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Sand Boxes
Sandboxes are great fun for all. But if your read too much, you'll never let your child near one.
Sand Boxes



europeangarden.com/easy_start_sandbox.aspx
DIY
Building a sandbox can be a very simple task as you just need something to hold a pile of sand together.



megahowto.com/how-to-build-a-sandbox
bostodelphia.blogspot.com/2008/05/sandbox-weekend.html
The Dangers of Sand

Warning on Bag of Sand
Sand in sandboxes poses a few theoretical the real risks. Most of these risks are remote, assuming that you used common sense in building your box, are supervising your kids and assuming that the published risks will only happen to other children.
Risks of Sand
Asphyxiation - if you inhale or swallow enough, you can die. This is rare, but does happen. You should never let a child tunnel or bury themselves or their friends. Children should always be supervised in a sandbox.
Inhalations risks - Silica is present in most sand. And in manufactured sand from rock from quarries, there can be a good amount of dust that contains silica and possibly asbestos and tremolite. Long term exposure to these can cause cancer and other lung disorders. Using "natural" beach sand and/or wetting before use will decrease most inhalational hazards. Power like sand should not be used for sandboxes.
Diseases - There are many known diseases that can be found in sandboxes. Most are from animal feces. Sandboxes should always be covered when not in use to decrease the kitty box event.
Crystalline Silica
The State of California EPA:
oehha.ca.gov/prop65/CRNR_notices/list_changes/111403lsta.html
California Code of Regulations
Title 22. Social Security
Division 2. Department of Social Services – Department of Health Services
Part 2. Health and Welfare Agency – Department of Health Services Regulations
Subdivision 1. Health and Welfare Agency
Chapter 3. Safe Drinking Water and Toxic Enforcement Act of 1986
§12000. Chemicals Known to the State to Cause Cancer or Reproductive Toxicity
Lists:
Silica, crystalline (airborne particles of respirable size)
---
October 1, 1988
as a CHEMICALS KNOWN TO THE STATE TO CAUSE CANCER
What OSHA says about crystalline silica:
Silica, Crystalline Silicosis is a disabling, nonreversible and sometimes fatal lung disease caused by overexposure to respirable crystalline silica. More than one million U.S. workers are exposed to crystalline silica, and each year more than 250 die from silicosis. There is no cure for the disease, but it is 100 percent preventable if employers, workers, and health professionals work together to reduce exposures.
SILICA DUST EXPOSURES CAN CAUSE SILICOSIS
Every year two million workers in the U.S. are exposed to crystalline silica, which can cause silicosis, a disabling and sometimes fatal disease. About 300 deaths are attributed to silicosis annually. Inhaling airborne crystalline silica dust also has been associated with other diseases such as tuberculosis and lung cancer.
The Occupational Safety and Health Administration (OSHA) is determined to reduce the potential threat of silicosis. Crystalline silica has been identified as a priority rulemaking action. In the meantime, OSHA is conducting a national special emphasis program on silicosis to inform employers and employees about the occurrence and hazards of crystalline silica and ways to reduce exposure to the dust. The 25 states and territories that operate their own occupational safety and health programs have been encouraged to launch similar special emphasis activities on silicosis.
Crystalline silica, also known as quartz, is a natural compound in the earth's crust and is a basic component of sand and granite. Silicosis is a disease of the lungs caused by breathing dust containing crystalline silica particles. The dust can cause fibrosis or scar tissue formations in the lungs that reduce the lungs' ability to work to extract oxygen from the air. There is no cure for this disease, thus prevention is the only answer.
SYMPTOMS OF SILICOSIS
Early stages of the disease may go unnoticed. Continued exposure may result in a shortness of breath on exercising, possible fever and occasionally bluish skin at the ear lobes or lips. Silicosis makes a person more susceptible to infectious diseases of the lungs such as tuberculosis. Progression of silicosis leads to fatigue, extreme shortness of breath, loss of appetite, pain in the chest, and respiratory failure, which may cause death. Acute silicosis may develop after short periods of exposure. Chronic silicosis usually occurs after 10 or more years of exposure to lower levels of quartz.
