International Journal of Pediatric Otorhinolaryngology
Volume 72, Issue 7 , Pages 1041-1046, July 2008

Fatal and non-fatal food injuries among children (aged 0–14 years)

  • Robert Altkorn

      Affiliations

    • Intertek, 2107 Swift Drive, Oak Brook, IL 60523, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 630 623 8141; fax: +1 630 623 6074.
  • ,
  • Xiao Chen

      Affiliations

    • Intertek, 2107 Swift Drive, Oak Brook, IL 60523, USA
  • ,
  • Scott Milkovich

      Affiliations

    • Intertek, 2107 Swift Drive, Oak Brook, IL 60523, USA
  • ,
  • Daniel Stool

      Affiliations

    • Intertek, 2107 Swift Drive, Oak Brook, IL 60523, USA
  • ,
  • Gene Rider

      Affiliations

    • Intertek, 2107 Swift Drive, Oak Brook, IL 60523, USA
  • ,
  • C. Martin Bailey

      Affiliations

    • Great Ormond Street Hospital for Children, London WC1N 3JH, UK
  • ,
  • Angela Haas

      Affiliations

    • Department of Speech Pathology, The Children's Hospital, 13123 East 16th Avenue, Aurora, CO 80045, USA
  • ,
  • Keith H. Riding

      Affiliations

    • British Columbia's Children's Hospital, 5767 Holland Street, Vancouver, British Columbia, Canada
  • ,
  • Seth M. Pransky

      Affiliations

    • Rady's Children's Hospital, 3030 Children's Way, Suite 402, San Diego, CA 92123, USA
  • ,
  • James S. Reilly

      Affiliations

    • Alfred I. duPont Hospital for Children, Nemours Children's Clinic, P.O. Box 269, Wilmington, DE 19899, USA

Received 7 January 2008; received in revised form 10 March 2008; accepted 12 March 2008.

Summary 

Objective

To identify and characterize food items with high risk of airway obstruction in children younger than 15 years.

Methods

This retrospective study collected injury data from 1989 to 1998 for 26 pediatric hospitals in the United States and Canada. Aspiration, choking, ingestion, and insertion injuries due to food items were analyzed. The data included 1429 infants and children. Results were compared with fatality data published by the American Association of Pediatrics in 1984.

Results

The 10 food objects with the highest frequency for both injuries and fatalities were identified. Peanuts caused the highest frequency of injury, and hot dogs were most often associated with fatal outcomes. The severity of respiratory distress prior to hospital evaluation varied for different foods. Age younger than 3 years was the highest-risk factor. Key characteristics such as bite size, shape, and texture were analyzed and found to demonstrate relationships with severity of clinical outcomes.

Conclusions

Children younger than 3 years remain at greatest risk of food injury and death. We found that hard, round foods with high elasticity or lubricity properties, or both, pose a significant level of risk. Consideration of the key characteristics of the most hazardous foods may greatly decrease airway obstruction injuries. Food safety education can help pediatricians and parents select, process, and supervise appropriate foods for children younger than 3 years to make them safer for this highest-risk population.

Keywords: Airway obstruction, Asphyxia, Child, Food

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PII: S0165-5876(08)00129-8

doi:10.1016/j.ijporl.2008.03.010

International Journal of Pediatric Otorhinolaryngology
Volume 72, Issue 7 , Pages 1041-1046, July 2008