processed surface outdoors: (five categories)
Asphalt (asphalt surface, asphalt edging)
Processed surface covered by ice and snow
Gravel
Pavements (pavement edges, kerbs)
Other (cement surface, processed stone surface, wooden floor, artificial grass, other
specified/unspecified processed surface).
Products involved are those products that
set off the accident
caused the injury
played a part in the accident in some other way.
Product details are recorded in the EHLASS statistics in terms of the two concepts of
product setting off accident and product causing injury, e.g. falling from a swing and
hitting the fence. Products can also be noted if they have played a part in the accident in
some other way. The product classification identifies not only manufactured products,
but also natural factors such as ice, snow, stone etc.
Plain text description of the accident event – the person's own description of the accident, generally just a short sentence.
21
5. RESULTS
Section 5.1 presents a general description of the incidence of accidents resulting in injuries on playgrounds, together with a breakdown of the different age groups involved.
Section 5.2 is an analysis of the equipment involved, related to the mechanism of injury,
the type of injury and the parts of the body injured.
5.1
Occurrence of accidents on playgrounds or
school outdoor premises
In 1998-1999, EHLASS recorded a total of 1,722 injuries occurring to children in the
0-12 age group on playgrounds or school outdoor premises. This figure relates only to
data from the hospitals in the investigation, but extrapolation indicates that it is likely
that there are about 16 000 accidents per year over the country as a whole. If the number
of 1,722 accidents is related to the total number of 0-12-year-olds in the areas of the
survey, we obtain an accident rate on playgrounds and school outdoor premises of 11
cases per 1000 children in this age group during 1998-1999.
Table 1 shows the distribution of accidents among different types of playgrounds. Six
out of ten injuries occurred on school outdoor premises.
Table 1
Distribution by place of occurrence
Where?
No.
Playgrounds in residential areas
School grounds (incl. playgrounds in school
grounds)
Playgrounds on other 'service' premises (incl.
child day care centres)
Other playgrounds (incl. unspecified playgrounds)
Total
Percentage
371
22
1044
61
175
10
132
8
1722
100
Injuries resulting from accidents on playgrounds or in school grounds. Children 0-12 years. EHLASS 1998-1999.
5.1.1 Sex and age distribution
Figure 1
no. of persons
injured
1500
1000
Boys
500
Girls
0
00-04
05-08
09-12
Total
Age group
22
In all age groups, it was found that boys tended to injure themselves more than did girls,
being involved in 57 % of the accidents, while the girls were involved in only 43 %.
Most of the injuries (44 %) occurred in the 5-8-year-old age group, with the
9-12-year-old age group accounting for 42 % and the 0-4 age group for 14 %.
Among the boys, there were 12.5 accidents per 1000 of the population age group per
year on playgrounds or in school grounds, as opposed to 9 per 1000 for the girls.
Among the 0-4-year-olds, there were five accidents per 1000, with 14 accidents per
1000 on playgrounds or in school grounds for the other two age groups.
5.1.2 Injuries by month of occurrence
Figure 2
Injuries by month of occurrence
150
Age
100
00-04
05-08
50
09-12
0
Ja
n
Fe
b
M
ar
Ap
r
Ma
y
Ju
ne
Ju
ly
Au
g
Se
p
Oc
t
No
v
De
c
no. of persons
injured
Month of injury
Month
Most of the injuries occurred in May, August or September: the number of injuries was
lowest in July.
5.1.3 Injuries by mechanism
Table 2
Injury mechanism related to age group
Injury mechanism Age group
0-4
No.
%
69
16
6
3
5-8
No.
478
198
38
17
%
63
26
5
2
9-12
No.
433
222
27
10
%
60
31
4
1
Total
No.
1075
457
80
34
%
Fall
Blow
Crushing
Foreign objects in
body opening
Other
164
37
15
7
13
6
30
4
33
5
76
4
Total
236
100
761
100
725
100
1722
100
In all age groups, it was falling accidents that dominated, reaching the highest number
in the 5-8 age group. In the 0-4 age group, they constituted a higher proportion (69 %)
of the injuries then in the other age groups.
23
62
27
5
2
5.1.4 Types of injuries
Table 3
Type of injury related to age group
Type of injury
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
Age group
0-4
No.
22
44
41
58
32
39
236
5-8
%
9
19
17
25
14
17
100
No.
80
169
138
189
114
71
761
%
11
22
18
25
15
9
100
9-12
No.
68
194
73
197
144
49
725
%
9
27
10
27
20
7
100
Total
No. %
170
407
252
444
290
159
1722
10
24
15
26
17
9
100
In all age groups, fractures were the most common, followed by contusions. Both were
commonest in the 9-12 age group.
5.1.5 Injuries by body area
Table 4
Injuries by body area related to age group
Injured body area
Head
Upper limbs
Lower limbs
Other
Total
Age group
0–4
No.
90
80
47
19
236
%
38
34
20
8
100
5–8
No.
260
265
153
83
761
%
34
35
20
11
100
9–12
No.
171
328
180
46
725
%
24
45
25
6
100
Total
No.
521
673
380
148
1722
It was the upper limbs that were most often injured, reaching the highest number in the
9-12 age group, where they accounted for almost half of the total number of injuries.
This was followed by head injuries, which were commonest in the 5-8 age group. In the
0-4 age group, head injuries were more common than injuries to the upper limbs.
24
%
30
39
22
9
100
5.1.6 Products involved
Table 5 shows the number of cases in which products from different product groups
were registered as setting off the accident or causing the injury, respectively. Stationary
playground equipment set of the most accidents, followed by other persons and sports
equipment. The commonest cause of injury was the outdoor surface.
Table 5
All products groups, as setting off the accident and as causing the injury.
No. of cases registered
Product setting off
the accident
Raw materials, structural elements
Stationary playground equipment
Other stationary equipment outdoors
Outdoor surface
Part of building
Means of transport
Toys
Sports equipment
Persons
Natural elements
Other
No product specified
Total
36
490
48
111
13
28
23
216
304
120
175
158
1722
Product causing the
injury
93
120
50
725
24
26
12
147
115
145
232
33
1722
In terms of the product groups involved in the accidents, accidents occurring on school
grounds (including playgrounds in school grounds) differ somewhat from accidents on
other playgrounds. Table 6 shows the number of cases where the commonest product
groups occur either as setting off the accident, as causing the injury, or as being involved in some other way. In other words, three different product groups can be recorded for each injury, which means that a given injury may be counted twice or even
three times in Table 6, which explains why the sum of the groups exceeds the total
number of cases.
25
Table 6
Most commonly involved product groups (setting off accident/causing injury/other significance) related to the type of playground
School grounds,
playground in school
grounds
Total number of cases
Product groups involved : 1
Stationary playground equipment
Other stationary equipment
outdoors
Outdoor surface
Raw materials, structural elements
Sports equipment
Persons
Natural elements
Other playgrounds
(not in school
grounds)
Total
No.
1044
%
100
No.
678
%
100
No.
1722
%
100
203
19
361
53
564
33
53
5
36
5
89
5
457
44
303
45
760
44
58
6
56
8
114
7
249
303
174
24
29
17
86
107
90
13
16
13
335
410
264
19
24
15
1) The number of injury events in which the respective product group is specified either as the cause of the accident,
the cause of the injury or as being involved in some other way.
In the accidents on school premises, other persons and sports equipment are involved in
a greater proportion of the cases (29 % and 24 % respectively). In this environment, it is
collisions, shoving, blows and tripping in connection with games and ball games that
are common. On the other hand, stationary playground equipment tends to be more often involved in the accidents on more out-and-out playgrounds (53 %) than in school
grounds including playgrounds in school grounds.
Analysis of products will be restricted to stationary equipment in playgrounds and outdoor surfaces, as it is these that are most commonly involved. Table 7 shows the products that were most frequently involved in accidents in the respective product groups.
Table 7
Most commonly involved products (setting off accident, causing injury,
other significance) in the 'stationary equipment on playgrounds' and 'surfaces outdoors' groups.
Products involved
Number of injuries
Stationary equipment on playgrounds, of which:
Swings
Climbing frames
Slides
Sand boxes
Play houses
Roundabouts
Outdoor surfaces,
of which:
Asphalt, edging
Processed surface, covered by ice or
snow
Gravel
Kerbs
564
208
168
82
24
13
8
760
125
115
23
7
26
Table 8
Playground equipment (products most commonly involved) related to cause
of injury, part of the body injured and type of injury
Swings
Climbing
frames
Slides
Sand boxes Play houses Roundabouts
n=208
n=168
n=82
n=24
n=13
158 (76%)
41 (20%)
9 (4%)
153 (91%)
7 (4%)
8 (5%)
53 (65%)
18 (22%)
11 (13%)
20 (83%)
1 (4%)
3 (13%)
12 (92%)
n=8
Injury mechanism
Fall
Blow
Other
1
7
(88%)
(8%)
1
(13%)
Part of the body injured
Head
Upper limbs
Lower limbs
Other
54 (26%)
98 (47%)
41 (20%)
15 (7%)
47
73
31
17
(28%)
(43%)
(18%)
(10%)
15
32
20
15
(18%)
(39%)
(24%)
(18%)
5
7
7
5
(21%)
(29%)
(29%)
(21%)
2 (15%)
5 (38%)
6 (46%)
2
5
1
(25%)
(63%)
(13%)
16 (8%)
42 (20%)
19 (9%)
88 (42%)
32 (15%)
11 (5%)
15 (9%)
42 (25%)
15 (9%)
65 (39%)
18 (11%)
13 (8%)
4
22
9
22
16
9
(5%)
(27%)
(11%)
(27%)
20%)
(11%)
2
6
4
4
5
3
(8%)
(25%)
(17%)
(17%)
(21%)
(13%)
2 (15%)
1 (8%)
1 (8%)
4 (31%)
5 (38%)
1
2
4
(13%)
(25%)
(50%)
1
(13%)
Type of injury
Concussion
Contusion
Wound
Fracture
Sprain
Other
Table 9
Outdoor surfaces (most commonly involved), related to the injury mechanism, the part of the body injured and the type of injury
Asphalt
n=125
Gravel
n= 23
Pavements
n=7
Injury mechanisms
Fall
Blow
Other
96 (77 %)
28 (22 %)
1 (1 %)
22
(96 %)
5
2
(71 %)
(29 %)
1
(4 %)
42 (34 %)
42 (34 %)
33 (26 %)
8 (6 %)
3
13
6
1
(13 %)
3
(43 %)
(57 %)
(26 %)
(4 %)
3
1
(43 %)
(14 %)
1
(14 %)
3
1
1
1
(43 %)
(14 %)
(14 %)
(14 %)
Part of the body injured
Head
Upper limbs
Lower limbs
Other
Type of injury
Concussion
Contusion
Wound
Fracture
Sprain
Other
19
25
28
25
19
9
(15 %)
(20 %)
(22 %)
(20 %)
(15 %)
(7 %)
7
5
7
3
1
(30 %)
(22 %)
(30 %)
(13 %)
(4 %)
27
Swings, climbing frames, slides and asphalt were the most frequently involved in the injuries. These products are further analysed as follows.
Table 8 shows that falls dominated among injuries involving playground equipment.
Most of the falls occurred from swings. They constituted a greater proportion (91 %) of
the total number of injuries associated with climbing frames, as compared with those
associated with other products. It can be seen from Table 9 that falls were also the main
source of injury when 'outdoor surfaces' were involved in the injuries, but were fewer
compared to when playground equipment was involved.
The part of the body most commonly injured were the upper limbs, with swings being
the product mostly involved in them. In the case of asphalt, injuries to the upper limbs
and to the head were equally frequent.
Swings caused the most head injuries. Head injuries constituted the greatest proportion
of injuries involving climbing frames.
Fractures were the commonest type of injury, and occurred primarily in connection with
swings. In the case of slides, contusions and fractures were equally common, whereas in
connection with asphalt, wounds were the commonest type of injury.
Table 10
The most commonly involved products, as setting off the accident and as
causing the injury.
Setting off accident
Causing injury
166
160
59
13
398
24
20
34
119
197
Swings
Climbing frames
Slides
Asphalt
Total
Swings, climbing frames and slides most often set off the accident, while the actual injury arose from contact with asphalt.
Table 11
Most commonly involved products, related to age
Product
Age group
5-8
9-12
40
38
37
12
109
88
24
54
59
42
21
59
208
168
82
125
127
275
181
583
0-4
Swings
Climbing frames
Slides
Asphalt
Total
Total
The most injuries occurred in the 5-8 age group. Injuries associated with swings and
climbing frames occurred primarily in the 5-8 age group, while those associated with
slides were commonest in the 0-4 age group. Injuries caused by asphalt occurred most
in the 9-12 age group.
28
5.2
Products most commonly involved
5.2.1 Swings
Table 12
Type of injury, related to injury mechanism, swings
Type of injury
Injury mechanism
Fall
Blow
Other
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
8
28
8
82
26
6
158
8
11
8
4
6
4
41
Total
16
42
19
88
32
11
208
3
3
2
1
9
Table 13
Type of injury, related to part of body injured, swings
Type of injury
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
Part of body injured
Head
Upper
Lower
limbs
limbs
16
14
14
1
5
4
54
10
1
79
7
1
98
11
2
8
20
41
Total
Other
7
2
6
15
16
42
19
88
32
11
208
Falls dominated, resulting in fractures in many cases. In one-fifth of the accidents associated with swings, the result was contusions, in which the head was the part of the
body most commonly injured.
As described:
'Was swinging high, jumped off and landed with his hand beneath him.'
'Jumped off the swing and caught her hand in a wooden fence, fractured wrist.'
'Fell from a swing and hit his head on a lump of concrete.'
'Walked behind a child swinging.'
'Was playing at jumping from the swings, fell and hit her arm.'
'The plastic swing broke in the middle, finger caught in the chain.'
'Leg trapped under the seesaw.'
29
Table 14
Type of injury, related to injury mechanism, climbing frames
Type of injury
Injury mechanism
Falls
Blows
Other
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
15
39
12
63
17
7
153
2
3
1
2
1
1
7
5
8
Total
15
42
15
65
18
13
168
Table 15
Type of injury, related to part of body injured, climbing frames
Type of injury
Head
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
15
15
14
1
2
47
Upper
Lower
limbs
limbs
8
7
55
5
5
73
10
12
2
31
Total
Other
12
1
4
17
15
42
15
65
18
13
168
Falls dominated, leading in most cases to fractures which, in turn, are mostly of the upper limbs. This was followed by contusions, which caused primarily head injuries.
As described:
'Was hanging from the climbing rope and fell to the ground, with most of his weight on
his arm, fracturing his elbow.'
'Got her foot caught in the climbing wall and fell about 1.5 m.'
'Was going to jump down from the climbing frame, but got a foot caught and fell into
the sand.'
'Fell from the climbing frame, which was slippery due to rain, landed on his stomach
and hit his forehead on the ground.'
'Was climbing in the frame, hanging by her knees, fell, landing on her back on the
ground.'
30
5.2.3 Slides
Table 16
Type of injury, related to injury mechanism, slides
Type of injury
Falls
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
2
18
3
18
5
7
53
Injury mechanism
Blows
Other
2
4
2
3
5
2
18
4
1
6
11
Total
4
22
9
22
16
9
82
Table 17
Type of injury, related to part of body injured, slides
Type of injury
Head
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
4
5
4
1
1
15
Upper
Lower
limbs
limbs
3
3
17
8
1
32
7
1
3
8
1
20
Total
Other
7
1
1
6
15
4
22
9
22
16
9
82
From slides, it was falls that were the commonest cause of accidents, generally resulting
in fractures or contusions. Fractures were the most common type of injury on the upper
limbs, whereas contusions most commonly affected the lower limbs.
As described:
'Fell about 1.5 m from a slide, landing on his shoulder.'