What EPA says about crystalline silica:
Health Effects of Inhaled Crystalline and Amorphous Silica
Recently, public concern regarding nonoccupational or ambient silica exposure, mainly to crystalline silica, has emerged making it important to evaluate background and ambient concentrations. Ambient emissions of silica rarely are estimated or measured in air pollution studies of particulate matter. Crystalline silica is widely used in industry and has long been recognized as a major occupational hazard, causing disability and deaths among workers in several industries. This is a health risk assessment covering the causes and studies of crystalline silica exposure.
National Resource Center for Health and Safety in Child Care (NRC) (Not able to find text in NRC site)
National Health and Safety Performance Standards for Sandboxes/Sand Play Areas:
Sand play areas must be distinct from landings areas for any equipment such as slides, swings, etc.
All sandboxes shall be kept covered when not under adult surveillance. This covering shall be secured to prevent entry by children or animals, and sufficient to prevent contamination by solids or liquids.
Sandboxes shall be equipped with constant and effective drainage systems and be constructed to present no safety hazards.
Sand shall not be of the compacting type and should be replaced by fine pea gravel that is smooth surfaced. Any media placed in sandboxes shall present no preventable health or safety hazards by its nature or structure.
Sterilized sand or pea gravel should be obtained for sandbox use.
Sand that becomes contaminated shall be replaced with sterilized sand or pea gravel or the contaminant removed, where it is possible, to capture and dispose of all the contaminant. Treatment of sand with chemicals to attempt to sterilize it within the sandbox is not recommended.
Sandboxes/sand play areas shall be inspected for signs of contamination and safety hazards before each use.
Sand in boxes and play areas shall be replaced as needed and
at least every two years.
The Quikrete MSDS for "Play Sand"
EMERGENCY OVERVIEW:
The product is a white or tan natural sand. It is not flammable, combustible or explosive. It does not cause burns or severe skin or eye irritation. A single exposure will not result in serious adverse health effects. Crystalline silica (quartz) is not known to be an environmental hazard. Crystalline silica (quartz) is incompatible with hydrofluoric acid, fluorine, chlorine trifluoride or oxygen difluoride. Note: Keeping Play Sand damp eliminates the hazards associated with its dust.
OSHA REGULATORY STATUS
This material is considered hazardous under the OSHA Hazard Communications Standard (29 CFR1910.1200).
POTENTIAL HEALTH EFFECTS:
Inhalation:
Silicosis Respirable crystalline silica (quartz) can cause silicosis, a fibrosis (scarring) of the lungs. Silicosis may be progressive; it may lead to disability and death.
Lung Cancer Crystalline silica (quartz) inhaled from occupational sources is classified as carcinogenic to humans.
Tuberculosis Silicosis increases the risk of tuberculosis.
Sandbox Care/Precautions
Sandboxes can provide hours of outdoor entertainment for children. While the infectious disease risks associated with sandboxes are generally thought to be low there are concerns about a few serious diseases. Proper sandbox design and supervision can greatly reduce these concerns and allow sandbox play to be an enjoyable and safe activity for children.
Potential Problems
Sandboxes can be used as large litter boxes by cats and wildlife such as raccoons. Various bacteria and parasites that can cause disease in people can be present in feces of these animals. Sandboxes can also attract spiders and other insects, and act as a breeding site for mosquitoes.
Sandbox Design
Sandboxes should be designed to keep animals out. Drainage holes should be provided to prevent water from accumulating in the sandbox. Wet sand can be a breeding ground for mosquitoes.
Keep It Covered!
Keeping your sandbox covered is the most important measure you can take to reduce the risk of disease. A proper cover will prevent fecal contamination from cats, raccoons and other animals. Most contamination occurs at night, and cats tend to bury feces, so not seeing anything in the sandbox does not mean it has not been contaminated. Many sandboxes available for purchase come with covers, and those are ideal. Otherwise, sandboxes can be covered with plywood, a tarp or some other secure cover. The cover must be secure enough that wind or curious animals cannot dislodge it. Covering is critical for sandboxes used by young children or other children that are likely to put sand in their mouths.
Sandbox Care
The sandbox should be regularly inspected for the presence of animal feces or insects. This is particularly important if the sandbox is not covered or if the cover has been left off. If stool is identified in a sandbox, it (and adjacent sand) should be removed with a shovel or other implement to avoid direct contact with the hands.
