 Welcome back to the afternoon or later afternoon session of our priorities hearing for Fiscal Years 2017 and 2018. This is our third panel and we're pleased to welcome Karen Bolton from the National Consumer League, Rachel Wintrob from Consumer Federation of America, William Wallace from Consumers Union, Ms. Joyce Davis from Keeping Babies Safe, and Dr. Sarah Denney from the American Academy of Pediatrics. So we'll get going. Please, Ms. Bolton. Thank you. My name is Karen Bolty. I'm the Health Policy Director of the National Consumers League, and we appreciate the opportunity to testify before you today. I am filling in for our Executive Director, Sally Greenberg, who is in Geneva attending the ANSI conference. So NCL is a private, non-profit advocacy group representing consumers on marketplace and workplace issues. Founded in 1899, we are the nation's oldest consumer advocacy organization, and I've brought a couple of our interns with me this summer so that they can see democracy in action. NCL is focusing our comments today as we have since 2012 on the issue of table saw safety. Table saws are among the most hazardous products that CPSC regulates. They cause tens of thousands of emergency room-treated injuries every year, including more than 10 amputations every day. It doesn't have to be that way. Safety technology exists that has been proven to virtually eliminate all of these devastating injuries. The commission was petitioned in 2003 to enact a safety standard to require table saws to meet that level of safety. NCL became involved with this issue in 2010 when we discovered that the agency had done nothing about the petition for seven years. We were gratified the next year when the commission voted unanimously to begin an ANPR on table saw safety. Incredibly, however, five years have gone by and the commission has yet to issue a proposed rule on table saws, not even a proposal, let alone a final rule. That is unbelievable to us. NCL has a simple message today. CPSC must act with urgency to finally put an end to the devastating injuries caused by table saws. Injuries from table saws happen in a split second, but they last a lifetime. NCL has met a number of these victims. They suffered debilitating pain, disfigurement, and career-ending, life-altering disabilities. These brave victims came to Washington, D.C. to meet with you and with their congressional representatives to urge the CPSC to act as quickly as possible to protect others from the unnecessary suffering that they are enduring. Each time you have given them your time, attention, and sympathy, unfortunately, what you haven't done is enact a safety standard. As you may recall, last year, our executive director, Sally Greenberg, appeared with one of these victims, Joshua Ward, from Sisters, Oregon. In 2012, when he was a high school junior in woodshop class, Josh was making cuts to a piece of plywood using an older model table saw. Unfortunately, the plywood caught and kicked back, violently drawing his left hand into the spinning blade, severing three of his fingers and breaking multiple bones in his hand. He had to undergo numerous surgeries, suffered from recurring infections, and after all of that, he was forced to give up his lifelong dream of becoming a firefighter. Tens of thousands of people suffer similar injuries every year, working on table saws that are more dangerous than they need to be. The CPSC has the power to put an end to these unnecessary tragedies, but you must move quickly because every day brings 10 more avoidable amputations. As you know, Underwriters Laboratories has been working for nearly four years on a voluntary safety standard for table saws that would include a requirement for an active injury mitigation system. This approach to table saw design has been demonstrated in the field for more than 12 years to greatly reduce the unreasonable risks that manifest tens of thousands of serious injuries each year, including some 3,500 amputations. NCL sits on UL's Consumer Advisory Council and we are a big supporter of the work it has done in the past on numerous product safety standards. However, we are deeply disappointed to learn that UL has been able to produce a UL table saw standard with an AIMS requirement. The UL standards technical panel used for table saws is heavily dominated by industry members who have voted no each time UL has proposed an AIMS requirement. UL says it is powerless to overrule the committee's vote. Frankly, we don't understand why UL cannot include requirements. It deems necessary to create an adequate safety standard under the UL banner. Unfortunately, as this case illustrates, unless the industry agrees voluntarily to adopt adequate safety measures to protect consumers, the change simply does not occur and consumers remain at serious risk and unreasonable risk. We have waited a long time to give the voluntary standard system a chance to bring needed protection to the market and it has failed to deliver. Since UL cannot do the job to protect users of table saws from these horrendous injuries, consumers must rely on CPSC to take prompt and affirmative action. We urge you to give this project your highest priority. CPSC's operating plan for FY 2016 included the expectation that a notice of proposed rulemaking for table saws would be issued by the end of the fiscal year. The commission's budget request for FY 2017 says the commission expects to issue a final rule within the fiscal year, which ends on September 30th, 2017. This rule is long overdue. NCL can't urge you strongly enough to adhere to this schedule. Please put an end to these preventable and heartbreaking tragedies. Thank you very much. Thank you, Ms. Bolton. My apologies for mispronouncing your name the first time and the second time, but I got to write the third time. Ms. Weintraub. Thank you, Chairman Kay, Commissioner Robinson, Commissioner Berkel, and Commissioner Mohorovic. I appreciate the opportunity to provide comments to you on the CPSC's FY 2017 and 2018 priorities. I'm Rachel Weintraub, Legislative Director and General Counsel with Consumer Federation of America, a non-profit association of approximately 280 pro-consumer organizations founded in 1968 to advance the consumer interest through advocacy and education. Before I begin, two points first. Please consider my written testimony as my full testimony for the record. I will be summarizing that this afternoon. And also, as I was reviewing my testimony and after listening to the first panel, I realized that I talk about a lot of numbers, a lot of numbers in this testimony because data-driven information is what is so compelling for action. But sometimes, when you talk about numbers and percentages, the essence of what those numbers are, that these are individuals and that these are families, sometimes gets lost. So I wanted to make that point before I begin. First, CPSIA implementation. Continuing to effectively prioritize the implementation of the Consumer Product Safety Improvement Act should remain a high priority. Because of the rules promulgated under the CPSIA, 16 infant durable products must now meet robust mandatory standards. The 2011 CRIB standard with third party testing and certification requirements is of particular significance as it is the strongest CRIB standard in the world and offers our nation's infants a safe sleep environment. 104 standards must continue to be prioritized. Another high priority for the CPSC should continue to be SaferProducts.gov. 29,000 reports, as of just this month, have been posted to SaferProducts.gov. And it continues to be an important tool for consumers, researchers, doctors, coroners, as well as the CPSC. We recommend that the CPSC continue to explore how to make SaferProducts.gov more useful and more accessible, including cross marketing efforts, social media, and collaboration with stakeholders. There are numerous product safety hazards that the CPSC should prioritize and continue to prioritize. On emerging hazards, we applaud the CPSC's work on hoverboards and crumb rubber, but we urge the CPSC to quickly provide concrete information for consumers about the safety of these products and materials. Window coverings. Due to the persistent hazard that cords on window coverings pose to children, CFA, kids, CU, parents for window blind safety, and others filed a petition with the CPSC in 2013, requesting a prohibition of accessible window covering cords. Despite six industry attempts to develop adequate voluntary standards, there were at least 184 deaths due to strangulation and 101 severe injuries caused by cords on window coverings from 1996 through 2012. At least 11 children die each year as a result of cords on window coverings. Deaths and injuries can be eliminated and substantially reduced by designs that are already available on the market. Cordless technology and cord cover designs. We urge the commission to promulgate a strong mandatory standard that will reduce confusion in the marketplace, lead to more homes with safer products, and eliminate and substantially reduce the strangulation risk for children. According to the CPSC's most recent data, and here come the numbers, at least 93,700 people were seriously injured while riding all terrain vehicles in 2014. The estimated number of ATV-related fatalities was 638 in 2013, though that number is likely to rise. In 2014, ATVs killed at least 61 children younger than 16, counting for 16% of fatalities, 54% of