'Fell from the slide, landing on a grass mound.'
'Walked into the slide, fell and hit her head against the edge of the slide.'
'Ran into the slide, hitting his little toe/foot against the edge of the slide.'
'Was using the slide, cut a gash in her thigh.'
'Slipped on the metal of the slide and hit his chin.'
'Tripped on a stone in the slide and knocked her teeth against the slide.'
31
5.2.4 Asphalt
Table 18
Type of injury, related to injury mechanism, asphalt
Type of injury
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
Injury mechanism
Falls
Blows
Other
13
22
23
17
14
7
96
6
3
5
8
4
2
28
1
1
Total
19
25
28
25
19
9
125
Table 19
Type of injury, related to part of body injured, asphalt
Type of injury
Head
Concussion
Contusion
Wound
Fracture
Sprain
Other
Total
19
8
10
1
3
1
42
Upper
Lower
limbs
limbs
6
6
20
9
1
42
10
12
4
6
1
33
Total
Other
1
1
6
8
19
25
28
25
19
9
125
The most common forms of accidents were falls, resulting in wounds, followed by contusions. Fractures and contusions occurred to equal extents. Wounds generally occurred
to the lower limbs.
As described:
'Was riding a soapbox down a slope and fell, knocking his head on the asphalt at the
bottom of the slope.'
'Fell off the fence and hit her arm on the asphalt.'
'Slipped on gravel when he was running, scraped his knee on the asphalt.'
'Uneven asphalt in the school grounds, put his foot in a hole.'
'Fell off her bike and hit her elbow on the asphalt.'
'Running down the slope, fell and landed with his hand on the asphalt.'
'Fell from about half a metre, hitting her head on the asphalt.'
32
6. DISCUSSION
6.1
Method discussion
The age groups have been divided into 0-4 years, 5-8 years and 9-12 years. The first
group, 0-4 years, includes one more year than the other groups, as there are very much
fewer accidents in this age range.
In general, boys tended to injure themselves more than girls, and so the differences between the sexes are included only in the general description, and not in those for the
products.
EHLASS contains very detailed information on home and leisure accidents, which imposes considerable requirements both on those who enter the data and those who use it.
Everything depends on careful instructions to those entering the data. The data has been
collected from only a small number of hospitals, which means that it cannot automatically be extrapolated to cover the entire Swedish population. At present, there is no data
at all from the major urban areas. In addition, the population in industrial towns and larger other towns is somewhat under-represented. If more hospitals could be involved, it
would improve the reliability of extrapolating figures up to a national level.
Despite the fact that the dropout in the register is 15.2 %, which means that there is
some risk in attempting to generalise the results from this investigation up to the country's entire population, it can nevertheless be seen how playground equipment is involved in injuries in playgrounds. In addition, most playgrounds in Sweden are made in
a similar way, which means that the injuries recorded by EHLASS are likely to look
much the same over the rest of the country.
Products are noted in the records as either setting off an accident or causing of an injury,
or as being involved in some other way. In some respects, this can be seen as a drawback, as it means that it is more difficult to process the material when attempting to analyse which products have been involved in the injuries.
6.1.1 Ethical aspects
Individuals cannot be identified in EHLASS, as all forms of identity have been removed. Nor is it possible even to see from which hospital the material came. Input material is coded at each source point before being sent to the Centre for Epidemiology for
collation. As all possibility of identification has been removed, there is no need for any
ethical assessment of this work.
6.1.2 Validity and reliability
Although the questionnaires filled in by the patients are validated, there are some weaknesses in the recording process. The injury could have put the patient into shock, rendering the description of events open to question. As far as small children are concerned, they cannot fill in the questionnaire themselves, and so the accident is likely to
be described by someone else, who was perhaps not even present at the time. This can
also mean that details and circumstances associated with an injury can be incorrectly
described.
Another weakness is introduced by the fact that many persons are involved in the recording process, which can result in dissimilarities or even mistakes in recording. When
33
details of the various products are to be noted, there may be variations in interpretation
of in what group a product should be recorded.
The EHLASS classification of products allows injuries in which ice or snow have been
involved to be recorded either as 'processed surface covered by ice or snow' or as 'ice or
snow'. This could be regarded as a weakness in the classification, as it means that the
same types of injuries can be classified in two different ways. It would be better if all
injuries in connection with ice or snow were gathered into a single group. The product
analysis has omitted 'processed outdoor surface, covered by ice or snow', as this can be
regarded as being a natural element, and not an artificial product. According to the
NOMESCO classification system, a product can be either a manufactured item, such as
a toy or a piece of furniture, or can also be a natural/external factor such as a person or
an animal, or a natural element such as snow, ice or stones. The recording system included the natural factor, as details were recorded of everyone seeking hospital treatment after an injury. Omitting the natural factor would have resulted in a large number
of injuries not being recorded (Nordic Medico-Statistical Committee, 1997).
The injuries are recorded from the participating hospitals' emergency departments or
out-of-hours treatment centres. It is possible that there are differences between units in
terms of the time available for the registration, which can affect the quality of the material and thus make its reliability uncertain.
It is difficult to use somebody else's data. EHLASS contains many different variables,
which means that it is sometimes difficult to know what they represent in the material.
In addition, it is very important to know how the material is processed in Excel, as this
is a prerequisite for performing the analyses. This, again, can constitute a possible
source of error in analysis and processing.
6.2
Results discussion
Boys tended to injure themselves to a greater extent than did girls. There may be a link
here with the fact that boys tend to be more daring, and take more chances, than girls, or
because they play in a different manner.
Most of the injuries occurred to the 5-8-year-old group, with the 0-4-year-olds injuring
themselves the least. This could be due to the 5-8-year-olds using the playgrounds and
playground equipment more frequently than do the children in the other age groups.
Perhaps the older children (9-12) are somewhere else, or that they are more aware of the
risks in playground environments. Equally, the smallest children usually have someone
keeping an eye on them, which can prevent many accidents. Another explanation could
be that the 0-4-year-olds cannot use all the equipment which the older children do use.
The most accidents occur during the months of May, August and September. The same
pattern was also noted by Mack et al., (1997). This is probably simply because it is during these months that playgrounds are used more frequently. During the winter, children
are not out of doors to the same extent as they are during the summer. On the other
hand, the ground surface probably presents a greater risk during the winter, as it freezes
and becomes hard. Another aspect is that snow tends to break the shock of falls, and can
prevent injuries resulting from a fall. As there seems to be a rise in the number of injuries during the spring, and particularly during May, it might be appropriate to make a
detailed inspection of all playgrounds each spring.
Injuries resulting from falls have been the main type of injury, which is borne out by results from other investigations (Sellström & Bremberg 1994, Mowat et al., 1998, Macarthur et al., 2000). The most frequent type of injury was fractures, which again was
also found in many other investigations (Chalmers et al., 1996, Mack et al., 1997, Mac34
arthur et al., 1999). In many cases, it can be difficult to prevent the actual fall from occurring, but compliance with the standards for suitable ground surfaces can perhaps enable the injury to be avoided, or at any rate to be less serious. The most injured part of
the body was the upper limbs, which was also found in work by Chalmers et al., (1996)
and Macarthur et al., (1999).
The results of the analysis indicate that the most important way of preventing injuries is
to provide and maintain suitable shock-absorbing ground surfaces. This is in good accordance with the results of the work by Boman & Björnstig (1998), who investigated
playground equipment in Umeå.
12 % of accidents among children in the 0-12 year-old age group occur on playgrounds
or in school grounds. This relatively high proportion is explained by the fact that the
material also includes accidents in school grounds, not being out-and-out playgrounds.
6.2.1 Swings
The analysis showed that swings were the product that was involved in the most accidents involving a fall, with fractures of the upper limbs being the dominating type of injury. Swings were generally the product that set off the accident, and so it is important
that the fall area beneath them should be covered by a suitable shock-absorbing surface
in accordance with the requirements of the standard.
Another important measure to prevent accidents is to place a guard around the swings,
to prevent children from running or walking into the path of someone using the swings.
This is illustrated by some of the accident descriptions, such as 'Happened to walk behind a child who was using the swing', 'Was playing in school grounds, using the
swings, hit by another child on the swings'. The barrier could be a wire mesh, a fence or
bushes.
Many of the accidents occur when children jump off swings and land on a fence or
something similar around them. It is therefore very important that the barrier should be
at a sufficient distance from the swing. 'Jumped off the swing, hit the fence with his foot
and forehead'.
The majority of injuries involving climbing frames were falls which, in most cases, resulted in fractures of the upper limbs. The climbing frame was generally the cause of the
accident. Again, a suitable shock-absorbing ground surface is an important means of reducing injuries, but it is also important that there should be sufficient free area around
the frame. There must be a guard rail around climbing frames to prevent children from
falling. Climbing frames often consist of many different parts, such as nets, slides and
ladders. It is therefore easy for clothes to catch or, for example, fingers or feet to be
trapped. Again, this is illustrated by comments such as 'Got a foot caught in the climbing wall and fell about 1.5 m', 'Was going to jump down from the climbing frame, but
caught a foot and fell into the sand'. Because of this, it is important to follow the recommended sizes for openings, including after repairs. Guard rails and hand rails must
be intact, and not have anything sticking out such as nails or splinters on which children
could hurt themselves.
6.2.3 Slides
Falls were the most common accident when slides were involved. It is therefore important to ensure that there is a suitable unobstructed area around slides, with no stones or
35
other solid objects at the bottom of the slide. Consider, for example, 'Fell from a slide,
landing head-first on the ground', 'Slipped on a stone in the slide, hitting her teeth
against the slide'.
The surface around a slide is very important, as most falls resulted in fractures to the
upper limbs and bruising of the lower limbs. Slides generally set off the accident. The
surface recommended in the standard should be used, depending on the possible fall
height. A slide should not face towards the south, as it can become extremely hot during
the summer.
6.2.4 Asphalt
Most of the injuries involving asphalt were falls, usually resulting in cuts of the lower
limbs. As opposed to injuries involving playground equipment, asphalt was often noted
as the product that caused the injury, as opposed to that which set off the accident. Asphalt does not meet the requirements in respect of a surface on to which children may
fall, and must not be used as a surfacing material for playgrounds. However, asphalt is
widely used in school grounds, and injuries from this environment are included in the
material I have analysed. I think that there may be a link here with the fact that there are
usually only a few adults out on school grounds to keep an eye on large numbers of
children. Another possible reason for these injuries could be that the asphalt is in poor
condition, resulting in falls occurring.
Examples of descriptions of the accidents:
'Uneven asphalt in the school grounds, put a foot in a hole.'
'Using a skipping rope in the school grounds. The surface had not been properly swept,
so that she fell backwards when stones rolled under her feet.'
6.2.5 General measures
The first step towards effective prevention of injuries is to look at the accidents that
have occurred. Statistics of injuries and near-accidents can show where work should be
concentrated, and which improvements give results.
When applying a preventive approach to playgrounds, the starting point has to be to
create a generally sound environment. It is important to consider not only an individual's risk behaviour, but also his/her environment.
We all need to learn to see the risks in the environment around us, and to play our part
in eliminating them. Anyone finding something wrong with a playground should immediately contact whoever is responsible for it. In this context, I believe that the difficulty of the general public in knowing who is responsible for the safety of a playground
is a major problem. One way of dealing with this could be to make sure that playgrounds display a sign showing who is responsible for them and for the equipment, and
also showing when they were last inspected. One way of resolving the uncertainty of
who is responsible for playgrounds, as well as to pinpoint the risks of accidents, can be
to use the Risk Line telephone number, where such a number exists. This is a telephone
service to which the public can ring to notify risks in their surroundings. In Västerås, it
is 020-93 00 00, but could vary from one area to another. The service is provided by
SOS Alarm, which then contacts the local authority or other body responsible for dealing with the risk. This provides a means of dealing with risks before an accident has occurred. The Risk Line helps the public to become involved, encouraging individuals to
spot risks in the environment.
In order to reduce the risk of injuries, it is important to improve information to playground owners on how playgrounds should be inspected, and on the applicable stan36
dard. Appropriate standards need to be set in terms of knowledge and experience of the
inspectors, as well as of those who carry out the regular checks. Each playground
should have a formal inspection plan, with the property-owner being responsible for ensuring that it is complied with. The new national public health objectives include a challenge to local authorities to improve supervision of their playground environments, and
to clarify property-owners' responsibility for safety in these environments.
It is important to consider the requirements of the standard when planning playgrounds.
This includes aspects such as ensuring that there is sufficient free space around the various items of equipment, and that the surface is suitable for the particular playground.
Surfaces could be, for example, sand or natural gravel. Playgrounds should be safely
separated from nearby footpaths or cycle paths. Equipment for small children under the
age of three must be separated from other equipment for older children. It is also very
important that all equipment should be properly secured and anchored, to eliminate any
risk of it tipping over. However, safer products must not be seen as an excuse for reducing supervision of the children.
The standard is not retroactive, so there is no requirement to convert existing equipment
to bring it into line with the requirements. For this reason, it is likely that there are still
many items of older equipment on playgrounds that have not been properly maintained.
Lack of maintenance, or poor maintenance, was found to be one of the most serious
shortcomings revealed by the Swedish Consumer Agency's market surveillance of playground equipment (Swedish Consumer Agency, 1999).
It is important to strike a balance between safety and the desire to produce a stimulating
and interesting environment. Although a good playground should be safe, it does not
necessarily have to be dull as a result. Playgrounds must also meet the varying requirements of children of different ages. If input from children can be included when
planning a playground, their views should be considered. Playgrounds are often planned
around the needs of the smallest children, with a sandbox, slide, climbing frame and
swings, which are not sufficiently interesting for older children. As a result, they may
wander off to somewhere else, where they can in fact be exposed to greater risks.
A guide to the design of playgrounds and equipment in order to reduce accidents, published by the Swedish Association of Local Authorities, includes three simple measures
that substantially reduce the risk of serious accidents.
-
It is important not to stint on safety. Equipment that breaks must be repaired immediately. Risks such as points where bodies or clothing can be caught should be
eliminated. Inspect equipment using the approved test pieces and gauges.
-
Carefully check the unobstructed areas around equipment, to provide space for falling off the equipment.
-
Check the properties of the shock-absorbing surface, using the test equipment specified in the standard. If necessary, replace the material by new shock-absorbing material (National Association of Local Authorities, 2000).
6.3
Proposal for further research
A proposal for further research into the safety of playgrounds is to perform risk analyses
of how children use playgrounds. It would be interesting to analyse children's attitude to
playground risks, and whether there is any difference between, say, girls and boys or between the different age groups.
37
7. CONCLUSIONS
This work has shown that the dominating injury mechanism for children in the 0-12 age
group who hurt themselves on playgrounds was falls, with the most frequent type of injury being fractures and the most injured part of the body being the upper limbs. In all
age groups, boys injured themselves more than did girls, with most injuries occurring in
the 5-8 age group. May, August and September were the months in which most injuries
occurred. Falls resulting in fractures to the upper limbs were the main types of accidents
from swings, climbing frames and slides. Most fall accidents occurred when a swing
was involved. Most injuries resulting from impact with asphalt were falls, usually resulting in cuts or abrasions to the lower limbs. The results indicate that the most important means of preventing injuries is to use a suitable shock-absorbing surface, and to
maintain it.
38
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41
APPENDIX
Incidence of playground injuries to persons over the
age of 12
1,958 injuries were noted in EHLASS during 1998 and 1999, as occurring on playgrounds and/or school grounds with their own playgrounds. This means that, in addition
to the 1,722 injuries to children up to the age of 12, there were 236 injuries to persons
over the age of 12, or 12 % of those injured.
Age group
Men
13-19
20-44
45-64
65-74
75-84
85Total
Women
Total
56
18
11
3
152
52
21
6
4
1
236
96
34
10
3
4
1
89
147
200
150
Men
100
Women
50
To
tal
85
-
0
13
-19
20
-44
45
-64
65
-7
4
75
-8
4
no. of persons injured
Age groups
More men than women were injured, being involved in 62 % of the cases of injury.
