LAST year parents, grandparents, and other caregivers spent $4.9 billion on cribs, cradles, baby carriers, car seats, high chairs, strollers, and other products for infants and toddlers. They were paying for things that were not widely used fifteen or twenty years ago: lightweight portable cribs that easily collapse for storage, car seats that double as baby carriers, oversized strollers for parents who jog. These products, however, are often hazardous. Last year more than 65,000 children were taken to emergency rooms for injuries associated with products for infants—yet most parents are unaware of the dangers.
Because the infant-products industry is now consolidated in the hands of a few large companies, because distribution is widespread over the Internet and through huge retailers such as Wal-Mart and Babies 'R' Us, and because magazines that target parents have proliferated, manufacturers can rapidly saturate the market with new products. By the time a product is found to be dangerous and recalled, hundreds of thousands or even millions of units may already be in use.
The Consumer Product Safety Commission is the federal agency charged with ensuring the safety of consumer goods. Last year the CPSC recalled ninety-five toys and infant products, adding up to tens of millions of units. Recalls have included certain models of Cosco tandem strollers , after 3,000 complaints that the locks on the folding mechanism failed. This could cause the stroller to collapse unexpectedly, and it resulted in injuries to more than 200 babies, including head injuries and lacerations requiring stitches. Also recalled were some Evenflo Snugli soft infant carriers, after thirteen reports that babies had fallen through the leg openings, and seven million Graco infant swings made before November of 1997—after 181 falls were reported, twenty-two infants were caught at the neck or the chest, and six children died.
When the CPSC initiates the recall of a product, it generally persuades the manufacturer to notify retailers that the product can no longer be sold and to issue a joint press release specifying why the product has been recalled and what people who own it should do (for example, stop using it and request further instructions from the company). The CPSC sends these press releases to television stations, magazines, and newspapers, and also makes them available on its Web site, at www.cpsc.gov (the commission's hotline phone number is 800-638-2772).
On the afternoon of May 12, 1998, in Chicago, a sixteen-month-old, Danny Keysar , was put down for a nap in a Playskool Travel-Lite portable crib by his day-care provider, Anna. When Anna checked on Danny a little while later, she found that the crib had collapsed while he was standing, trapping his neck in the V of its folded rails. Danny was no longer breathing. Though the toddler weighed only twenty-five pounds, the rails collapsed under his weight, folding shut at the center hinges.
Anna had been caring for the child in her home for ten months, and as a licensed day-care provider, she was required to undergo periodic safety inspections. Illinois inspectors had been to the home just eight days before the incident occurred. After Danny's funeral a newspaper reporter discovered that his death was not an isolated incident: four other children had died in Playskool Travel-Lite cribs. (One other child died three months later.) The government had deemed the Travel-Lite dangerous and had ordered it off the market five years earlier, in a product recall. But it was not the only portable crib that had been recalled. From 1993 to 1997 more than 1.5 million portable cribs with a similar design (center hinges on the top rails)—marketed by other companies whose names parents associate with good products for children, such as Baby Trend , Century Products , and Evenflo —were recalled (see the CPSC Web site for model numbers). In 1991 an eleven-month-old in Los Angeles became the first baby known to have died in one of these cribs, and Danny is believed to have been the twelfth.
After Danny died, his parents, Linda Ginzel and Boaz Keysar (both professors at the University of Chicago), founded Kids in Danger (www.kidsindanger.org), a nonprofit organization that is dedicated to teaching parents how to protect their children from unsafe products. Ginzel and Keysar initiated and championed the Children's Product Safety Act , which was signed into law in August of last year by the governor of Illinois, George Ryan. The law makes it illegal to sell or lease a children's product that has been recalled, and ensures that recalled products are not used in licensed day-care facilities. Hailed as model legislation by the CPSC, the law was enacted in Michigan last June.
HOW did such a product make its way to store shelves in the first place? When I called the CPSC for an explanation, Russ Rader, the public-affairs officer, told me that his agency was prohibited by the Consumer Product Safety Act from releasing all of the product-specific information I wanted. For thorough answers I turned to the Freedom of Information Act , which provides the public with direct access to documents held by federal agencies.
I filed a request for documents on Baby Trend, Century Products, Draco (not to be confused with Graco, another manufacturer of products for infants), Evenflo, and Playskool portable cribs. It was months before the documents arrived. Section 6(b) of the Consumer Product Safety Act was largely to blame for this delay. Sometimes referred to as a "reverse FOIA,"6(b) requires the CPSC to allow the manufacturer an opportunity to comment on the information (including testing data, consumer complaints, warranty claims)that the CPSC plans to release in response to a FOIA request if the company is identified by name. The CPSC is the only health-and-safety agency with such a restrictive statute.
Over the next year I filed dozens more requests for CPSC files on products certain models of which had been associated with the injury or death of children, including Safety 1st bed rails and bath seats, Century TraveLite Sport strollers , Century Lil'Napper infant swings, Baby Bjorn infant carriers , Playskool 1-2-3 high chairs , and Cosco cribs , toddler beds, and infant swings. Most of my requests were answered within three months. But the files had obviously contained information that someone didn't want me to see: individual pages or entire documents had been removed, and sentences had been deleted by hand, with swipes of a black felt-tip pen.