children killed younger than 12, children under 16 suffered an estimated 24,800 or 26% of serious injuries in 2014. According to CFA's data that we gather through media reports, which is definitely not all inclusive. But according to CFA's data, in 2013, 2014, and 2015, there was an average of 175 deaths per year as of June 12th. In 2016, as of June 12th, there were identified at least 217 OHV deaths. We urge the CPSC to complete the ATV rulemaking, which should include a serious analysis of the safety hazards posed to children by ATVs, the adequacy of existing ATV safety training and training materials, and efforts to ensure that children are not riding ATVs that are too large and too powerful for them. In addition, we urge CPSC to prioritize the increasing epidemic of ATVs and ROVs on roads. Highly concentrated liquid laundry detergent packets pose a serious risk of injury to children when the product is placed in their mouths and squirts in their eyes. In 2016, thus far, 4,900 children, five, and younger were exposed to laundry packets. In 2015, there were 12,594 exposures. In 2014, there were 11,714 exposures. In 2013, there were 10,395 exposures. These were all to children, five, and younger. According to a recent 2016 pediatric study, child exposures to laundry packets rose 17% from 2013 to 2014. Children exposed to laundry detergent packets were five to 23 times more likely to be hospitalized and 8 to 23 times more likely to have serious medical outcomes than children exposed to other detergent types or forms. In addition, two children's deaths were associated with laundry packets. We very much appreciate the active role that the CPSC has played in the voluntary standards process, and with the completion of the voluntary standard, urge the CPSC to carefully monitor the incident data to ensure that the voluntary standard is in fact reducing incidents. If the data indicates that the voluntary standard is not successfully addressing the hazard posed by laundry packets, we urge the CPSC to move forward with an effective mandatory standard. Furniture tip-overs. According to the CPSC's data, every two weeks when a child dies and more than 38,000 people are injured annually as a result of a piece of furniture, appliance, or television tipping over. Between 2000 and 2011, there were 349 tip-over-related deaths. Two-thirds of those deaths involved toddlers. The ASDM standard for furniture must be improved to more effectively protect the public, and hazardous products must be removed from the marketplace. Lame retardant chemicals are found in numerous types of consumer products and are associated with serious human health problems, including cancer, reduced sperm count, learning deficits, hyperactivity, and hormone disruption. These chemicals migrate from household products into air and dust. As a result, 97% of U.S. residents have measurable qualities of toxic flame retardants in their blood. Children are especially at risk because they come into greater contact with household dust than do adults. Studies show that children who are developing brains and reproductive organs are most vulnerable, have three to five times higher levels of flame retardants than their parents. We urge the CPSC to prioritize this issue and to take effective steps to protect consumers from the health hazards posed by flame retardants while not diminishing fire safety protections. In 2013, CFA released a report demonstrating that children from low-income families are at greater risk for unintentional injuries than children from higher-income families, in which also concluded that data must be collected on the relationship of income to product-related unintentional injuries and death. We urge the CPSC to consider including information indicating socioeconomic status in the NICE database. Now a few enforcement issues. First, recall effectiveness. The vast majority of consumers never realize a product that they own has been recalled. While there are now requirements for recall registration cards and online mechanisms for certain infant-durable products, much more must be done to ensure that consumers find out about recalls of products they own and ensure that consumers remove the products from their homes. On import surveillance, we applaud the CPSC's current commitment to enforcing its safety mission at the ports of entry to the United States, establishing a self-sustaining full-scale import surveillance program. Ensure that CBP and FDA will prevent unsaved products from entering the United States marketplace. In conclusion, we support the CPSC's existing priorities to strengthen its efforts to fulfill its mission to protect consumers from hazards posed by consumer products. We urge the CPSC to consider including the additional priority issues that we outlined and note the urgency of these issues. We look forward to working with the Commission. Thank you, Mr. Walsh. On behalf of Consumers Union, the Policy and Advocacy Hour of Consumer Reports, thanks very much for providing this opportunity to testify on the CPSC's agenda and priorities. The following comments highlight several areas that we hope the agency will emphasize over the next couple of years. Durable Infant and Toddler products. We strongly support and applaud the CPSC's ongoing efforts under Section 104 of CPSC. As a result of the robust safety standards developed through this process, numerous infant and children's products are manufactured to be far safer than they once were. And compliance must be tested and certified by a third party. As the CPSC's work continues in this area, we hope we will soon see strong final rules on high chairs, infant bathtubs, infant bouncer seats, sling carriers, and children's folding chairs and stools. We also understand that CPSC staff plans to propose rules over the next six months regarding gates and other enclosures, residential changing tables, infant inclined sleep products, stationary activity centers, and booster seats. We look forward to reviewing these proposals and urge the commission to continue in the next two fiscal years to make it Section 104 activities of top priority. Merging Product Hazards. We appreciate that the commission considers it a priority to detect consumer product safety risks in a timely and accurate manner and understands the importance of its data analysis and research capabilities in doing so. Its public communications about new, previously unknown hazards and its related work with manufacturers and retailers can help keep consumers safe from hazards in new products or existing products that present new hazards. For instance, we credit the CPSC's outreach on self-balancing scooters or hoverboards with helping consumers and retailers learn that many of these products presented a risk of fall and of electrical fire. We also appreciate that the agency recognizes, including in its draft strategic plan, that identifying emerging product hazards and taking action on them presents unique challenges. We are concerned that it sometimes takes too long for the CPSC to meaningfully respond to new hazards when they emerge. For example, despite the agency's commendable public outreach and work with standard-setting bodies on hoverboards, we are concerned that the hazards were not identified until consumers had bought hundreds of thousands or even millions of the products, and many dangerous products remain both in homes and on the market, leaving consumers at risk. We understand that this is a multi-faceted issue and that various parties have different responsibilities, and we look forward to working with the agency during fiscal years 2017 and 2018 to address any and all barriers that may exist to quicker action. We note one additional point, which is that when a product with an emerging hazard is overseen not just by the CPSC but also by another federal agency, we urge the commission to nevertheless assert its essential role in protecting consumer safety. The commission, put plainly, has the expertise in a lot of cases. Furniture and television tip-overs. We appreciate the agency's work to improve public awareness of the hazard from furniture and television tip-overs. This includes the agency's excellent anchor-it campaign to encourage parents and caregivers to securely anchor furniture and TVs. However, we remain very concerned about the continued risk of injury or death to young children. With a child injured every 24 minutes on average as a result of a TV or furniture tip-over incident, we continue to urge the commission to use every tool at its disposal to ensure hazardous products are addressed in a manner that eliminates known risks. We also look forward to working with the CPSC, our non-profit and public health partners and all stakeholders to improve the inadequate voluntary industry standards covering some of these products. Courted window coverings. We believe that hazardous, accessible window covering courts pose an unreasonable risk of injury to young children. In May 2013, we and eight other groups petitioned the CPSC to promulgate a mandatory safety standard for window coverings. We are glad the commission has advanced the petition since that time and appreciate the work commissioners have done to raise awareness about the hazard, gauge retailers and push manufacturers toward constructive action. We urge the commission to keep moving forward as expeditiously as possible. To prevent future tragedies, we continue to support the development by