Most of the injuries (64 %) occurred to young persons in the 13-19 age group. At the
other end of the scale, the oldest person involved was a woman over 84.
Injury mechanism
Injury mechanism
Falls
Blows
Crushing
Foreign objects
Other
No.
%
143
58
11
3
21
61
25
5
1
9
The commonest type of injuries were falls, making up more than half of the total.
42
Type of injury
Type of injury
Concussion
Contusion
Wound
Fracture
Sprain
Other
No.
%
10
58
31
64
60
13
4
25
13
27
25
6
Fractures dominated, followed by contusions and sprains.
Injured part of the body
Injured part of the body
Head
Upper limbs
Lower limbs
Other
No.
%
39
84
97
16
17
36
41
7
It was the lower limbs that were most frequently injured.
As described:
'Fell off a skateboard in the school grounds, hitting the ground.'
'Fell on the edge of the sandbox, on his way home in the dark.'
'Was sledging with her daughter, fell, twisting her knee.'
'Ran into each other when playing rounders.'
'Fell down from the swing, hurting his back, hip and rib.'
'Rollerblading, fell over and scraped her hand on the asphalt.'
'Out with the dog. Slipped on a large snow-covered sheet of ice.'
'Tripped on a manhole cover in the school grounds, landing on his hand.'
'Fell out of a tree.'
43
Annex E: Expert groups
Steering group meetings:
- London, United Kingdom, March 7, 2002
- Sintra, Portugal, October 12, 2002
- Paris, France, April 9, 2003
- Berlin, Germany, November 6, 2003
- Vienna, Austria, June 6, 2004
- Programme workshop ECSA, Stockholm, Sweden,
September 20, 2004
- Current list of members
Report
Date:
2002-03-15
Present:
Johan Lund, Norway, Gudula Brandmayer, Austria, Janice Cave, United Kingdom, Mathilde
Sector, Austria, Helena Menezes, Portugal, Lotten Strindberg, Sweden, Monique Ridder, The
Netherlands, Tania Vandenberghe, ANEC, Carine Renard, Belgium, Stephanie Märzheuser,
Germany, Elke Speltincx, Belgium, Eleni Petridou, Greece, Michal Grivna, Czech Republic,
Teresa Robledo de Dios, Spain, David Stone, ISCAIP, Joanne Vincenten, Alliance
Guests: Mrs. C. Knols, Mr. P. Cornall, Mr. H. Nordin
To:
European Child Safety Alliance, General Business Meeting
Subject:
Meeting held in London, March 7th, 2002
* Note: Corrections and omissions to these meetings should be forwarded to Joanne Vincenten.
Welcome and introduction by J. Vincenten
Review of agenda and logistics
Member Introduction – A brief presentation was made by each member.
There was a suggestion by H. Menezes to provide the document name by the agenda item for easier
reference of documentation for the future meetings.
1. Review of November minutes (November meeting notes document)
J. Vincenten asked for errors, omissions. No changes were provided by the members.
2. Child White Book follow-up (Child White Book)
nd
J. Vincenten informed the members of the minor updates in the White Book that were done for a 2
printing and she asked for requests from members for additional copies. Spain needs new version for
its translation, as well as ANEC, CRIOC, M. Grivna, E. Petridou, G. Brandmayer, S. Märzheuser, L.
Strindberg. H. Menezes asked for the list of edits, and J. Vincenten stated a summary of changes with
a new copy of the White Book will be sent to all.
E. Petridou asked to update certain statistics, for a future/new version. J. Vincenten commented that a
new version will be completed within the next 18 months, including updated WHO mortality data.
Translation of the updated version is varied—currently Spain plans to translate and print the Book,
Greece will translate it in order to post in on their website (to print need funding), Czech plans to
translate and print it, while Portugal would need funding to translate. G. Brandmayer and S.
Märzheuser stated they would like to translate parts of the Book. France has also stated interest. No
2002.v004/14.03.00./sec-hie
1
discussion of this in Belgium. J. Vincenten stated that each country who will be printing should contact
her for graphics and artwork.
E. Petridou mentioned she would like to have a Greece version of the White Book, with amendments
to the figures, and the author’s name on the book. Vincenten agreed and stated she would appreciate
receiving the Greek version, along with further explanation of the changes in order to explain the
differences between the versions for anyone who inquires. This was agreed upon by the members as
a whole.
J. Vincenten then discussed how to disseminate the White Book to ministers of health in the EU. Not
all members have provided their national link. Certain Members stated they were not aware of this
initiative. J. Vincenten explained the goal would be to write a letter and distribute it to the Ministry of
Health in each country, mentioning the national partner, but coming from the Alliance. Discussion was
about what language should be used. If native language is used then the national organization does a
cover letter and signature with an English letter from the Alliance to accompany it. Also, a broader
network for dissemination would be desired like including the Ministry of Education, etc. Another point
of discussion was how to best achieve political action—recommendation from D. Stone was to
generate publicity by sending it to the media as well, in the form of an open letter, in order to have
political impetus. G. Brandmayer stated this open letter could be added to her Safety Day campaign.
J. Vincenten agreed that such a letter would be a good follow-up to the first press release of the
launch, with request for call of action. D. Stone emphasized it would be less effective to keep it a
closed letter. E. Petridou stated the need to make it individualized, call of action based on national
needs. T. Robledo de Dios stated that she represents the Ministry, therefore she could only co-sign a
letter with the Alliance. M. Ridder stated that the White Book letter itself is not enough for the press to
pick it up. L. Strindberg stated the letter would be useful for countries in different ways. J. Vincenten
agreed that the common letter needs to be tailored to each countries target audience. T. Robledo de
Dios stated it was important to present this letter to the Commission as well. L Strindberg and G.
Brandmayer stated the option to send it to the Parliament. Vincenten emphasised the need for
individual contact with Parliament members. Co-repere 1 and 2, to prepare council meetings, to each
division and these committees would also be a good venue to circulate correspondence.
(Task: J. Vincenten is to write the letter for the White Book, to Ministry of Health, edits from partners,
dissemination to number of Ministries as well as media. Vincenten to send updated versions of the
White Book to those stated above)
3. Mori Report
J. Vincenten reviewed that the government contacts will not be provided by Mori due to Mori offering
confidentiality of the interviews. Parent data files are available for the individual countries (not
representative due to the limited sample and funding constraints). J. Vincenten brought up the key
questions: edits and comments to the final report, and to whom to disseminate this report to. E.
Petridou and T. Robledo de Dios stated that they would not want the government information from
their country shared, as it is not scientific. T. Robledo de Dios stated that she was interviewed and
was not offered confidentiality. H. Menezes stated that using the government data would start an
internal war in Portugal as she viewed it as incorrect, and only individual perception. L. Strinberg, S.
Märzheuser, J. Cave were satisfied with the interviews performed in their country. M. Ridder and H.
2002.v004/14.03.00./sec-hie
2
Menezes were not satisfied. G. Brandmayer stated certain items were incorrect in the Austrian
interview. D. Stone stated we could identify the methodological problem of the government survey and
not lose the data. C. Renard stated it was so little information that it was not helpful. First decision, do
we split up the report, parent and government. Yes. Minor edits for the parent report and more major
edits on the challenges, problems with the government report. No wide distribution of the government
report, but be made available for who wants it. Also J. Vincenten re-stated the availability of the parent
files for each country. E. Petridou stated the need for a social attitudes instrument to be used
throughout the EU. M. Sector stated the IPP project ‘Social Attitudes’ by G. Furian funded by the
Commission.
Sector agreed to provide this to the Alliance if agreed upon by G. Furian.
(Task: M. Sector to provide social attitudes instrument to Alliance. M. Sector and J. Vincenten to make
edits on parent (minor) and government (major). The parent and government reports would then come
back to the Alliance for review).
4. Medical Experts Panel
J. Vincenten introduced the topic of forming a medical experts panel to provide advice to the Alliance,
and then turned it over to L. Strindberg. L. Strindberg stated the need for input from medical experts
regarding injury. J. Vincenten stated she spoke with the European Paediatricians (CESP) group who
are interested in being part of a medical experts panel, but mentioned the problems-legal and
otherwise-which would be a great commitment. ANEC stated their support for a panel as this is helpful
for their work in setting standards. M. Ridder stated they tried in the Netherlands to set this up, but for
each issue a different expert is required. G. Brandmayer stated the importance of paediatric surgeons
for assisting with campaigns. E. Petridou stated the medical experts opinions would be helpful, but
that the questions we have for the committee are very difficult; in practice the panel would have to be
paid. H. Menezes stated the need to find the right person for the issue. D. Stone agreed with E.
Petridou that the persons expect to be paid for this level of expertise and commitment. He stated the
usefulness of a resource list for the injury prevention committee, but to make it clear to the panel that
no payment would be involved from the Alliance. D. Stone stated for lobbying having the European
Paediatricians group is extremely important for campaigning and lobbying assistance. J. Vincenten
stated that CESP is very interested in working with the Alliance. Agreement was to possibly put
together a resource list, but look into the legal issues. E. Petridou recommended S. Märzheuser as
link. S. Märzheuser agreed to investigate this issue in a small working group (D. Stone, B. Märzheuser
Wood ). M. Grivna stated the possible panels that may already exist. Further questions will be made to
ANEC as to their establishment of such a committee.
(Task: Working group to investigate establishing a resource list of medical experts)
5. Draft Child Product Safety Guide
J. Vincenten gave out the document: compilation of comments on the Guide and stated the intent of
the meeting discussion is to decide the scope of the guide and the intended target audience. First
point of discussion is the degree of depth of the Guide. ANEC stated the Guide is a good introduction
to standardization and that should be stated. J. Vincenten stated the Guide is to be made available for
injury practitioners as well as government representatives. H. Menezes stated the Guide could help to
motivate professionals to be involved in standardization; so difficult to perform as it is voluntary and
2002.v004/14.03.00./sec-hie
3
there is no funding for it. As a result consumers and health professionals not present in the working
groups throughout the year and have little opportunity to impact standardization. E. Petridou stated
what is also missing is the enforcement of the standards; could ANEC and the Alliance state the
compliance issue. Sector stated looking at the CSPC in the US at its website for how to provide this
information to parents on the website. J. Lund stated that the Guide in his experience would not assist
in getting money for standardization—who will pay is the main problem, to get persons involved, and
then ANEC could provide the documents to assist with increased understanding of the issues.
T.Vandenberghe stated the need to describe the realities of the process, especially the lack of balance
in the process—manufacturers are the majority of attendees at meetings as they have the money to
be present and the consumers are the weakest. L. Strindberg stated that enforcement of the
standards should be stated. M. Sector stated she would like to also have in the Guide what current
activities are being done in standardization, and what are best practices. J. Vincenten noted the
leverage by using the Guide for advocacy. H. Menezes emphasized what ANEC stated, that
consumers and health professionals need a voice in the process and therefore budget for it. She
stated the need for data to show the manufacturers why change is necessary, to comply. J. Vincenten
asked the members to read over the comments and reply to the Alliance if they have new edits or
further comments. J. Vincenten will send the comments documents by email.
(Task: Alliance members are asked to make additions in the Guide for best practices (or lack of) in
various standardization topics (loose strings in UK, lack of inedible standards) as well as current
activities by standardization organizations. J.Vincenten will forward the comments document by email)
6. Member Roles and Responsibilities to Alliance
J.Vincenten started the discussion asking the need for Alliance members’ roles and responsibilities.
Who decides who is a member, what tasks must people perform. M. Ridder stated she needed to
know how much time is involved when one is a member, as this is not clear. M. Grivna stated that he
does not believe there is a problem with this issue. CAPT stated that they were not comfortable
signing a contract with SafeKids USA for example, as there are consequences to that. J. Vincenten
commented on the need for consistency in representation. All members agreed that no letter or
contract is needed at this time and that it is up to the country to decide who are the representatives—
and what each can contribute as to their level of involvement, as it is a management and financial
issue.
7. Alliance Financial Report
J. Vincenten passed out the financial report which was provided to the Commission, and will forward
the Commission report summary. She stated the 50/50 budget arrangement with the Commission, and
the 50% by the Alliance was offset by contributions in kind, and Johnson and Johnson (USD 100,000).
E. Petridou asked for clarification of what the Alliance covers for member meetings and asked for a
manner to trace the reimbursement by sending the number of the transfer. Vincenten stated the
arrangement is that the Alliance covers the travel and members provide accommodation, meals.
(Task: Vincenten will provide by email the summary of the Commission report and look into the having
a transfer number sent to the members once refunds are completed)
2002.v004/14.03.00./sec-hie
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8. Updates/announcements
Portugal workshop-H. Menezes introduced the national Portugal conference and the link to the
Alliance workshop. J.Vincenten stated the need for abstracts, with potential audience 75 to 100, and
need for recruitment of key national working partners for attendance.
The Alliance was presented to the law firm and thanked them for their support.
2002.v004/14.03.00./sec-hie
5
Report
Date:
2002-03-15
Present:
Johan Lund, Norway, Gudula Brandmayer, Austria, Janice Cave, United Kingdom, Mathilde
Sector, Austria, Helena Menezes, Portugal, Lotten Strindberg, Sweden, Monique Ridder, The
Netherlands, Tania Vandenberghe, ANEC, Carine Renard, Belgium, Stephanie Märzheuser,
Germany, Elke Speltincx, Belgium, Eleni Petridou, Greece, Michal Grivna, Czech Republic,
Teresa Robledo de Dios, Spain, Joanne Vincenten, Alliance
Guests: Mrs. C. Knols, Mr. P. Cornall, Mr. H. Nordin
To:
European Child Safety Alliance, Drowning Campaigning
Subject:
Meeting held in London, March 8th, 2002
1. Announcements
Scorecard project-Vincenten reviewed the project briefly, project abstract was distributed at the
November meeting.
Website-Vincenten made partners aware of the alliance website and asked members to update their
contact information.
2. Presentations
Mathilde Sector from Sicher Leben presented an overview of the interviews she performed with the
Alliance members on campaigns in general and specifically a water safety campaign. She highlighted
the results, challenges, advantages of an Alliance campaign, etc.
(see presentation handout 1)
Peter Cornall from RoSPA provided an overview of his background and his philosophy regarding
water safety-to minimize risk and INCREASE risk perception. He gave quotes for drownings in the UK
rd
(3 cause of accidental death, 400-600 per year for all age groups), along with location and risks
(bathtubs, vacation home on the first day). He highlighted the lack of international water symbols, and
the lack of legislation regarding fencing). He also stated the importance of Risk Assessment—the
need for a tool that would make owners aware of risk associated with having a pool, etc. He agreed to
provide the Alliance with the UK water symbols which are going to be put through the ISO
standardization procedure.
2002.v005/14.03.00./sec-hie
1
Helena Menezes from APSI presented her work on fencing, showing pictures of appropriate fencing,
made more cosmetically acceptable. She agreed to make the Alliance aware of her progress in
proposing fencing recommendations.
Eleni Petridou from C.E.R.E.P.R.I announced that she will be receiving a grant from Johnson and
Johnson for a water safety campaign; she stated potential activities such as producing a video,
performing a risk assessment by children before and after the campaign, and looking at pool fencing in
Greece.
Gudula Brandmayer explained the potential initiatives to be undertaken by her organization in
partnership with Sicher Leben, for water safety activities this summer in Austria.
Stephanie Märzheuser presented a brief overview of her previous water safety campaign in Germany.
Johan Lund presented an overview of the numerous organizations involved in water safety in Norway.
Cilia Knols from the Consumer Safety Institute presented regarding marketing strategies. She
highlighted the need to evaluate potential donors to find a suitable donor.
