#Do the benefits of Christmas outweigh its harms?

The Christmas season is associated with preventable harms from cards, tree decorations, and presents, as well as overeating and overdrinking, so do the benefits of Christmas outweigh the harms?

In the Christmas issue of The BMJ, Robin Ferner and Jeffrey Aronson dig out some cautionary tales from the archives.

They find that Christmas cards can be a potential source of harm. In 1876 a young man developed arsenic poisoning after painting festive cards with the highly toxic Scheele’s Green paint. More recently, a woman amputated her finger tip while posting Christmas cards through the spring-loaded flap of a letter box.

Injuries from falls while decking the house with Christmas lights are common—and a reminder not to get on ladders—they may tip when you’re tipsy.

Items swallowed unintentionally can also pose problems, they write. Bulbs from Christmas lights, sharp pointed confetti stars, and Christmas tree shaped decorations, have all found their way down toddlers’ throats and have had to be removed.

Christmas trees, too, can bring pain as well as pleasure. Pine needles can penetrate the lungs, causing breathing difficulties, and branches can poke you in the eye, causing corneal abrasion. Burns from candles are also common (at least in Bern, Switzerland, where it is customary to light candles on Christmas trees).

Christmas presents pose unforeseen dangers too, they add—for example, a pet hamster spread lymphocytic choriomeningitis virus, while Haitian bongo drums carried anthrax bacilli in their goatskin hides.

Excessive eating and drinking too much alcohol can not only increase waistlines, but also trigger outbreaks of gastroenteritis and salmonella infection and cause heart complaints (“holiday heart syndrome”).

Finally, some people take advantage of the Christmas holidays to enjoy outdoor pursuits, at least in warmer climes. In Australia, Christmas brings an increase in catastrophic injuries from jet skiing.

So is it worth it, ask the authors?

In 2002, researchers analysed the cost effectiveness of Christmas and concluded that “Christmas is not cost effective.”

But cost effectiveness is not everything, they say. “Most of our sources are anecdotal, and we did not find strong evidence of widespread adverse effects. So we will leave you to decide whether the benefits of Christmas outweigh its harms.”

In conclusion, they say “Stay safe, keep calm, carry on, and enjoy a very Merry Christmas!”