Dr Rimell and his colleagues1 deserve accolades for their exemplary research on childhood choking, which appears in this issue of JAMA. It is valuable to have suggestions for changes in regulations based on specific data and to have evidence that long objects with round components are hazardous even when they meet current standards. A staff report to the Consumer Product Safety Commission (CPSC) in 1987 identified as hazardous not only round (spherical) but also teardrop-shaped objects and cones and pointed out that many objects involved in chokings were too large to fit into the test cylinder,2 suggesting a need to increase the minimum size specified in the regulations. Rimell et al also found 14 objects that met current standards but caused choking deaths and suggest increasing minimal size standards. Long objects with round components could also be tested using the test fixture for rattles, which is larger in
Baker SP, Halperin K. Designing the Death Out of Balloons. JAMA. 1995;274(22):1805. doi:10.1001/jama.1995.03530220071036
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