Monique Ridder from the Consumer Safety Institute (CSI) presented the Child Safety Water Safety
Campaign for the Netherlands 2002/2004. She highlighted the total budget for the campaign was
400,000 EUR, split 50/50 from the government and from CSI funding. Print materials, research,
persons, and buying of airtime were other costs.
3. Round tableDiscussion
J. Vincenten started the discussion by asking for feedback from the members regarding key
components of a water safety campaign. All members contributed their opinions and the following was
agreed upon.
Title: Water safety campaign
Target group: 0-18 years old (certain countries would like to place special focus on specific age
groups, immigrant populations, others on tourist populations)
Potential messages: Use your eyes, not your ears (CSI campaign slogan) / Children are not
waterproof / be water smart
Activities: swimming pool fencing recommendations (link H. Menezes), international water symbols
(link P. Cornall), tourist injuries (link E. Petridou), floating devices standardization (L. Strindberg& S.
Hakansson, ANEC)
§
Needs:
Data- drowning and near drowning mortality and morbidity (hospital discharge, length of stay),
exposure data, for an injury pyramid. In order to make a Fact Sheet and start a “White Book-for Child
Drowning in Europe”. Also a risk perception (link J. Cave) and Risk Assessment Tool (link P. Cornall).
Literature Review-to provide epidemiological data or evidence for interventions, with focus on Europe
2002.v005/14.03.00./sec-hie
2
Materials- Poster, image for EU distribution, Fact Sheet, overview article, position statement,
nd
Drowning White Book (for 2 year and more visual materials).
4. Summary
Vincenten made a summary of the meetings progress for members. Members requested an Alliance
‘water safety campaign statement’ of some sort for them to use for press releases, info sharing, etc.
(Task: J. Vincenten to write and send position statement to members for feedback)
2002.v005/14.03.00./sec-hie
3
Report
Date:
2002-10-12
Present:
M. Sector, K. Pürtscher, C. Renard, J. Cave, M. Hayes, K. Phillips, M. Malinowska-Cieslik,
H. Menezes, L. Strindberg, M. Grivna, J. Lund, T. Vandenberghe, E. Speltincx, B. Laursen, S.
Mjönes, J. Pauwels, R. Mercer, E. Rocha, J. Vincenten, E. Petridou, V. Delwart, M. Ridder, T.
Zevenhuizen-Hiemstra
Absent
with notice:
T. Robledo de Dios, A. Marchi, F. Briand, S. Märzheuser
To:
European Child Safety Alliance
Subject:
European Child Safety Alliance Steering Committee meeting held in Portugal,
October 12, 2002. 13.00-17.00h
1
Welcome and introductions:
J. Vincenten introduced herself and asked each participant to introduce himself or herself. This was
completed.
2
Review of last meeting minutes:
J. Vincenten asked for edits or comments from the last meeting minutes. M Ridder stated that the
costs for the Water Safety Campaign in the Netherlands were: 400,000 EUR included all costs. This
change was acknowledged and will be made.
3
General comments on the Sintra conference:
H. Menezes stated that it was helpful for her to have the conference here in Sintra, to assist her team.
M Ridder stated she did not understand the closing plenary session in how it met the goals of bridging
practice and research in child injury. K. Purtscher stated she especially enjoyed the last session as it
highlighted social deprivation in child injury. L. Strindberg agreed that the presentation by L. Laflamme
was very scientific. T. Vandenberghe stated she would support having this conference again to
provide the opportunity to network. J. Lund recommended having a satellite meeting in Vienna in 2004
at the World Conference; he stated the workshop was very broad. M.Hayes stated for a first meeting it
was excellent, and it worked the way it did as it was small-enabled practitioners to attend. E. Speltincx
stated she would appreciate having the presentations posted on the Internet, with publications from
the presenters and C. Renard would like to receive an original copy of the program book for her
library.
4
Updates of old business arising from the minutes:
J. Vincenten stated the following documents are products from year 1 to share with other countries:
• White book translations and advocacy plans: Greece is proceeding with this, although
graphics are not yet available due to technical difficulties, but coming soon. J. Vincenten
thanked J. Cave for her quick action in having ECSA represented at the WHO Health and
Environment meeting to keep injury on the agenda and having the opportunity to be present at
the meeting of the ministers in 2004 is one to pursue.
• Mori Report review and distribution: The Report in initial layout was circulated to the Steering
Committee. A final version will be circulated again for last comments and finalised this fall.
Aims for the Report are to use it for programming, for campaigning and politically in an
advocacy sense. H. Menezes and E. Petridou asked for a national subset of the data.
• Medical Experts Panel: J. Vincenten explained she searched for a medical experts panel at
ANEC but it does not exist at this organisation. However ANEC supports the setting up of such a
panel. The problem to establishing a panel is the legal and economic costs involved. S.
Mjönes stated he was willing to discuss the issue with the CESP Board. L. Strindberg stated
she needed assistance with a child development tool and would appreciate an expert.
2002eco.v030/14.03.02./sec-zev
1
•
5
E. Petridou recommended we deal with issues on an ad-hoc basis. J .Vincenten stated she
would provide CESP with the necessary rationale and background for the panel.
Child Product Safety Guide: J. Vincenten presented the draft version of the Guide and the goal
is to have it ready for the Paris ECOSA meeting. J. Vincenten asked for persons to assist with
the final edits. H. Menezes, T. Vandenberghe and L. Strindberg agreed to review it again at
the next stage early in the new year.
Drowning Campaign 2003:
J. Vincenten introduced the topic by stating that the term campaign is broad and open. J.Vincenten
stated it is a water safety promotion and drowning prevention campaign, for countries to choose as an
area of focus for this year and next. J. Vincenten asked for Alliance members to briefly summarise
their past and future activities for this campaign.
•
Country activities 2002 and 2003:
- M. Ridder from the Netherlands stated that they have started a drowning campaign in April of 2002
with brochures, radio and TV spot. Swimming pools had a great interest in the brochures and
requested a German version due to German tourists. Next activities are: 1) co-ordinated events in 250
swimming pools on a particular day and 2) to improve local government participation in improving
water safety in local neighbourhoods. Evaluation is currently underway for the 2002 activities, but
preliminary results show high awareness of risk by parents but low awareness of the consequences.
For some countries it is stated how the design and broadcast of tv-commercials is paid for. In the
Netherlands a commercial bureau is being paid to produce the tv-commercial (and radio). For
broadcasting Consumer Safety Institute pays 25% of the commercial price (which is still a lot, about
200.000 EURO a year).
- E. Rocha from Portugal stated their are no promotional activities have occurred yet but there is a high
interest from the local governments in southern Portugal to join a European Campaign on this issue;
she stated the surveillance data is missing for tourist deaths in Portugal. H. Menezes also from
Portugal stated she is interested in radio spots and brochures for Portugal.
- E. Petridou from Greece summarised their campaign to compare unintentional drowning mortality data
from the European countries and to do coalition building for distribution of campaign materials (0 to 14
target group and parents). Next activities are a short video, radio spot and evaluation studies. Greek
resources produced so far includes: poster, leaflet, sticker, bookmark.
- K. Purtscher from Austria stated that they have produced a brochure for parents of kindergarten
children. Children were addressed during the summer months via Safety Bears in swimming areas to
provide safety tips. A cinema spot was also performed and radio spots for 9 weeks in the summer.
Negotiations are underway with a travel agency to provide brochures to tourists before travelling.
- J. Vincenten asked how the groups are funding the design and showing of the spots. K. Purtscher had
sponsorship money for the design and time donated. E. Petridou mentioned the difficulty in having
donated time if a sponsor is stated on the spot.
- J. Cave from the UK stated that her organisation ROSPA has produced a teaching aid package for
teachers at school, to purchase. Also a water review report is to be published for UK to push for more
resources, due to high profile drowning cases. Also trying to identify causes of near misses. For next
year ROSPA is planning to tackle the tourist drowning problem. They are trying to establish how many
Britons drown abroad as these are not included in the UK statistics. They receive lots of media
exposure but do not produce many materials other than the school packages as many organisations
do that.
- C. Renard from Belgium stated there has been increased collaboration with other agencies in Belgium
working on child accident prevention to inform them about the issue of drowning, 0-19 years old. Also
a press action with a good response throughout the summer—still lacking campaign materials. This is
the first time joint action occured with CRIOC, K&V and the French counterpart.
2002eco.v030/14.03.02./sec-zev
2
- M. Grivna from the Czech Republic stated he was unsuccessful in gaining funding for a campaign so
used an existing circle in which to circulate Red Cross materials on drowning which needs to be
professionalized in the future.
- M. Cieslik from Poland stated a large NGO took on diving injuries—they produced school packages for
schools and teachers, as well as TV, cinema and radio spots. They also produced posters and
brochures for lake areas and swimming pools.
- T. Vandenberghe representing ANEC stated that there is a newsletter article about the ECSA
drowning campaign, as well as ISO Bulletin. Also a push for warning labels for lifejackets for infants
not to be worn together with diapers. ANEC also commented on the draft standard for swim seats.
- J. Lund explained in Norway the five national organisations working with water safety have established
a forum for water safety for better co-ordination of the wok. They are proposing a drowning conference
for Nordic countries to share experience: what works in drowning prevention? Also the forum has
agreed to improve the drowning injury statistics, target ethnic minorities, also to measure the
swimming ability of 10 year olds, as well as target tourists as a high risk group.
• European concepts and creative for drowning campaign:
CAPT is the only organisation which will not be participating in a water safety campaign at this point
but ROSPA will be doing campaign activities for drowning in the UK. J. Vincenten explained that we
now have a fact sheet and a literature review. H. Menezes proposed to summarise the data of the
literature review under headings and state the needs for research to be done in Europe. Also she
recommended searching for articles in French as there is a new study on the height of pool fencing.
J. Vincenten presented a proposed Communication Plan for a European Safety and Drowning
Prevention Campaign-in partnership with the European Child Safety Alliance. E. Petridou stated that it
was up to the country to choose what it needs and who it wants/can target. J. Vincenten stressed that
we need to decide as an Alliance which resources would be useful in order to be cost-effective.
J. Pauwels stated it is important to have posters and media attention each summer and not just for
one year versus printed material which is more costly. E. Speltincx agreed that materials from the
Alliance would support national campaigns. H. Menezes supported the tool box concept once the
documents are improved and nationally translated dependent on need and means. She emphasised
the need for a Drowning White Book for ages 0 to 18 as well as what to do in case of a drowning
victim. E. Petridou recommended a cinema spot to use at outdoor cinemas in the South, and to
advance the statistics as well as a design for a poster. Greece also has an awareness survey to
share. K. Purtscher agreed to use a European cinema spot as well as their existing national spot. H.
Menezes agreed to use English TV spots with subtitles. J. Cave agreed to share her info for tourists to
raise awareness of drowning risks abroad. L. Strindberg emphasised the use of the translated
documents on the website regarding tourists travelling. J. Vincenten asked who would for sure be able
to use a TV spot: Greece, Portugal, Belgium, and Austria confirmed. J. Vincenten showed the Keep
Watch Australia spot. She asked the group how we come to agreement on which spot to use from
others. J. Vincenten stated she would circulate the existing spots and their rules of use with the
Alliance and start discussion. The agreement from countries was to try to use an existing drowning
prevention TV spot as the European TV Spot. Resources listed in the communication campaign plan
will be drafted in the coming months in English for country review (see attached presentation for
reference) with the addition of a tourist questionnaire/checklist. All resources will be made in hard copy
and put on the website with links to country sites.
• Themes for campaigns over the next 4 to 6 years:
J. Vincenten stated it would be useful to discuss a schedule of themes for the coming years, and how
long do the themes span. She stated she would circulate an email questionnaire to assist with the
decision upon themes, in order to assist with planning.
6
Announcements of New Business:
• Survey for a current awareness bulletin:
M. Hayes reported that CAPT and the Alliance is trying to build capacity of practitioners at a local level
by providing awareness bulletins on child injury technical information and grey literature. Once survey
results are available they will be circulated.
2002eco.v030/14.03.02./sec-zev
3
• Research network formation:
J.Vincenten explained that there is discussion right now to have a child injury prevention research
group to bring these professionals together to design a European research agenda. J. Lund
recommended linking on an existing organisation such as: www.workingonsafety.net
• ECOSA Conference 2003
th
April 10-11, 2003: next Steering Committee meeting on Wednesday the 9 of April 2003 if the date is
still available.
• Vienna 2004 Conference:
June 6-9, 2004 in which a main topic is the development of a child safety charter.
• Alliance business planning for 2004 to 2006:
A new plan will be drafted in the next year to determine future activities.
J. Vincenten thanked the Steering Committee for their input and adjourned the meeting.
2002eco.v030/14.03.02./sec-zev
4
Report
Date:
2003-04-09
Present:
J.
Cave, V. Delwart (Johnson and Johnson), O. Finkelstein (F. Briand), B. Frimodt-
Moller, M. Grivna, M. Hayes, S. Märzheuser, H. Menezes, R. Mercer, E. Petridou, K.
Pürtscher, C. Renard, M. Ridder, M. Sector, F. Steinbacher, L. Strindberg, C. Tierens,
T. Vandenberghe, J. Vincenten
Absent with notice:
H. Aruniit , J. Lund, M. Malinowska, K. Phillips, J. Pauwels, R. Gofin
Guests:
Dr. E. Rocha, V. Benesova, Dr. R. Kisser, Dr. W. Rogmans
To:
Subject:
Meeting held in Paris, April 9, 2003
Welcome and introduction by J. Vincenten
Review of agenda and logistics
J. Vincenten welcomed the group and asked for each member to introduce him/herself. She stressed
the importance of having consistency of country members at meetings. E. Petridou stated that Cyprus
would like to join and she would send the information to J. Vincenten.
1. Review of minutes
J. Vincenten asked for errors, omissions to the last minutes. J. Vincenten asked M. Hayes if it was
accurate that his organisation would not be participating in the drowning campaign. He agreed, as
RoSPA is the lead in the United Kingdom. J. Vincenten asked E. Petridou if she was able to do the
translation of the White Book. E. Petridou stated that it was now possible but costs were associated.
H. Menezes stated J&J Portugal were informed about the white book translation and wanted to
partner, but were not interested in the White Book translation necessarily. J. Vincenten asked V.
Delwart to provide another contact person at J&J Portugal and she agreed. M. Grivna stated he was
interested in preparing a national version, translation not being a problem, but he is still looking for a
publisher and funds. No other comments provided. J. Vincenten noted that text and data would be
possibly updated in the new year in preparation for the ministers of Health and Environment
Conference.
2. Updates of old business
J. Vincenten informed the group that the Parent Survey is now published and was released to the
media on April 7th, World Health Day. All members received a copy at the meeting and will also have
a small number sent to each organisation. She also provided a copy of the Standards and Regulations
Guide, which is now published. J. Vincenten thanked L. Strindberg, H. Menezes, and T.
Vandenberghe for their additional technical support in producing this document. She highlighted the
page 37, Summary and Recommendations. Next step with this document could be to present a
seminar/workshop to inform people more about this topic and specifically the gaps. The document will
be officially public April 10, 2003 to the media and presented at the ECOSA conference. Technical
2003.v018/13.04.02./sec-zev
1
spokespersons are Portugal and Sweden. H. Menezes will also have a press release in Portugal. J.
Vincenten encouraged national members to use the European press release as a basis and then add
the national issue. T. Vandenberge stated this document is a very good introduction for persons who
want to know more about the topic. For additional copies J. Vincenten asked to be notified. An initial
mailing will be provided to each organisation.
3. Drowning prevention campaign
- Drowning Materials
J. Vincenten provided samples of the drowning prevention materials: parents checklist, factsheet,
vacation materials, poster, prescription pads, and small ads. She stated the small ads were
controversial, due to media limitation of space for information, therefore only giving one safety tip in
each ad. Portugal stated it appears, as if the prevention of drowning is dependent on only one
solution. H. Menezes stated she would use the ads, with the Alliance logo, the message “you can do
something about it” and it will have multiple solutions on one ad. E. Petridou stated she would use ads
and K. Purtscher will use the graphics from the Alliance and create own text. R. Mercer stated she
liked the piece of advice being separate so that each country can pick and choose. K. Purtscher stated
one should not overload the public, state one message. J. Vincenten summarised the discussion to
provide one solution per ad and have each country edit this piece as needed. The same for the
doctor’s advice prescription pad.
E. Petridou stated that for active supervision of children, age could be listed, but J. Vincenten stated
three different ages were suggested. E. Petridou suggested “young children” could be added. The
group agreed and J. Vincenten will do the edits. Also, drowning is the 2nd leading cause of INJURY
death, in order to be accurate.
For the fact sheet J. Vincenten stated that the U.S. statistics are in until European statistics are
gathered. If any more edits, please provide these to J. Vincenten.
R. Mercer stated the order of the information on the checklist for parents is confusing. J. Vincenten
stated that there was no consistency in the order sequences provided by the group. R. Mercer agreed
to present an order to the group today and the group can vote on it.
Regarding the poster format, it is horizontal in order to accommodate the feedback to have more
information on it. E. Petridou suggested using signs instead of bullets. M. Ridder stated that in the
Netherlands experience, the parents did not notice the signs or pictures used, and the text now is too
much. R. Mercer stated “do not dive” should be used instead of “jump into”. H. Menezes stated that
pictures needed to be on the checklist. M. Sector asked if water as background could be added to the
poster if graphically doable and the website needs to be more noticeable. K. Purtscher stated for
Austria the poster is to raise awareness and the checklist is for action. J. Vincenten agreed there is too
much text on the poster and would be reduced.
The group agreed to use the English versions of the campaign materials for tourists. The group
agreed to eliminate the last bullet “teach children water safety rules” and replace with “teach your
children never to swim alone” for the poster.
2003.v018/13.04.02./sec-zev
2
J. Vincenten thanked the group for this decision and informed the group that these materials will be
provided on the Alliance website and national translations/versions can be added there or links to
national websites. J. Vincenten then provided the group with “water wise on vacation” text which is not
yet formatted due to the need to reduce the text first. J. Cave agreed it was too much text and
therefore suggested to cut it into two pieces, before vacation and arrival, a minimal version with only
the questions and full version on the website or at the travel agencies was also suggested. The group
agreed and regarding format, agreed to link it to the other pieces using the duck logo and make it
travel oriented.
R. Mercer presented the order for the fact sheet, with comments that: checks are for action therefore
“do not rely” needs to be edited to say an action “use flotation devices”. H. Menezes suggested that
under the bullet “stay sober near the water” to cut the 2nd sentence about adolescent drinking and the
group agreed. M. Sector also suggested cutting the second sentence under bullet “Wear a life jacket”
and the group agreed.
The following edits will be made: see annex 1
Drowning booklet
J. Vincenten presented the table of contents for the Drowning Book that is in progress. O. Finkelstein
stated that the drowning material in France has been very effective. J. Vincenten asked for countries
to provide her with electronic versions of their materials.
She then asked for each member to present an update on his/her national drowning activities.
M. Ridder provided an overview on the drowning campaign in the Netherlands (see attachment).
Swimming pool launch is May 8, 2003.
L. Strindberg stated she is discussing using the European materials with partners, in Sweden.
S. Märzheuser stated they will do a press release June 3, 2003 and she will place the materials on the
website and in the German play safe campaign.
K. Purtscher stated Austria would have a common press conference in June: Sicher Leben will focus
on safety in sports and movement and Grosse Schutze Kleine will focus on drowning. They will
translate the text of the European materials and also use a German commercial TV spot. As well, the
organisation stresses CPR training in co-ordination with the Austrian Red Cross, Youth Red Cross. F.
Steinbauer stated that the Sicher Leben focus is to emphasise movement, go swimming but swim
safely.
O. Finkelstein stated in France there has been a campaign for several years focusing on fencing,
phone near the pool, CPR and began standardisation work for barriers (completed) covers, shelters,
alarms. There is also now a law approved in Jan. 2003 to have standardised devices for pools. Now
France is working on a decree for enforcement of the law and issues of responsibility between the
actors (pool owners, manufacturers of devices, etc.). E. Petridou asked her to share a copy of the law
and the decree with the Alliance.
B. Moller stated that the Danish Council for Water Safety has a TV spot and has not responded how it
would like to participate. It focuses on safety in boating, sailing, with a campaign usually every
2003.v018/13.04.02./sec-zev
3
summer. She stated she has used the drowning information for her newsletter and hopes this will
motivate the Council to act.
E. Petridou stated that J&J in Greece supported development of materials for a drowning safety
campaign, including a TV spot. She will use the European material and will reproduce this in Greek.
Also planned is a puppet play, video, stamps, info on calling cards, and school infobox for teachers.
The launch will have many ministers, CDC representative, on May 27, 2003. The campaign will also
be evaluated. See attachment.
M. Grivna stated that the Czech Republic did a one-week campaign in 2002 with the Water Rescue
Service, and did a short video with the National Institute of Public Health. Problem is lack of details on
the drowning data, other than mortality numbers, but there is good co-operation with the partners.
H. Menezes stated they have little funding but much interest. Launch date May 29, 2003. She
explained they will produce a 5-6 minute video spot and make copies (including all supporting
documents) in order to distribute it all over the health care system in Portugal. Also posters in
pharmacies, and small CPR training. Also want to push voluntary adoption of pool fencing, so
important to see the French documents. Also want to focus on diving injuries via national workshops to
professionals. As well to have articles on water safety to distribute nationally. J. Cave offered to
provide diving info to Portugal from their last campaign. M. Grivna offered his movie which has victims
explaining prevention messages.
J. Cave stated they now have a national standardisation of water graphical signs and symbols in the
UK, which has been adopted by the International Lifesaving Organisation in Europe. Next step is
standardisation of beach flags and symbols. The UK also has produced Guidelines for School outings
To Water Sites (www.teachernet.gov.uk/visits) and Safety of Tourists Abroad aired nationally. Press
releases are planned for Easter and in the summer (on a sunny day) as well as a Drowning And Water
Safety Conference March 2004.
R. Mercer stated she would do press releases based on the European materials, especially drowning
while on holiday.
C. Tierens and C. Renard stated that Belgium will get the info on their Internet, and do a press
release, but no campaign due to lack of resources, personnel.
J. Vincenten congratulated the group for all of their efforts and was impressed by the planned use of
the toolbox materials, made possible by J&J. The TV spot will be available in English early May. An
international version with only images and music will be able to be personalised with national text and
voices – for those countries that expressed interest – electronically.
Final versions of the print material will be available May 1 and hard copies available mid May. Still to
come is the European press release in May and the countries are encouraged to rewrite it to be
attractive to national press. Also coming is the website for May 15, 2003 (please provide links or
documents to upload).
4. New campaign themes
2003.v018/13.04.02./sec-zev
4
J. Vincenten asked the group to provide an update on future planned campaigns. M. Ridder stated in
the Netherlands there will be a campaign on traffic safety, as well as either burns and scalds or safe
sleeping, to include sudden infant death syndrome. R. Mercer stated CAPT (Ireland) may look at the
safety of children of disadvantaged backgrounds, and burns or scalds for this year, but next year’s
theme is not yet set. F. Steinbauer stated it is still open in Austria. H. Menezes (Portugal) stated they
will continue with car seats, and doing campaigns with legal and regulatory efforts, as well as
empowerment of children. Also, focus on children with disabilities who have major barriers to access.
M. Grivna (Czech) stated they are doing burns and scalds this year, open for next year. R. Kisser
stated Austria will do safe home, promotion of exercise, safety curriculum for schools, bicycle safety,
burns in the home (scalds included in the safe home) and on car seats. These 6 are continuously
running campaigns. Sweden stated they stress “Safe and stimulating environments for children”. S.
Marzheuser stated they will do an outdoor activity such as garden safety in line with last year’s
playground safety. E. Petridou stated she will follow the ECSA themes.
5. Announcements
J. Vincenten announced that the following tasks are coming up:
1) Business Plan 2004-2006, what is worthwhile to do at a European versus a national level will be
important to identify.
M. Ridder suggested doing an email information/evaluation form. The group agreed. Also the group
agreed to update the present material, such as the White Book, etc. R. Mercer asked for descriptive
information on evaluation methods being used in Europe, in order to improve national programmes –
then could be a topic for future seminars/workshops.
2) Set a fall meeting
Discussions have been underway with countries to host a fall meeting and small seminar. Sweden
may be an option, but no date is specified and the location must still be fixed. We can ask for
suggestions for topics and then make a match to location and expertise. E. Petridou suggested
combining it with an ANEC meeting. Feedback will be obtained from T. Vandenberghe.
3) Proposal to the Commission
J. Vincenten also announced and circulated a summary for a draft proposal to the European
Commission for action on child safety. As part of the Alliance business plan of 2001 to 2003, acquiring
funds to complete the tasks outlined in this plan is one of our goals. A recent call for proposals for the
new public health programme of the European Commission has been announced and may be a
source of funds for some of the interests/activities of the Alliance already identified in our plan. The
call is not to fund ongoing operations or functioning of networks like our Alliance, but to advance
programme actions at a European level. Based on the description of the call for proposals and our
current business plan, J. Vincenten has drafted a broad proposal to meet the submission criteria. The
proposal focuses on standard tools, process and resources to develop National Child Injury action
plans. Members were asked to review the proposal over the next 3 weeks and provide their comments
by email and if interested in participating.
Vincenten asked for interests for partnerships. R. Mercer asked what would be other sources of
funding for annual sustainability long-term. K. Purtscher asked for a transparent process for potential
2003.v018/13.04.02./sec-zev
5
partnerships. E. Petridou had suggestions for other aspects of the proposal, members were asked
again to forward their comments in writing for consideration. Countries that want to be included in the
proposal would need to respond by April 30, 2003.
4) Collaboration and Upcoming Conferences
Also in progress is collaboration with the European Ministers of Health and Environment Conference
in June 2004 to place injuries on the agenda. She also announced the World Conference in Vienna,
June 2004. M. Grivna announced the Safe Communities Prague Conference as pre-conference to
Vienna in June 2004.
R. Mercer asked for an update on the Volvo proposal which J. Vincenten stated there has been no
response. K. Purtscher asked for the Alliance to consider a reaction to the health of children around
the world to address the issue of war and terror.
2003.v018/13.04.02./sec-zev
6
Changes for the Drowning Prevention Materials
Checklist Sequence
1. Actively supervise
2. Fill or cover garden ponds
3. Surround your private pool
4. Be prepared near the pool
5. Stay sober near the water
6. USE flotation devices to HELP protect CHILDREN.
7. Wear a life jacket
8. Safe use of watercraft
9. Take swimming lessons
10. Swim with a lifeguard
11. Respect flags and symbols
12. Be aware on vacation
13. Teach children the rules
14. Get trained in CPR
Checklist Edits
§
Remove the second sentence from # 5 ‘Stay sober’
§
Remove the second sentence from #7 ‘Wear a life jacket’
§
Remove #13 title ‘Teach children the 4 Rules’ including bullets and replace with title ‘Teach your
children never to swim alone’
th
§
Fix the spacing at #3, 6 sentence ‚a child could‘
§
Add to #1 ‚Actively supervise‘ ‚Actively supervise all young children
Poster Edits
nd
§
Replace the title with ‘Drowning is the 2 leading cause of injury death for children in Europe‘
§
§
Add water waves to background if possible
Add to ‚Actively supervise‘ ‚Actively supervise all young children
Ads Edits
§
Keep to one message per ad
§
Replace the title with ‘Fact: Drowning is the 2 leading cause of injury death for children in
nd
Europe‘
RX Pad Edits
§
Add to ‚Actively supervise‘ ‚Actively supervise all young children
§
Delete “do not dive” and replace with “Do not jump into”
Waterwise on Vacation
§
Same format as the other materials regarding logo, with a travel graphic
for SECTOR:
§
Split into two documents: ‘Safety Tips Before You Go on Vacation’ and ‘Safety Tips While on
Vacation’
Keep only the questions, delete the text (will keep the full version on the website)
2003.v018/13.04.02./sec-zev
7
Report
Date:
2003-04-09
Present:
Veronika Benesova (Czech Republic), Gudula Brandmayr (Austria), Janice Cave (UK),
Sabine van Eck (The Netherlands), Liisa Joutsi (Finland), Stellina Kiosse (Greece),
Stefanie Märzheuser (Germany, Carine Renard (Belgium), Elsa Rocha (Portugal),
Angela Seay CESP), Mathilde Sector (Austria), Lotten Strindberg (Sweden), Tania
Vandenberghe (Belgium), Joanne Vincenten (ECSA), Trea Zevenhuizen (ECSA)
Guests:
Diana Smith (Communication consultant), Femke Zwaal (Communication consultant)
Absent with notice:
U. Ewert, B. Frimodt-Moller, M. Hayes, J. Lund, M. Malinowski-Cieslik, A. Marchi,
Eleni Petridou (represented by Stellina Kiosse), C. Tierens
To:
Subject:
Meeting held in Berlin, Germany, November 6, 2003
Welcome
J. Vincenten welcomed the group and thanked the Charité Children’s Hospital for hosting the meeting.
S. Märzheuser offered to provide tours of the hospital for any members interested. J. Vincenten
thanked S. Märzheuser for the conference facilities and logistical assistance for the meeting. A brief
greeting was provided by the head of the hospitals pediatric department.
Introduction/Agenda/Minutes
J. Vincenten asked the group to interview their neighbour and be able to introduce them to the group,
and include the biggest challenge regarding child safety in their country. The group completed this. No
changes for the agenda and no additions or changes to the previous minutes.
Drowning campaign
European: J. Vincenten introduced T. Zevenhuizen to give a presentation on the European drowning
prevention campaign 2003 “Be water wise”. She explained the goal, promotional materials/toolkit,
challenges (European media-does it exist?, European distribution targets in addition to national, and
evaluation: can a European campaign work as a joint campaign?). Presentation available on request.
The Netherlands: T. Zevenhuizen also provided an overview of the national campaign in the
Netherlands “Watervlug” which started in 2002 and continues to 2004. She described the toolkit and
the results of the evaluation- 86% valued the event and want to participate next year again, and
materials valued as useful. Upcoming activities are to stimulate swimming abilities for young children
in 36 municipalities and a project with a focus on open water.
Comment: M. Sector asked the group if they agreed on the value of a TV spot and the group agreed
that yes, but the costs are too high to broadcast in their country. The group expressed concern with
bathtubs seat and the need to discuss what can be done about this as an Alliance.
Austria: G. Brandmayr presented next on the Austrian campaign for 2003, in conjunction with the
European campaign, 2002 to 2003. She presented the video spot, news clip, water safety days, and
2003.v042/14.01.02./sec-zev
1
posters. She commented that the media work was free of charge and the fact that Austria was part of
a European campaign was helpful in gaining support. Presentation available on request.
Comment: S. Märzheuser commented that the European logo was so successful that it should be
“branded” somehow as it is more appealing for politicians to discuss a European issue.
Portugal: E. Rocha provided the group with the campaign materials used and, adapted to Portugal and
the organisation. The Alliance logo was placed on all materials. Sugar packs were also printed with
the drowning message and were very successful. The radio spot was used on the national paediatric
help line, while the caller waited. She stated the strong points being the strength and the impact of the
campaign material, and the weakness being the lack of human and financial resources. Also she
stated the lack and difficulty of obtaining data. E. Rocha stated that to obtain free support it helped to
be part of a European campaign. She suggested that perhaps the Alliance could assist in funding
partners on a European and national level for the European campaign.
