(1046) National Trends in Pediatric Foreign-Body Ingestions: 2003–2022

Introduction: Esophageal foreign body (EFB) impactions are a common occurrence in children with complications occurring in up to 10%. Type of EFB is a major contributing factor influencing patterns and severity of injury and have shifted over time depending on societal trends, consumer product availability, and public policy. A 2010 policy statement from the American Academy of Pediatrics noted the need for further injury prevention strategies. The aim of this study is to evaluate the epidemiology and trends of EFB ingestions in children over the past 2 decades.

Methods: This is a retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS) database for children < 18 years who presented to the ED with foreign body ingestion between 2003 and 2022. Number of cases and type of object ingestion were recorded. Inverse probability weighting was used to generate national estimates and trend significance of the rates of EFBs over time was analyzed via linear regression.

Results: A total of 52,315 EFB ingestion injuries were managed in the ED with a national estimate of 1,589,325 cases in the study period. National incidence of EFB have increased from 7.3/10,000 children in 2003 to 14.2/10,000 children in 2022 (R2 = 0.8, p < 0.0001). The most frequently ingested objects overall were coins (44.7%), toys (15.8%), and batteries (8.7%). The annual rate of ingestions increased significantly from 2003 to 2022 for magnets (0.25 to 1/10,000 children R2 = 0.885, p < 0.0001) and toys (0.63 to 2.3/10,000 children R2 = 0.825, p < 0.0001), with both objects representing a greater proportion of EFB injuries over time. Coins represented a smaller proportion of EFB injuries over time (66% in 2003 versus 43% in 2022).

Conclusions: There has been a shift in the proportion of EFB object types ingested in children. This may be reflective of the adoption of digital currency and rapid shifts in within the consumer market and availability of newly developed electronic products. Continued surveillance by the medical community and by policy makers is crucial to further develop effective injury prevention initiatives.