 Okay, we're going to resume with panel two if we can ask folks who are chatting off to the sides and in the back if they could please try to wrap up their conversations at a respect to the next panel. So we're joined today for our second panel at our priorities hearing and we have beginning with Dr. Kieran Quinlan, the American Academy of Pediatrics. We've had a slight change in our panel but that works for us. Sally Greenberg from the National Consumers League and with her as well as Joshua Ward from Oregon. We have Rachel Wontrop from the Consumer Federation of America and we have Will Wallace from Consumers Union. We'll start, please, Dr. Quinlan with you. Please go ahead. Good morning. Good morning. Chairman Kay and commissioners Adler, Berkel, Marharovic and Robinson. I'm Kieran Quinlan. I am here today on behalf of the American Academy of Pediatrics. The AAP represents over 64,000 pediatricians in the country and I'm a pediatrician and currently serve as the chair of the American Academy of Pediatrics Council on Injury, Violence and Poison Prevention Executive Committee as well as an associate professor of pediatrics and preventive medicine at the Rush University Medical Center in Chicago. The AAP appreciates the opportunity to speak today. Unintentional injuries are still the leading cause of death of children from one to nineteen in the fifth leading cause of death for children below the age of one. And pediatricians use the guidance of CPSC in the counseling that we provide to our patients every day in clinic as we talk to the families of our patients about environmental hazards, household dangers and the like. So I'll walk through some of the areas that the AAP believes that the CPSC should prioritize in the coming fiscal years and fiscal year in order to protect children's health and safety. This list has been abbreviated for the purposes of time so I refer you to my written submission for the completes of recommendations. First, recreational off-highway vehicles. Pediatricians, we do see firsthand the tragedies that can result from children riding on ROVs. Children are not developmentally capable of operating these heavy complex machines and no child under the age of sixteen should operate an ROV. And we must do all that we can to ensure that children do not operate or ride on these vehicles. The AAP applauds CPSC's proposed rule to improve ROV safety and opposes congressional attempts to delay the rulemaking. Second, laundry detergent packets. Research carried out by my colleague Dr. Gary Smith in Columbus, Ohio and others published in the journal Pediatrics in November of 2014 found that after laundry detergent packets first emerged on the market in 2012, they've come to pose a serious poisoning risk to young children. The poison control system received calls for over 17,000 exposures, children who were exposed to this product, children under the age of six who came in contact with these laundry detergent packets between 2012 and 2013, including very tragically one confirmed death. There are now just under a thousand children poisoned by these products a month in the U.S. Children younger than three years of age account for about 73% of the cases. Children who come in contact with the concentrated chemicals in these laundry detergent packets become quite sick, some with very serious trouble breathing, some with seizures, some need intensive care unit care, some are intubated and put on ventilators, some lose consciousness. Efforts are underway to address this issue through standards development organizations. Unfortunately, the ASTM standard will ultimately only be voluntary. A mandatory CPSC standard is a straightforward way to best protect children against injury and even death from these cleaning products. Next, liquid nicotine, the liquid nicotine that's used associated with electronic cigarettes. So I turn to the serious child poisoning hazard that's posed by liquid nicotine, a standard sized eyedropper bottle of liquid nicotine could be enough to kill four toddlers. It's also attractive to children with bright colors and flavors that are like candy and appeal to children, such as cotton candy flavored and gummy bear. These products are also easily accessible and there is no current federal requirement for child resistant packaging of this liquid. With the rising popularity of e-cigarettes, liquid nicotine refills are becoming increasingly common in the households across the country. So not surprisingly, liquid nicotine poisonings are increasing at an exponential rate. There were nearly 4,000 calls to poison control centers about liquid nicotine exposure in 2014, a 250% increase from 2013. The AAP strongly supports the prompt action to institute a standard upon receipt of congressional authority to require child resistant packaging. Next is a TV and furniture tip overs. A July 2013 article in the journal Pediatrics found that between 1990 and 2011, an estimated 380,000 patients under 18 were treated in emergency departments for a TV-related injury and this equals an average of about 17,000 children a year. Like TV tip overs, furniture tip overs can result in horrific injuries or even death as well. Both furniture and TV tip overs are entirely preventable events. Furniture strengths, securing these items to the wall can make all the difference, but strengthening the stability performance requirements in the relevant safety standards would be the most effective solution. This may require a mandatory standard from the CPSC. Next, button cell batteries. Since 2003, there's been a significant rise in the incidence of severe injuries involving children who ingest button batteries. The AAP has participated in a national button battery task force, including experts from medicine, public health, industry, poison control, and government. The most serious injuries are usually associated with 20 millimeter diameter 3-volt lithium batteries about the size of a nickel. If a button battery becomes lodged in the esophagus, it can cause tissue injury and necrosis within hours, leading to perforation or death, if not removed, urgently. We urge CPSC to continue its work to strengthen the relevant voluntary standards to include a provision to securely enclose all button cell batteries and also to work in support of design changes that would eliminate this serious health hazard, even if ingested. Next, safe sleep messaging. On safe sleep, the AAP appreciates CPSC's ongoing work on promoting these messages in multiple languages. We urge the commission to strengthen this messaging even further by banning crib bumpers. And finally, microwave safety. This is sort of a different topic. I don't know that the commission has heard much about this yet, but we wanted to just share this with you and get it on your radar. We're concerned about the injuries that occur when young children are able to access the contents that were heated in a microwave oven. They're able to access them themselves. They can open the door of a microwave oven, access the heated contents, and typically spill them down the front of their face and the front of their chest. Some of these are very serious injuries with lifelong cosmetic consequences. These are entirely preventable with an engineering fix that would require making it so that young children can't open a microwave oven. They really have no business opening. These are young kids as young as 18 months of age. So a two-year-old opening a microwave oven, there's really no reason for a very young child that aged to ever open a microwave oven door. And we're sort of developing a bunch of research to address this. But we'd like to share that concern with you. We think that this is an issue that can be prevented. We are operating through the usual processes, going through underwriters laboratories and the standards technical panel to operate within the system and try