For many of the diseases of concern, feces are not infectious for 24 hours or greater after being passed. Therefore, daily inspection and removal of feces can reduce the risk, but only if all feces and neighboring sand that has been contaminated are removed…this may not be easy.
If animals feces are found in a sandbox used by young children or children that are likely to put sand in their mouths, it is prudent to change the sand before allowing them in. Sand should be periodically replaced. If the sandbox is uncovered, more regular changing of the sand (a few times a year) is warranted.
Hygiene
Children (and anyone else having contact with sand) should always wash their hands immediately after playing in a sandbox or having contact with sand outdoors.
Food or drink should never be consumed in a sandbox.
Other areas with sand exposure
In some situations, children will play in sand that cannot be covered, such as beaches or playgrounds that have a sand base.
The same hygiene practices should be used at the beach as are used in an outdoor sandbox.
Sand should not be used as an impact-absorbing material for playgrounds because it is almost impossible to cover those areas.
Sandbox Diseases
The following diseases are particularly important in terms of sandbox exposure.
Cutaneous larval migrans
This condition can be caused by various species of parasites
that can infect animals such as cats and
dogs. Eggs of the parasites are passed in the feces of infected animals and
release larvae, which can
penetrate a person’s skin, causing irritation and inflammation. A playground
sandbox contaminated with
cat feces was implicated as the cause of an outbreak of cutaneous larval
migrans at a day sports camp
in the southern United States. This condition is very rare in northern areas
such as Canada.
Visceral and ocular larval migrans
These are caused by parasites that can infect animals like
cats, dogs and raccoons. Disease occurs in
people through ingestion of parasite eggs that are passed in the animal’s
feces. The eggs then hatch
inside the body and the larvae then migrate through various internal organs
(visceral) and occasionally
the eye or brain (ocular or neurological).
Frequent playing in a sandbox was associated with the
presence of antibodies against the parasite
Toxocara in a study of children in Brazil.
Visceral and ocular larval migrans are very rare in northern
climates such as Canada, but devastating
disease can occur.
Toxoplasmosis
An infection caused by the protozoal parasite Toxoplasma
gondii. Cats shed parasite eggs in their
feces. These eggs become infective after a minimum of 24 hours.
Bacterial diarrhea
Various bacteria that can cause diarrhea in people can be
passed in the stool of animals. These include
Salmonella, E. coli and Campylobacter. The role of sandboxes in transmission
of these is unclear.
Hazards of the Sandbox Itself
The other worry with homemade sandboxes is whether the wood is arsenic treated. Since the 1970s, wood injected with arsenic has been hammered into outdoor decks, benches, picnic tables, and playsets. Thirty years ago it seemed like a good idea. Suck the water out of wood and inject chromated copper arsenate (CCA) to create a highly rot-resistant wood. This is the greenish-gray tinted wood commonly called pressure-treated, or Wolmanized. CCA-wood stands up to weather, mold, and pests but we now know the arsenic can seep out onto surfaces and drip onto the ground beneath.
Arsenic causes cancer, including skin, bladder, and lung cancer. It's much more toxic than scientists once believed, even at very low levels and young children's growing bodies are especially vulnerable to the cancer-causing poison. Kids tend to put their hands into their mouths, and if those hands have arsenic from playset surfaces or the dirt beneath them, children end up ingesting the poison. Arsenic can also cause nerve damage, immune system and hormone disruption, diabetes, high blood pressure, and heart disease.
The federal government banned arsenic-treated wood in 2004 for playgrounds and home use. But if the sandbox or play set your child plays on was built before 2004, chances are it contains arsenic.
The best option if you have an old sandbox is to seal the wood with a solid or semi-transparent deck stain. Inspect the wood every six months and seal it at least once a year. Sealing a solid or semi-transparent deck stain has an immediate effect on arsenic exposure but varnishes and clear sealers do not give adequate protection.
For new construction, look for naturally rot-resistant wood (Forest Stewardship Council certified cedar and redwood are good choices), wood composites, recycled plastics, or less toxic pressure-treated lumber.
Published Hazards of Sand:
Int J Legal Med. 2008 Nov;122(6):499-502. Epub 2008 Jun 11.
Fatal outcome of a sand aspiration.