Censorship notwithstanding, the files told a story that the official recall press releases had failed to reveal. Thick with the minutiae of childhood death (autopsy reports, notes of police investigations, pictures of dummies arranged in products to simulate the death scenario, a grandmother's letter describing how her grandson had been caught in the restraint straps of an infant swing and nearly strangled, a CPSC engineer's report concluding that an infant carrier still on the market presented a risk to children), the files described in excruciating detail how children had been injured or had died.
What struck me first about the CPSC files was the frequency of stories like Danny's. A file on certain models of the Graco Converta-Cradle included seventeen investigation reports of incidents, involving nine deaths. A letter to me from the Freedom of Information officer at the CPSC clearly stated that more incidents had occurred but that 6(b) and other Freedom of Information exemptions prevented him from releasing those files to me. The file on baby carriers described 185 incidents from 1990 to 1999, most of them falls. The file on infant swings described fifteen asphyxiation deaths.
One after another, the stories played out the same way. A baby was injured or died at home or at a day-care center. The CPSC was notified. When the CPSC had accumulated sufficient information to suggest that a product was associated with a systematic pattern of injuries or deaths, the agency deemed the product too hazardous to sell, and recalled it. Whereas the Food and Drug Administration has the budget and the authority to test products before they are put on the market, and the National Highway Traffic Safety Administration has extensive authority to set mandatory safety standards for motor vehicles, the CPSC can do little to prevent inadequately tested products from being sold.
THE U.S. Consumer Product Safety Commission was born out of the consumer movement of the late 1960s and early 1970s. In 1972, against the wishes of President Richard Nixon, Congress enacted the Consumer Product Safety Act, establishing the CPSC as an independent federal regulatory agency. The CPSC was endowed with broad powers: to create mandatory safety standards for consumer products, to collect and maintain a national database of product-related injuries and deaths, to recall hazardous products, and to ban products that could not be made safe by a standard.
In 1981 President Ronald Reagan pushed for and won from Congress changes that eroded the agency's authority. For example, the CPSC was restricted in its ability to establish mandatory safety standards for products if their manufacturers agreed to set standards voluntarily. It is Reagan's legacy that few durable baby products are regulated by mandatory government standards today; chief among them are car seats and cribs. (Car seats are regulated by the National Highway Traffic Safety Administration.) Safety standards for almost all others are voluntary.
Safety standards specify which hazards a manufacturer must address and how a product must be tested. A manufacturer can decide to comply with voluntary standards or not, as the term implies. For some products, such as front and back baby carriers, no voluntary standard exists. A committee began work on a standard for plastic carriers with hard handles in November of 1997; it was not finished until July of this year. Few parents and caregivers know this. Nor do they know that since 1996 more than 2.8 million baby carriers of this type have been recalled, all for the same reason: the handles unexpectedly unlatch, and the infant can fall to the ground. The CPSC has reports of more than 3,000 unlatching incidents and more than a hundred injuries, including skull fractures and concussions.
Most standards are "in development" for two to five years. During this time millions of units might be sold. Standard-setting rarely keeps pace with manufacturers' marketing departments, so new products are the least likely to have been tested according to a uniform standard. Parents take safety for granted, wrongly assuming that the product wouldn't be on the market unless it had passed rigorous government tests.
The Draco All Our Kids portable crib underscores the danger of having voluntary (as opposed to mandatory) safety standards and the CPSC's lack of pre-marketing testing authority. Draco, a Taiwanese company that maintained a small office in California, sold 13,000 portable cribs from 1992 to 1994. The CPSC was alerted to a problem in October of 1994, when a Rhode Island mother reported that her toddler was standing in his crib, leaning on the top rail, and fell when the rail collapsed. The child sustained minor injuries. At the time, CPSC regulators were well aware of the dangers posed by many other brands of portable cribs; the Playskool Travel-Lite had already been recalled, and others were under investigation.
A Draco employee told CPSC investigators that the company had subjected "prototype samples" of the All Our Kids crib to the structural-integrity test specified by the voluntary standard for play yards and portable cribs: manufacturers' engineers were to apply a fifty-pound vertical force on each of the crib's top rails, at all locations considered likely to fail. According to a letter from the company to the CPSC, Jerry Teng, the president of Draco, and his chief engineer, John Wang, had supervised the development and testing of the All Our Kids crib. But when the CPSC asked for proof of this testing, the company had little to provide, explaining that most of the development was done in Taiwan.
By the time the CPSC recalled the crib, in 1996, Draco had gone out of business, the California office had been vacated with no forwarding address, and Teng had apparently moved back to Asia.
During a recall investigation most large manufacturers can demonstrate to the CPSC that their product complies with a voluntary safety standard—if a standard for that product exists. But voluntary standards often require only minimum levels of performance and fail to address all the known hazards. It is virtually impossible for a parent to know which hazards have been foreseen and forestalled: this information appears nowhere on a product.
