{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:42:41Z","timestamp":1791229361292,"version":"4.1.0"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Inj Prev"],"published-print":{"date-parts":[[2001,9]]},"abstract":"<jats:p>\n                  <jats:italic>Objective<\/jats:italic>\u2014To investigate a local \u201cepidemic\u201d of incidents of strangulation by hanging from continuous cloth towels in dispensers.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Method<\/jats:italic>\u2014The coroner's office in all provinces and territories were contacted. Five cases of hanging from continuous cloth towels in Canadian schools were identified and reviewed.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Results<\/jats:italic>\u2014There were four deaths, and one near-death, all males age 7 to 12. Two cases were attributed to a \u201cchoking game\u201d that provides a sensation (impending loss of consciousness) described as \u201ccool\u201d. In three cases, the child was alone at the time. All deaths were due to strangulation from hanging and all occurred in school washrooms. One child (playing with two friends) recovered after admission to an intensive care unit.<\/jats:p>\n               <jats:p>Towel dispensers were removed from the two index schools. In one province the Ministry of Education encouraged removal of towel dispensers from all schools and education of students of the dangers of \u201cchoking games\u201d.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Conclusions<\/jats:italic>\u2014Thrill seeking from partial asphyxiation appears to underlie these incidents. Awareness of such cases should prompt appropriate education strategies to highlight the serious consequences of this form of risk taking behavior in young males. In Canada, these incidents have resulted in changes in the design of, and legislation regarding, cloth towel dispensers.<\/jats:p>","DOI":"10.1136\/ip.7.3.231","type":"journal-article","created":{"date-parts":[[2002,10,1]],"date-time":"2002-10-01T15:53:59Z","timestamp":1033487639000},"page":"231-233","source":"Crossref","is-referenced-by-count":43,"title":["Self strangulation by hanging from cloth towel dispensers in Canadian schools"],"prefix":"10.1136","volume":"7","author":[{"given":"D","family":"Le","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A J","family":"Macnab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,9,1]]},"reference":[{"key":"2025092606145133000_7.3.231.1","first-page":"7","volume":"28","year":"2001","journal-title":"J Traffic Med"},{"key":"2025092606145133000_7.3.231.2","unstructured":"Scott SM, Wiebe RA. Near-hanging and choking injury. In: Levin DL, Morriss FC, eds. Essentials of pediatric intensive care. 2nd Ed. New York: Churchill Livingstone, 1997: 999\u20131001."},{"key":"2025092606145133000_7.3.231.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540450052034"},{"key":"2025092606145133000_7.3.231.4","first-page":"1417","volume":"155","year":"1996","journal-title":"Can Med Assoc J"},{"key":"2025092606145133000_7.3.231.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(95)70124-9"},{"key":"2025092606145133000_7.3.231.6","doi-asserted-by":"publisher","DOI":"10.1097\/00006565-199406000-00007"},{"key":"2025092606145133000_7.3.231.7","first-page":"171","volume":"6","year":"1995","journal-title":"Adolescent Medicine: State of the Art Reviews"},{"key":"2025092606145133000_7.3.231.8","unstructured":"Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying cause mortality files, United States, 1992. Hyatt, Hyattsville, MD: National Center for Health Statistics, 1994."},{"key":"2025092606145133000_7.3.231.9","first-page":"125","volume":"10","year":"1999","journal-title":"Adolescent Medicine: State of the Art Reviews"},{"key":"2025092606145133000_7.3.231.10","first-page":"13","volume":"10","year":"1999","journal-title":"Adolescent Medicine: State of the Art Reviews"},{"key":"2025092606145133000_7.3.231.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(00)70135-1"},{"key":"2025092606145133000_7.3.231.12","first-page":"57","volume":"144","year":"1991","journal-title":"Can Med Assoc J"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ip.7.3.231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T13:15:01Z","timestamp":1758892501000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/ip.7.3.231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,9]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2001,9,1]]},"published-print":{"date-parts":[[2001,9]]}},"alternative-id":["10.1136\/ip.7.3.231"],"URL":"https:\/\/doi.org\/10.1136\/ip.7.3.231","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,9]]}}}