CPSC of a mandatory standard to eliminate the risk of strangulation and we urge the CPSC to propose such a rule without delay. Liquid detergent packets. We applaud CPSC for its education and outreach work on the hazard posed by liquid laundry packets and its very influential participation in the ASTM international process to establish a voluntary safety standard for them. We're hopeful that this standard will lead to a meaningful drop in injuries and are currently working very closely with all stakeholders to ensure that there is adequate data to measure the standards effectiveness. However, given the demonstrated ongoing threats to young children, we continue to urge CPSC to consider promulgating and a forcible mandatory standard if the voluntary standard is not effective. Safe sleep. We remain very concerned by the continued risk to infants from padded crib bumpers. We urge the commission to promulgate rules that would ban them from sale. We're also concerned by the availability in the marketplace of supplemental mattresses specifically designed for use in play yards, which present an enhanced risk of suffocation to children. We support the pending petition by keeping babies safe to ban supplemental mattresses for play yards and urge the commission to initiate a rulemaking to do so. It should start this rulemaking without delay rather than postponing action until 2017, as proposed by the media review. Thalates. We remain concerned about the serious health risk posed by certain thalates, and we were pleased to see the agency publish a proposed rule last year. We strongly support the majority of the rules provisions, though in crafting a final rule, we continue to urge CPSC to revise the proposed rule to make permanent the interim bans on DIDP and DNOP and to permanently ban DIOP. Surveillance and enforcement. We commend the CPSC for its commitment to monitor imports of products at as many ports as possible to prevent entry of dangerous products into the U.S. marketplace. CPSC should also continue to more broadly monitor the marketplace to ensure that older, unsafe products are removed from the secondhand market and from child care facilities. Effective implementation of product recalls remains a challenge. We urge the CPSC to continue to make this a priority, working with manufacturers to increase public awareness of product registration and to better ensure effective public awareness of recalls. I know that we also very much look forward to the workshop. SaferProducts.gov. We have long supported and continue to strongly support the SaferProducts.gov public 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 FY 2017 and 2018, 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. Flame retardant chemicals. As a co-petitioner, Consumers Union strongly supports the request by Earthjustice, the Consumer Federation of America, and nine other groups for CPSC to promulgate rules on certain flame retardant chemicals. We urge you to grant the petition to protect consumers from the documented health risks of the specified flame retardants in the household products covered by the petition. Liquid nicotine. We support the expeditious implementation of the Child Nicotine Poisoning Prevention Act, which directs CPSC to require child-resistant packaging for the most accessible kind of liquid nicotine containers. We urge the agency to use all its available tools to reduce the risk to children of poisoning from highly toxic liquid nicotine. Bike helmets. Consumer Reports will soon release its newest story and updated ratings on bike helmets. We will stress that biking presents a greater risk of head injury than many consumers may think. We thank the CPSC for speaking with us during the development of this story and look forward to working with the agency and all stakeholders to ensure that the CPSC bicycle helmet standard continues to drive the market toward helmets that provide greater protection from impact. Outdoor equipment. We remain concerned about injuries resulting from outdoor equipment, including pressure washers, which we scrutinized in a story published this March. An analysis of CPSC data showed that pressure washers sent several thousand consumers to the emergency room last year. Due to an extreme potential risk of laceration, we are no longer recommending pressure washers that come with nozzles that produce sprays of less than 15 degrees, and are asking manufacturers to stop including tips and settings that produce streams finer than 15 degrees. We are also concerned about carbon dioxide poisoning caused by portable generators, used indoors and in partially enclosed spaces such as garages. We are pleased that the CPSC makes generator safety a priority, and we urge the agency to consider a briefing package before the end of this fiscal year that includes solutions for reducing and eliminating generator related hazards. In conclusion, we greatly appreciate 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 2017 and 2018. Thank you, Mr. Wallace, Ms. Davis. Good afternoon. My name is Joyce Davis, and I'm the founder of Keeping Baby Safe, a national nonprofit organization that is committed to ensuring every baby in America. Leap safely with the safest products on the market. It has been 16 painful years since my four month old son Garrett was killed when we added a supplemental mattress to his play yard. He rolled over and suffocated. This mattress was advertised as suitable and safe. Many of you already know my story. That terrible day changed my life and the lives of my family and friends. This tragedy was the reason I founded Keeping Baby Safe with the hopes and prayers that other families won't face the same tragedy. Over the past year, I felt some of my prayers were to be answered. The CPSC unanimously agreed to docket our petition to ban the sale of this awful product as it has been so misused across America. I am disheartened to learn that the CPSC may not consider this ban in its 2016 fiscal year even after the public comment you received was 99% in favor of a ban. Today and on every other day in America, there is one painful reality. The same supplemental mattress that killed my baby is still regularly sold in stores and online. While the CPSC still considers this petition and may push off a decision until the 2017 fiscal year, the rest of us can't wait for another baby to die. We continually reach out to retailers to show how this product has proven fatal for babies. We send links to a short KBS video that demonstrates what can happen to a baby when he or she is wedged between the side of a supplemental mattress and the mesh of a soft-sided playard and how easy it is for this to happen. We send certified letters to these retailers. We rally the local media to recognize this paramount issue. We have made some headway. Such superb companies as Toys R Us, Sears, Kmart, Bye Bye Baby, and Wayfair are working closely with us to ensure these products are never sold in their stores or online. Yet it is amazing to me that other major retailers such as Walmart, Target, and Amazon continue to sell deadly supplemental mattresses. They tell us they are waiting for you to make a decision. Even though so many organizations and individuals tell them the products they are selling is causing babies to suffocate. They don't argue or even hint to us that they believe supplemental mattresses are safe. They provide no evidence to the contrary. We have repeatedly attempt to remind these retailers that there are mandatory hazard labels printed on all playards in accordance with ASTM F406-13 disclosing the risks of using supplemental mattresses. Parents are told not to use these mattresses and are instructed to only use the original mattress pad contained in the playard package. Still, these major retailers and others in direct contravention of their own warning labels continue to sell these dangerous mattresses creating confusion in the marketplace. In 2014, KBS was asked to present our findings at the ASTM Playard mattress meeting. We showed the warning labels, various supplemental mattresses, photos of an attract baby, and then I asked all the retailers and manufacturers in the room if they would allow any of their family members to use their products. The answer was unanimously no. Confusion remains. Because this risk is not readily apparent when shopping for products separately or together, many young families innocently buy products that are so dangerous to little ones. They mistakenly rely on the idea that a major retailer wouldn't sell something unsafe. This is why we have filed this petition with the Consumer Product Safety Commission. The warning labels have failed. Without your action, these supplemental mattresses will remain available to consumers, putting off a decision until 2017 since the wrong message about the severity of this issue and rewards manufacturers and retailers which are violating their own standard. That is why we so desperately need you to finally act. Please, in fiscal 2016, to ban these mattresses. As you wait, retailers and manufacturers are acting with reckless disregard to these hazard labels by intentionally ignoring these warnings and choosing to manufacture and market these supplemental mattresses. Such retailers and manufacturers are profiting on families who trust the brand. It has been very distressing to watch. In December, we were not surprised to learn that the American Academy of Pediatric has joined in our effort to urge this commission to ban the sale of supplemental baby mattresses. According to the AAP, supplemental mattresses for playards do not have a place in a safe sleep environment. These products pose a suffocation hazards to infants. We hope this support from the AAP and many healthcare experts nationwide will help encourage you to vote on this ban. In April, the CPSC released its latest fatality reports of baby suffocating and soft-sided playard. It proves yet again that we continue to lose infants while our petition is being debated and discussed. The cause of infant death that occurred during sleep have increased in incident, including suffocation, asphyxia and entrapment. The updated data from 2014 through 2016 shows the number of infants who lost their lives. I can read you those numbers, but I think we all agree that any number is unacceptable when it comes to easily preventing these deaths. We seek a ban on a product, supplemental mattresses, that fulfills no greater good, but instead is a product that industry has already determined to be unsafe as set forth in warning labels that have adopted themselves years ago. We simply seek to remedy a loophole in commerce that allows manufacturers and retailers to put into commerce a product that they themselves know to be unsafe. Warning labels are important, but in this case, the warnings are being circumvented by certain manufacturers and retailers for pure profit. For all of these reasons, a total ban on the sale of supplemental mattresses is necessary. No other mother should have to suffer the way I have as there is a clear and obvious way to prevent further tragedy. I urge and implore you to approve our petition that calls for the banning of the sale of supplemental mattresses in retail establishments and online in the United States. Please, please, please make this ban a priority in fiscal 2016. There is absolutely no reason to wait. Thank you, Ms. Davis, Dr. Denney. Good afternoon, Chairman Kay, Commissioners Berkel, Mojorewicz, and Robinson. My name's Sarah Denney. I'm a pediatrician in the Emergency Department at Nationwide Children's Hospital in Columbus, Ohio. And I'm here on behalf of the American Academy of Pediatrics where I sit on the Executive Committee for the Council on Injury, Violence, and Poison Prevention. We really appreciate this opportunity to make recommendations on key areas that we suggest that CPSC prioritize in the coming year. There's a lot of overlap from what we wanna prioritize with some of the other panelists, so I'll just speak briefly on each of the topics that we wanna focus on. First is safe sleep messaging. The AAP really appreciates the CPSC's ongoing work to promote safe sleep, but there's still a lot of work to be done to reduce the high incidence of sudden unexplained infant death or suites, which stands at 3,500 infant deaths every year. We've seen very little progress in reducing the rates of suites in a decade or more, and in high-risk populations and sleep-related infant deaths, specifically, we're seeing an increase in those rates. CPSC should strengthen its critical safe sleep messaging by banning crib bumpers and supplemental mattresses for play yards. There's no evidence that these products prevent any injury, and there is potential risk for suffocation, strangulation, and entrapment of infants. The second area that we'd like to prioritize are laundry detergent packets. As you already know, in April, in the journal Pediatrics, Dr. Gary Smith and his colleagues published an article finding that child exposures to laundry detergent packets rose 17% from 2013 to 2014, and that laundry packets specifically are uniquely dangerous relative to non-packet laundry detergent and dish detergents with greater rates of hospitalization, intubation, and serious medical outcomes. The AAP has participated in the ASTM process to protect children from these products, but we have concerns about the voluntary standard. We urge CPSC to stay engaged in the ASTM process to ensure that the implementation of the standard entails true public health surveillance tracking of child exposures to assess its effectiveness. And if its effectiveness is not demonstrated, then to move forward with the mandatory safety standard. We'd also like CPSC to encourage manufacturers to be more transparent with their data so that we can really truly assess what the exposure is and really track those incidents. Third area is liquid nicotine. Liquid nicotine poses serious childhood injury. We know that children less than five are at significant risk of injury and death from poisonings of all types, and this is because of their developmental age. Everything's new to them, they're curious, they're little explorers, they've also become more mobile. Now they can crawl, they can climb, they can stand, they can reach. So when you combine those two things with their inability to recognize consequences of actions or potential harm from ingestion, you have the perfect storm. Not sure if you've seen actually the liquid nicotine bottles, but they're colorful, they often have little cartoon characters on them, they smell really good, they come in flavors like bubblegum, cotton candy, all kinds of things would be very enticing to a child. Because toxicity is weight-based, it only takes a very small volume of highly concentrated liquid nicotine to have severe effects or even kill a toddler. We know that one standard size bottle can be enough to kill four toddlers. The AP strongly supported the enactment of the Child Nicotine Poisoning Prevention Act of 2015, which requires CPST to enforce child-resistant packaging starting in July. We encourage the commission to thoroughly examine the issue and prepare for prompt enforcement. We've heard a lot about window coverings today, I'm gonna just briefly discuss that. As you know, window cord coverings prevent an avoidable home hazard. In fact, the window cord covering cords are on the CPSC's top five hidden hazards in the home list. Infants who are in a crib that are placed near a cord could grab the cord, pull it into their crib and strangle themselves. Or as you've heard from other testimony today, small children, toddlers, preschool and school-aged children can also access these cords and get them wrapped around their neck. The voluntary standards have failed to effectively address this issue for 20 years. We're still seeing almost one death a month from the window cord strangulations and that doesn't even take into account the kids who are injured from hypoxic brain injury and other injuries related to these window cord coverings. The AAP strongly supports CPSC's efforts to advance a proposed rule to protect children from this avoidable threat. I would like to move next to TV and furniture tip-overs. We are eager to see the CPSC and industry do more to prevent furniture and TV tip-overs. We join others in questioning why the Ikea mom dresser has not been recalled despite three toddler deaths since 2014. We know that between 1990 and 2010 an estimated furniture-related deaths were reported. Restraints securing these items to the wall can make a difference and we appreciate the Anchor It campaign very much. But I hear from families frequently that they live in rental properties and are not able to anchor things to the walls. So we know that strengthening the stability performance requirements and the relative safety standards would be the most effective solution. This may require a mandatory standard from CPSC to ensure the protection of all children. Lastly, recreation off highway vehicles or ROVs. These are becoming increasingly popular over the past few years for both recreational and work use. And at the AAP we recommend that no child under the age of 16 operate or ride an ROV. The safe methods for securing children in these vehicles have not been established. We urge CPSC to continue prioritizing this issue through ongoing monitoring of morbidity and mortality associated with ROVs to assess the effectiveness of the voluntary safety standard and to do more to keep children from riding these vehicles. So thank you so much again for this opportunity to comment and we look forward to partnering with the commission to continue protecting the health and safety of all kids. Thank you, Dr. Denny. And thank you to the rest of the panel for testifying. We'll now turn to questions from the commissioners. Dr. Denny, I wanted to start with you please in one of the areas that you left it with, which is educating parents. And from my own experience, there's probably nobody who sees us parents at our worst than pediatricians because when we're trying to corral, especially with multiple children in a pediatricians office to say that we have a hard time focusing as an understatement. But it's a critical moment clearly for pediatricians to take a snapshot of what's going on with the family and to get a sense of the health and well-being of a child. From a pediatricians perspective, how reasonable is it to expect parents to be able to receive these educational messages and internalize them and act on them, even if they're able. You made a great point about Anchor It. As valuable as that campaign can be, it just may not be effective to its fullest extent because of the limits of rental properties. But as you engage with parents and as your colleagues engage with parents, how realistic is it for us as policy makers to expect that that's gonna solve a problem? That's a great question. And that's something within injury prevention that we struggle with all the time. Speaking broadly around various injury mechanisms, we know from injury prevention studies that education is really important and families do wanna hear those messages from their pediatrician. But when we really see the needle move, like whether we're talking about child passenger safety by helmets, whatever it may be, when there is a policy in place that helps move the needle so much more. So we talk and we talk and we talk. A great example would be about the crib bumpers. We talk and talk and talk about the safest place is alone on their back in an empty crib. But when a family walks into a store and sees bumpers everywhere, and I hear the same comments, well, it was in the store, so I thought it was safe. We're taking two steps forward with education then we're taking a step back as soon as that family steps foot in the store. So I think education is very, very important and that's part of our jobs as pediatricians. Every visit's supposed to have anticipatory guidance where we talk about your child's gonna be walking soon. It's time to get up those safety gates or those kind of things. It's definitely part of our job and we definitely own some of that responsibility. But it's hard when there's products on the market too that compromise what the message we're trying to portray. And I appreciate you pointing out not only that you're pediatrician, but specifically what you do at nationwide in injury prevention. So you do have that added expertise and there are persistent hazards and the panelists testified to many of them that have gone on for decades and there have been educational efforts. And when is enough enough from your perspective from understanding injury prevention, when do you determine that an effort needs to be augmented and that education just alone is not gonna cut it? Well, I think kind of what the panelists said this morning is we're all working towards policy change. That's our ultimate goal. The education campaigns are kind of what's going on in the meantime so that we can prevent these. I mean, it's heartbreaking seeing these injuries and these deaths come through our doors and so we just wanna do whatever we can in the meantime until we can achieve that policy change. Thank you, it's very helpful. Ms. Davis, thank you for coming in. Obviously, you and I have talked many times about the subject. I don't think that we could sufficiently convey how frustrated we are as well with trying to move forward on all these topics at the same time and I can see how frustrating it is as well on the outside for all the work that you've done. It's still not where you want it to be. I'm wondering while we continue to have our staff do their technical work on the issue, is there something else that can be done to drive down the demand for the need for supplemental mattresses? And I know from the experiences that we have and we all know this when you have a play yard and you put in that mattress, it's like a concrete cement floor. It's so uncomfortable, which to me seems to drive up the demand for parents to feel like they wanna make it softer for their child. Is there something that you can think of that we can be doing in terms of the play yard standard or something else that would make it so that when parents buy these products and use these products, they wouldn't want to use a supplemental mattress? Thank you. Unfortunately, no, I mean the warning labels are there and they have failed and we have done numerous educating on a nationwide level with you and with other organizations and through our website and parents continue to use them and if you would read the comments on Amazon or any retailer that's selling it, it's really moms miseducating other moms. They're not going in and saying, what product are you using? Oh, it's just I want that mattress and most of the time the mattresses don't fit those play yards. So it's very evident here that that mattress is a suffocation hazard, a very well-known suffocation hazard and we post that. We post that on websites that sell it and parents right above us and grandparents, oh my child's or my grandchild slept all night, thanks for the mattress and we've posted the warning labels on those sites and it's just blatant disregard and quite honestly, there's no evidence that the mattress pad that comes with the play yard is unsafe. It's just a parent's misconception because we sleep on firm, thick mattresses so every parent or grandparent believes that's what they should provide to their child, as did I and they are a known suffocation hazard, nobody's reading the warning labels, the voluntary standard, it's all failed and the only thing left to be done is ban these mattresses and thankfully, like I mentioned, toys are us, bye-bye baby, Wayfair, Kmart, Sears, they have all worked with us and watched our video on the danger of supplemental mattresses and they've stopped selling it across the board in stores and online and we've spoken to many manufacturers as well as the retailers about this, parents are not coming in and asking for a replacement mattress. That mattress pad is the safest way for a baby to sleep and the only way we see this working, I mean, we continually educate but it's really a ban on, this product serves no purpose. So is what you're seeing from your research that people are buying it just because it's there or they actually feel like they need something to soften the play or sleeping environment? Both, I think they might think that, oh maybe I need something better, my baby's not sleeping and then they Google it and this product is available. Yeah, and that's why I got to my first question if this ban goes through, might there be something else that we're gonna have to deal with because of the same issue of parents saying it's just not soft enough and I wonder if we can meet it in both ends. Do something to soften or maybe softens not the right word, something to make these parents' minds that the sleep environment is good enough for their children in play yards for those who need to use them and then also deal with the suffocation hazard. I just wanna make sure that, I think we shared the goal. We wanna end the suffocation hazard however we have to do that. Yeah, thank you. I think when we revise our safe sleep for babies video which we did together in 2010, that would be one of the topics that we would include in the new update because that video is aired in over 1200 hospitals nationwide on the newborn channel and it continues to be the most watched video. So I think just continually educating and putting that message out there that the mattress pad is the safest. But again, if the product's not available, people are not make shift making mattresses, they're not, that's a fallacy. And just like when we spoke at the ASTM, all the manufacturers and the retailers came up to me and they said, we would never put our children or grandchildren in this. It's a deadly combination and unfortunately everyone knows that except for new moms who might be out there. But together they're a deadly combination and slowly the retailers and are realizing that. We'll keep up with good work on your end and we'll keep up our end. Thank you. Ms. Weintraub, we just talked about the retailers. What role do you think the retailers have in the safety system? There have been, I've had many conversations with retailers and some associations and some take the view of leave us alone. We don't know anything. We don't see anything. We don't have any expertise. It's all the manufacturer's problem. We just provide store shelves and others say, yes, you can hold this accountable, especially if it's private label or something. From your perspective of having seen CPSIA, where do the retailers fit in and if you can compare product categories, hoverboards, other things, and what role you think is an appropriate one for the retailers to play. Thank you for the question. Certainly over the years that I've been working on this, I think that retailers play a very critical role. Not only could they leverage their buying power for safety, could they in fact make products safer by having requirements for the products that they purchase, but they are often the entity that consumers interact with the most. So in terms of conveying safety information, in terms of having point of sale information, there are some retailers that are going, taking this role incredibly seriously. Some retailers for laundry packets, you will see warnings. Some retailers will have recall notices readily available. And some retailers take recalls very seriously, make that process as easy as possible for consumers. And some retailers also, like Joyce was saying and like others have said, they are leading. They are choosing to be leaders on safety in different categories, whether it is window coverings or supplemental mattresses or choosing not to sell hoverboards that don't meet new safer standards. So there's an incredibly important role that retailers play and have continued to play. And also in voluntary standard activities, retailers are an important part of that area as well. Great, thank you. I apologize to Ms. Balti and Mr. Wallace. Please don't read into me not asking you questions that we didn't have questions. We just unfortunately ran out of time. Krishna Robinson. Thank you. Thank you to all of you for your presentations today. These issues that you raised to us are critically important for you to continue to put on. We care very much and we just really appreciate your thoughtful presentations. Ms. Davis, I particularly wanna thank you. You also, like the parents we saw this morning, have found such an important contribution to make to safety for other families, to prevent the tragedy from happening to other people that happened to you. I do wanna say that while we're not gonna get to the final decision on the petition for a ban during fiscal year 2016, the good news is that the fiscal year 2016 is getting close to the end and by the end of that, so just in the next couple months, we're expecting a package that from our staff, which is the process, obviously, that we have to go through and I'm sure Chairman Kay has explained this to you, for us to know a path forward in terms of determining what we should do with the petition to ban and I commit to you that I will do everything I can to act as quickly as possible once we get that package. Dr. Denny, I just wanna say to you how impressed I am constantly by the AAP. You guys pop up everywhere. I mean, you are in so many different venues and always pushing for the safety of children. I was recently at an advisory meeting for the National Center for Fatality. Review and Prevention and Jim Cotto was there and I mean, we work with Amy Gandhi all the time. We were just talking with her recently in my office about trying to get pediatricians to educate parents. You educate them about so many dangers but about tip-overs and window-blind cords as well and you've just been such a wonderful organization to work with and I thank you and your fellow physicians. Ms. Bolte, I remember very vividly Josh and Sally coming in and I hate to even think about the fact that that was a year ago and I totally agree with you that we need to get moving on table saw as it's been long enough. You mentioned in your written presentation that there had been industry representatives pushing back against the inclusion of AIMS and the UL standard and I think you also briefly mentioned it in your oral comments. Could you tell us what reasons you see for that opposition? Well, I mean, I think it's typical industry if it's not going to be required that they don't necessarily want to include it on their technology. So I'm not all that familiar with the UL process. I didn't know how much you'd participate. Yeah, yeah, so Sally is really the expert so I could consult with her and we could get back to you. Because I have a vague recollection of running into somebody from UL at the CFA dinner last year and them being, I thought they were cautiously optimistic. They were gonna be able to get a standard that included the AIMS technology. So I was sorry to read that they weren't able to do that. Are there other safety features for table saws that you think are important that are left out of the current standard other than the AIMS technology? I'm sorry, I'm really only familiar with the AIMS technology. Okay, well, thank you so much for your presentation today. Ms. Weintraub, I did read your written comments and I do wanna say you're always on top of everything even probably more than I am in terms of what's going on at the agency. So you probably know this, but I was very encouraged with respect to the mid-year when our staff asked for another $500,000 for testing. And when I asked, frankly, I said to them, are we just throwing this money away? Because what are we doing about ATVs to make them safer? They were incredibly excited about this new autonomous driving system which you probably know about. Because some of the testing for ATVs in terms of making them more stable, it's been difficult to test because they don't wanna injure drivers testing them. But now that they have this autonomous driving system, they are cautiously optimistic that we're really gonna be able to come up with some real solid progress. So I'm very, very encouraged by that. I would also like to say that in your written comments you support the proposed changes in the voluntary recall rule. Like I said this morning about 6B, you know that I'm very much in full agreement with you that we should be going forward with this. However, this is another area in which the chair and I disagree. And he has control over the forward momentum on that. So work on him. Because I very much think that we should be going forward with that. You discussed the greater incidents of product related injuries in low income families. And we've been really looking at that because we know what the nice data do and do not include. There's a field for race. We have addresses, but that's not public. But what we've been trying to do is figure out with some other agency data sets if there's a way of doing an overlay so that we can get some socioeconomic information because we think it would be critically important. But I just wondered if you had any thoughts on that. Well, that's really great to hear. You know, in so many substantive product safety categories, I feel like there's an untold story because we have broad numbers, but we don't know if there's a disproportionate impact in the midst of particular communities. And if there is, could that inform our safety efforts? Whether it's the standard, whether it's the educational efforts. So it's incredibly important to CFA and to other organizations. And we're so glad that you're looking at it. So I think in terms of proxies, it's something that we have been researching ourselves. We are trying to understand how zip code could work as a proxy. Also how healthcare payers because certain populations obviously obtain health. That's a great idea. We hadn't thought of that. Health care in different aspects. But so I can definitely share our thinking. I think we have a lot of ideas. We had preliminary a number of conversations with various entities to try to get an understanding about how all of that could work together. And I think it would be a huge benefit to really all consumers to better understand the socioeconomic correlations. I agree totally. And we've been really frustrated with just having anecdotal information. And we really think that, particularly with the educational effort because different socioeconomic groups and different communities get their information differently. So I'd look forward to working with you on that. Mr. Wallace, you mentioned saferproducts.gov. And I just want you to know that one of the concerns that I have, we've put in a huge effort in my office in trying to get more entities involved in reporting to us. But one of the huge frustrations that we have is that basically only a third of the reports that we receive actually end up becoming publicly available because there's not enough information. So we're trying to figure out how we can do that differently. Whether it's an email that goes back to people saying we need this information or fields like we all fill out where they won't accept the form unless you fill out required information and so forth. Because in addition to getting more of them, we'd like to find a way in which we can actually make those, all the reports that do come in, ones that can be publicly available. Could you tell us if you have any additional ideas on what we might be able to do additionally or differently to identify emerging product hazards than we do now? Well, I think that this is a difficult one because I know how hard the commissioners, all of you work on this issue and how seriously you've taken. I know how hard the staff were on this issue. Partly it is a function of statutory limitations. Partly it's a function of resource limitations. So in the big picture, we're probably looking at big changes. So you don't have any immediate suggestions for us? Immediately, no. And what about monitoring the secondhand market because that's been a huge frustration for all of us? I would just say that as much as possible, and I know the commission already does some work in this area, connect with the major points in the middle. So that could be major online sellers, major websites where sales might take place, community websites and community locusts that bring people together for these types of sales or connect them, I would suggest that. We're also, for whatever it's worth, trying to see if we can get some traction on the third party platform providers that everybody seems to be using now, and they under our statute because it was done before. There were a third party platform providers. They don't have any obligation to report to us, so we're trying to figure out how to use those two. Either you or Dr. Denny, I would really love to know your thought on whether you think the child resistant packaging is going to be enough to eliminate this unreasonable danger of the liquid nicotine. So I think that like so many other things, it's got to go hand in hand with education. The lids are significantly different if you're holding a bottle that has the child resistant packaging versus not. I mean, there is a significant difference in the ability to open it, but families also just need to be aware that that should be treated like any other poisonous substance in the house and be kept out of the reach of children. So I think it kind of goes hand in hand. I think it's going to play a very important role, but I also think we need, as we're seeing more and more use of e-cigarettes and liquid nicotine, we need to also be educating people on the hazards. Thank