Expert Commentary

Seasonal holiday injuries: A research roundup

Holidays are a time for celebration, but also a source of injuries. Several research studies examine both common and uncommon types and sources of seasonal holiday injuries, which usually peak on the week after Thanksgiving and continue until the end of the year.

a ladder with christmas lights
(Generated by DALL-E with directions from Naseem S. Miller)

Winter holidays bring celebrations, family traditions, light decorations, special foods and delicacies, and indoor and outdoor activities.

But they can also bring injuries and health problems. Research shows a range of injuries in kids and adults stemming from swallowing Christmas ornaments and decorations, falling from a ladder when putting up lights — or falling from Santa’s lap, suffering burns from touching the candles on a menorah or from biting into a hot deep-fried donut. In some, binging on alcoholic drinks can induce atrial fibrillation, leading to a condition known as “holiday heart syndrome.”

Each year, nearly 18,400 people visit emergency rooms because of accidents with Christmas decorations, according to USAFacts, a non-profit organization that provides U.S. data and reports, using data from the Consumer Product Safety Commission. The peak of those injuries is usually the Sunday after Thanksgiving.

To be sure, compared with other holidays such as Memorial Day, Fourth of July and Halloween, Christmas has a lower number of injuries, a 2010 study found. But seasonal holiday injuries and health issues make headlines each year.

Earlier this month, a Michigan woman suffered significant burns after her robe caught fire at a church’s Christmas event, reported Hometown Life, a Gannett-owned publication. “Someone put a candle in the wrong place,” the fire chief told the news outlet. A 9-year-old boy suffered injuries after falling from a float in the West Alabama Christmas Parade, according to WVUA 23 News. And ABC News ran an explainer about holiday heart syndrome.

For journalists looking to inform their audiences about health-related holiday topics, we’ve gathered several studies. They’re listed in order of publication date.

Research roundup

Enjoy the Holiday Spirit, Not the Holiday Heart
Ali Syed, Benjamin D. Seadler, David L. Joyce. The Journal of Thoracic and Cardiovascular Surgery, January 2023.

Alcohol is typically part of holiday celebrations and gatherings in Western society. Short-term alcohol use in excess and binge drinking are linked with memory loss, impaired judgment, unintentional injury, violence and driving under the influence.

But a less commonly known consequence of binge drinking is alcohol-induced atrial arrhythmia, known as “Holiday Heart Syndrome,” which was first described in the 1970s, the authors write. (In the United States, 5% to 10% of new atrial fibrillation diagnoses are related to alcohol abuse.)

Symptoms include palpitations, shortness of breath, anxiety, weakness and chest pain.

The authors note that the exact biochemistry of the syndrome is unknown, but the correlation between atrial fibrillation and binge drinking is “undeniable.”

Avoiding A Crisis at Christmas: A Systematic Review of Adverse Health Effects of ‘Chrishaps’ Caused by Traditional Hazard Sources and COVID-19
Ursula Wild, David M. Shaw, Thomas C. Erren. Australian and New Zealand Journal of Public Health, February 2022.

This study aims to find out “which hazards have been scientifically associated with old Christmas essentials such as decoration, gifts, menus, and Santa himself, as well as new challenges associated with COVID‐19?”

The authors examined the findings of 30 studies, most of which were case reports or retrospective analyses, which are types of studies that examine data collected in the past.

The various hazards of Christmas included allergic reactions to poinsettias, Christmas trees and candles; swallowing of Christmas decorations; and falling from ladders, roofs and furniture. In one case, a patient had a supposed case of cyanosis — a condition where the skin, lips and nails turn blue — after receiving a blue bed linen as a Christmas gift.

Christmas dinners can also pose risks, such as higher cholesterol levels and weight gain, the authors write. Also, “two other risks from eating were documented: abdominal pain after eating without chewing and eating a piece of Christmas cake together with a plastic robin,” which was part of the cake decoration, they write.

Pediatric Ingestions of Christmas Past, Present, and Future: A Review of Holiday Trends, 1997 to 2015
Patrick T. Reeves, Jayasree Krishnamurthy, Eric A. Pasman and Cade M. Nylund. Clinical Pediatrics, February 2019.

The authors use National Electronic Injury Surveillance System data from 1997 to 2015, focusing exclusively on cases of children, up to 17 years old, who went to an emergency department due to ingesting Christmas decorations, including ornaments, bells and candles during December and January.

There were an estimated 22,224 such cases over the period studied. Children aged 2 and younger accounted for 84% of the cases. Almost 96% were either treated and released or examined and released without treatment.

The peak of such injuries occurred during the Christmas week.

 “Future advocacy efforts might focus on improving social awareness, parental education, or even federal oversight with regard to these possibly dangerous decorations,” the authors write.

“Oh the Weather Outside is Frightful”: Severe Injury Secondary to Falls While Installing Residential Christmas Lights
Michael R. Driedger, et al. Injury, January 2016.

