ANZJPH study highlights festive season risk hazards, or ‘Chrishaps’

Person in red dress about to cut into a cake sitting on table. Candles and plastic Christmas tree cutout also resting on table.

Jeremy Lasek – PHAA

By now, most are ‘back at work’ (physically or remotely) and we can look back at how the majority of us have ‘survived’ another period of Christmas craziness.

That theme of ‘surviving Christmas’ is the subject of a new article in the Australian and New Zealand Journal of Public Health (ANZJPH), which explores the festive season’s hazards.

This article complements How COVID-safe Santa can save Christmas’, a 2020 ANZJPH editorial aimed at helping Santa develop a COVID-safe Christmas plan; it considered whether Santa should conduct virtual or non-contact (click and collect) visits, and even considered whether Santa should delay Christmas. The authors said “the wellbeing of 2.2 billion children may have depended on his decision.”

The 2020 editorial reported: “From the outset we classified Santa as an essential worker. If Santa was required to remain at home on Christmas Eve it could precipitate an unprecedented mental health catastrophe as the world’s children wake up to empty stockings. Having already suffered mum and dad’s home-schooling in 2020, Santa offers some much-needed hope this Christmas. Whatever the level of lockdown, Santa must be permitted to deliver this essential service.”

On a similar theme, the 2021 ANZJPH article noted a 2009 British Medical Journal article, saying it, “dealt with the question of Santa Claus’ dubious public health credentials. When the authors challenged Santa as a healthy role model, they used circumstantial information and pointed to his smoking and overeating. Moreover, Santa’s potential role as an infectious disease vector who may become “a contact tracer’s nightmare” was emphasised. This should now be updated with regard to COVID-19.”

However, the new ANZJPH study on Christmas’ effect on physical and mental health goes well beyond the role of Santa Claus.

Titled, ‘Avoiding a crisis at Christmas: a systematic review of adverse health effects or ‘Chrishaps’ caused by traditional hazard sources and COVID-19’, it explores a range of Christmas-related hazards which authors named ‘Chrishaps’.

The research suggests “Chrishaps pose a potential minor public health threat that should be borne in mind every festive season. Assessing and discussing specific public health implications of Chrishaps requires systematic risk research to be conducted.

“Our overall study question was “which hazards have been scientifically associated with old Christmas essentials such as decoration, gifts, menus, and Santa himself, as well as new challenges associated with COVID-19”?”

The authors conducted an extensive literature search for the adverse events they classified as Chrishaps:

“Our aim was to systematically collect scientific evidence of adverse health effects associated with Christmas in terms of hazards to which we refer as “Chrishaps” (we expressly mean not only injuries from accidents or falls, but also threats to health from other risks such as high-fat foods or allergenic substances). To this end, we conducted a systematic literature review regarding the conceivable novel festive hazards posed by COVID-19 and regarding injuries, mishaps, and accidents around traditional hazard sources.”

Chrishap hazards

The literature review revealed many hazards, including allergic reactions to the popular Christmas plant, Poinsettia, and even Christmas trees. “Also described were intoxication (e.g. by glow sticks), aspiration or swallowing of Christmas decorations (including a Christmas tree-bulb or other glass ornaments, confetti stars, button batteries, a plastic robin or a plastic Christmas tree) or Christmas candies.”

A serious case of Chrishaps was identified as “when a finger-tip was lost in a mailbox together with the dropped-off Christmas letters.”

“No reports could be found that either Santa Claus himself or one of his companions were involved in accidents which should reassure insurance agencies,” the ANZJPH report said. “For the important question whether the risk of falling is greater with Santa’s costume and Christmas sack than without, an empirical ‘yes’ was reported.

“But what about those who Santa visits? When decorating, there is a risk of falling, for example, when putting up residential Christmas lights or decorating the interior. Among these risks, falls from ladders or roofs were the most common, but also from furniture, with some significant injuries like lacerations, strains and sprains, or fractures. Lifting heavy objects (e.g. a box of decorative materials) may cause injury to the lower back.

“Christmas dinners also posed risks. We cherish Christmas as a time for good food, drink and merriment. Yet, the (in)famous Christmas pudding (especially well known in Great Britain) must be appreciated as a potential health hazard due to the alcohol and ethyl carbamate it contains (especially when doused in brandy and set alight).

“Overeating (‘calorie overload’), to our surprise, has been rarely identified as a Chrishap in our systematic literature search. However, a positive correlation between Christmas and higher cholesterol values was reported and, perhaps unsurprisingly, weight gain was associated with Christmas. Two other risks from eating were documented: abdominal pain after eating without chewing and eating a piece of Christmas cake together with a plastic robin.”


“Given the potential hazards and Chrishaps documented, implications for public health may need to be explored to reduce such risks. Systematic risk research is required given the majority of articles were case reports.

“To assess and discuss specific public health implications of Chrishaps higher level studies are needed along with targeted injury surveillance. Overall, further research and effective information may limit Chrishaps and ensure we have a safe and merry Christmas.”

Footnote: The ANZJPH article Avoiding a crisis at Christmas: a systematic review of adverse health effects or ‘Chrishaps’ caused by traditional hazard sources and COVID-19 was jointly authored by Ursula Wild, David M. Shaw, Thomas C. Erren.


Image: Karolina Grabowska/Pexels

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