Making an Impact

A world leader in pediatric injury research, the Center for Injury Research and Policy (CIRP) works to reduce death and disability due to injuries through research, education, advocacy and advances in clinical care. Effects of the research conducted at CIRP can be felt at local, national and global levels. From design changes in consumer products to new public policy, CIRP's influence is leading the way to a safer world.

Biomarker of Concussion Recovery in Children

Dr. Ginger Yang and her team, in collaboration with Dr. Elaine Mardis from the Institute for Genomic Medicine and Dr. James MacDonald from Sports Medicine, recently completed a pilot project, funded by The Abigail Wexner Research Institute at Nationwide Children’s Hospital and The Ohio State University Discovery Theme Initiative on Chronic Brain Injury. The project aimed to longitudinally monitor salivary expressions of a panel of microRNAs (miRNAs) over time in concussed children ages 5-17 years to identify biomarkers that can detect concussed children who are at risk for persistent post-concussion symptoms (PPCS). This project found:

  • Of the 91 miRNAs expressed above background levels, 13 salivary miRNAs were significantly upregulated post-concussion in children with PPCS compared to those without PPCS, suggesting that salivary miRNAs may serve as an objective prognostic biomarker for PPCS.
  • The expression levels of the 13miRNAs that were differentially expressed in the two groups were consistently higher in children with PPCS than those without PPCS across the three timepoints, except for one miRNA. 
  • Among the 13 miRNAs identified, one was also identified in a prior study, with significantly different expression levels between children with and without PPCS.

Learn more here.

The Make Safe Happen™ App

The Center for Injury Research and Policy (CIRP) at Nationwide Children’s Hospital developed a mobile app to help families make their homes safer. The Make Safe Happen app provides parents and caregivers with room-by-room safety checklists and links to purchase safety products for their homes. It also allows those parents and caregivers to set reminders and track their progress in making their homes safer.

The Make Safe Happen app became available for free on iOS and Android systems in January 2015. 

Dr. Lara McKenzie, a principal investigator at CIRP, decided to create the app after becoming the mother of triplets. While Dr. McKenzie had devoted her career to childhood injury research and prevention, it wasn't until she became a parent herself, that she realized how challenging creating a safe home could be for a busy family. The Make Safe Happen app makes this challenge easier by providing tips to families, recommending types of products best suited to their homes, and encouraging them along the way.

The Make Safe Happen™ app is dedicated to making homes safer for children and was built with the knowledge and commitment of Nationwide Children’s Hospital, Center for Injury Research and Policy, and was funded by a grant from the Nationwide Foundation.

New Shopping Cart Stability Standard

ASTM International, a voluntary safety standard development agency, approved a revised standard for shopping carts in April 2015. For the first time, the standard includes a stringent stability test for carts – the same one used to test shopping carts in Europe.

The move came after Dr. Gary Smith, director of the Center for Injury Research and Policy, called for changes to shopping cart regulations using data from two studies on shopping cart injuries. His 2013 study found that more than 24,000 children per year were injured in shopping cart related incidents from 1990 through 2011. The great majority of those injuries occurred among children 4 years of age and younger. While Dr. Smith applauded the new standard, he advocates for more to be done to protect children. Dr. Smith has pushed for safer carts since 1995 and continues to urge for carts to be redesigned.

“This new stability provision in the shopping cart safety standard represents an important step forward for child safety,” said Dr. Smith. “However, there is still work to be done to improve the safety design of shopping carts. Ultimately, we must require that the child seating area in the cart is near the floor to significantly reduce the risk of injury from falls and tip-overs.”  

Proposed Federal Laundry Detergent Packet Legislation

Proposed Federal Laundry Detergent Packet LegislationMembers of the U.S. Senate and House of Representatives introduced legislation in February 2015 to address child exposure to laundry detergent packets. This legislation is, in part, a response to a 2014 study from the Center for Injury Research and Policy and the Central Ohio Poison Center – both based at Nationwide Children’s Hospital – that highlighted the problem.

