HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Read responses to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Le, D Articles by Macnab, A J Search for Related Content PubMed PubMed Citation Articles by Le, D Articles by Macnab, A J

Self strangulation by hanging from cloth towel dispensers in Canadian schools

Department of Pediatrics, University of British Columbia, Vancouver, Canada

Correspondence to:
Dr Andrew J Macnab, Critical Care Research Office, L317, Children's and Women's Hospital of British Columbia, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada
amacnab{at}cw.bc.ca

Objective—To investigate a local "epidemic" of incidents of strangulation by hanging from continuous cloth towels in dispensers.

Method—The coroner's office in all provinces and territories were contacted. Five cases of hanging from continuous cloth towels in Canadian schools were identified and reviewed.

Results—There were four deaths, and one near-death, all males age 7 to 12. Two cases were attributed to a "choking game" that provides a sensation (impending loss of consciousness) described as "cool". In three cases, the child was alone at the time. All deaths were due to strangulation from hanging and all occurred in school washrooms. One child (playing with two friends) recovered after admission to an intensive care unit.

Towel dispensers were removed from the two index schools. In one province the Ministry of Education encouraged removal of towel dispensers from all schools and education of students of the dangers of "choking games".

Conclusions—Thrill seeking from partial asphyxiation appears to underlie these incidents. Awareness of such cases should prompt appropriate education strategies to highlight the serious consequences of this form of risk taking behavior in young males. In Canada, these incidents have resulted in changes in the design of, and legislation regarding, cloth towel dispensers.

Keywords: youth; self inflicted; asphyxia

This article has been cited by other articles:

				Unintentional Strangulation Deaths From the "Choking Game" Among Youths Aged 6-19 Years--United States, 1995-2007 JAMA, March 26, 2008; 299(12): 1418 - 1421. [Full Text] [PDF]

				Suicide Trends Among Youths and Young Adults Aged 10-24 Years--United States, 1990-2004 JAMA, January 23, 2008; 299(3): 283 - 284. [Full Text] [PDF]

eLetters: