A seemingly harmless plastic ball with colourful rubber knobs and a simple device that you flick to trigger a spin are among the toys that have been recalled from shelves because of the danger they pose to young children.

Last December, Toys ‘R’ Us Singapore issued a voluntary recall of Bruin Wiggle Ball toys because their rubber knobs and plastic backs can detach, posing a choking hazard to children. And remember the fidget spinner that became a worldwide craze last year? Some models were taken off the shelves in Britain because they were found to have small parts that could pop out easily, also posing a choking hazard.

Indeed, “the biggest concern with regard to toy safety is choking risk”, said Dr Kao Pao Tang, head and senior consultant at the children’s emergency department of National University Hospital.

This often happens when toys come apart, either by design or due to misuse, said Dr Kao. The small bits of the toys can then end up in the mouths of young children. Toys can also get lodged in the child’s nostrils or ears.

Many toy-related injuries occur in children under five years old. Among them, children aged one to three account for about half of the cases, said Dr Chong Shu-Ling, a physician at the KK Women’s and Children’s Hospital's department of emergency medicine. “Although the majority of these injuries are minor, some are serious and have led to surgery or hospitalisation.”

Whether toys can become choking hazards depends largely on the design as well as the age – and thus the behavioural development – of the child playing with them.

Older children would know that they should not be putting small toys in their ears or nose, for instance. “Thankfully the incidents we have seen thus far usually ended with the child either spontaneously expelling or swallowing them,” said Dr Kao.

Here is a look at what makes some toys dangerous for children.

When beads and small toys are no child’s play

Items such as beads, small toy parts or Lego bricks can end up in children’s body cavities – the most common of which is the nostril, according to National University Hospital’s Dr Kao Pao Tang.

Such incidents form some of the 500-plus cases of toy-related injuries that KKH sees each year, according to Dr Chong Shu-Ling.

Toys can cause injuries such as cuts and bruises, or indirect injuries, such as when a child falls down because he has stepped on a toy. Toys with very rough surfaces may also cause physical abrasions or wounds, said Dr Chong.

She gave the example of a two year- old boy who was left to play unsupervised, and had pulled out the button eyes of his rabbit soft toy. He popped one button into his mouth but did not like its taste. He then accidentally inserted it into his nose, and had to be taken to the hospital for help.

Tricycles, skate scooters and ride-on toys

Larger toys such as skate scooters, tricycles and ride-on toys may cause a child to slip and fall if not used properly or under close supervision.

Ride-on toys should be used away from the stairs, swimming pool and other dangerous spots.

Baby walkers should not be used as they are unsafe and do not aid with the child’s motor development. Canada has banned their sale since 2004. In Singapore, baby walkers are easily available.

“Babies can reach a speed of 1m per second in a walker, which is too fast even for an attentive parent to catch should the child speed towards an open door, down the stairs or towards a boiling pot,” according to the KK Women’s and Children’s Hospital website.

Ingesting button cells can cause bleeding, burns

There can be dire consequences when a child inserts a button battery up his nostril. “In the worst case, we have seen the nasal septum totally perforated within half a day of the battery being inserted,” said Dr Kao Pao Tang.

It is not just the battery’s acid, but also its electric current that can cause harm. “Most modern toys are designed in such a way that it is not usually easy to remove the batteries, but failure of such design is not uncommon,” said Dr Kao.

For example, wear and tear can cause the screws securing the battery cover in place to come loose.

In the case of battery-operated fidget spinners, Spring Singapore advises parents to ensure the devices have tightly secured cases to prevent young children from opening them. Button batteries and battery fluid pose very serious risks, and swallowing them can lead to choking, internal bleeding, and chemical burns, it warned.

Laser toys can cause serious eye injuries

Perhaps the most common of potentially dangerous toys are the handheld light-sabers associated with the Star Wars movies. Spinning tops that project laser beams also pose a risk.

“When used unsafely, these toys can be dangerous and can cause serious, immediate and permanent eye injuries to the person using the laser and anyone else within range of the laser beam,” said Dr Janice Lam from the National University Hospital Eye Surgery Centre.

It is why the US Food and Drug Administration has warned about the potential danger of laser toys in a guidance document.

No eye injuries related to laser toys have been seen at KK Women’s and Children’s Hospital, NUH or the Singapore National Eye Centre, though Dr Lam has seen eye injuries caused by lasers used in science or engineering labs.

“Eye injuries sustained after a laser beam is shone into the eye may not be painful and often are not reported until later on when vision may already be impaired,” warned Dr Lam.

Injuries from a laser beam include superficial corneal burns, damage to the eye lens leading to cataracts, burns to the retina which may result in a permanent retinal hole or scar, and blindness, she said.

Lasers should never be shone directly at anyone, nor should laser pointers be treated as toys.

In Singapore, lasers and laser pointers are regulated by the National Environment Agency (NEA), which states on its website that “even at a very low power of 5mW (milliwatts), when the laser is aimed directly at the eye, it will cause temporary flash blindness”.

It is no safer to use more powerful laser pointers like the so-called Class 3b or 4 laser pointers that have power in excess of 5mW.

“A split-second brief exposure from such lasers is not likely to cause permanent injury immediately because the eye will blink and move to avoid the beam, but it can lead to visual loss in later years,” the NEA says.

Toy safety checklist

Not all toys marketed for children are safe for young kids. And even if they are safe, they may not remain so if they are broken or old.

When buying a toy, parents can check if a safety alert has been issued by visiting www. spring.gov.sg/productsafety, or international sites such as US Safer Products at www. saferproducts.gov, according to Spring Singapore.

Dr Chong Shu-Ling from KK Women’s and Children’s Hospital’s department of emergency medicine has the following recommendations.

Before you buy:

  • Take the child’s age, interests, and skill level into consideration.
  • Make sure all toys are well-designed and well-constructed.
  • Follow the age recommendation stated on the packaging.
  • Look for warnings or other safety messages on the packaging.
  • Avoid toys with sharp points or edges.
  • Check the rigid eyes and noses on soft toys to ensure they cannot be pulled off.
  • Make sure small parts of larger toys cannot be broken off.
  • Avoid toys that shoot objects into the air.
  • Avoid toys that are loud to prevent damage to the child’s hearing.

After you buy:

  • Read carefully all instructions included in and on the toy packaging.
  • Throw away toy packaging such as plastic, cellophane and styrofoam.
  • Throw away broken toys that cannot be fixed.
  • Supervise children playing with balloons and discard broken pieces as these can be ingested by the child. A young child may also insert them into his nose or ears.
  • Examine toys regularly for signs of wear and tear.
  • Check toys periodically for broken parts and other hazards.
  • Damaged toys should be thrown away or repaired immediately.
  • Wooden toys should be sanded if edges have become sharp or splintered.
  • Check outdoor toys for rust or loose parts.