Oregon public health raises awareness of the "choking game"

Many Oregon eighth graders know about, even participate in this potentially fatal activity
Oregon Public Health officials want parents and healthcare providers to be aware of a dangerous and potentially fatal activity in which many young teens are engaging.
According to the Oregon Healthy Teens Survey, conducted every other year by Oregon Public Health, as many as 2,600 eighth graders in the state have participated in the "choking game," also sometimes called Pass-Out, Space Monkey, Flat Liner and Blackout. The survey also found that one in three eighth graders had heard of someone participating in this activity and that 6 percent reported participating themselves.
Oregon is the first state in the US to systematically assess this behavior. "The Oregon Healthy Teens Survey is a key tool for monitoring health behaviors among our youth, and without public health conducting this kind of surveillance study most people would be unaware of this threat to the health of our children," said Kohn. Kohn also noted that injuries are the leading cause of death for children and young adults.
The "choking game" is an activity in which people strangle themselves using a belt, tie, scarf or similar item, or teens strangle each other using their hands to achieve euphoria. After a short time people can pass out, which can cause injury, long-term disability or death.
"Many people will be surprised at how widespread this dangerous behavior is," says Mel Kohn, MD, MPH, acting director at Oregon Public Health, "so parents, healthcare providers and others who work with teens should be alert for signs of participation in strangulation activities, particularly in young teens."
Sarah Ramowski at Oregon Public Health, the lead author of a report on these data published by the Centers for Disease Control and Prevention (CDC) in this week's Morbidity and Mortality Weekly Report, says that warning signs that a child may be participating in this activity include: • Unexplained marks on the neck • Bloodshot eyes • Ropes, scarves, belts tied to bedroom furniture or doorknobs • Unexplained presence of leashes or bungee cords • Pinpoint bleeding spots under the skin on the face, especially the eyelids • Discussion or mention of this activity • Disorientation especially after spending time alone.
According to the CDC report there have been 82 deaths occurring in 31 states from this activity from 1995 to 2007. In Oregon, an Eagle Point sixth-grader died in 2006 due to this activity.
To read the full report please visit: www.cdc.gov/mmwr.