Greece: S. Kiosse presented the two phases of the drowning prevention campaign in Greece, starting
in 2001. Phase I was the burden of unintentional drowning in Greece, 1996 to 2000, compared to
other countries in Europe. Also a questionnaire was given to kindergarten, school-aged children to
determine their knowledge of drowning risks. Phase II was the Greek Coalition for Drowning
Prevention, diffusion of the materials, press conference for Drowning Prevention Day. Now the
campaign is in the evaluation phase, an initial questionnaire to evaluate water safety knowledge of
children in schools and to the general public to determine visibility of the media and its impact.
Germany/Czech/Sweden/UK/ANEC/Belgium/Finland: S. Märzheuser (Germany) stated that water
safety is presented each year as part of a safety day. V. Benesova (Czech Republic) stated that the
National Injury Day was on water safety, and that they are undergoing data collection on drowning and
near drowning. L. Strindberg (Sweden) stated that water safety is an important topic but that her
organisation does no concrete actions on it. J. Cave stated that the UK also does a secondary
campaign in January as many drown on the ice. T. Vandenberghe (Belgium) stated that ANEC is
urging a ban on bathtub seats and asks for collaboration with the Alliance. C. Renard (Belgium) stated
that she did a small campaign last year with no budget and she tried this year with the spot, but the
spot was not well accepted as it was found shocking and no preventive message. L. Joutsi (Finland)
stated that the drowning campaign in Finland focuses on middle-aged men, as well as a home
accident prevention campaign and drowning is one topic among others. S. van Eck (The Netherlands)
stated that it is a financing issue at the moment to do more water safety campaigning.
Comments: E. Rocha stated that the guidelines of the World Drowning Congress stated that the term
drowning encompasses near drowning and submersion thus the term “near drowning” no longer
exists. A. Seay stated that she sees many opportunities for ISCAIP to assist the Alliance in water
safety activities. F. Zwaal stated that the presentations gave her many ideas for finding partners. J.
Vincenten closed the discussion by summarising that many countries have expressed interest to to
continue with the water safety theme next year and the group agreed that being part of a European
campaign was important. Topics to follow-up on are: bathtub seats and other directives work with
ANEC, data collection on drowning, CPR and tourist focus.
th
7 World Conference on Injury Prevention and Safety Promotion
M. Sector presented a short summary of the Conference, urging the members to participate. J.
Vincenten stated that we will be hosting the next business meeting in Vienna. To reduce expenses for
members to attend the conference by supporting air travel we have also requested to ISCAIP a joint
seminar and we are still awaiting a response.
2003.v042/14.01.02./sec-zev
2
Public Health Programme 2003
J. Vincenten stated that the Alliance has received funding for the public health programme grant. She
asked for any questions country partners had. She stated the group has till the end of November to
respond. As stated in the overview approximately 10,000 Euro (60%) is available for each country to
create a national action plan. Countries are required to provide approximately 6,500 Euro (40%), for
example by in kind staff hours. In addition 60% costs for all travel, and accommodations to meetings
are included. Specific questions should be directed to J. Vincenten by November 30, 2003.
Evaluation and needs assessment
M. Sector presented the results from the 18 surveys completed. Focus was on frequency of
communication, priorities, campaigning and the role of business partners. F. Zwaal asked questions
regarding arguments for partners to join the Alliance, dilemmas of having partners, and benefits for the
partners and for us (in addition to money). Sponsor guidelines will be drafted and circulated.
The group stated that four weeks would be ideal for feedback on large documents, and at least two
weeks for meeting preparations. The frequency of emails is perhaps too much, but the group still
agreed to send all announcements and to mark the very important emails with a priority sign.
For the Alliance priorities the group agreed on the current goals and that the new topics were sub
goals: rapid inclusion of Eastern Europe (how to fund?) and data needs, advocacy / capacity building.
The group will have further discussion on the above issues in smaller groups the following morning.
Consensus was that a European campaign was valuable, that drowning prevention will continue in
some form, and that a new theme is to be discussed. That ‘reminder’ campaigns are valuable i.e.
continuation of drowning.
Closing: J. Vincenten provided an overview for the following day and opportunities for networking with
other agencies.
2003.v042/14.01.02./sec-zev
3
Report
Date:
2003-04-09
Present:
Sabine van Eck (The Netherlands), Liisa Joutsi (Finland), Stellina Kiosse (Greece),
Stefanie Märzheuser (Germany), Carine Renard (Belgium), Elsa Rocha (Portugal),
Angela Seay (CESP), Mathilde Sector (Austria), Lotten Strindberg (Sweden), Tania
Vandenberghe (Belgium), Joanne Vincenten (ECSA), Trea Zevenhuizen (ECSA)
Wanda Geisendorf (Sweden), John Mason and Gene Rider (RAM Consulting), Antiopi
Guests:
Sotiriou (Greece), Diana Smith (Communication consultant), Femke Zwaal
(Communication consultant)
Absent with notice:
U. Ewert, B. Frimodt-Moller, M. Hayes, J. Lund, M. Malinowski-Cieslik, A. Marchi,
Eleni Petridou (represented by Stellina Kiosse), C. Tierens
European Child Safety Alliance, Advocay seminar
Meeting held in Berlin, Germany, November 7, 2003
To:
Subject:
Welcome
J. Vincenten welcomed the group, thanked S. Märzheuser for yesterday’s dinner and reviewed the
highlights of the previous day. She then announced that we would begin with a breakout session.
Three groups were asked to identify tasks for each of the Alliance priorities as listed in the 2001-2003
Action Plan and current evaluation report. The group reported back to the following:
Alliance priorities 2004-2008
Priority 1: Increase the profile of Child Injury Prevention.
The target group would be first the media, then policymakers and consumers. Secondly, what is the
message: must be on the innocence of children, the cost-effectiveness of the programs, and be based
on concrete examples (not only drama but also solutions). Tasks would be to collect existing data and
distribute it via press releases, campaigning and producing educational materials.
Priority 2: Share information and best practice.
The group agreed on the following tasks:
-
European database of networking (a direct link on the website)
-
Business meeting and seminar (seminar ideas were fundraising, public relations, lobbying,
communication-IT improvements)
-
Provide country summaries online, in the Directory of Members list, with visuals (completed,
upcoming, new ideas, successes and challenges) with contact person via emails
-
Best practice and research - more links on the website, for Safety Lit, Cochrane review, links
to the journals
-
Update the White Book now
-
Update the Safety Regulations report in 2 to 3 years, or on request if there are big changes
2003.v043/14.02.01./sec-zev
1
-
Improve a rapid communication system with ANEC and other organisations / once a week
email memo possibly
-
Advocate for injury data collection and compiling, accurate and reliable
Priority 3: Lead a co-ordinated approach for awareness and promotion activities.
A. Latest data on drowning, 2003 summer. Produce a press statement- impact of the campaign
and inform the Commission.
B. Next campaign theme: continue with drowning but investigate the themes: burns, road safety,
home safety. Many questions as to what research needs we would have.
C. Business partners. Establish guidelines for partnership with the Alliance.
The group discussed their views on each priority and J. Vincenten stated that the discussions here
would be used to draft the initial business plan. J. Vincenten thanked the group for the discussion. She
introduced the agenda for the remainder of the day. She then introduced D. Smith for the topic:
Advocacy- what is it?
D. Smith presented integrating strategies to improve children’s Environmental Health. She gave
examples of advocacy activities and IEC = information, education, and communication. A brief
discussion followed regarding a children’s health and environment booklet used as an advocacy
example (presentation available on request). V. Benesova stated that the injury data in this booklet
was too old and needs to be updated. The group agreed. G. Rider stated that the report was attractive
and recommended a few simple messages be flushed out. M. Sector questioned the font size and
amount of information included as being too difficult to process. D. Smith stated the next level of
communication tools for this topic was a simpler short ‘card’:
Summary points of advocacy presentation
Success in Advocacy:
1
Define the goal clearly
2
Provide strong evidence
3
Check levels of stakeholder enthusiasm
4
Review existing initiatives
5
Integrate activities in what already exists
6
Involve influential groups
7
Communicate solutions (as well as injury risks)
8
Work locally, local relevance
Constraints in Advocacy:
1
Partners not sufficiently motivated
2
Funding problems
3
Lack of political pressure, media pressure
4
Insufficient attention
2003.v043/14.02.01./sec-zev
2
How experiences get copied: Make success stories widely available
- Priority issue in several countries
- Clear, simple text explaining how it worked, success factors
- Evaluation with results
- Details and access to contact persons
- Opportunities for adaptation and translation of materials
- Funding available
Transferability
- Building a strategy together
Which partners?
- Provide sources of information
- Part of target audience (involved in the policy-making process)
- Represent role models
- Represent key channels of communication
- Provide channels of dissemination of information
- Provide expertise and credibility
- Assist in resource mobilisation- funds, volunteers, etc..
How to work with partners
- Discuss goal, strategy and develop messages
- Review existing case study activities for possible replication, adaptation
- Identify opportunities to integrate into existing activities
- Visit stakeholders to ascertain levels of enthusiasm and willingness to support/contribute
- Record material development (booklets, press release, etc.)
- Evaluation
(Diana Smith, November 3, 2003)
J. Vincenten introduced the topic, Advocating Injury Prevention as part of the Health and
Environment Ministers Conference process
The major outcomes from the conference will be a Minister’s declaration and action plan. What does
injury have to do with the environment? The environment is more than the air we breathe, it is where
we live, learn and play. J. Vincenten reviewed the conference process and stated that injury is a part
of the WHO process. She asked for input on the WHO report, as well as getting injury on the national
action plan in the member countries. She also stated that we need to convince the European
Commission that is developing a parrell strategy to include injury in its plan, as it will be some law for
countries to follow. She asked for input on how to work together to be a stronger voice, specific
actions to be heard, convincing so we can. Benefits of working on this together: potential future funds,
policy setting, and data collection.
2003.v043/14.02.01./sec-zev
3
Actions to get on the EC agenda?
- Approach other directorate generals to spread the message
- Letter / meeting with Wallström
- Intelligence gathering: motivation for the EC strategy? Identify a key person working on the process
and find out why injury is not included
- Convincing arguments: opportunities for success (as well as the biggest problem, especially Eastern
Europe)
- Have national ministers and commissioners support inclusion of injury
- European Parliament health members approached
- Question: is there an appointed representative from each country that has influence over all
Directorates? They could help us advocate for inclusion of injury
- Have a targeted approach with key arguments, how injury fits in
- Link the EC process to the Vienna World Conference
W. Geisendorf reminded the group that this Minister’s conference is not the only opportunity.
If we are not successful this time another opportunity will come again.
D. Smith introduced the next agenda item, to receive an overview of three advocacy case studies and
to define the successes and constraints in each case.
Advocacy case studies
Toy noise (presentation available on request)
W. Geisendorf presented the case to protect children’s’ hearing by regulating the noise of toys. She
presented the process of standardisation for noise levels of toys, with industry and the Commission.
What led to success? Don’t give up, co-ordinate the actions and opinions of those who push for a
change, work on all possible levels-in all personal arenas, the help and commitment of medical
expertise, including involving grandparents.
Scalds (presentation available on request)
G. Rider presented the case to reduce scalds, Paediatric Scald Injury Prevention. He summarised the
model of injury prevention factors, emphasising the need to combine injuries with costs in order to
present the impact on society and to broaden the scope of the problem. Once a scald has occurred,
apply cold water (Germany recommends: shower for 20 Centigrade minutes, at 20 degrees, no ice).
Currently no research exists to prove the critical temperature that is ‘ too hot’ for children’s sensitive
skin and a recommended safe hot water temperature. RAM is currently doing research with a virtual
child model to answer this question. Once this is determined effective advocacy strategies of the
researched facts need to be strategically communicated for effective campaigns.
The group agreed that we need a simple message for each injury, such as ‘stop, drop and roll’. G.
Rider stated that a goal is to come up with a simple message and to list 8 to 10 Don’t Do’s. He stated
that six more months are needed to present the finalised results.
Inedibles (presentation available on request)
A. Sotiriou presented the process on standardising inedibles starting 1996 to the present. She
presented the objective as communicating the risk and propose legislation/standardisation.
2003.v043/14.02.01./sec-zev
4
She stated the advocacy tools were: exchange of information, current data and request for legal
regulation. Successful results were: withdrawing or modifying of products by the industry,
communication channel improved, better awareness by the public.
General comments: G. Rider stated that all of these cases were successes, that it takes time and
perseverance to create changes. L. Strindberg stated that medical practitioners need to be more
involved, especially doctors from all over Europe, in order to transform it from a national issue to an
international issue. W. Geisendorf stated that for toy noise legislation she brought a doctor with her to
explain the cases to the Commission. E. Rocha stated that stories need to be told to persuade parents
and the public. As inedible cases are few, focus on the single stories, as the data for inedibles is so
difficult to obtain. J. Mason stated that strategically confronting industry is an excellent approach and
that the Alliance has all the tools to be successful in tackling this issue.
J. Vincenten asked for the group to state the keys to successful advocacy in the cases reviewed.
Keys to successful advocacy
1
Be strategic
2
Common goal / message / alignment of partners
3
Tell a story
4
Evidence-based information
5
Perseverance – don’t give up
6
Work with the medical experts (conduct forums to bring them together)
7
Passion – identify and train a point person to carry the message
8
Be professional
Constraints to successful advocacy
1
Difficulty in getting buy-in from the medical experts
2
Lack of data
3
Lack of independence in the review process
Closing
J. Vincenten thanked the group for the great progress and involvement at this meeting. All were
asked for input and actions for the Budapest Conference and J. Vincenten will follow-up with that. A
draft of the Alliance Business Plan will be circulated for the end of the year.
The group agreed that our next meeting could be held Sunday morning June 6, 2004 in Vienna in
order to assist others to link into the World Conference. The group also agreed that the 3rd week of
September 2004 would be a good time for Sweden to host the next Alliance workshop.
2003.v043/14.02.01./sec-zev
5
Report
Date:
Present:
Guests:
Absent with notice:
To:
Subject:
1
2004-06-06
Sabine van Eck (The Netherlands), Liisa Joutsi (Finland), Stellina Kiosse and Aghis
Terzipis (Greece), Gabriele Elsäßer (Germany), Elsa Rocha and Helena
Menezes(Portugal), Lotten Strindberg (Sweden), Tania Vandenberghe and Ariane Van
Cutsem (Belgium), Joanne Vincenten (ECSA), Wim Rogmans (ECOSA), Bjarne
Laursen (Denmark), Michael Hayes (UK), Francoise Briand and Odile Finkelstein
(France), Johan Lund (Norway), O. Kalakouta (Cyprus), Rezo Pace-Asciak(Malta)
M. Malinowski-Cieslik (Poland), A. Nicholson (CESP), R.Gofin (Israel)
André Janssens (Communication consultant), Virginie Delwart (Johnson&Johnson
Europe), Morag Mackay (Canada),
Meeting held in Vienna, Austria, June 6, 2003
Welcome and Introductions:
Joanne Vincenten welcomed all to Vienna and thanks Mathilde Sector and Sicher Leben for hosting
this meeting in Vienna. Mathilde Sector could not be present, as she was very much involved in the
th
organisation of the 7 World Conference. J. Vincenten also thanked the participants who came to
Vienna for the ECSA meeting.
Agenda item 8 was moved further up between agenda items 3 and 4. There were no further agenda
changes or additions.
Stellina Kiose: inquired if the next ECSA campaign theme would be decided at this meeting.
Joanne Vincenten: we will attempt to discuss this as part of agenda item 4
Introductions follow, as there are some new participants from the new EU-Member countries.
J. Vincenten thanked everyone for commenting on the white book. Extended thanks were given to
Janice Cave for her reviewing and editing of the document. Thanks also went Johnson & Johnson for
printing.
