Increase in nonfatal choking among kids

Choking is a leading cause of injury among children, especially for children 4 years of age and younger, a new study warns.

The study by researchers at the Center for Injury Research and Policy of the Research Institute at Nationwide Children’s Hospital of Columbus, Ohio, and colleagues at the Centers for Disease Control & Prevention examined nonfatal food-related choking among children 14 years of age or younger from 2001 through 2009.

During the nine-year study period, more than 12,000 children were treated each year in U.S. emergency departments for injuries from choking on food, which equals 34 children each day, Nationwide Children’s Hospital officials said in a news release.

According to the study, published in the July online issue of Pediatrics, hard candy caused the most choking episodes (15 percent), followed by other candy (13 percent), meat, other than hot dogs (12 percent), and bones (12 percent).

These four food types alone accounted for more than half of all the choking episodes in the study.

“Other high-risk foods, such as hot dogs, seeds and nuts, were more likely to require hospitalizations,” said Dr. Gary Smith, MD, DrPH , director of the Center for Injury Research and Policy.

“These foods have high-risk characteristics that make them more likely to block a child’s airway or make them more difficult to chew, which can lead to more serious choking events,” Dr. Smith said.

More than 60 percent of the choking episodes occurred among children 4 years of age and younger.

In line with physical and neurological development, the number of choking episodes decreased with increasing age until 7 years of age, after which the number of episodes remained relatively unchanged through age 14.

However, the number of choking episodes involving candy increased with increasing age, and by age 4 years, more than half of choking episodes involved candy.

“Although the Consumer Product Safety Commission has well-established surveillance systems in place, as well as legislation and regulations to protect children from nonfood-related choking, no similar monitoring systems, legislation, or regulations currently exist to address food-related choking among children,” added Dr. Smith, also professor of Pediatrics in The Ohio State University College of Medicine.

“Implementing improved monitoring of food-related choking incidents, placing warning labels on foods that pose a high choking risk, changing the design of foods consumed by children to reduce the risk of choking, and developing public awareness campaigns to educate parents about the danger of food-related choking among children could all help reduce the number of choking episodes in the United States,” Dr. Smith said.

Child caregivers should be aware of food choking prevention recommendations and guidelines, experts say.

Children younger than 5 years of age should not be given hard candies or gum, and raw fruits and vegetables should be cut into small pieces.

Young children should be supervised while eating and should eat sitting down.

Choking is a year-round hazard among children and a leading cause of injury and death, especially among children 3 years of age and younger. Food, coins and small toys can cause choking if they get caught in the throat and block the airway.

Risky Foods for Young Children

Children younger than 4 years of age should not be given round, firm foods unless they have been chopped into very small pieces. The following foods are common choking hazards:

– Hot dogs and sausages.

– Nuts and seeds.

– Chunks of meat and cheese.

– Whole grapes and fruit chunks, like apples.

– Hard, gooey, or sticky candy.

– Popcorn.

– Chunks of peanut butter.

– Raw vegetables, such as carrots.

– Chewing gum.

– Marshmallows

Dangerous Household Items

– Latex Balloons.

– Coins.

– Marbles, small balls or ball-shaped objects (less than 1.75″ in diameter).

– Toys with small parts or toys that can be squeezed to fit entirely into a child’s mouth.

– Pen or marker caps.

– Small button-type batteries.

Prevention Tips

– Learn first aid for choking and CPR (cardiopulmonary resuscitation).

– Be aware that latex balloons pose a choking risk to both young children and older children.

– Children should never run, walk, play or lie down with food in their mouths.

– Cut food for young children into small pieces.

– Always supervise mealtimes.

– Be aware of older children’s actions. Choking incidents can occur when an older child gives dangerous foods, toys or small objects to a younger child.

– Avoid toys with small parts and keep small household items out of the reach of infants and young children.

– Small parts test devices are available at many toy stores and baby specialty stores. If the part can fit in the tube, it is too small for a young child.

– Check the minimum age recommendations on toy packages. Age guidelines reflect the safety of a toy based on potential choking hazards as well as children’s development.

– Do not allow young children to play with coins.

This is the first study to use a nationally representative sample to examine nonfatal food-related choking among children treated in U.S. emergency departments over a multi-year period.

Data for the study were obtained from the National Electronic Injury Surveillance System – All Injury Program (NEISS-AIP), which is operated by the U.S. Consumer Product Safety Commission. The NEISS-AIP provides information on consumer product-related and sports- and recreation-related injuries treated in hospital emergency departments across the country.