New study finds increase in nonfatal food-related choking among children in the US

Choking is a leading cause of injury among children, especially for children 4 years of age and younger. A new study by researchers at the Center for Injury Research and Policy of The Research Institute at Nationwide Children's Hospital and colleagues at the Centers for Disease Control and Prevention examined nonfatal food-related choking among children 14 years of age or younger from 2001through 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.

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 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."

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."