Authorities warn against risky 'choking game' after U.S. study reports 82 deaths
Helen Branswell, Medical Reporter, THE CANADIAN PRESS
14/02/2008 8:50:00 PM
TORONTO - At least 82 children and teens in the United States have died over the past 12 years playing what's known as "the choking game," the U.S. Centers for Disease Control said Thursday as it urged parents to look for telltale signs their adolescents may be partaking in the dangerous fad.
Canadian authorities have also been studying the phenomenon, and have data that show 74 hospitalizations of children who survived the game at least long enough to get to hospital. But not all do. A website set up by the family of one boy who died after accidentally suffocating himself has received reports of 38 deaths in this country.
The boy, Jesse Grant, 12, died in April 2005, after choking himself on a computer cord. He learned the game he called "black out" at summer camp the previous year. The game is also know as space monkey, the scarf game, and the pass-out game, and five minutes to heaven, among other names.
His family, which lives near Barrie, Ont., started an organization and website called GASP - Games Adolescents Shouldn't Play - to gather statistics and get out the word on the dangers of the choking game.
"It just keeps going on like a bad weed," his mother, Sharron Grant, said Thursday, noting she remembers seeing kids playing it when she was 15. People as old as 82 have e-mailed the website to say they remember playing the game as children.
The choking game involves intentionally choking oneself or being choked by someone else to the point of almost losing consciousness or actually fainting. The lack of oxygen induces a brief state of euphoria or a high.
While all acknowledge the game has been around for years, the CDC said Thursday there appear to be some new twists that may be behind what looks like a spike in cases.
Robin Toblin, the study's lead author, said the reports of deaths point to increased use of ligatures and of children or teens attempting to induce the state while on their own. If something goes wrong, there is no one to call for help.
"Because most parents in the study had not heard of the choking game, we hope to raise awareness of the choking game among parents, health-care providers and educators, so they can recognize warning signs of the activity," said Toblin, who is with the CDC's National Center for Injury Prevention and Control.
Steven McFaull, an injury prevention researcher with the Public Health Agency of Canada, has searched for evidence of choking game cases in the databases of the Canadian Hospitals Injury Reporting and Prevention Program, a network of 14 pediatric and general hospitals around the country that collect injury statistics.
McFaull found reports of 74 children or teens brought into hospital with injuries sustained during choking games. One of the children died.
"What we're seeing in our database really are what we've called the secondary injuries, where they've passed out or at least got close to it, lost their footing," he said, adding he'd like to do more work to get a better handle on how widely and how often the games are being played.
"If there were no kids around to catch them, then they've basically done what we might call a dead-man drop."
Those falls caused broken bones and head injuries. But experts say that when kids use ropes, nooses and other ligatures, what started out as a way to get a drug-free rush can have tragic consequences.
Grant said GASP has received 38 reports of deaths among Canadian children, all but two of which dated from 1992 onward. And reports of deaths have come in from as far afield as Egypt, England, Australia, India and South Africa. (Grant says the website verifies deaths through conversations with family members and news reports before adding them to the site's statistics.)
Dr. Andrew Macnab, a professor of pediatrics at the University of British Columbia, has been studying asphyxial games, as they are more properly called, since treating a child who was hospitalized after playing but who survived his injuries.
A study Macnab conducted in Ontario showed that depending on the school, between 37 per cent and 68 per cent of children aged about 12 knew about the game. Alarmingly, almost half of them thought playing it posed no risks.
"The few that I've been able to talk to said: 'We see people faint all the time, they always wake up, why would I think any different?"' Grant, whose organization had collaborated with Macnab, said.
"They just have no idea. And it just baffles me still that they don't have that degree of 'Jeez, I could get hurt doing this."'
About seven per cent of the children Macnab surveyed admitted having tried the game. "That's an awful lot of children," he said from Vancouver.
Grant said she's been frustrated in efforts to get schools to teach children about the dangers of the choking game. She believes schools fear they may be teaching kids something they don't already know and could find themselves legally liable if a death occurred.
"My reply to that is 'We aren't showing them anything that at least 50 per cent of them don't already know,"' she said, adding that those kids who haven't yet heard of the game need to learn that it can have fatal consequences.
CDC officials warned parents to be on the lookout for signs their children might be playing the game.
Most parents whose children died playing the game were unaware of the phenomenon before their child's death, the CDC experts warned.
Signs include bloodshot eyes and marks on the neck, frequent and severe headaches or the unexplained presence of items like dog leashes, choke collars, bungee cords or ropes, scarves and belts tied to bedroom furniture.
Most - 87 per cent - of the young people who died playing the game were males. Most of the cases clustered in the 11-to-16 age range, but children from six years old to 19 years old were among the reported deaths. (The researchers looked only for deaths in those under 20 years of age.) Deaths were reported in 31 states, with no evidence of clustering in certain areas.
Three or fewer deaths a year were reported in the period from 1995 to 2004, says the study, which was based on media reports.
But there were 22 deaths in 2005 and 35 in 2006. Nine were reported in the first 10 months of 2007; the researchers acknowledged they didn't know how to explain the decline.
They said, however, that the study probably underestimates the numbers of deaths caused by the choking game that are actually occurring, because some deaths may be registered as suicides.
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On the Net:
The GASP website is found at http://www.deadlygameschildrenplay.com/en/home.asp
What is it? Asphyxial games involve self-strangulation or strangulation of another person to the point where the person loses or almost loses consciousness. The lack of oxygen reportedly induces a rush or a high.
Is it new? People studying the phenomenon say it's been around for generations.
What's new now? Researchers at the U.S. Centers for Disease Control think there are some changes that are making the game more dangerous. They say kids appear to be more commonly using ligatures - nooses, belts, scarves - to self-strangle. And they say kids are doing it on their own - meaning there is no one to call for help if things go wrong.
What are the stats? There are few, because these deaths can easily be confused with suicides. But the CDC says at least 82 kids in the U.S. have died since 1995. A Canadian group set up to draw attention to the problem says it knows of 38 deaths in Canada.
Does it go by other names? In addition to "the choking game," the practice is called "blackout" or "the black out game," "the pass out game," "five minutes to heaven," "Harvey Wallbanger," "flat liner," "space monkey" and "suffocation roulette," among other names.
WHO Dreams up this stuff to do?????