The study found that from 2012 through 2013, U.S. poison control centers received reports of 17,230 children younger than 6 years of age swallowing, inhaling or otherwise being exposed to chemicals in laundry detergent packets. A total of 769 children were hospitalized during that period, and at least one child died.

The proposed bill would require the U.S. Consumer Product Safety Commission to set mandatory safety standards for liquid detergent packets that address:

  • Child-resistant packaging for packet containers
  • The design of the packets to make them less attractive to children and reduce the likelihood that children will be exposed to them
  • The contents of the packets to make them less dangerous
  • Proper warning labels

The Commission could adopt a voluntary standard now being developed by ASTM International, a standards development organization, or it could create its own standard. The bill was introduced by Sen. Dick Durbin of Illinois and Rep. Jackie Speier of California. Dr. Gary Smith, the director of the Center for Injury Research and Policy, provided input on the language contained in this legislation.

“It is not clear that any laundry detergent packets currently available are truly child resistant; a national safety standard is needed to make sure that all pod makers adopt safer packaging and labeling,” said Dr. Smith.

More information about CIRP’s laundry detergent packet study can be found here, and more information about the proposed legislation can be found here.

Cheerleading Safety

In October 2012, the American Academy of Pediatrics released a policy statement with new guidelines designed to help prevent cheerleading injuries. The statement came after the Center for Injury Research and Policy published six journal articles focused on cheerleading injuries, including the first national study on those injuries in 2006.

National cheerleading organizations have adopted many of the recommendations made in the CIRP studies., a project of the USA Federation for Sport Cheering and the American Association of Cheerleading Coaches & Administrators, cites CIRP research in promoting safety in the sport.

Developing a Safer, Child-Resistant Spray Bottle

Center for Injury Research and Policy researchers, led by Dr. Lara McKenzie, announced the development of a new spray bottle in September 2012 with the goal of reducing household cleaning product-related injuries in young children. A 2010 study from Dr. McKenzie found that spray bottles were the most common source of those injuries.

The bottle has a two-trigger mechanism which restricts the ability of young children to use it, and the mechanism locks after each use. CIRP developed the bottle with The Ohio State University’s Department of Design and the Department of Mechanical and Aerospace Engineering.

RIO™ Data Used in High School Field Hockey Policy Change

The organization that regulates U.S. high school sports began requiring eye protection for field hockey players in 2011 after the Center for Injury Research and Policy provided the group with statistics from the High School RIO™ (Reporting Information Online) injury surveillance system, then housed at CIRP. After reviewing the data, the National Federation of State High School Associations said that the potential risk of injury to 64,000 student athletes warranted the new requirement.

CIRP researchers and others examined that same RIO™ data and found that before the change, players had a 5-times greater risk of eye injury if they played in states without an eye protection requirement.

Window Guards in New York City

In September 2011, the New York City Council revised its law requiring window guards in many apartment buildings. A month earlier, the Center for Injury Research and Policy had published a study showing that 14 children per day were treated in U.S. emergency departments after falling from windows, and children 4 years old and younger were at particular risk.

The New York City Council relied on the data from the CIRP study and contacted CIRP for guidance in its ordinance. The New York law is now the strictest such law in the United States, and the revision made it easier to enforce.

Government Accountability Office Report on Concussion in High School Athletes

Center for Injury Research and Policy findings on concussion in high school athletes was cited in a 2010 United States Government Accountability report on the subject. The report highlighted in particular CIRP’s work with the High School Reporting Information Online (RIO) injury surveillance system to calculate national estimates of high school athlete concussions.
The GAO report focused on:

  1. What is known about the nationwide occurrence of concussion,
  2. Federal concussion prevention programs,
  3. The components of key state laws related to the management of concussion, and
  4. Voluntary nationwide concussion management guidelines.

View the report here.