to get that to happen. So in conclusion, thank you for the opportunity to comment. And I look forward to answering your questions. Thank you, Dr. Quinlan. Ms. Greenberg and Mr. Ward. Yes, thank you Chairman Kay and commissioners. I'm submitting these comments on behalf of the National Consumers League. I also want to thank my colleague Christine Hines for letting me substitute in for her slot as a scheduling problem. So in any event, the National Consumers League is a private nonprofit advocacy group representing consumers on marketplace and workplace issues. We're the nation's oldest consumer organization founded in 1899 and I serve as executive director. So I would like to focus my comments today on the issue of table saw safety. Josh Ward who's with me and they're gonna split our time. Table saws are among the most hazardous products that CPSC regulates. I have personally built furniture using a table saw and know how dangerous they can be. According to the agency statistics, there are roughly 40,000 emergency room treated table saw injuries every year, about 4,000 of which are amputations. That's more than 10 amputations every single day. NCL has been involved with the issue of table saw safety since 2010 when we sent a letter to the CPSC urging speedy action on a safety standard for table saws. At the time, it had been seven years since the petition was filed with the commission to require table saw sold in the United States to be equipped with active injury mitigation technology that was already on the market and was proven to prevent serious lacerations and amputations from table saw accidents. It's now five years later and still the agency has not issued a proposed rule on table saws. 10 amputations occurring every day while consumers wait for a safety standard. Three of those amputations happened to Josh Ward, who's on my left, who traveled all the way across the country to tell you his story. Now Josh isn't here for himself because whatever you decide to do, it's going to be too late to prevent his injuries. But he came all the way to show you what happens when unsafe table saws remain on the market and explain how one split second on a table saw has changed his life forever. So he will ask you, I know, to act as quickly as possible to prevent this from happening to anyone else. Josh is from Sisters Oregon. In 2012, he was a junior at Sisters High School in a woodshop class and he was instructed to make a series of unsupervised cuts to a piece of plywood using an older model table. Unfortunately, the plywood caught and kicked back, violently drawing his left hand into the spinning blades, severing three of his fingers and breaking multiple bones in his hands. After extensive surgery and treatment, his surgeons were able to save one of the three fingers. He has struggled mightily undergoing many surgeries and his medical bills recently topped $350,000. Needless to say, this injury and incident has had a devastating effect on him. He's had to give up one of his lifelong dreams. He's going to tell you about it in terms of his career. But he is a fighter. He's undergone extensive treatment. He saw the valuable work done by healthcare providers and he set his sights on a different career. Again, he will talk about that from his own perspective. Josh strongly supports the enactment of a national standard that will require table saws to be equipped with safety technology that would prevent what happened to him from happening to anyone else. He knows the safety technology exists. In fact, his school bought a safer saw after his incident. But a national standard is what's needed to protect all table saw users from these foreseeable, painful and permanent injuries. CPSC has known about table saw technology for over 10 years and it's time for the agency to enact a safety standard. I'd be less than candid if I didn't express my disappointment in the commission's slow pace toward adopting a mandatory safety standard on table saws. It is the mission indeed of the CPSC to get dangerous products out of the marketplace or require them to be designed to operate safely. Table saws prevent, present an unusually easy case. We have a consumer product that causes grave injury and proven safety technology to prevent those injuries. 10 amputations a day could have been prevented virtually 100% of the time. To me, that screams out for a requirement that every table saw be required to adopt a safer design. By doing so, you could prevent the terrible injuries Josh and so many others have endured. Now, I understand you have legal and procedural hoops to jump through and that takes time. And I understand there are also powerful industry groups and high priced lawyers and lobbyists working against the public's interest. But here we are again over a decade after the petition for a table saw standard was filed with this commission and we don't even have a proposed rule. So yes, I'm disappointed and discouraged by the lack of progress on this very fixable product hazard. CPSC's budget request for FY 2016 says the commission expects to issue a notice of proposed rulemaking on table saws during the next year. We strongly urge you to issue the NPR early in the fiscal year and then move expeditiously to receive public comment and issue a final rule as soon as you can. During the five years I've been working on this issue, I've met a number of individuals who suffered serious lacerations and amputations from table saw injuries. Now I've had the great pleasure of spending a few days with Josh. While he's strong and is overcoming his injuries with tremendous spirit and perseverance, we all know that the lifelong physical and emotional pain and disability he suffers were preventable. We ask you to act as quickly as possible to make table saws safer and put an end to these preventable injuries. Thank you for considering our views and I'll turn the floor over to Josh. As Sally said, my injury occurred in December of 2012. I was a junior in high school. It was pretty standard cut. A teacher told me to cut a 24 by 24 piece of plywood directly in half. Pretty standard cut, nothing really special. As I was in the cut, I'll actually demonstrate this piece of paper if you can actually see it. As pushing the piece of wood through the blade, the edge of the board started lifting, which allows the blade to catch the end of the blade, which turned the piece of wood, which then turned through my hand in the table saw, which actually, they came up with new standards I believe in 2008 with better plastic guards, which you know that it probably would have not protected my hand with the lifting of the board. It would have lifted the guard with it still in zoo, putting my hand in the blade. So after the accident, I was taken to the hospital, rushed to the hospital, immediately put into a 12 hour surgery with two hand surgeons. After the hand surgery, they were able to reattach my middle finger. Unfortunately, my ring and pinky finger were not able to be reattached due to vascularity in the fingers. Due to the accident, I've lost 50% of the functionality of my fingers that remain with an artificial joint in my middle finger and a fusion in my thumb joint due to loss of the anatomy in my hand. During the seven days in the hospital after the accident, within those three days, I had three surgeries, to maintain vascularity in my hand. In those seven days, I was staying in a room for 95 degrees with a heat lamp on my arm to help with blood flow to the fingers in hand, to hopefully save the fingers that I had. This was definitely a lot of pain, a lot of suffering, not only emotional pain for me, but also the strain on my parents. I don't know how many of you had kids, but seeing your kid go through such pain and it's almost harder on them than it was on me. After that, I went through seven months of physical therapy, which started out of just getting a moving. The first three weeks is just kind of just making a move yourself. I was not allowed to move them, to move up to picking up to a cotton ball, to picking up a Lego piece and just baby steps. There was a lot about the small goals, which is definitely really hard, going from being able to rock climb and fly fish and be able to do everything in Oregon it has to offer. And now it's definitely a struggle every day. After the accident, due to cut nerves, I lost sensation in my fingers, which allows me to be susceptible to injuries such as heat, cold and cuts, which has maybe susceptible to infection. Any injuries due to blood flow can cause infections, which I incurred a two-year-long bone infection that took a quarter inch off my finger, 10 rounds of IV in oral antibiotics and 180 hours in hyperbaric oxygen therapy treatments. And as Sally said, $350,000 worth of medical bills. And this has definitely all been really hard. It's definitely made me a stronger, better person, but it's definitely something that nobody should have to go through. Not a teenager, not a kid, not an adult. It is not something I would wish upon anybody. And that's what I think a safety standard should be mandatory so we can prevent this. As Sally says, it has changed my career path. Before the accident, I had a plan as a firefighter paramedic. And due to the injury, my hand does not have the durability, the requirements to be a firefighter. So with paramedic, a lot of medicine is involved. So to keep on the side of medicine and helping people, I changed my career path to nursing, which I just finished my first year for my undergrad and worked to my master's degree. But it's definitely what I'm working for. And it's definitely been a lot of pain and suffering. I don't. And that's why I'm here. And I want to have a standard so that it doesn't happen to anybody else. Thank you, Ms. Greenberg, Mr. Ward, Ms. Wantra. Chairman Kay and commissioners, thank you so much for the opportunity to provide comments on CPSC's FY 2016 and 2017 priorities today. I am Rachel Weintraub, legislative director and general counsel at Consumer Federation of America, which is a nonprofit association of approximately 280 pro-consumer groups founded in 1968 to advance the consumer interest through advocacy, research, and education. Please see my full comments, my full written comments, as this is a summary. The implementation of the Consumer Product Safety Improvement Act should continue to be the highest priority for the CPSC. The CPSC has been effectively prioritizing CPSIA implementation. Because of the rules promulgated by the CPSC and the incredible dedication and effectiveness of CPSC staff, infant-durable products, including bath seats, portable bed rails, full-size cribs, non-full-size cribs, infant walkers, toddler beds, play yards, bedside sleepers, soft infant carriers, handheld carriers, bassinet strollers, infant swings, and frame child carriers must now meet new robust mandatory standards. That is pretty amazing. But the CPSC and all of us still have work to do. Under section 104, or Danny's Law, to promulgate future standards for other products, including gates, high chairs, boosters, hook-on chairs, changing tables, infant slings, infant bouncer seats, infant bathtubs, folding chairs, and stationary activity centers. We look forward to working with the commission to continue this incredibly important work. Another high priority for the CPSC should continue to be saferproducts.gov. We know that out of earlier this month, 20,902 reports have been posted to saferproducts.gov and it continues to be an important tool for consumers, researchers, doctors, carners, and the CPSC. And we recommend that the CPSC continue to explore how to make saferproducts.gov even more useful and accessible to consumers. There are numerous product safety hazards that the CPSC should prioritize. While the CPSC is working on some of these issues, many of them in different ways, we urge the CPSC to further prioritize these issues. We applaud the CPSC for beginning of rulemaking on window coverings in response to the petition, CFA, Kids in Danger, Consumers Union, Parents for Window Blind Safety, and other organizations filed requesting that the CPSC promulgate a mandatory standard for cords on window coverings. Due to the documented and persistent hazards that cords on window coverings pose to children, the petition asked the CPSC to prohibit accessible window covering cords when feasible and require that all cords be made inaccessible when prohibiting them is not possible. A strong mandatory standard to address the hazards posed by corded window coverings is necessary because according to CPSC data, there were at least 184 deaths due to strangulation and 101 severe injuries caused by cords on window coverings from 1996 through 2012. The CPSC estimates that at least 11 children die each year as a result of cords on window coverings despite six industry attempts at developing a voluntary standard that have all failed to significantly reduce the risk of strangulation and asphyxiation by window covering cords to children. Descent injuries can and should be eliminated by designs that already exist in the marketplace. They are already available, cordless technology, cord-covered designs exist. A strong mandatory standard for window coverings will reduce confusion in the marketplace and lead to more homes with safer products. We urge the commission to promulgate a mandatory standard as quickly as possible as these products pose risks to children every single day. Roves and ATV safety. Roves are recreational off-highway vehicles pose hazards to consumers and the CPSC staff is aware of 335 deaths and 506 injuries related to road crashes from January 2003 to April 2013. From January 1st, 2014 through May 31st, 2015 alone however, CFA and its partners documented 95 road fatalities and that is likely an undercount. CFA has raised the following concerns within and about the ANSI Rova voluntary standard process, the inadequacy of the stability standard, the insufficient occupant protection measures, the insufficient handling provisions, the lack of maximum speed for these vehicles, the inadequacy of measures to ensure seat belt use by occupants in Roves. Unfortunately, the Rova industry has not been responsive to these concerns, raised by CFA, the CPSC and others to improve the effectiveness of the voluntary standard and due to the inadequacies of the standard and now that the comment period which had been extended but which ended and this was the third time that a comment period has been extended since 2009, we urge the CPSC to move forward as quickly as possible with the promulgation of a mandatory standard. As I was sitting through the previous panel, I received a very discouraging email from one of my colleagues who alerted me that this year alone, or I'm sorry, that in the past six days, 23 people have died on ATVs and this is likely an undercount that is from data that we are collecting from public reports. According to the most recent data released by CPSC, at least 99, 600,000 people were injured while riding ATVs seriously, seriously enough to require emergency treatment in 2013 and the estimated number of ATV fatalities which was an undercount when reported was 650. But again, just this year alone or just in six days, we know that 23 people died while riding ATVs. In 2013, ATVs killed at least 62 children younger than 16 accounting for 15% of ATV fatalities and children under 16 suffered an estimated 25,000 serious injuries in 2013, representing 25% of all injuries. CPSC must prioritize the issue of ATV safety. We urge the commission to complete their rulemaking, to protect children and to protect all ATV riders. Further, another serious hazards that CFA and our colleagues have documented is the issue of ATVs on roads. There is a huge dichotomy where at least 35 states allow and permit legally ATV operation on roads, even though the industry, public health officials, ATV stakeholders primarily argue unequivocally that ATVs should not be operated on roads. We're working within a coalition to communicate these hazards and we urge the CPSC to do the same. Laundry packets, highly concentrated single load laundry, liquid laundry detergent packets pose a serious risk of injury to children when the product is placed in their mouths or squirts in their eyes. According to the American Association of Poison Control Centers, from January 1st, 2015, until May 31st of this year, 2015, 4,864 children, five and younger, were exposed to these products. Based on two years of data, the National Poison Data System reported that 769 children required hospitalizations for injuries that included seizures, vomiting blood, fluid in the lungs, dangerously slow heartbeats and other hazards as a result of ingesting the contents of these packets. While the voluntary standard of which we were very engaged in in its current form addresses the packaging container of the packets to some degree, addresses the taste and burst strength of the individual packets and includes warning labels. And these are all good things, more should be done. CFA and its partners have urged that the voluntary standard not only ensure that the outer packages are child resistant, but also require that the packages are individually wrapped to prevent ingestion or eye injuries. Address the design and color of the packet so that they aren't as attractive to children. Address the composition of the packet so that the consequences of exposure aren't as dire. Multiple layers of safety are needed. And what we urge the CPS to do is once the voluntary standard has been finalized and implemented to carefully, carefully monitor the incidents. And if it is not working effectively to move forward on a stronger mandatory standard. Furniture tip-overs are another hazard that we are very concerned about. As you well know, every two weeks a child dies as a result of a piece of furniture appliance or television falling on him or her. We applaud the CPSC's work on the anchorage campaign and we look forward to working with the commission to consider changes to the voluntary standard and perhaps mandatory standard to significantly affect these hazards. Briefly as well, flame retardants and consumer products. Flame retardants can be found in numerous types of products and cause significant types of systemic harms. Children are especially at risk and we urge the CPSC to prioritize this issue and to take a theft of stuff to protect consumers from the hazards posed by flame retardants while not diminishing fire safety protections. We urge the CPSC to consider how to address the data needs correlating socioeconomic status with unintentional injuries. And we also urge the commission to continue to work on recall effectiveness. We know that too many recalled products remain in consumers home with a lack of knowledge about these recalls. We support the voluntary recall rule and look forward to working with the commission to improve recall effectiveness. I appreciate you're holding this hearing and look forward to taking your questions. Thanks, Ms. Wanchap. Mr. Wallace. On behalf of Consumers Union, the Public Policy and Advocacy Arm of Consumer Reports, thank you very much for the opportunity to be here today and comment on CPSC's agenda and priorities. We thank you, your staff, and all CPSC staff for their work. The following testimony highlights some of the areas on which we hope the agency will focus, some of which my co-panelists have also emphasized as priorities for the commission's upcoming work and some which differ. First, on durable infant and toddler products, we support and applaud CPSC's ongoing efforts to implement the Consumer Product Safety Improvement Act. The agency has developed strong safety standards through this process with a major positive impact on consumer safety. Because of CPSC's work, numerous infant and children's products are now manufactured to be far safer and must be tested and certified by a third party to ensure that they meet tough safety requirements. We urge CPSC to continue working closely with the ASTM subcommittees to develop strong mandatory standards addressing these hazards. Here's an example of one reason why. Although Consumer Reports' most recent tests of high chairs found that most models rated highly in terms of safety, in 2013, we identified a particular model where an unharnessed child could slide beneath the tray. The product was ultimately recalled, but a brief examination of the marketplace suggests that there are many retailers that still offer for sale the old version of this high chair. Child safety would benefit from the enforcement authority CPSC would gain with a mandatory safety standard for high chairs as well as other durable infant and toddler products where there isn't one yet. SaferProducts.gov. We have long supported and continue to strongly support the SaferProducts.gov database. Thanks to this tool, consumers, medical providers, and safety professionals are better informed about potential safety hazards in the marketplace. Industry also receives valuable feedback regarding hazards associated with their products. In addition, SaferProducts.gov enables consumer representatives and government officials to better track and address developing hazard trends. Consumer reports often urges consumers to submit safety-related issues they experience to the database, and we regularly transmit to CPSC reports of unsafe products that we receive from consumers. Also, when our testing indicates a safety risk, the database is often a useful tool for us as well as for CPSC and the relevant manufacturer, both of whom we inform about our findings to see if consumers may have already been affected by the potential defect. In FY 2016 and 2017, we encourage the agency to continue its efforts to make SaferProducts.gov as up-to-date and consumer-friendly as possible to increase public awareness and use of this tool and to use consumer postings to help track trends and identify emerging hazards. We also encourage the agency to conduct frequent follow-up investigations of recurring types of consumer complaints. Surveillance and enforcement. Consumer Reports commends the agency for its commitment to monitor imports of children's products as rigorously as possible and at as many ports of entry as possible. We support the CPSC's continued efforts to ensure the safety of imported children's products and by preventing, to the fullest extent possible, entry of dangerous children's products into the U.S. marketplace. CPSC should also continue to more broadly monitor the marketplace to ensure that older, unsafe products, including drop-side cribs, are removed from the secondhand market and childcare facilities. Effective implementation of product recalls does remain a challenge. We urge the CPSC to continue to make this a priority, working with manufacturers to increase public awareness of the important product registration and to better ensure effective public notice of recalls, and we look forward to working with you on that. Liquid detergent packets. Since 2012, exposures to the toxic contents of liquid detergent packets have generated tens of thousands of calls to poison control centers nationwide. Several hundred children, mostly, have become very ill and two children are confirmed to have died by ingesting one of these detergent packets. Consumers Union appreciates CPSC's education and outreach work on this issue and its influential participation in the ASTM international process to establish a voluntary safety standard. We hope manufacturers will agree, without delay, to address the hazard in a comprehensive way that substantially reduces the risk of injury and also to release injury data that they have to verify the reduction. However, given the demonstrated ongoing threat to young children, we urge CPSC to seriously consider promulgating enforceable standards during FY 2015 and 2016 to ensure that happens. Courted window coverings. In May 2013, Consumers Union and eight other groups petitioned CPSC to promulgate a mandatory safety standard for window coverings. We applauded CPSC when the petition was granted in October 2014, as well as when the commission voted unanimously to publish the ANPR this year. Both were important steps toward eliminating the unreasonable safety risks posed by courted window coverings. We urge the commission to keep moving forward as expeditiously as possible. Successive voluntary standards, including the current version of the ANSI WCMA A100.1 standard, have not adequately mitigated the risk of strangulation on courted window coverings. Many years after CPSC began first working with WCMA, the latest version of the voluntary standard still allows for the major hazards from pull cords and continuous loops that are responsible for at least 57% of the strangulation incidents investigated by the CPSC. Consumers Union believes that hazardous, accessible window covering cords present an unreasonable risk of injury to young children. And to prevent future tragedies, we support the development by CPSC of a mandatory standard to eliminate the risk of strangulation. And we urge CPSC to propose such a rule as soon as possible. Thalates. We remain concerned about the serious health risks posed by certain thalates and we're pleased to see the commission approve publication of a proposed rule earlier this year. As we stated in joint comments submitted by the Breast Cancer Fund, we strongly support the majority of the rules provisions, including making permanent the interim ban on DINP and permanently banning four additional thalates, D-I-B-P, D-P-E-N-P, D-Hex-P, and D-C-H-P. We also commend the chronic hazard advisory panel for an open and transparent scientific review and rulemaking process, as well as for undertaking a thorough independent and expert peer review of the best available science on the exposure to and health hazard from certain thalates. And crafting a final rule for the commission to consider before the end of FY 2015, we urge CPSC to revise the proposed rule to make permanent the interim bans on D-I-D-P and D-N-O-P and to permanently ban D-I-O-P. For FY 2016, we look forward to working with the agency on awareness and outreach efforts related to the final rule. Outdoor vehicles. We are concerned along with our co-panelists about the hazards associated with the use of altering vehicles and recreational off-highway vehicles. And as proposed, rule CPSC indicated that its staff is aware of 335 deaths and 506 injuries related to a row of crashes spanning from January 2003 to April 2013. We urge CPSC to prioritize ATV and ROV safety and to issue final mandatory standards that protect consumers and especially children from these risks. We have several other areas of concern, including liquid nicotine, where we support legislation that would direct CPSC to require child-resistant packaging for the most accessible kinds of liquid nicotine containers. We urge the agency to use all its available tools to reduce the risk to children of poisoning from this highly toxic liquid nicotine. On television and furniture tip-overs, we continue to be very concerned about the risk of injury or death to young children as a result of these tip-overs. We appreciate the agency's work on this summer's excellent Anchorage campaign to improve public awareness of the hazard and encourage parents and caregivers to securely anchor furniture and TVs that could harm a child. We are also engaged in several efforts to inform consumers about the hazard posed by TV and furniture tip-overs and are pleased to be coordinating our efforts to maximize the positive impact for safety. Flame retardant chemicals. We urge the commission to use all its available authority to address the risk of toxic flame retardants to consumers while maintaining fire safety. CPSC should prioritize these efforts to prevent future harm to consumers, especially children who come into greater contact with household dust than adults. Lead and other heavy metals. We urge the agency to continue to address the safety hazards associated with lead and heavy metals that may be in consumer products, including in products not covered by the current standards for toys and paint. We urge the commission to work diligently with ASTM International in the development of effective heavy metal standards for all consumer products, bike helmets. Consumer Reports recently wrote about bike helmets for the June 2015 issue of our magazine in which we stressed that wearing a helmet is essential to preventing traumatic brain injury. Our tests evaluated 23 bike helmets and found that all of them absorbed the force of impact within the limits set by CPSC bike helmet standard, and all except one received at least a very good rating for impact resistance in our tests. We look forward to working with CPSC and all stakeholders to ensure that the CPSC bicycle helmet standard, which has not been revised since it was adopted in 1998, continues to drive the market so that bike helmets provide consumers with greater protection from impact. Outdoor Equipment. We are concerned about injuries and deaths resulting from outdoor equipment, especially carbon monoxide poisoning caused by portable generators used indoors and in partially enclosed spaces such as garages. We applaud the CPSC for making generator safety a top priority and urge the agency to continue developing solutions for reducing and eliminating generator-related hazards. Button cell batteries. We appreciate the commission's efforts to push industry towards creating a safer product design for button cell batteries, and we encourage the agency to continue work on this significant health hazard during the next two years. Button cell battery ingestion, usually by small children, causes rapid and severe gastrointestinal tissue damage and perforation and even death. In conclusion, we greatly appreciate the CPSC's important efforts to address hazards associated with consumer products, and we applaud the commission for its leadership and achievements over the past year. We look forward to continuing to work with the agency to fulfill its mission in FY 2016 and 2017. Thank you, Mr. Wallace. We'll now turn to questions from the commissioners, and I'll begin, and again, thank you to the panelists. I apologize, as I did to the first panel, that we're not gonna be able to cover all these issues as in depth as we would, but we're gonna try to get to what we can. Mr. Wallace, I'm gonna start with you, and you mentioned bike helmets, and the fact that that standard needs work, which I agree with. We had earlier this year, as I know you're familiar with, in our mid-year, adopted an amendment to have the staff revise its rule review plan and put that out for public comment. Do you plan on submitting comments related both to the bike helmet and any other rules as part of that? We do. That'd be great. Thank you, and I hope that anyone else who's participating or listening or watching will do that as well. Thank you for that, Ms. Winejob. I'm gonna ask you what will probably sound like a strange question, but I wanted to make one comment before that on the issue of the socioeconomic data. That's something that I'm really interested in, and we're gonna obviously have a data hearing this afternoon, and it's a part of that. I hope that's something that CFA will continue to work on because we do need help with that. We need a better understanding and an ability to really target and to know where these injuries and incidents are really occurring, so I hope you'll continue that work. On what will sound like a strange question, you've been following this commission for a number of years, and you've seen it move at different paces throughout that time. And I'm curious, and I'm asking this in all sincerity, I'm curious from your perspective, why are the reasons that you see the commission not necessarily moving as quickly as you would like? And as you answer that, if the answer to that entirely is the current chairman's incompetence, I can live with that. I seriously do want you to answer that with an all candor, thank you. It's a very interesting question. I think there's numerous reasons depending on the issue. I think some have to do with resources. I think while it's great that CPSC is moving on roads, ATVs has frankly been languishing for years, and I think my understanding is that's a resource issue. I also think that on many issues, there are numerous requests for extensions and they almost universally seem to be granted, and I hope that it is based on an extensive review of information provided and really ensuring that the reasons are legitimate. I also think sometimes it could be for particular staffing reasons where a particular, perhaps there could be, and this is very much from the outside obviously, where maybe there are disagreements within the commission that are leading to a lack of action on other issues. And sometimes I think it has to do with the industry influence of particular issues and huge infusions of resources and political efforts to make the commission's work harder and more complicated to move forward. Great, thank you for that, and I appreciate that the thoughtfulness behind that answer. Mr. Ward, a tough question for you as well. You've obviously been through a very difficult experience and your life has been changed on a going forward basis. What we've heard particularly with this product and products that are similar to that is consumers are fully informed. They understand the risks and it's pretty much on the consumer if they don't abide by the riskiness of the product when they're dealing with it. First, have you heard that before? I can't imagine you haven't. Yes, I have. And having experienced this and gone through it and probably talked to other victims and talked to others who have not been victimized. And we heard some of this in the first panel from Mrs. Thomas, which you talked about. There is a sense of, well, that can't happen to me. How much do you feel like now knowing what you know that consumers are fully informed about the risks associated with these products? I feel that they're informed about the risks. I'm afraid they're not informed about the new safety technology that's out there, preferably Sawstop or Bosch's new technology. But I feel that they're informed about the risks. They're not informed about the new safety, that the new safety technology that is offered. And if you feel like people are informed about the risk, why do you feel like, and Ms. Greenberg mentioned this, that there are 10, on average 10 amputations a day? Why is it continuing? What's going on? What's the disconnect between users seemingly, and you mentioned this, seem to understand the risk, yet the injuries continue to happen? And Ms. Greenberg, if you want to jump in as well, please go ahead. Well, there's an assumption that informed about the risk means that you can prevent the kinds of accidents that happened to Josh, but he didn't do anything wrong. He was just feeding a piece of, he didn't get too close to the blade. He, the blade just grabbed, I mean, the piece of wood just grabbed his hand. And it's, you know, it happens in milliseconds. So there's really no, you know, there's no mistake on the part of the user in many of these cases. Many of these cases, the users are very experienced woodworkers, and we brought three guys a couple of years ago to meet all the commissioners. You know, most of you are not here at the time, but they were all very experienced woodworkers. And, you know, stuff happens, you know, the wood lifts up, it may be green, I don't, Josh, Josh, I only made two pieces of furniture, Josh, made a whole lot more, so, but stuff happens that is not expected, and the user hasn't done anything wrong. That's why, you know, we think it's unreasonably dangerous, and it needs a standard to prevent those injuries. And I appreciate that answer, and it looks like my time has expired, so I'm gonna move on, but that's my sense as well, is that consumers may understand, as Mr. Ward mentioned, that there are risky products, but they don't appreciate exactly how they're risky and how that risk might present itself as they're using it. Thank you for your testimony, Commissioner Adler. Thank you very much, and as I was sitting here and listening to the testimony from these various groups, it really warmed my heart to see the degree of commitment, the degree of competence, and to see just how absolutely helpful your testimony is to us. I really do consider you partners in the product safety endeavor, partners who scold us on occasion, and on occasion when you're scolding us, it's absolutely justified, and I can't thank you enough for that. And I wanted to, and I started to pick on Mr. Ward and Ms. Greenberg, but when the chairman was asking the question, the thought that was coming through my mind, and I just want to reiterate that, and I'll start with Ms. Greenberg. When I met with those woodworkers, and one of the fascinating things to me was that they were all experienced woodworkers, and one or two of them said, well, it was my fault, and when I tried to pin down why it was their fault, it was almost as though, because I got injured. But do you see a high degree of consumer carelessness and listening to Josh describe his injury, and Josh, I'm gonna ask you that same question. What degree of consumer carelessness was involved in the majority of these incidents? I would say there's little to no consumer carelessness. These are very dangerous products that do not permit any miscalculation at all, or even you put a piece of wood in and if it spins out of your hands and it spins your hand with it, you really haven't done anything wrong in Josh's case. That's exactly what we saw. So when we talked about these woodworkers, they are all extremely careful, and of course they blame themselves, and you're probably getting under reporting of these incidents unless somebody has to go to the hospital, because people think, hey, I took the risk by having a table saw and working on a table saw. So we try not to blame consumers. We try to make sure that we have the safest products possible in the marketplace, and I think table saw just prevent this tremendous amount of danger as we've seen, and we need to protect consumers to the extent possible with a mandatory standard. And sometimes products are just dangerous and there isn't a lot we can do, and sometimes there is something we can do. So Josh, I'm just gonna ask you the question. Were you careless when you were using the table saw? Of course not. Safety was definitely always on the mind. It's always, when you're using dangerous tools like a table saw, it's a one track mind. You're focused on one thing. And just to continue on what was Sally saying, I think the big thing is we keep talking about experienced woodworkers. We gotta remember these are consumers. Sometimes these people aren't in wood shops. They're not getting the training. They're going to Home Depot, getting a table saw and using it at home without any training. And that's where this flesh mitigation technology comes in is, as we've seen, it works. There's no human error about it. You can mess up. It's there to prevent injury. Some cuts you can't use the safety guards that are on table saws now. And this makes it so you don't have to. You don't have to use the plastic guards. You are able to have clear visibility of the wood you're cutting. And this technology is so much better than what we have right now. And it takes the human error out of it. A sneeze, a slight miss of just any error. It happens so fast that you really don't know what happens. It happens as quick as a snap. And this technology truly will prevent that. You also made an observation. I want to ask you to comment on it that it's part of this infection that you got because of the deadening of the nerves in your fingers. You actually had to undergo many, many hours of hyperbaric chamber. That's my worst nightmare of ever having to do it. And I assume it was extraordinarily uncomfortable. And so thank you for coming down and for sharing your story. Ms. Weintraub and Mr. Wallace and also Dr. Quinlan. We heard comments this morning about the degree of involvement of public groups in voluntary standards organizations development. And I think you've all had a reasonable degree of experience working with voluntary standards organizations. I'm wondering if you have any comments about the current status of voluntary standards development with respect to public participation, with respect to conflicts of interest and any other concerns that you might have with that. Ms. Weintraub, if it's okay, I'll start with you. Sure. And I work a lot with involuntary standards. And with over the years, I've developed the following list of parameters for successful voluntary standards. Some of which meet some of these, some of which do not. I think adequate participation by consumer groups and public health officials is dire, as was stated earlier. But you also need funding for participation. Also the process itself needs to be transparent. Information must be shared with all participants. If there are notes, there are studies, they must be shared. There must be adequate notice to meetings. And the process must be understandable, knowing how it works, what participation means, what the process is. So that process must be logical. Also, there must be the potential for regulatory oversight if the process fails to meet its goals. And there must be participation by a regulatory agency. It has to be widely used and accepted to be effective. And within the standard, it must be clear which products are within the scope, which institutions must comply or must not. And there needs to be some sort of consequences for non-compliance. We agree, as was stated earlier, the process should not be wholly controlled by industry. All participants must have the ability to raise issues, to raise concerns, and those concerns must be addressed. And also, the underlying goal is that the problem, the hazard, must be effectively addressed. I see my time has expired and I see Mr. Wall shaking his head, so we'll take that as a concurrence. Thank you so much. Thank you, Commissioner Adler, Commissioner Robinson. Thank you to all of you for taking the time and to come in today and for these thoughtful, thoughtful presentations, both written and oral. Dr. Quinlan, I was looking at your presentation and you said that you represent 64,000 of physicians who are pediatricians and pediatric subspecialists and pediatric surgeons. Could you just tell us approximately what percentage of the total board-certified physicians in those medical specialties your organization represents? You clarify what you mean. Do most of the pediatricians, pediatric surgical subspecialists, pediatric subspecialists, I'm assuming you have to be a board-certified physician to be in the AAP, right? Okay, and can you tell me what percentage of the board-certified physicians in those specialties belong to your organization? Oh, you know, I don't know offhand. Is it most of them? I would imagine, yes. Okay, and you're here on behalf of them, is that correct? Yes. Okay, I just, I wanted to thank you for your testimony today. I was heartened by your positions on the various issues and I just want you to know that this applies very useful pressure on the agency for things we already have authority over, such as crib bumpers, but it also highlights the statutory constraints that we have in areas such as the nicotine, child-proof packaging, and the laundry packets, and I thank you for your testimony. Ms. Weintraub, you said you've collected data from public records on ATVs. Are you doing that on ROB accidents and death as well? Yeah, yes. Excellent. Are you comparing that with ours to make sure we have all of that? We make it publicly available. Excellent. So we do. Ours is more current because CPSC death data has huge lags in time. Right. And even when death data is released, it's often incomplete, so it's hard exactly to compare because what we're doing is in real time and what CPSC release is, is older. Excellent. Well, I'm glad to know about the resource. I didn't. You mentioned in your written testimony, not in your oral, but in your written testimony, the voluntary recall rule. And it has been languishing and I have repeatedly stated that I think this should be a priority. Do you believe that this rule is related to public safety? I think it's directly related to public safety. Why do you believe that? First of all, we know that, looking at the Hope Chest as an example, that there are products that have been recalled but are still causing harm. And if this rule results in clearer information to consumers and communicates more effectively to consumers about a recall, it can very concretely save lives. Also, if it enables CPSC to have more enforcement authority to ensure that manufacturers are complying with their corrective action plans, that could very directly correlate to live saves and injuries averted. Thank you. And Mr. Ward and Ms. Greenberg, I think one of you can answer part of this and one of you the other, but I was very interested in the fact that I believe that we have estimated that the cost of amputations from table saws is somewhere in the range of $35,000. And you, Mr. Ward, said that your medical expenses were over $350,000. We do the best we can with the data we have, but it's critically important for us in doing cost-benefit analyses that we have some grasp of reality when it comes to the cost of these injuries. So let me ask you, first of all, Mr. Ward, does that $350,000? Are those all direct medical costs? And so I'm asking implicitly in that if you're including pain and suffering, loss of work for your mom or dad, impact on your career choices when you come up with the $350,000. That is just direct medical costs. Okay, and Ms. Greenberg, perhaps you could address for a moment whether you think that the $35,000 that we use for that estimate is a gross understatement of what real costs are for amputations. Well, based on our work with consumers who've undergone our surgeries after being injured by a table saw, those medical costs exceed $35,000 by a large amount. So there's such a thing, I suppose, I don't know if this is considered an amputation, but I know that people slice off the tips of their fingers, et cetera. Those costs may be factored in. I'm not quite sure what the CPSC uses to estimate $35,000. It sounds like a lot lower than the costs that we know about from working with victims. Thank you. Mr. Wallace, you have mentioned recall effectiveness as part of, our recall effectiveness as part of the surveillance and enforcement activities and have urged us to make this a priority. I have very limited time left and I want to comment about one other thing, but if you have any ideas, my staff and I have been looking very closely at trying to come up with ideas to improve our recall effectiveness. And if you have any ideas, I would love for us to be able to find ways of partnering with your organization to improve that. But I would also like to comment that we've heard comments today about saferproducts.gov. This website has been critically important, but it's pretty new at the agency, as all of you