ECSA participated in an Austrian Press Conference on Child Safety, Tuesday June 8, 2004, launching
nd
the 2 edition of the white book. All were invited to attend.
As it is difficult finding European media ECSA would like to enquire which national country members
would like to host a national press event to promote the white book. Countries interested should follow
up with J. Vincenten.
If required ECSA can provide a PDF version of the White Book to be used on websites. For translation
needs ECSA can offer a word document of the White Book. 20-30 copies will be sent to each
member.
Gabriele Ellsäßer: stated that the mention of playground standards in Germany were missing from the
legislation chart in the white book, they have been in place since 1999.
J. Vincenten: stated that there was no reaction from Germany on this point during the reviewing
process. It will now be noted and updated in the next version.
A warm welcome to all new EU-members followed.
2 Meeting Minutes of November 6 and 7, 2003, Berlin:
Elsa Rocha: noted the following statement for the last minutes. A uniform definition of drowning is
important for purposes of registration, diagnosis and research. The following definition was accepted
at the World Congress on Drowning Amsterdam 26-28 June 2002, and published on the
"Recommendations of the project - World Congress on Drowning": Drowning is the process of
experiencing respiratory impairment from submersion / immersion in liquid".
2004/v046.eco/1401.02/vin-ron 20-08
1
3 Child Safety Action Plans (CSAP)-PHP
Joanne Vincenten provided an overview on who, what, where, when and why
ECSA is co-ordinating the project. 18 member states are participating.. Two countries – France and
Spain- have not sent back the letters of mandate, if these will not come the two countries will be
replaced by Cyprus and Malta.
The funding for the project is 60% EU-funding and 40% ECOSA funding.
In some countries there is also national support for the project (UK, Austria, Norway).
The aim of the project is to create overall child injury prevention, which should be recognised by their
national governments. Standard tools and measures will be used to access the countries level of child
safety, best practice will be collected and provide for countries to develop their national plans. A
capacity building workshop will be offered to the countries to assist with the various stages of the
project. A public report on the project will follow.
As great numbers of forms in relation to financial accountability have to be signed, thus the project has
not started yet. The project will start in September 2004 and will end in winter 2006. This project is
important in order to bring injury prevention on the political agenda in a wide range of countries and
make efforts in injury prevention comparable.
Joanne Vincenten introduced Morag Mackay, director of the Child and Youth Injury Prevention Centre
from the Children’s Hospital of Eastern Ontario, epidemiologist and child injury practitioner as the new
coordinator for this EU- Project for the next two years.
Questions on the project:
Helena Menezes: In Portugal the Health Minister will accept the plan as a governmental plan, but
there will be no financial support. Injury is now first priority, meaning a subsection of the National
Health Plan.
Gabriele Elsäßer:
For Germany it would be better if the plan can be put into the section of Health Promotion. She asks
for an official recommendation of ECSA on EU-level that this will be part of Health Promotion..
Stellina Kiosse: Greece is making a report on the burden of injuries in co-operation with European
Commission. They are constructing a Web board, which also serves as chat platform for injury
prevention scientists and practitioners, all of this as part of the Injury working party for the Public
Health Programme. This board can be part of the ECSA project, meaning having links of both on the
websites.
Joanne Vincenten: As soon as the project gets started we will look at the best communication form.
The expert group will design a core set of indicators for the country assessment stage on childhood
injury prevention and a draft will be sent out to the countries. The signing of the contract with the EC is
close, as there are so many countries involved many legal issues needed to be resolved.
Virginie Delwart: Does ECSA have to pre-finance the project and will get the money back two years
later?
Joanne Vincenten: No, there is a first instalment project.
4 Ministers of Health and Environment Conference – Budapest June 2004
The Budapest Conference at the end of June is the political kick off point for this EU-project. A
Strategic action plan for Europe will be passed and this will be the base for the ECSA Action Plan
Project. A copy of the Budapest Declaration can be found in the Vienna meeting enclosure. Each and
everyone’s support on the national level is necessary to get injury prevention on the European political
agenda. During our fall meeting we will ask countries to share their strategies of meeting with the
national governments to get support.
5 Drowning Campaign
A brief update was provided by country participating in the drowning campaign.
Austria: will continue its drowning campaign using again the media as a partner for active and reactive
media releases. The Austrian drowning spot will be broadcasted in the afternoon programme in July.
Close co-operation has been made with the Austrian Life-Saving Society. They will include drowning
prevention material at their events and training units.
Norway: There are three main actors in Norway being active in drowning prevention, especially
working with refugees. A National Action Plan for Drowning is envisaged by the Norwegian Council of
Drowning Prevention. This plan matches with the National Drowning Campaign and the ECSA
Campaign
2004/v046.eco/1401.02/vin-ron 20-08
2
th
Portugal: is repeating the campaign from last year, as it was very successful. May 18 they had a
videoconference between Faro and Lisbon with a lot of media presence. One part of the campaign are
seminars for local people, CPR-Training, reactive media-releases and activities to draw the attention
to drowning prevention among tourists. Partners are airports, post offices and tourist industry. A
database in corporation with pediatricians and rescue services has been put in place.
Greece: There is no support from Johnson&Johnson in 2004 for a drowning campaign. Greece will
use the material, which was produced in 2003 and will use this where possible (Videos for ships,
leaflets to be distributed on the islands and corporations with the life guarding companies).
Virginie Delwart: Within Johnson&Johnson the National Offices decide what they will support, so there
is no influence from the European level.
The Netherlands: The Consumer Safety Institute makes two year campaigns, June to June every two
years. In 2004 (year 2) the main topic will be open water and child safety - research with municipalities
will be undertaken.
France: They organise a campaign on Drowning Prevention every year. Leaflets and posters are
distributed nationally. In January 2003 a law for pool fencing was launched. This law includes private
houses as well as rented houses. The fee for not having the pool fenced is € 45.000.
Belgium: The focus in Belgium is legislation and new techniques in drowning prevention. There exists
a new electronic surveillance system for swimming pools, which is currently tested.
UK / ROSPA: A Conference on Drowning was held in March 2004.
Czech Republic: A data collection project on drowning (3 year study) has now been completed. Near
drowning is a big problem there, children drown in ponds, buckets for rainwater or being unsupervised
in vacation camps. Further analysis will be undertaken.
Germany: There is a strong corporation with non-governmental institutions. The focus in the drowning
prevention work lies on infants and toddlers, teaching swimming skills and CPR- Training
ANEC: Survey on climbing skills of children in relation to pool advocate, that there will be no European
standards written for bath seats and asks for support from the Alliance in this position and building the
case. The common tenor is “ Bath seats serve no useful purpose” and a joint action will be
undertaken. A request for national cases involving bath seats and child injury will be conducted over
the summer.
6 Play Safety Forum request:
Helena Menezes introduced the Play Safety Forum and its request for supporting a recently drafted
manifesto. (See enclosure 5 of Vienna meeting)
Sabine van Eck: asked how ECSA got involved and expressed her concern of the negative tone of the
document. (Safety people versus manufacturers)
Helena Menezes: answers that this forum wants to bridge the gap and wants to find the balance
between risk and safety and should be seen as an interdisciplinary approach.
Sabine van Eck: wants to include a common goal, which should be the prevention of serious and
deadly accidents/injuries.
Johan Lund: agrees with the manifesto as the risks change for the kids growing up today. He is not
voting for a injury free society.
Gudula Brandmayr: adds that ECSA as an independent entity has to be cautious with the industry so
that it does not become their voice.
Lotten Strindberg: was in favour of voluntary standards that have to be well communicated. People
need to have the information on what standards are for.
Michael Hayes: The focus should not be on the playground, but on the play. Children must have
healthy lifestyle and play is part of it. It is important to be on the inside of these type of developments
with industry and not on the outside, but be aware of what the industry is or will be doing with it.
Helena Menezes: There are three Alliance members part of the forum, the manifesto is not an Alliance
document, but the Alliance can contribute.
Joanne Vincenten: The overall agreement is that the Alliance will participate and that there should be
a comment added that we want to prevent death and serious injury.
7 Alliance structure and operations
Johan Lund from Norway made an appeal to become a full member of the Alliance. So far he has
been an observer, but that status did not make him happy at all. He is dedicated to the subject and
wants to participate for 100% with the Norwegian Safety Forum. Moreover, Norway is a European
country, although not a EU country, but part of Europe and very safety orientated certainly as children
are concerned. Members expressed positive support about the discussion and no negative comments
were raised.
2004/v046.eco/1401.02/vin-ron 20-08
3
Joanne Vincenten stated to look into the matter of membership, but expressed that reimbursement of
travel costs, might be difficult from a non EU country where Commission support is provided.
nd
Cyprus expressed concern that their country statistics are not included in the 2 edition of the white
book. J. Vincenten replied that the WHO database for Europe did not have their stats and that is the
database used for all the data in that report.
Virginie Delwart of Johnson & Johnson made a presentation about business partnerships. First about
the J&J business partnership (see attached presentation); about being the first and current business
partner that supports the Alliance financially. She showed the reasons why the partnership with ECSA
fits with J&J’s values and business interests. She gave some examples of safety initiatives that have
been taken as a result of this partnership. 95% of the Alliance goals have been achieved over the last
three years, but there are more challenges ahead. J&J would like to see other companies participate
as business partners and also wants the Alliance to develop working relationships with organisations
with similar interests. J&J, RAM and Nieuwe Maan are working together to help the Alliance to set up
business partnerships with international companies. J&J emphasised the importance of broader
financial support for the Alliance in order to guarantee its continuity.
After a short lunch break André Janssens from Nieuwe Maan (communications) discussed with the
group the opportunities for business partnerships with international companies. Not all countries are
experienced in working with companies and for some members this would not even be possible. A
quick scan showed that Portugal, Germany, Netherlands, UK, Austria and Belgium already have
business relationships that support the action programs in these countries. It was decided to form a
working committee with these members to exchange experiences and knowledge in best practices.
André will invite members to share information on this. The question was raised by Germany if this
would lead to older age groups (14-18) as a target group for the Alliance. Currently youngsters might
be viewed as a more interesting marketing target group for companies. This is not decided yet, at the
moment all efforts are focusing on initial contacts with companies that comply with the defined criteria
for business and cultural fit indicators. At the moment, serious discussions have begun with IKEA,
Toyota and Volvo. Some concerns were expressed (no tabacco industry) or about specific companies
(or the obesity issues against McDonald’s) but companies that would be totally unacceptable for one
member, would not create any problem for another member. Therefore a lot of policy development to
be done, the exact reason why members will be invited to join the working committee on business
partnerships.
8 Sweden workshop
Lotten Strindberg presented the program for the workshop in Stockholm on September 19-21. The
workshop builds up to the ‘Stockholm Manifesto’ and will take position about safer environments and
how to handle these risks. The ambition of the program is to look behind the figures. Everyone is
welcome to come to Stockholm and participate in this workshop. The venue is a city hotel instead of
going out to the countryside.
9 Announcements
Wim Rogmans joined and thanked all members for their work and initiatives. He thanked J. Vincenten
for her leadership in the Play Safety Forum. He also congratulated her with the advocacy work of the
Children’s Environment and Health Action Plan of WHO and the success of getting injury prevention
nd
as the 2 goal in the declaration that will be accepted at the Ministerial conference in Budapest in
June. W. Rogmans thanked everyone for the contribution given to the Alliance. The Alliance is the
most successful project of ECOSA.
Greece reported, that they have been working on a web board for injury prevention, with interactive
statistics and a web database. The website is pilot tested at the moment.
Johan Lund from Norway announced the European Public Health Association meeting in Oslo in
October, and invited everyone to attend.
Portugal mentioned a health conference to be held in May 2005 contact E. Roche for more
information.
J. Vincenten closed the meeting and gave directions to the world conference centre for the reception
later that day.
2004/v046.eco/1401.02/vin-ron 20-08
4
Workshop programme
Sunday September 19, 2004
12.30-17.00
18.00-20.00
Alliance business meeting
Welcome reception - Stockholm City Hall
hosted by City of Stockholm
Monday September 20, 2004
8.00-9.00
9.00-10.30
Björling Room
Registration
Welcome and opening address- plenary
What risks are our children facing in
Europe? The true stories of how injury impacts the lives
children, families and the community; not just the statistics.
Karin Lindell, Konsumentverket
Ragnar Andersson, Karlstad University
Robert Ekman, Räddningsverket
Per Hamid Ghatan, Karolinska Institute
10.30-11.00
Refreshment break
11.00-13.00
Case study debates
Each session will use a specific case to introduce the
topic, two responders will make brief comments and
then open debate and discussion on this case and
related issues are to follow. A series of key questions
will be posted in each session to guide the discussions
and provide final key statements and solutions to build
the ‘Stockholm Manifesto’.
A. Kid and cars seats - So much good practice not
being used.
Case presenter: Thomas Turbell, Swedish National
Road and Transport Research Institute
Do children up to the age of 3 years have more
protection while travelling rearward in cars?
Responders: Helena Menezes, Portuguese
Association for Child Safety and Injury Control and
Anna Claesson, Volvo
Discussion will follow regarding rearward facing
and other child passenger restraint concerns.
(Child seat products will be on site for interactive
demonstration and discussion purposes)
B. Problem products - Do we get rid of the problem or
can we fix them?
Case presenter: Robert Bell, European Nursery Group.
Prams, strollers, buggies what is going wrong?
Responders: Yvonne Lievens, Consumer Safety
Institute, The Netherlands and John Mason, RAM
Consulting
Discussion will follow on the strollers and other
problem products where design and packaging may
solve the problem. (Strollers, bath seats, baby
walkers, inedibles, medicines and other problem
products will be on site for interactive demonstration
and discussion purposes.)
Björling Room #1
Björling Room #2
11.00-13.00
Klubben Room
C. Playgrounds - Must it be out with the old and
in with the new only?
Case presenter: Harry Harbottle, Richter
Spielgeräte GmbH Germany
Being creative in providing play environments for
children.
Responders: Eleni Petridou, Center for Research and
Prevention of Injuries, University of Athens and Eva-Carin
Banka Johnson, IKEA Sweden
Discussion will follow regarding safe and creative
play environments.
(Play equipment will be on site for interactive
demonstration and discussion purposes)
13.00-14.30
14.30-16.30
Björling Room #1
Björling Room #2
Klubben Room
16.30-17.00
17.00-18.00
Björling Room
19.00-22.30
Lunch provided
Case study debates: repeated from the morning
A. Kids and car seats
B. Problem products
C. Playgrounds
Refreshment break
Key statements and solutions from debates
Report backs from debate session to provide statements
and solutions for drafting the ‘Stockholm Manifesto’
Reception and dinner - Boat tour and Fjäderholmarna
island restaurant, hosted by RAM Consulting
Tuesday September 21, 2004
9.00-10.30
Björling Room
10.30-11.00
11.00-13.00
Björling Room
What changes can we make to create a safer
environment for children?
What Injury Practitioners and Researchers can
do. Ian Scott, World Health Organization
What governments can do?
Erik Hansson, European Commission
Rob Dortland, Ministry of Health the Netherlands
What industry can do?
Dirk Weytjens, Johnson & Johnson
Refreshment break
Summary of solutions, presentation and discussion
of the Stockholm Manifesto
Joanne Vincenten, European Child Safety Alliance (ECSA)
Wim Rogmans, European Consumer Safety Association
(ECOSA)
Close of workshop
* Workshop schedule subject to change
The Stockholm Manifesto
DRAFT
European declaration on child injury prevention.
September 21, 2004
Scientific Evidence
The magnitude of injury as the leading killer of children for every Member State in Europe is
well documented.
§
Whereas the WHO Lancet publication June 2004, “Burden of disease attributable to
selected environmental factors and injury among children and adolescents in Europe,”
stating that childhood injury is the largest disease burden for children compared to any
other disease.
