Emergency departments saw about the same number of foreign ingestion cases during the pandemic but a higher proportion were batteries and magnets. A study’s abstract findings will be presented at the 2021 American Academy of Pediatrics National Conference & Exhibition
ITASCA, IL – More children swallowed small magnets and batteries as compared with other foreign objects in 2020 -- a year when a COVID-19 stay-at-home order was in place -- than in prior years, research shows.
The abstract, “Feast or Famine: A National Stay-At-Home Order Is Associated with an Increase in Pediatric Foreign Body Ingestions Presenting to Emergency Departments in 2020 Compared to 2011-2019,” will be presented during the American Academy of Pediatrics 2021 National Conference and Exhibition.
Researchers analyzed data from more than 100 hospitals provided by the National Electronic Injury Surveillance System database to evaluate the frequency of suspected foreign body ingestions in children ages 17 and under. They found that the number of foreign body ingestions remained roughly the same each year from 2017 through 2021, but the proportionate number of button or cylindrical battery and magnet ingestions increased significantly.
“Button batteries and small-rare-earth-magnet-sets represent the most dangerous objects a child can ingest,” said CPT Patrick T. Reeves, MD, FAAP, assistant professor of pediatrics at the Naval Medical Center at San Diego. “Due to their abilities to cause electromagnetic force discharge, these objects can tear through tissue, cause bleeding and even death. Parents should treat these objects like the Dark Side of the Force and strive to decrease children’s access to these items in the home.”
Emergency rooms see approximately 55,000 and 60,000 children for foreign ingestions annually, according to the research. The majority of children who ingest foreign objects are between ages 0-5 who have ingested batteries, magnets, coins, toys, desk supplies, bathroom items, jewelry, fasteners (screws, nails, etc.) and holiday items, such as Christmas ornaments and décor.
Most foreign bodies that are ingested by children will pass into the stomach and eventually leave the body through defecation. However, some objects, such as electronic button batteries or small-rare-earth magnets, pose a significant to danger for children that can lead to death.
Recently the U.S. Consumer Product Safety Commission recalled some small high-powered magnet sets, but more work is needed, according to the authors.
They call for the design of dedicated campaigns to include education for children, parents, other caregivers, and clinicians to prevent the purchase of these items and ways to remove them from the home.
Elyse M. Geibel, MD, LT, MC (NFS/FMF), USN with the Naval Medical Center San Diego Pediatrics will present the study abstract at 2:30 pm CT Sunday, October 10, 2021. To request an interview, journalists may contact Dr. Reeves or Paula Amann.
Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media or may be preparing a longer article for submission to a journal.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.
ABSTRACT
Abstract Title: Feast or Famine: A National Stay-At-Home Order Is Associated with an Increase in Pediatric Foreign Body Ingestions Presenting to Emergency Departments in 2020 Compared to 2011-2019
Elyse Geibel
San Diego, CA, United States
Sunday, October 10, 2021: 2:30 PM –
Foreign body ingestion among children is a well-known, potentially hazardous injury that can prove fatal. A recent single–center report demonstrated an increased frequency of caustic/toxic ingestions during the pandemic, but the trend in foreign body ingestions has yet to be evaluated. Our study aims to investigate whether the stay–at–home order during the COVID-19 pandemic associated with an increase in foreign body ingestion frequency.
We used the National Electronic Injury Surveillance System (NEISS) database to evaluate the frequency of suspected-foreign body ingestions (FBI) in children ages 0-17 years of age for years 2017–2020. For the purposes of our analyses, we identified 2017-2019 and 2020 as the pre-COVID-19 and COVID-19 periods, respectively. FBI frequencies were then annualized based on the number of years contained within each period. We used the NEISS coding manual to assign classes to the consumer products implicated in FBI including: electronics (including cylindrical and button batteries), magnets, coins, toys, desk supplies, bathroom items, jewelry, fasteners (screws, nails, etc.) and holiday items (Christmas ornaments, holiday décor, etc.). Escalation of care was defined as hospital admission or transfer. All reported values are populations national estimates generated from actual FBI encounters at NEISS sampled emergency rooms and were calculated using the NEISS-supplied weights and variance variables. Rao-Scott Chi-square was used for all categorical comparisons.
The majority of FBI occurred in children age 0-5 years. During the COVID period, 57% of ingestions occurred in males. There was no significant decrease in estimated total FBI between the pre-COVID-19 and COVID period (59,933 (95% confidence intervals (95% CI) 42,978-76,888) vs 54,926 (95% CI 39,532-70,319); P=0.06).The estimated number of ingestions occurring in school decreased from pre-COVID-19 (2,678 (95% CI 1,855-3,501)) compared to COVID-19 (1,189 (95% CI 579-1,800), P=0.008). The estimated number of children requiring escalation of care due to FBI increased between the two time periods (6,923 (95% CI 4,605-9,241) vs 8,041 (95% CI 5,305-10,777); p=0.0016). The estimated frequency of magnet ingestions increased significantly between the two time periods (2,891 (95% CI 1,861-3,921) vs 4,816 (95% CI 3,213-6,419), P<0.0001).The number of estimated electronics FBI also increased significantly (5,757 (95% CI 3,833-7,681) vs 6,881 (95% CI 4,417-9,344), P=0.001).
While there was no significant increase in the frequency of total foreign body ingestions during the pandemic, the proportion of the most dangerous ingestion subtypes (magnets and electronics) up trended significantly. As expected, the frequency of FBI that occurred at school significantly decreased. The injury patterns described in this analysis, particularly with respect to electronics and magnets, provides an opportunity for targeted advocacy and education of patients, parents, educators, and other caregivers. This should guide future pandemic public health campaigns to increase home safety and prevent future FBI.
Table 1. Total Foreign Body Ingestions
Table 1 shows basic demographic information of children who presented to Emergency Departments (EDs) in the United States from 2011-2020 for foreign body ingestions as well as estimated frequency of ingested object by type. Actual frequencies correspond to database encounters. Estimated frequencies involve population estimates with generation of 95% confidence intervals.