The study examines the health outcomes of 40 patients in Canada who were admitted to a level 1 trauma center from 2002 to 2012 with severe injuries suffered due to falling while installing Christmas lights. The researchers found this activity can result in life-altering injuries.

In total, 95% of the patients were men with a mean age of 55. Most of the falls (65%) were from ladders and 30% of the patients fell from a roof.

The most common injury was to the head and torso. About 43% of the patients had spine injuries.

“Given the heights associated with this activity, as well as the often hazardous weather conditions, adherence to safety precautions is essential,” the authors write.

Seasonal Foreign Bodies: The Dangers of Winter Holiday Ornamentation
Andrew T. Trout and Alexander J. Towbin. Pediatric Radiology, October 2014.

Children can suffer minor or severe injuries if they swallow winter holiday decorations and ornaments. These injuries mostly occur in children under 5.

In this “pictorial essay,” the authors provide radiology images of a wide range of holiday ornaments they’ve seen in children, including whole glass baubles, large and small, metal hooks used to hang ornaments on trees, small plastic ornaments, individual Christmas lights and Hanukkah decorations, including spinning tops and foil-wrapped coins.

Radiologists play a key role in identifying these foreign bodies in children, the authors write.

“Around the winter holidays, ornaments and decorations can become a source of foreign bodies for pediatric patients, and familiarity with the appearance of these seasonal foreign bodies can be helpful in their identification,” they write.

Jewish Holidays and Their Associated Medical Risks
Jacob Urkin and Sody Naimer. Journal of Community Health, June 2014.

This study summarizes the findings from the existing literature regarding the health hazards related to celebrating Jewish holidays, including Rosh Hashana, Yom Kippur, Passover, Sukkot, Purim and Hanukkah.

The authors highlight several injuries related to Hanukkah, which lasts eight days — starting in late November or in December — and is observed by lighting candles on a candelabrum called a menorah.

“Most of the injuries in Hanukkah are related to burns in children who were carelessly handling lighted candles,” the authors note.

Children often receive foil-wrapped chocolate coins, or gelt, during Hanukkah. Another source of injury is children ingesting the foil covering gelt.

The most popular sweet during Hanukkah — deep-fried donuts called sufganiyot — can be a source of burns in the mouth.

“We assume that the reason for these injuries is that the fluid cream, jam or caramel at the center of the pastry tends to heat much quicker than the surrounding baked dough, especially when heated in the microwave oven. Then, without sensing its extreme heat at the center, the hungry subject will bite into burning hot fluid,” the authors write.

Epidemiology of Pediatric Holiday-Related Injuries Presenting to U.S. Emergency Departments
Anthony D’Ippolito, Christy L. Collins and R. Dawn Comstock. Pediatrics, May 2010.

The study investigates eight major holidays in the U.S. and finds that among children younger than 19, approximately 500,000 holiday-related injuries were treated at emergency departments between 1997 and 2006.

Labor Day, Memorial Day, Fourth of July and Halloween were the holidays with the highest number of injuries per year overall. Christmas, in fact, had the least number of injuries.

Among the study’s other findings:

  • Overall, boys sustained 62% of the injuries.
  • Nearly 30% of injuries were in children younger than 5.
  • The most common injuries were cuts, bruises, fractures and sprains.
  • Nearly 66% of the cuts were to the face.
  • The greatest proportion of deaths occurred around the Fourth of July and New Year’s.

“Parents should closely supervise children who are younger than 5 years on Thanksgiving and Christmas when the proportions of injuries were significantly greater among these younger children compared with the other age groups,” the authors write. “On New Year’s, those aged 15 to 19 years had a significantly greater proportion of injuries compared with all other holidays.”

The BMJ Christmas issue

The BMJ, a prestigious medical journal, has a well-established annual Christmas issue that includes a mix of light-hearted features and peer-reviewed research. Below are highlights from this year’s issue:

  • One study makes the case for the Barbie doll to expand her range of medical and scientific professions.
  • Another study draws a link between a new Doctor Who episode shown during the holidays, especially Christmas Day, and lower death rates in the following year across the UK.
  • To the relief of coffee drinkers, a study finds that coffee machines are not responsible for spreading disease in hospitals.
  • A small study finds putting a chair beside a patient’s bed in the hospital room nudged physicians to sit during the visit, which in turn resulted in higher patient satisfaction.
  • If you’re a fan of the Great British Baking Show, you’ll appreciate this study, which examines the health benefits and harms of Christmas recipes on the show. Results: you can have your cake and eat it too.
  • And if you’re popping the cork on a sparkling wine bottle on New Year’s Eve, be careful, because cork eye injuries can be significant, according to this study. It takes 0.05 seconds for the cork to travel from the bottle to your eye, the authors write. They also share a useful guide for opening a bottle of sparkling wine.

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