Parents are the Key Campaign

In 2010, the Centers for Disease Control and Prevention began the “Parents Are the Key” campaign to promote safe teen driving. CIRP staff members helped pre-test and launch that campaign as part of a pilot project in Columbus. Every year in the United States, about 3,000 teens lose their lives in automobile crashes. The Parents are the Key campaign was created to raise awareness about this issue and provide parents with information and tools they can use to increase the safety of their child behind the wheel.

Youth Helmet Ordinances in Ohio Cities

CIRP published research in 2007 examining pediatric hospitalizations for bicycle-related injuries. After finding that more than 33% of cases involved traumatic brain injury, CIRP director Dr. Gary Smith worked with the Columbus City Council in 2008 to pass a new youth helmet law. CIRP also partnered with a number of organizations in the effort:

Bexley (2010), and New Albany (2016), suburbs of Columbus, passed similar laws with support of Dr. Smith and other CIRP researchers.

National Standard to Prevent Furniture Tip-overs

ASTM International, a standards development organization, issued a revision to its safety specification for chests, door chests, and dressers in November 2009 after the Center for Injury Research and Policy published a study about injuries associated with furniture tipovers. The study found that 40 children per day are treated in U.S. hospital emergency departments with those injuries.

The study recommended that all heavy furniture should be anchored to walls, and all heavy furniture should be sold with anchoring devices. The 2009 revised standard added the provision that tip-over restraints “shall be included with each item of furniture covered under the scope of this standard.”

Ohio Booster Seat Law

Ohio expanded its Child Passenger Safety Law in 2009 after researchers from CIRP and other groups advocated for a booster seat provision. Research shows that children who use booster seats are 59 percent less likely to be injured in a motor vehicle crash than those using seat belts alone. The state’s Child Passenger Safety Law now includes these requirements:

  • Infants and young children must ride in a child safety seat until they are 4 years old and weigh at least 40 pounds.
  •  Every child ages 4-8 who is no longer in a car seat must use a booster seat until she research 4'9" tall.
  • Children and teens ages 8-15 who are not in booster seats must use adult seat belts.

View more information about the Ohio Booster Seat Law.

Congressional Resolution on Pediatric Acquired Brain Injury

A 2009 congressional resolution cited Center for Injury Research and Policy findings in supporting a plan to reduce pediatric acquired brain injury (PABI). CIRP found in 2006 that pediatric traumatic brain injury – a subset of PABI -- is a substantial burden to the health resource burden in the United States, accounting for more than $1 billion in total hospital charges every year.

The resolution can be viewed here.

eBAY Policy Changes

The online retailer eBay announced it was strengthening efforts to stop the sale of recalled products after a Center for Injury Research and Policy examination revealed that during a one-month period, 190 eBay auctions contained or were suspected to contain a recalled children’s product or toy. Approximately 70% of these auctions resulted in a sale.

eBay said it would send warning notices to people who post recalled items in an attempt to end the sale of these items. In addition, further violations of the recall policy could result in the seller losing the right to list products on eBay. The company also provides shoppers with links to the U.S. Consumer Product Safety Commission website so shoppers can check if a product has been recalled.

Adding Residential Voice Notification to the National Fire Alarm Code

The National Fire Protection Association changed the National Fire Alarm Code in 2007, in part to allow the use of voice notification for residential smoke alarms. The change came as a result of a 2006 study from the Center for Injury Research and Policy which found that smoke alarms using a mother’s recorded voice was more effective at waking a child than a conventional alarm using a tone.

High School Football Kickoffs

The group in charge of high school football rules used the High School RIO (Reporting Information Online) injury surveillance system to make an important decision about kickoffs in 2007. The National Federation of State High School Associations Football Rules Committee was considering moving kickoff placements – possibly leading to more runbacks and more exciting game.

The committee examined data from RIO, then housed at CIRP, and determined that moving the kickoff placement would likely result in an increased risk of injury for high school football players. The committee ultimately decided against changing the rule.

Learn more.