The Medical Minute: Halloween safety for trick-or-treaters

October 27, 2004

John Messmer
Penn State Milton S. Hershey Medical Center

As Halloween creeps up, kids will dream of spooky costumes, jack-o-lanterns and haunted houses. Halloween is one of the most thrilling nights of the year for children. Unfortunately, it's also one of the most dangerous. As kids hit the street to trick-or-treat, the potential for unintentional injury rises. In fact, children are four times more likely to be hit by a car on Halloween than any other night of the year. Halloween can indeed be scary, with increases in pedestrian injuries, burns and falls among children.

"Children may be distracted by the excitement of the night and the fun of trick-or-treating, and may not take safety to the street. Careless street-crossing coupled with drivers' more limited vision at night can make for a deadly mix," said Susan Rzucidlo, pediatric trauma coordinator for Penn State Children's Hospital. "Many of the risks kids face on Halloween can be avoided if parents discuss important safety precautions with their kids."

Setting the trick-or-treat ground rules

Rzucidlo suggested a few simple guidelines for parents to help keep kids safe. Among them, adults always should accompany children under age 12 on their trick-or-treat rounds and attach the name, address and phone number with the area code to children's clothing in case they get separated from adults.

For kids ages 12 and older, Rzucidlo said parents need to be sure their children know their own home phone number. Parents should instruct children to travel only in familiar areas or neighborhoods and along a pre-established route. Children should never enter a home or an apartment building unless accompanied by an adult and they should be given a set time to return home.

Always restrict trick-or-treating visits to homes with illuminated porches or outside lights. As for candy, tell children to bring their treats home before eating them. Parents always should check treats to ensure that items have not been tampered with and are sealed safely. Be careful with fruit. Inspect the surface closely for punctures or holes and cut it open before allowing a child to eat it.

According to Rzucidlo, people also need to be mindful of the other kids in the neighborhood. Remove breakable items or obstacles such as tools, ladders and children's toys from steps, lawns and porches. Keep jack-o-lanterns lit with candles away from landings or doorsteps where costumes might brush against the flame.

Pedestrian injuries

Halloween is the most dangerous night of the year for child pedestrians. Darting out into the street is one of the most common causes of pedestrian death among children. As children scurry from house to house, it is important to take proper precautions.

Visibility is key. Parents and children should decorate costumes, bags and sacks with retro-reflective tape and stickers and use costumes that are light or bright enough to make children more visible at night.

Traffic can be a particular threat to trick-or-treaters who are too caught up in the excitement of the evening's events to be mindful of motorists. Teach children to walk, not run, while trick-or-treating and remind them to stop at all street corners before crossing. Make sure they cross streets only at intersections and crosswalks and warn them against darting out into a street or between parked cars.

Motorists must be equally cautious at Halloween, in case kids are not playing it safe. Drivers should slow down in residential neighborhoods, obey all traffic signs and signals, and watch for children walking in the street or on medians and curbs. Motorists also should enter and exit driveways and alleyways slowly and carefully. It also is a good idea to teach children to exit and enter the car on the curbside, away from traffic.


On Halloween night, cumbersome costumes and blinding masks can make walking safely through dark neighborhoods difficult. To prevent fall-related injuries, parents should apply face paint or cosmetics to a child's face. It's safer than a loose-fitting mask that can obstruct a child's vision. If a mask is worn, be certain it fits securely. If necessary, cut the eyeholes to allow for full vision.

Give trick-or-treaters flashlights and make sure their costumes are short enough to avoid tripping. Secure hats so they don't slip over children's eyes and make sure kids wear shoes that fit. Adult shoes are not safe for trick-or-treaters and can result in falls. Allow children to carry only flexible knives, swords or other props. Anything they carry could injure them if they fall. Teach children not to cut across yards. Lawn ornaments and clotheslines are "hidden hazards" in the dark. It's much safer on the sidewalk.


Fires and burns are the third-leading cause of unintentional injury-related death among children. Look for "flame resistant" labels on costumes, masks, beards and wigs. Use fire-resistant material when making costumes. Avoid costumes made of flimsy material and outfits with big, baggy sleeves or billowing skirts. Such costumes are more likely to come in contact with an exposed flame, such as a candle, than tighter-fitting costumes. And always keep candles, jack-o-lanterns, matches and lighters out of children's reach.

Finally, if children complain about trick-or-treat ground rules, remember -- they'll have less fun if they get injured. For more information on preventing injuries, contact the Injury Prevention Program at Penn State Children's Hospital, Penn State Milton S. Hershey Medical Center, at 717-531-SAFE (7233).

(Media Contacts)

Last Updated March 19, 2009