Santa may get a bad rap for being an unhealthy role model but he represents only a small fraction of a multitude of real life health hazards of the Christmas season reported in the literature.

German researchers have conducted a systematic review of Christmas health mishaps – dubbed “Chrishaps’ and found that they extend far beyond the usual warnings relating to overeating and drinking.

Medical literature reports dating back as far as the 19th century document incidences of adverse health outcomes from the Christmas period, whether it be due to the weather, decorations, gifts or Christmas food and drink.

Dr Ursula Wild, an occupational medicine physician at the University of Cologne, reviewed 36 papers relating to Christmas hazards and found they come in many different shapes and guises and can affect everyone from children to world leaders.

She points to a report of a likely hip fracture experienced by former US president Ulysses S. Grant on Christmas Eve 1883 as a result of slipping on ice at the door of his home. The injury was misdiagnosed as ‘muscle strain’ but left him immobile and in pain for months.

In the northern hemisphere there have been thousands reports of snow and ice-related injuries related to sleds, toboggans and skates.

Falls and other physical injuries related to other Christmas activities also appear to be some of the more common occurrences during the festive season, with five separate papers reporting on accidents such as when putting up residential decorations and residential Christmas lights.

“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,” writes Dr Wild with colleagues in the Australia and NZ Journal of Public Health (link).

A ‘jingle bell’ ingested foreign body. Pic: Michael Wilsey

Perhaps not surprisingly some of the most common health hazards reported for Christmas related to (over)eating and drinking. As far back as 1946 there were articles being published in medical journals reporting ‘calorie overload’ from Christmas dinners. Since then, there have been a variety of reports ranging from ingestion of foreign bodies such as plastic toys hidden in Christmas cake to mistakenly eating decorations such as candles. In the 1980s there were even reports that excessive ingestion of hormone-fattened turkey was causing higher-pitched voices in men and a decrease in female pregnancies.

Christmas meals are also implicated in many case reports of choking, not to mention the many incidences of overeating or inappropriate eating leading to gastric pain, dyspepsia and food poisoning.

Surprisingly, allergic reactions appear to be one of the most common health hazards of Christmas, with case reports of reactions to Christmas trees and holly, as well as to foods such as nuts. Contact allergies have been reported with Christmas presents such as laptops and balloons in people who have nickel or latex sensitivity.

And of course overindulgence in alcohol is a major factor in health risks at Christmas, the review found. In addition to the well-known risks related to alcohol intoxication, the systematic review also found reports of burns due to brandy being lit on a Christmas pudding. However an Australian report found that medical staff were not at risk of high alcohol levels from eating too much Christmas pudding.

The article authors concluded that when compared to the numerous reports of Chrishaps, Santa Claus should be allowed a little indulgence by public health authorities.

“No reports could be found that either Santa Claus himself or one of his companions were involved in accidents which should reassure insurance agencies. 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,” they noted.