Safety standards for infant products are written under the auspices of the American Society for Testing and Materials , which stipulates that all stakeholders (manufacturers, consumer advocates, and the CPSC) must participate in standard-setting discussions. Twice a year committees meet for four days to hash out safety standards. The same 1981 Consumer Product Safety Act amendment that limited the CPSC's right to set mandatory standards requires the agency to assist in the development of voluntary standards. Manufacturers and consumer advocates have a vote, but CPSC representatives do not. At a meeting about hard-handle carriers last February, attendance was typical: twenty-eight manufacturers, their consultants, and staff from their testing labs; seven consumer advocates; one retailer; and one CPSC regulator.
Bath seats, which are designed for bathing an infant in a regular bathtub, illustrate how inadequate this process is. A bath seat, made of plastic, is affixed to the bottom of the tub with suction cups. The baby's legs straddle a plastic post attached to a chest-high plastic ring that surrounds him. The baby can hold on to the ring for support. The CPSC estimates that about a million bath seats a year are sold in the United States—one for every four live births.
Bath seats hit the U.S. market in 1981, with no voluntary safety standard in place. The CPSC first learned of a bath-seat drowning in 1983. By the end of 1994, with eighteen fatalities having been reported, the commission requested that the industry begin work on a voluntary bath-seat standard. Paul Ware, of Safety 1st, was elected to chair the safety-standard committee. Safety 1st is a major player in the bath-seat market, and a safety standard might require a redesign of the product.
The CPSC believed that two features of bath seats were contributing to the majority of deaths: leg openings that were larger than they needed to be, and suction cups that didn't always do their job. Instead of straddling the plastic post, an infant could fit both legs through one leg opening and then slip through and drown—a phenomenon called "submarining." The agency pushed Ware's committee to prevent such incidents by incorporating a maximum leg opening into the standard. The suction cups were hazardous for two reasons: they came off too easily, and if the bottom of the bathtub was covered with an anti-skid strip or appliqué, the suction cups didn't always stick. Without adequate suction the bath seat was more likely to tip over. The CPSC asked Ware's committee to address these issues, too.
In April of last year, after five years of work, during which time forty-three more infant deaths were reported (including at least ten associated with the Safety 1st bath seat), the bath-seat committee approved the safety standard. It did not call for any significant structural changes:the leg openings are just as wide, and the suction cups are just as likely to detach. In other words, the committee disregarded the CPSC's requests, the arguments of consumer advocates, and the continuing death toll. The product is as dangerous as it ever was: bath-seat drownings remain stable at a rate of about eight a year.
How can companies market such a dangerous product? They lay the blame for drownings on irresponsible parents, arguing that incidents happen because children are left alone. Parents believe they should never leave a child unattended in a bathtub, yet data on bath-seat drownings indicate that too many caregivers do exactly that. Thinking that a baby is safe in a bath seat, a parent leaves for a minute to answer the phone or to respond to another child. In fact, according to Clay Mann, a professor of pediatrics at the University of Utah who is affiliated with the Intermountain Injury Control Research Center , bath seats increase the probability that a caregiver will leave a child unattended in a bathtub. By providing a "hands-free" support for the baby, bath seats foster the impression that it is safe to leave a child alone "just for a minute," and actually increase the likelihood that a child will drown.
Most large baby-product manufacturers appear to be cognizant of these dangers, and have avoided the bath-seat market altogether. It is ironic, then, that a leading bath-seat manufacturer is named Safety 1st. "One provision CPSC had manufacturers agree to is that they would never put on the outside of the box that the [bath seat] is a 'safety device,'" a CPSC regulator says. "But we couldn't do anything about the name Safety 1st.... People just look at their box and look at the name of the company and assume it is a 'safety' product."
On July 25 the Consumer Federation of America and eight other consumer groups filed a petition with the CPSC, asking the agency to ban the product completely, arguing that it poses "an unreasonable risk of injury and death to children."
The risks associated with consumer products will never be completely eliminated. People will always manage to be injured by seemingly innocuous products such as lawn ornaments and videocassette recorders. The problem is not how to prevent deaths that occur in unforeseen, highly improbable circumstances. Rather, the problem is how to fix a regulatory system that allows so many babies to die in brand-name products before and after the products are recalled. These deaths were not unforeseen, and more are certain to occur. Manufacturers who fail to test their products sufficiently and a government agency plagued by inadequate funding and restrictive statutes are responsible.
In 1997 a Government Accounting Office report noted that the Consumer Product Safety Commission had carried out its mission with a budget of $42.5 million, a decrease of 60 percent since 1974 (adjusted for inflation), and a staff of 480—43 percent fewer positions than in 1974. Today the agency's budget is a mere $50 million, and its staff remains frozen at 480. At the same time, many of the industries the CPSC regulates have grown rapidly—among them, home-improvement equipment, snowmobiles, scooters, and baby products. Clearly, the agency needs more funding to carry out its work. "If I could double our budget," says a CPSC regulator, "the agency would be stronger." At the top of the wish list: funds to hire more engineers and lawyers and to build more-sophisticated testing labs. In the meantime, manufacturers continue to pump new baby products into the retail pipeline, and consumers continue to buy them.