you, I'm out of time. Thank you, Commissioner Robinson, Commissioner Berkel. Thank you, Mr. Chairman. And again, just to reiterate my colleagues, thanks, thank you all for being here and for taking the time and the energy to come here and present your priority issues for our agency. And especially to you, Ms. Davis, again, it takes an incredible amount of courage to take heartache and turn it into a mission. So thank you for your courage and for your willingness to take on this issue. Some of the themes that have come up and not just to this panel, but we've heard them over and over again, and they seem to be repetitive and common themes. So I'd like to just talk about a couple of them and get your assessment and your ideas about this. So the one is laundry packets, laundry pots, and that is something that many, three of you on this panel have raised and others have raised it as well. So I do want to talk briefly about, because it was referred to, the article that was referred to from Dr. Smith and others in, I think it was March or April of this year, and the fact that that article did talk about a 17% increase in laundry pods and exposure to them, but the fact is that it didn't take into account and rightly so, because the data isn't available yet, that there is a new safety standard that went into effect at the end of 2015, of which many in this room were a part of putting that standard together and there will be a tougher film on that packet, there will be a bittering agent, there will be much clearer warnings as well as child resistant packaging. So that to me is a huge effort and collaboration to get to that point. And also we talked earlier today as well about the working groups. And I know, Rachel, you have done and will continue to do a lot of work on the issue. So I feel like we should take a step back and wait to see. And I think if I'm hearing all of you correctly that you're asking us to pay attention to the new standard and see if it's effective and to pay attention to the data. But at this point, it seems to me we're in a decent place at least because there has been a recognition by all of the parties that this is a problem we need to address, we've addressed it with a new standard. And now we're gonna even continue dialogue and collaboration with the two working groups. So are you all, and Ms. Bolte and Ms. Davis, I don't, this wasn't an issue that you brought to us, but maybe Rachel, William and Dr. Denny, you could just, if you agree with that assessment or you think there's something else should be done in the meantime. Well, I think you're spot on. I think the key is making sure that all of the data is looked at and that there is a very keen attention placed for all of us, all stakeholders are involved once that data is reviewed. And I think so it's not only the speed and the seriousness, but also the scope of the information. And I think that's really where we are. I think the important study that came out in April really documented how pervasive this hazard is and why it's so important for us to really look at this data and the differences between the consequences of ingestion from these packets versus other detergents. So I think that type of research is really important also to gather at this point. But given that there are the changes that you outline from the standard, that will be making their way and they have been already into the marketplace, but figuring out the right parameters in terms of time when we can as quickly as possible assess the efficacy of the standard is where I think we are. Thank you, Mr. Wallace. I agree that generally you're spot on with how we see it too. I would agree with Ms. Wontrob that at this point our top priority is making sure that we have the data we need to assess whether or not it's working. Thank you. Dr. Denny? Yes, I would agree that this is clearly on everybody's radar and we definitely appreciate the steps that have been taken thus far, but again, we just want to make sure that the data is being reported in a true way and that everybody's clear on what the numbers are and what they mean. Thank you all. The next sort of common theme was tip overs and in our mid-year it was actually, I believe a unanimous vote, our amendment to assess the voluntary standard and we think that was a good way we have asked our staff to assess the current standard for tip overs and to see whether or not it is adequate or if it's not adequate what would it take to become an adequate standard. So we're, again, I think that's a good place to start in this discussion that we've asked our staff, there are the experts in this to assess whether or not that standard is adequate and in the meantime, if there's anything else that you think we could be doing, that would be helpful too. Ms. Weintraub or Mr. Wallace or Dr. Denny? Yeah, and I also think it's sort of the research phase that really looking for information, analyzing what products in the market are meeting the standard, whether they are, and I think there's a lot of opportunity for more research, I know some of it is being undertaken by some of our colleagues and by you I hope as well, but I think this is really one where the numbers themselves I think are not sufficient but there really has to be an analysis of the marketplace so we can really get a handle on compliance with the standard and then also whether the elements of the standard are really all together working to prevent the hazards that we're all seeking to prevent. Thank you, Mr. Wallace, do you have anything to add? I would just add that that is an important place to start. It's certainly not all that we think the commission needs to be doing, but we are hopeful that this hazard is that these months now are really when we're gonna address this hazard. Thank you, Dr. Danni, anything to add? No, I would just say we as physicians need to continue educating parents on the importance of anchoring things down and we always say in medicine, you don't know what you don't know and so as a parent you don't realize that's a risk unless you hear of that happening in the news and that kind of thing. So for parents who haven't heard about it we just really feel like if we can design the risks out of products that just takes one more thing off the plate of what the parent is trying to, you're trying to raise a child, you're trying to keep them safe. I mean, there's a lot going on there to keep a handle on so we can design those risks out of the product. That would be our goal. Thank you. Another topic that's sort of a common theme is recall effectiveness and I do wanna say and I am looking forward to our workshop and getting together, certainly better minds than mine to talk about this issue. One of the things I don't think we've done as an agency is measure recall effectiveness so it's hard to know whether or not there is a problem and we heard from Ms. Coles earlier today, heard difficulties in getting information so that's one piece that I would like as us for us to talk about going forward. How do we measure recall effectiveness? Is it really a problem or is it that we're not measuring the right outcomes? And so that I'm looking forward to that and I will say that we did, compliance has agreed to put in place an electronic version where a company who has a corrective action plan and has to file a monthly report that it will be an electronic document now and hopefully that will help our agency assess information more completely and thoroughly and at least have it all in one place and be able to see whether or not there's, one of the issues that concerns me is are there more injuries and more deaths post-recall? And if there isn't, is that a good sign that the recall was effective and was successful? So I hope, and I am hopeful that this electronic form will help us in that endeavor. Ms. Baltina to leave you out. And I don't know based on what you said with regards to this is really Sally's Greenberg's expertise and I'm happy to submit the questions to her but because you did raise some issues and I just wanted to kind of talk about it a little bit and certainly can put it in writing to Ms. Greenberg but so this technology that seems to be available, the I call it aims but it's the active injury mitigation system but there seems to be more difficulties with that. But I'm wondering, do you have any information whether or not that technology will apply to all table saws, the small tabletops or the larger, more commercial saws? I think it can be applied to all table saws but I would like to check and get back to you on that. Okay, okay. One of the problems with this issue and I'm sorry, Commissioner Adler isn't here because this is really his champion, this issue is with regards to the patent and all of the technology and the issues that surround that and so when technology is introduced others have been hit with a patent infringement so it's very complicated and finding our appropriate role in that really is the challenge for us. So I will submit those questions to Ms. Greenberg. One last thing because- I mean I would say on the patent issue that it's NCL's position that the patent should not stand in the way of CPSC issuing a mandatory safety standard for table saws but we'd welcome your question and we'll reply after the hearing. Okay, and one last thing and that is I do wanna defend the chairman on his position with 6B because I owe it to him after this morning because he is following the