Kettner M, Ramsthaler F, Horlebein B, Schmidt PH.
2 1/2-year-old boy who ingested sand while playing in a sandbox with his older brother
J Pediatr Surg. 1996 Oct;31(10):1448-50.
Sand aspiration: a case report.
Choy IO, Idowu O.3-year-old boy who suffered severe respiratory compromise secondary to sand aspiration - lived
Mayo Clin Proc. 2004 Jun;79(6):774-6.
Accidental burials in sand: a potentially fatal summertime hazard.
Zarroug AE, Stavlo PL, Kays GA, Rodeberg DA, Moir CR.boy died after his self-made tunnel in a sandbox collapsed; several kids died at construction site
Pediatr Surg Int. 2003 Jul;19(5):409-12. Epub 2003 Jun 11.
Pediatric sand aspiration: case report and literature review.
Efron PA, Beierle EA.10-year-old boy who suffered from aspiration of particulate matter after being buried in sand
J Med Assoc Thai. 2004 Jul;87(7):825-8.
Severe sand aspiration: a case report with complete recovery.
Glinjongol C, Kiatchaipipat S, Thepcharoenniran S.5-year-old boy, previously healthy, was admitted to Ratchaburi Hospital after being buried in a sand pile
Clin Exp Dermatol. 2009 Dec;34(8):e620-2. Epub 2009 Jun 1.
Dermatitis papulosa adultorum.
Kraigher O, Brenner S.Sandbox dermatitis
MMWR Morb Mortal Wkly Rep. 2007 Dec 14;56(49):1285-7.
Outbreak of cutaneous larva migrans at a children's camp--Miami, Florida, 2006.
Centers for Disease Control and Prevention (CDC).identified exposure to cat feces in a playground sandbox as the likely source of infection
Epidemiol Infect. 2006 Jun;134(3):617-26.
Risk factors for Salmonella Enteritidis and Typhimurium (DT104 and non-DT104) infections in The Netherlands: predominant roles for raw eggs in Enteritidis and sandboxes in Typhimurium infections.
Doorduyn Y, Van Den Brandhof WE, Van Duynhoven YT, Wannet WJ, Van Pelt W.S. Typhimurium DT104 salmonellosis from playing in the sandbox
Kinderkrankenschwester. 2006 Feb;25(2):55-7.
[Toxocara canis -- the hazard in the sandbox?]
[Article in German]
Scheid PL, Georgi E.
Laeknabladid. 1996 Sep;82(9):627-634.
[Zoonotic parasites of cats and dogs found in playground sandboxes in the Reykjavik area, Iceland.]
[Article in Icelandic]
Smaradottir H, Skirnisson K.zoonotic protozoans Cryptosporidium parvwn and Toxoplasma gondii and the zoonotic nematodes Toxocara cati and T. canis. And a Giardia sp
J Clin Microbiol. 1989 Dec;27(12):2706-9.
Cat-contaminated environmental substances lead to Yersinia pseudotuberculosis infection in children.
Fukushima H, Gomyoda M, Ishikura S, Nishio T, Moriki S, Endo J, Kaneko S, Tsubokura M.Y. pseudotuberculosis serotype 1b and 3 strains isolated from soil from the dried-up puddles and sand and feces from the sandbox
Tremolite
A form of the human carcinogen asbestos, found in rocks and in manufactured sand made from crushed rocks. Studies of manufactured sand commonly used to fill children'??s sandboxes have found asbestiform tremolite, which is known to cause asbestosis, lung cancer and abnormal tissue growth; and nonasbestiform tremolite. The second is almost indistinguishable from the first in its chemical composition and appearance, and many scientists argue that it presents similar health hazards.
For Future Reference:
Langer, A M (04/02/1987). "Asbestos in play sand". The New England journal of medicine (0028-4793), 316 (14), p. 882.
Safe Sand Alternatives

Safe Sand Caribbean Sand sold by the ton
Pea Gravel
Birdseed?
Buckwheat
Black Beans (must be kept dry)
Rice (indoor only - although many use it outdoors)
Rubber mulch (must have been run through a magnet if tire rubber)
Shredded paper (indoors only)
Aquarium rocks
Moon Sand
Crushed walnut shells - pet stores
Flaxseed - horse & feed stores

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