Although it rarely happens, children can be killed while playing in sand. “Sand dunes, beach digging, and other areas of substantial sand buildup, including deep backyard sandboxes, represent the greatest risk,” researchers warn.

The cases of two children illustrate the potential hazard. In one instance, a 10-year-old boy was killed when the tunnel he was digging in his large backyard sandbox collapsed and buried him. In the other, another 10-year-old died after a sand pile buried him at the construction site where he and his friends were playing.

Both boys died of suffocation due to the pressure of the sand on their chests.

Dr. Abdalla E. Zarroug of the Mayo Clinic College of Medicine in Rochester, Minnesota, and colleagues describe the incidents in the journal Mayo Clinic Proceedings.

Although such accidents appear few and far between - only 15 have been reported in the medical literature - parents should be aware of the potential danger, according to the researchers.

They note that, depending on the age and strength of the child, being buried in even one foot of sand could overwhelm a child’s ability to breathe.

In an accompanying editorial, Dr. Jay L. Grosfeld advises that children should only be allowed to play in sand dunes, dig tunnels at the beach, or build large sand castles when an adult is supervising.

The fact that one child in the current report died in his backyard sandbox suggests that there needs to be a limit on the depth of home sandboxes, according to Grosfeld, who is surgeon-in-chief at Riley Children’s Hospital in Indianapolis.

In that case, the boy was buried for 10 minutes before he was pulled out; in the other incident, at the construction site, rescue workers searched for an hour before finding the boy trapped under 12 feet of sand.

“An important message,” Grosfeld writes, “is that young children need to be supervised. If either of the two reported events had been observed, the chance of prompt extrication and survival would have been better.”

SOURCE: Mayo Clinic Proceedings, June 2004.