direction of Congress. Congress through statute and CPSA, they had an option to remove the prohibitions and the limitations of 6B and they did not. They felt that it was very important that we protect this information from industry when it's disclosed to us, we have a lot of authority to ask for that information and so it's incumbent upon us to protect it so and they've made it clear to us not to proceed forward with rulemaking so I do wanna defend you on your actions. Thank you, Commissioner Buerkle, that was the first time I ever wanted to cut somebody off for defending me, Commissioner Mohorovic. Thank you, Mr. Chairman. I have two lines of questioning that I wanted to get to but Dr. Denny, if you don't mind, humoring me a bit on the discussion of information and education campaigns and I'm not a communications expert but from what I've learned, a big part of the effectiveness of a communication campaign in terms of one that does require action so not just information but also is motivating enough to get somebody to act and do something is location, timing, when they're receiving this information and I don't know if you'd wanna comment on it and I'll give you an opportunity to after I'm done here quickly but I think when parents are in the pediatrician's office they're in a very receptive environment to receive information. I think that it's a great opportunity for us to take advantage of in terms of some of these products that were mentioned that regardless of future efforts that we might do on a regulatory basis, products are still out there whether they're supplemental mattresses, whether it's a billion corded window blinds, whether it's several billion pieces of furniture that may not be anchored to the wall. I don't think drowning prevention was mentioned too but one that lends itself unfortunately more to education campaigns I think than product regulatory efforts to mitigate the hazard. What can we do as an agency to, and I'll admit that this is somewhat informed from my personal experience. I've got eight year old twins and a four year old and we were pregnant in the Washington area and Chicago area. I've never seen any CPSC information campaigns at all of the numerous pediatrician's offices that we've been to and not that we've been besieged by an amazing amount of crises but for normal checkups, et cetera. What can we do in thinking about it in terms of your role as a member of the board to get our award winning campaigns, to get our information in those doctor's offices where parents sometimes they're stuck because they're unplanned visits so they have to sit there for a long time and that's not a complaint against pediatricians at all but you can't tell what kind of volume you're going to get from those waiting in your waiting rooms but they're sitting around there looking at the walls around them. What can we do to have a greater partnership to get CPSC messaging in those pediatrician's offices? That's a great question and if you find the solution we would love that in the entry. That's always our question in entry prevention is how do we get the message we're trying to portray to those families that we're trying to affect the behavior change. There's an article published in Pediatrics several years ago called Drowning in a Sea of Advice and it talks about how many recommended topics there are for pediatricians to discuss at a well child visit. Not to mention the list the mom brings in of the things she wants to talk about and then you've got the other kids running the room or that's right or caregiver I should say so there's so much to cover in such a short period of time that it's really hard to get all the messages through in that visit. So I work in the emergency room we definitely look for those teachable moments in that setting so I do a lot of talking about bike helmets where I am or trampolines there's definitely those teachable moments there but thinking about other ways to explore the social media campaigns the amount of mommy misinformation that goes on in social media is just astounding to me and so I know the academy just did a big laundry pod social media campaign this past week we got a lot of traction trying to get the message out we've worked with NHTSA on some of their child passenger safety things so trying to come up with some out of the box ideas and reaching people through different mediums I think is kind of where we're headed because expecting the pediatrician to be able to cover so many different things in a visit is really difficult. Screening is a good thing in that visit too because if a family is doing X, Y and Z things correctly then you don't need to cover those but if they're doing these three things wrong you wanna spend your time doing that so it is a very tricky balance and we're always educating our pediatricians on the safety things we are facing too and other things like that but I think some other creative campaigns are important. Well if we think not even so much out of the box but how about out of the cardboard box I mean what if we could we possibly physically get some of our visual campaigns our poster campaigns through to pediatricians offices so they don't have completely sympathetic to that long list of everything that somebody's supposed to get to I think that's a very very good point but outside of that then environment what about in the pediatricians room I know that the industry certainly puts a lot of care and attention in terms of the environment that they wanna have in those rooms and they can't look like a NASCAR driver's suit with labels all over it and posters but is that something in the art of the possible that we can work on together between the CPSC and AAP to see if we can get some of our materials in your I mean I would really look forward to the day to be able to look in I bet I'll probably get to get a lot of photographs email to me or or or tweet it to me of our CPSC campaign material in pediatricians offices and those that have them thank you I'm not saying that it doesn't take place but to make it a lot more regular so then also that would be potentially some subjects that wouldn't have to be orally discussed between pediatrician and parent is that something that's in the art of the possible or something that you would like to champion on behalf of AAP with us I think that the academy would certainly I mean we partner with the CPSC and a lot of different things and partnering on campaigns and getting those campaigns beyond just the organizational level but down to the pediatricians is certainly something we'd love to work with you guys on. Right, great. Well CPSC owes AAP a debt of gratitude and I think there's a long list of things that we're very complimentary and thankful for your support and I think this would be perhaps one that we can add to the list in terms of helping us get the information, the educational campaigns out there in terms of safety with products that we otherwise can't get our hands on to be able to regulate but still pose very real injury and fatality threats to our consumers and your patients so thank you for that. Ms. Weintraub, good to see you again. At such a young age I think you're probably already you're probably already up for a lifetime achievement award in terms of consumer product safety efforts. I wanted to ask you about the priority that you mentioned orally and I read it in my written, in your written statement I looked again this time to try to find it but I'm a little bit curious in terms of your ask with regards to saferproducts.gov I mean in suggesting that it remain a focus for the CPSC well we've got it and it's up and I think a previous set of questions had to do from Commissioner Robinson had to do with some of the opt-ins in terms of unfilled potential filings et cetera but what more is it that you'd like to see as do specifically or stop doing or more of or less of with saferproducts.gov? Thank you for the question and I know we've worked together for a very long time in different capacities it's always good to work with you on safety issues. For saferproducts.gov what I was thinking of and I think it's multifaceted actually but in terms of ensuring that consumers are aware that saferproducts.gov is a resource for them in terms of a place to look for information as well as a place to report information because I think that the utility of the database only increases the more data is contained within it so certainly I know many organizations have been thinking about and I think it would be great to have more of an organized conversation about how do we leverage the existence of the database so that consumers are more aware how can we use different organizations, different stakeholder groups, different collaborative efforts to make saferproducts.gov a household name. Something that I talk about a lot is just as a new parent knows about baby-proofing or particular room in their home and putting up a gate and locking up the cleaning products underneath their sink they also need to know that saferproducts.gov is a very important source of information for them as well as an important place where they can report information to share it with other consumers. Great, thank you very much, I appreciate that. Thank you, Mr. Chairman. Thank you, Commissioner Mohorovic. Thank you to the panel, Dr. Denny, Ms. Davis, Mr. Wallace, Ms. Wontrop and Ms. Balti. We'll now take a five-minute break and have the fourth panel come up. Thank you.