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Brush Up on Barbecue Safety

Oh, those glorious summer barbecues. And, of course, the trips to the emergency room for burns, food poisoning, the occasional bit of steak that went down the wrong way and won't come up, and a host of other hazards.

Over the years, the medical literature has recorded all of those and more. But unreported until now, says a physician here, is the latest hazard. It's the wire brush used to clean the grill.

In the past year, says Paolo Campisi, M.D., an ear, nose, and throat specialist at the Hospital for Sick Children, three children have shown up at the emergency department to have broken-off wire bristles removed from their throats.

In one case, a 15-year-old boy, the wire fragment had migrated through the child's neck and come to rest between the carotid artery and the jugular vein, he said.

"Certainly the location didn't make any of us happy," Dr. Campisi said, noting the fragment could easily have punctured either of the blood vessels.

The boy had been eating barbecued steak with his family a few days earlier and had felt a scratch in his throat, which he put down to a charred piece of meat. But when he was still unable to eat several days later, he saw a doctor who referred him to the hospital.

"When I looked at the x-ray, I knew right away what it was, because we'd seen it already a couple of times that year," said Dr. Campisi, who has submitted a report on the hazard to the Journal of Pediatric Surgery.

Barbecue experts -- well aware of the usual gamut of possible grilling injuries -- were nonplussed nevertheless by the wire-brush reports.

"It's bizarre beyond belief," said Donna Myers, a spokesperson for the Hearth, Patio and Barbecue Association, an industry trade group. "We've never heard of it."

She said it's hard to imagine how a bristle could stick to barbecue grill after it has been cleaned and then get into food. "There should be nothing left for it to stick to," she said, "but we are going to address it with our members."

In general, Myers said, barbecues pose the same risks as any other appliance that uses heat, and safety measures are just common sense. "They're things like don't put a hot grill on your wooden deck and don't let kids and dogs play around a hot barbecue," she said.

Burns from barbecues are common and most are probably minor. But a 1991 British study showed that 2.16% of the cases seen in the burn unit of a Buckinghamshire hospital were from bonfires and barbecues.

Aside from the issue of heat, the various types of barbecues have their own hazards, the association says.

Gas barbecues burn propane that's under pressure. An over-filled propane tank can leak, creating an explosion hazard. Also, some people store spare tanks near the barbecue, where they can overheat.

But a more common hazard comes when the barbecue doesn't light the first time. Trying again too soon can cause the unlit gas to explode, frizzling hair and burning skin. The association recommends waiting five minutes with the barbecue lid open before re-lighting.

Electric grills don't have that problem, but they have all the dangers associated with electrical appliances. For example, just as one doesn't take one's hair dryer into the shower, the association recommends not using an electric grill in the rain.

If you use wood in your barbecue, don't burn lumber impregnated with copper-chrome-arsenate, once used as a preservative. A 1975 article in the journal Clinical Toxicology reported on five children who suffered arsenic poisoning after they ate meat grilled over such a fire.

Probably the most common side effect of grilling is the so-called "barbecue syndrome" -- food poisoning of various kinds. Again, precautions are just common sense, says Myers. Among them:

Keep your hands clean.

Keep meat cold before grilling it.

Keep raw meat, poultry and fish and their juices away from other food.

Sanitize cutting boards and countertops with chlorine bleach.

Cook meat thoroughly.

If you want a long-term fear, consider that charred meat, as well as meat cooked at high temperatures, contains heterocyclic amines, or HCAs, compounds that have been linked to cancer.

Unlike smoking, the cancer risk from grilled meat is hard to quantify, says Karen Collins, M.S., R.D., a dietitian who is nutrition adviser for the Washington-based charity American Institute for Cancer Research, which focuses on links between diet and cancer.

She cited a National Cancer Institute study that found that those who ate their beef medium-well or well-done had more than three times the risk of stomach cancer than those who ate their beef rare or medium-rare.

On the other hand, the study also found that people who ate beef four or more times a week had more than twice the risk of stomach cancer than those consuming beef less frequently.

If you're worried about cancer, Collins suggests, try cooking your meat indirectly -- off to one side of the barbecue flame -- and at a lower temperature. Studies have also shown that marinades or a few minutes of microwave cooking before grilling reduce the formation of HCAs.

Other rare barbecue risks:

Toothpicks. In a letter to the New England Journal of Medicine earlier this year, physicians reported on a 67-year-old woman who was at a barbecue and accidentally ingested a toothpick, which led to a right coronary perforation.

Barbecue skewers. Although they're ill suited for the purpose, they can be used as weapons. In 2003, German researchers reported the case of a 42-year-old man who bled to death after a barbecue skewer was shoved through his superior vena cava. "Considerable force" was needed, they said.

Cadmium poisoning. In 1961, researchers reported that using a refrigerator shelf as an improved barbecue grill caused cadmium toxicity, which has symptoms ranging from headache and chest pains to pulmonary edema and death.

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