Food legislation taken from internet funnies

We’ve all giggled over those stupid product warning labels that seem written for people inconceivably dumb. We can only imagine the wild and crazy lawsuits behind them and the foolish predicaments people must have gotten themselves into. While they’re a source of endless internet jokes, when health officials use them as templates for food legislation to protect us from ourselves, they’re really taking this parental role thing too far.

Today, the Gotham Gazette in New York City reported of a bill introduced this past month* by the City Council in response to food so dangerous, that a 2-year old child died while eating it last year.

The food was a grape.

Council Member Domenic Recchia, who represents parts of Brooklyn, introduced bill #807, which would mandate any entity in the City selling food to post signs or labels on all bite-size foods with warnings that they pose a choking danger for children under five years of age.

He told media that the bill could raise awareness of foods that are dangerous for children. “A lot of parents don’t have any idea what choking hazards are,” he said. “They would never think of a grape as dangerous.”

According to the legislation, beginning on July 1, 2009, each year the City Department of Health and Mental Hygiene would “create a list of foods that it determines pose a significant choking hazard to children under the age of five.” Thereafter:

c. It shall be unlawful for any person to sell or offer for sale any food designated by the department under subsection b to be a food posing a significant choking hazard without displaying the following label in conspicuous and legible type: WARNING: CHOKING HAZARD FOR CHILDREN UNDER 5 YEARS OF AGE. ADULT SUPERVISION REQUIRED.

d. Any person who violates subdivision c of this section or any of the regulations promulgated thereunder shall be liable for a civil penalty not to exceed two hundred and fifty dollars for each violation.

e. The department and the department of consumer affairs shall enforce the provisions of this section. A proceeding to recover any civil penalty authorized pursuant to subdivision d of this section shall be commenced by the service of a notice of violation returnable to the administrative tribunal established by the board of health where the department issues such a notice or to the adjudication division of the department of consumer affairs where the department of consumer affairs issues such a notice. The notice of violation or copy thereof when filled in and served shall constitute notice of the violation charged. The administrative tribunal of the board of health and the adjudication division of the department of consumer affairs shall have the power to render decisions and to impose the remedies and penalties provided for in subdivision d of this section, in addition to any other remedies or penalties provided for the enforcement of such provisions under any other law including, but not limited to, civil or criminal actions or proceedings.

Education versus legislation

As everyone at pediatricians’ offices and emergency rooms well know, very small children will put practically any small object into every orifice they can — all in the split second that their parents aren’t looking. But when the object blocks the airway, children can choke. No one denies this very real danger. According to the Centers for Disease Control and Prevention, 160 children ages 14 years or younger died from an obstruction of the respiratory tract due to inhaled or ingested foreign bodies in 2000. Of these, 41% were caused by food items and 59% by nonfood objects. Thousands more children were treated in emergency rooms for choking episodes.

As Dr. Martin Belson, a board certified pediatrician and pediatric emergency physician, explains at Kid Emergencies, most aspirations of a foreign object occur in toddlers between 6 months and 3 years of age. The 2004 National Vital Statistics Report from the CDC reported that 58 infants under one year of age died after an object had lodged in their airway or esophagus. While the numbers are low, every case is, of course, tragic.

Intense education efforts by a multitude of medical professionals and professional health organizations** have long worked to warn parents to keep small objects away from very young children, especially because of the choking danger, and offered safety precautions to help prevent choking when children begin to eat table foods. National Safe Kids and the American Academy of Pediatrics have given a long list of foods that can be potential choking risks for young children, including hot dogs, apple chunks, raw vegetables, cheese, cherry tomatoes, olives, marshmallows, caramels, sunflower seeds, cherries, raisins, peanut butter, chips, M&Ms, popcorn, jellybeans, and more.

Even more nonfood objects can pose a choking danger for young children, from coins, buttons, marbles, balls, balloons, watch batteries, tiny toys and toy parts, jewelry, paper clips, to office and art supplies.

The bottom line, any object small enough to fit through a 1 ¼-inch circle or is smaller than 2 ¼ inches long is unsafe for children under 4, according to Kid Source.

Weighing the costs and effectiveness

“It's always a good idea to protect kids,” said one supporter of the legislation. But even the best of intentions aren’t always a good idea in practice. As much as every parent and healthcare professional wants to prevent every needless loss of life, are store warning labels likely to be effective? And are there downsides that deserve consideration?

Practically every edible food could be served in small enough pieces to pose a choking hazard, which means virtually any food sold could potentially be required to come with a warning. In its 2000 “Economics of Food Labeling” report on the experience of national food labeling policies, the USDA Economic Research Service said that a large number of warnings typically cause consumers to disregard them completely, leading many people to not act on the warnings. When every food is plastered with warnings, no one will ready any of them.

Making food stores responsible for warning adults and liable for pediatric chokings also come with costs. Business’ costs of labeling, complying with governmental oversight, liability insurance and defending lawsuits are passed onto all consumers in higher food prices, reported the ERS. With families already struggling with rising food costs, the effects on the health and well-being of children are important considerations. Other costs of governmental label policies on taxpayers also must be considered, which include paying for expanded government agencies to establish label standards, and for monitoring and enforcement. As reported by the Gotham Gazette and New York Sun, no cost analysis of the bill has been done by Recchia’s office.

Most aspiration episodes occur when normal children are in their own homes, under their parents’ care, according to CDC National Vital Statistics. This suggests that the potential privacy costs of warning labels could be especially burdensome. Think about that for a moment. As the legislation demonstrates, and the council members stated, they believe parents don’t know that small objects can choke a child and that government knows better than parents how to protect children. Since most chokings occur in homes, the next logical step is that the government will feel justified to monitor private homes of small children.

For their protection.

© 2008 Sandy Szwarc

* Check out the other legislation. Introduced by Council member Peter Vallone: Intro 799, calling for the creation of a government database, to be overseen by the New York Police Department and the Department of Health and Mental Hygiene, that would keep tabs on the “emotionally disturbed.” A spokesperson said the surveillance system would help officials identify people who need help. It appears NYC is already expanding its electronic surveillance system which has been monitoring residents' blood sugars since last year, as covered here.

** Choking Prevention Resources for Parents

Kid Source
choking safety and prevention

Kids Emergencies
choking prevention, when to seek medical care, how to perform Heimlich in babies and children

American Academy of Pediatrics
toy safety guidelines
choking prevention and first aid

American Red Cross The Red Cross
toys and choking safety

Consumer Product Safety Commission
toy safety and choking hazards

National Safety Council
baby-proofing your home