know. And we have talked to the AAP, we've talked to other physician groups. We've been trying so hard to plug into pieces of data that we don't have access to through our statistical NICE system. So if any of you have any ideas about ways that we can plug into groups to get them to report product-related injury information to the agency, it would be hugely helpful to us. And I thank you all on my time's expired. Thank you, Commissioner Robinson. Commissioner Berkel. Thank you, Mr. Chair. And thank you all very much for being here today and for your very compelling and informative testimony. I just have a couple of questions. Joshua, first, thank you for being here. You're not quite as... I mean, I don't know what I should say, whether it's... You are engaged, but maybe not as professional as the other ones. This is something new to you when you're here. So we appreciate you being here and telling your very personal story. I'm a little bit concerned because when you gave your testimony, you mentioned that your teacher... This is a class in high school you were taking, a shop class, and they directed you to do the project without any... They weren't there to supervise. Is that... Was that customary? I mean, I just think... And I think to Sally, to Ms. Greenberg's point about not being consumer faults or carelessness, that may be of concern. But I do wanna commend you. I started out my professional career in nursing and I have a daughter who just graduated from nursing school. And it's a wonderful profession and they will be very glad to have you. We need good nurses, so thank you very much. To Ms. Weintraub and Mr. Wallace, I just have a couple of questions to clarify. When you talked about TV tip overs and you commended the CPSC about our new anchor at Campaign and we are very proud of it and really feel like we've gotten, I think, a great bang for the buck and it's a good campaign. Are you saying that the educational campaign is sufficient or that we need to go further with the mandatory standard? I think it's very important and I thought it was creative and effective and it was great to see so many of the commissioners engaged in it. But I think that's part of the work, but not all of it. And I think moving forward to strengthen the existing voluntary standards and to seriously consider a mandatory standard is necessary as well. Thank you. And Mr. Wallace? I concur. Thank you. And then again, clarification with regards to laundry pods. When you say that there were other concerns, additional concerns that you have with the voluntary standard, is that based on my understanding as a subcommittee is just completing and is working on a new voluntary standard for laundry pods to address the issues. So are your concerns regarding the current standard or that standard going forward? No, it's the standard moving forward. We've worked extensively within the committee along with CPSC staff who's been outstanding. And we're pleased with where the standard has come but it still has further to go. In particular, for the outer packaging, child resistant packaging is an option but it is not the sole option and is not required even within the voluntary standard. And also we're concerned about the individual packets themselves and while this newer version, which is not out yet, seeks to address it in some way, which is great. It's doing so by looking at the EU standard, which deals with it by looking at burst strength and solubility time in a liquid as well as with a bittering agent but it does not include sort of an outer packaging for the individual packet and we think that could go a long way and there's a few other things as well. And I believe that's in your written testimony. Thank you. And Mr. Wallace? Yeah, I'd say that we agree with that. We believe that the current draft standard is, I mean, we're very encouraged by the direction that it's come but we believe that there's certainly more that needs to be done to comprehensively address the hazard. Thank you. Mr. Wallace, just one last point of clarification. When you were testifying, you mentioned that when you get complaints regarding a product or an issue, you then relay it to CPSC and let us know about it. Is there a process? Is there a cooperation? How does that work when you get that information? What do you do with it before you proceed and let us know about it? Sure, our external affairs folks have been working very closely with the commission to set up a regular monthly transfer of data. And that's coming to effect this year in 2015. Okay, maybe you could clarify that just a little bit. Sure, sure. So, and we've worked closely together going back and forth to make sure that it's in the format and basically to make sure that it's as useful as possible to the commission's work. Okay, and is there a cooperation so that when someone gives you information, you verify it, you get information before it goes to the commission? We get information directly from consumers before it goes to the commission. We make clear that it's coming directly from the consumer. Okay, good. I appreciate all of your answers and I do thank you again for being here. Thank you. Thank you, Commissioner Berkel. Commissioner Mohorovic. Thank you, Mr. Chairman. Thank you to the entire panel for your testimony and your participation today. I have a general question about our Section 104 rule makings. They were mentioned in several of the testimony today. And since the nature of our hearing today is about the agency's priorities and agenda, I'm sure many of you have been familiar with the product categories that we have on schedule to promulgate or look at voluntary standards to make mandatory standards from them. And I was wondering if anybody on the panel has any concern with regards to the schedule of the product categories as they are today. I think of product categories like crib bumpers and monitors, other stationary children's furniture. And I didn't know if anybody had any issue or concerns or wish that we had placed certain product categories for promulgation under 104 in advance of others and I wouldn't expect anybody. In fact, I had to ask my staff because I couldn't recall the exact order of the 104s that we've gotten our current fiscal year as well as planned for 16. But I didn't know since it was mentioned about the 104s whether or not there was any concern or desire for the agency to move up in terms of a priority, certain product categories or others. And if there's no responses, we'll just let the crickets chirp, Mr. Chairman. But I wanted to give the opportunity for the panel if they wish we were moving forward in a 104 on a certain category, perhaps not in substitute, but in a higher priority in a shorter timeframe than those that we have on schedule right now. Thank you. Anybody on the panel? I would just say that I think the staff is really managing this process very well. And while you mentioned bumpers, we think that bumpers should be banned and we think the commission should be taking other action outside of the 104 process on that product. But we don't specifically have concerns about the current product listings or the order. Thank you. Thank you, Mr. Chairman. Thank you, Commissioner Mohorovic. So this concludes the second panel. I appreciate Dr. Quinlan you coming in and I'll say as an aside by the way, even though I didn't get to ask you a question, I had your testimony in mind when my five year old son asked me this morning if he could take his breakfast out of the microwave and I went through that weighing that parents go through what to say. I really was thinking, well, what would Dr. Quinlan say in this case? Ms. Greenberg, Mr. Ward, Ms. Wondrop and Mr. Wallace. Thank you very much. So I'm looking at the clock and where we are. Looks like we do have time at least for a 10 minute break so we'll pause now and reconvene at 11.45. Thank you.