§
Whereas injury is the leading cause of death for child in Europe and occurs at twice the
rate of a death from cancer and 8 times that of a respiratory-related death.
§
Whereas for every child that dies from injuries another 160 children are admitted to a
hospital for a severe traumatic injury and then still another 2000 children are treated in
accident and emergency departments.
§
Whereas the estimate for the overall socio-economic burden of all injuries in Europe is
almost 400 billion Euro annually.
§
Whereas the childhood injury death rate has a difference of 8 times between the leading
EU Member State of Sweden and the lowest EU Member State of Latvia.
Yet injury is predictable and preventable, research has validated proven best practices that do
reduce injury deaths and disability, most often through a combined approach of education,
engineering and enforcement measures.
§
Whereas road accidents have been more than halved with reduced speed limits, traffic
calming, safer car fronts for pedestrians and cyclists, child passenger restraints and
bicycle helmets.
§
Whereas drowning deaths have been reduced with the use of pool fencing and personal
floatation devices (PFD).
§
Whereas burns and scalds have been more than halved with the use of smoke detectors,
water temperature regulators, child resistant cigarette lighters, and clothing that does not
easily catch on fire and burns more slowly.
§
Whereas fall injuries and deaths have been reduced with the use of window and balcony
guards, stair gates and to a lesser extent, protection against falling and the relationship
between height of equipment and impact absorbing surfacing in playgrounds
1
§
Whereas poisonings have also been reduced by one third using child resistant packaging,
safe storage units and education programmes.
§
Whereas choking, suffocation and strangulations have been reduced with product and
environment modifications/redesign that have been researched and prepared for standards
and regulations.
Commitments
Commitments to address injury have been identified in the past by major organisations and
governments.
§
Recalling that, according to the Constitution of the World Health Organisation (WHO) of
7 April 1948, Health is “a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity”.
§
Recalling article 152 of the Treaty of Maastricht (1992) that provides the EU legal
competencies to take action to protect safety and health of European Citizens in order to
“ensure that a higher level of human health protection shall be included in the definition
and implementation of all community policies and activities.”
§
Recalling the Decision No 1786/2002/EC of the European Parliament and of the Council
of 23 September 2002, that “health is a priority and a high level of health protection
should be ensured in the definition and implementation of all community policies and
activities.” As well that “attention should be given to the right of the community
population to receive simple clear and scientifically sound information about measures to
protect health and prevent diseases, with a view to improve quality of life.” And further
that “the community is committed to promoting and improving the health, preventing
disease and countering potential threats to health, with a view to reducing avoidable
morbidity and premature mortality and activity-impairing disability.”
§
Recalling the Decision No 372/1999/EC of the European Parliament and of the Council of
8 February 1999 adopting a programme of community action on injury prevention in the
framework for action in the field of public health (1999 to 2003) and now fully integrated
in the Public Health Programme.
§
Recalling the Directive 2002/95/EC of the European Parliament and of the Council of 3
December 2001 on general product safety states that a “safe product” shall mean any
product which under normal or reasonably foreseeable conditions of use does not present
any risk or only the minimum risks compatible with the product’s use considered to be
acceptable with the a high level of protection for the safety and health of persons taking
into account the categories of consumers at risk when using the product, in particular
children and the elderly.
§
Recalling the United Nations Convention of the Rights of the Child signed on November
20, 1989, sets out in Article 6 that states parties shall “recognise that every child has the
inherent right to life” and shall “ensure to the maximum extent possible the survival and
development of the child” and in Article 24 states parties “recognise the right of the child
2
to the enjoyment of the highest attainable standard of health”, “right to play” and “the
right to a safe environment”.
§
Recalling the signed Declaration and Child Environment and Health Action Plan for
Europe in Budapest, 25 June 2004, by 52 ministers of Health and Environment at the 4th
Ministerial Conference for Health and Environment in which one of the four goals states
that “we aim to prevent and substantially reduce health consequences from accidents and
injuries and pursue a decrease in morbidity from lack of physical activity by promoting
safe, secure and supportive human settlements for all children.”
Recommendations
WHO
§ To encourage and assist countries and organizations to determine and monitor
consistently the size and nature of child injury in their jurisdiction.
§
To facilitate countries and organizations to systematically exchange information on
effective means of prevention and implementation of programs on child injury.
§
To assist in building capacity for countries and regions to address child injury.
§
To work cooperatively with other UN agencies such as the UNECE Transport Division to
strengthen regulations and increase enforcement of child transport measures.
§
To improve the WHO mortality database by providing age group appropriate child injury
data and currently available national data.
European Commission (including candidate countries and EEA)
§
To have child safety integrated into all relevant community policies.
§
To improve data systems at the European level in order to provide population-based
injury data, exposure data, long term consequences post-injury, and rapid information on
emerging issues.
§
To establish a European Agency for home and leisure safety and consumer safety with
special attention to children.
§
To support and fund proven injury prevention measures that reduce child injury deaths
and serious injury in a combined approach of education, engineering and enforcement of
standards and regulations, specifically through:
- development of a European database on good practices in child injury
prevention with accessibility to all.
- consumer involvement in standardization work for balanced representation
- enhanced development and increased enforcement of child safety standards
3
- establish a product safety directive specific to childcare products
- an annual child safety campaign at the European level
Member States
§
To assess the national burden of child injury and adoption of proven best practices to
reduce injury, disability and assure the resources allocated to address the issue is
commensurate with the extent of the problem.
§
To integrate child injury prevention into national public health programmes and prepare
and implement a national strategy on child injury prevention with appropriate action plans
and dedicate resources.
§
To establish government leadership in child injury prevention, including designating a
focal point and facilitating multi-sectoral collaboration with other ministries and
departments, including a coordinating body for exchange and collaboration for all parties.
•
To increase funding to support the development and enforcement of child safety standards
and balanced participation of expert consumer organizations.
•
To provide harmonized child injury data including cause and circumstances, which is age
group appropriate and timely.
•
To develop child friendly communities that enable walking and biking as major modes of
transport and increased public play spaces that balance play value and acceptable risk.
Business
§ To comply with national and European standards and regulations.
• To apply ‘design for safety’ from concept through production, to quality control,
including risk assessment and product approval.
• To improve transparency by confidential sharing of safety testing prior to market
availability and accident reports when on the market.
• To ensure communication between all parties.
• To achieve harmonised standards and regulations within industry worldwide at a high
performance level.
• To have balanced representation in the development and review of standards and
regulations.
4
Non Governmental Agencies (NGO’s)
§
To build and extend proper networks of collaboration with other NGO’s with an interest
in safety and with major stakeholders in business, government and academia.
§
To provide expertise in the field of child injury prevention on what works and on the
implementation of these best practices, standards and regulations in various settings and
cultures.
§
To communicate with consumers on actions that can be taken to reduce child injuries.
5
6
Update list Members European Child Safety Alliance
Austria
Austrian Institute for Home and
Leisuretime Safety / Sicher Leben
Ms. M. Sector
Ölzeltgasse 3, A-1031 Vienna, Austria
Tel: +43 1715 6644 321
Fax:+43 1715 664430
Email: mathilde.sector@sicherleben.at
Denmark
National Institute of Public Health
Dr. B. Frimodt-Møller
Svanemollevej 25
DK 2100 Copenhagen, Denmark
Tel: +45 3920 7776 (ext.310)
Fax:+45 3927 3095
Email: bfm@niph.dk
SAFE KIDS Austria/ Grosse schützen
Kleine
Mrs. Gudula Brandmayr
Auenbruggerplatz 34,
A-8036 Graz, Austria
Tel: +43 316 385 3764
Fax:+43 316 385 3693
Email: kinder.unfall@meduni-graz.at
Estonia
Consumer Protection Board of Estonia
Contact person: Dr. H. Aruniit
Address: Kiriku 4, 15071 Tallinn
Tel.: +372 6201 700
Fax: +372 6201 701
Email: helle.aruniit@consumer.ee
Belgium
CRIOC-OIVO
Mrs. C. Renard
Ridderstraat 18,
B-1050 Brussels, Belgium
Tel: +32 2 547 06 82
Fax:+32 2 547 06 01
Email: carine.renard@oivo-crioc.org
Kind en Gezin (Child and Family)
Dr. Erwin Van Kerschaver
Hallepoortlaan 27
Tel: +32 11 87 09 715
Fax:+32 2 534 1448
Email:
Erwin.VanKerschaver@kindengezin.be
Cyprus
Ministry of Health
Medical and Public Health Services
Dr. O. Kalakatou
10, Marcou Drakou
1449 Nicosia, Cyprus
Tel: +357 22400222
Fax: +357 22400223
Email: ykalak@spidernet.com.cy
Czech Republic
Charles University
Mrs. V. Benešová, md, PhD
Address: Charles University, Vúvalu 84,
150 06 Prague-Motol
Tel.: +420 22 443 5943
Fax: +420 22 443 5941
Email: veronika.benesova@lfmotol.cuni.cz
22-11-04 2004/v030/1400.00 ecsa package
Finland
The Finnish National Rescue Association
(FINNRA)
Mrs. L. Joutsi
Ratamestarinkatu 11
FIN-00520 Helsinki, Finland
Tel: +358 9 4761 1324
Fax:+358 9 4761 1400
Email: liisa.joutsi@spek.fi
France
Ministère de l' Économie, des Finances en de l'Industrie.
Commission de la Sécurité des Consommateurs
Mrs. F. Briand
Cité Martignac,
111, rue de Grenelle
75353 Paris 07 SP, France
Tel: +33 1 4319 5653
Fax:+33 1 4319 5700
Email:Francoise.briand@csc.finances.gouv.fr
Germany
Bundesarbeitsgemeinschaft mehr Sicherheit
für Kinder e.V.
Dr. S. Märzheuser
Heilbachstrasse 30
53123 Bonn, Germany
Tel: +49 228 98 08 56
Fax:+49 228 98 08 60
Email: stefanie.maerzheuser@web.de
United Kingdom
Child Accident Prevention Trust
(CAPT)
Mrs K. Phillips
18-20 Farringdon Lane
London EC1R 3HA, Great Britain
Tel: +44 20 7689 4741
Fax:+44 20 7608 3674
Email: katrina.phillips@capt.org.uk
RoSPA the Royal Society for the
Prevention of Accidents
Mrs. J. Cave
Edgbaston Park, 353 Bristol Road
Birmingham B5 7ST, Great Britain
Tel: +44 121 248 2129
Fax:+44 121 248 2001
Email: jcave@rospa.com
Greece
C.E.R.E.P.R.I.
Athens University Medical School
Department of Hygiene and
Epidemiology
Dr. E. Petridou
Mikras Asias Street, Goudi 75
115 27 Athens, Greece
Tel: +30 210 746 2187
Fax:+30 210 746 2105
Email: epetrid@med.uoa.gr
Luxembourg
Ministère de la Santé
Division de la Medicine Preventive et
Sociale
dr. Y. Wagener
Villa Louvigny
L-2120 Luxembourg
Luxembourg
Tel: +352 478 5544
Fax: +352 46 7527
Email: yolande.wagener@ms.etat.lu
Malta
Ministry of Health
Office of the Director General (Health)
dr. K. Vincenti
Office of the Director General (Health)
Palazzo Castellania 15
Valletta, Malta
Tel: +356 22 99 24 22
Fax: +356 21 25 02 31
Email: karen.vincenti@gov.mt
The Netherlands
Mrs. S. Van Eck
PO Box 75169
1070 AD Amsterdam,The Netherlands
Tel: +31 20 5114 545
Fax:+31 20 5114 510
Email: s.vaneck@consafe.nl
(Northern) Ireland
Royal Society for the Prevention of
Accidents, RoSPA Northern Ireland
Mrs. J. Bisp
Nella House, Dargan Crescent
Belfast BT3 9JP Ireland
Armagh, BT604BA
Tel: +44 28 9050 1160
Fax: +44 28 9050 1164
Email: JBisp@ROSPA.com
Poland
Jagiellonian University, Medical College
Mrs. M. Malinowska-Cieslik Ph.D
Institute of Public Health,
UI.Grzegorzecka 20
31-531 Krakow, Poland
Tel: +48 12 424 1392
Fax:+48 12 421 7447
Email: mxciesli@cyf-kr.edu.pl
Italy
Dr. A.G. Marchi
Salita Madonna di Gretta 19
34136 Trieste, Itly
Via dell'Istria 65/1
34100 Trieste, Italy
Tel: +39 040 422461
Fax: +39 040 422461
Email: agmarchi@tele2.it
Portugal
APSI Portuguese Association for Child
Safety and Injury Control
Mrs. H. Menezes
Vila Berta 7-r/c Esq.
P-1170-400 Lisbon, Portugal
Tel: +351 21 887 01 61
Fax:+351 21 888 16 00
Email: hmenezes@apsi.org.pt
22-11-04 2004/v030/1400.00 ecsa package
Slovenia
Institute of Public Health of the
Republic of Slovenia
Population Health Research Centre
Mrs. M. Rok-Simon M.D.
Trubarjeva 2
1000 Ljubljana
Slovenia
Tel: +386 1 244 1530
Fax: +386 1 244 1447
Email: Mateja.Rok@ivz-rs.si
Spain
Ministerio de Sanidad y Consumo
General Directorate of Public Health
Mrs.T. Robledo de Dios
Paseo del Prado, 18-20
28071 Madrid, Spain
Tel: +34 91 596 4167/8
Fax:+34 91 596 4195
Email: trobledo@msc.es
Sweden
Swedish Consumer Agency /
Konsumentverket
Mrs. L. Strindberg
S-11887 Stockholm, Sweden
Tel: +46 8 429 0571
Fax:+46 8 429 8900
Email:lotten.strindberg@
konsumentverket.se
22-11-04 2004/v030/1400.00 ecsa package
AFFILIATED ORGANISATIONS
OBSERVERS
Europe
ANEC European Association Coordination Consumer Representation in
Standardization
Mrs. T. Vandenberghe
Tervurenlaan 36, box 4
Tel: +32 2 743 2470
Fax:+32 2 706 5430
Email: tania@anec.org
Israel
Hebrew University-Hadassah
Hadassah School Public Health & Comm
MedDept. Social Med, Mother/Child Health
Unit
Dr. R. Gofin MD, MPH
PO BOX 12272
91120 Jerusalem,Israel
Tel: +972 2 677 7502
Fax:+972 2 643 1086
Email: gofin@cc.huji.ac.il
CESP Confederation of European
Specialists in Paediatrics
Dr. A. Nicholson
Our Lady of Lourdes Hospital,
department of Paediatrics
Drogheda
Co.Louth, Ireland
Tel: +353 41 983 7601 ext. 2464
Fax:+353 41 983 3868
Email: alf.nicholson@nehb.ie
International
ISCAIP International Society for Child
and Adolescent Injury Prevention
Mrs. M. Dennis
C/o Healthcare Alliances
Britannia House
11 High Street
Cowbridge, Vale of Glamorgan
CF71 7AD, UK
Tel: +44 1446 774864
Fax: +44 1446 774864
Email:
mdennis@healthcarealliances.co.uk
22-11-04 2004/v030/1400.00 ecsa package
Norway
Norwegian Safety Forum
Department of Preventive Medicine
Mr. J. Lund M.Sc.
PO BOX 2473 Solli
N-0202 Oslo, Norway
Tel: +47 22 23 4422
Fax:+47 23 28 4311
Email: johan.lund@fnh.no
Switzerland
Swiss Council for Accident Prevention (BFU)
Research Department
Dr. Uwe Ewert
Laupenstrasse 11
CH-3001 Bern, Switzerland
Tel: + 41 31 390 22 06
Fax: + 41 31 390 22 30
Email: u.ewert@bfu.ch
22-11-04 2004/v030/1400.00 ecsa package

Consumer rights for child safety products- European Child Safety Alliance

Transcription

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