Choking Hazard Research Articles

Pediatric exposure to choking hazards is associated with parental knowledge of choking hazards

Objective To evaluate parental knowledge regarding household food and non-food choking hazards. Design Cross Sectional Survey. Setting Tertiary Care Children's Hospital. Participants Parents presenting to a Pediatric Otolaryngology Clinic with a child <4 years old. Methods Parental survey asking which choking hazard foods (CHF) they allow their child to eat, previous instruction of CHF, knowledge of non-food choking hazards, and their knowledge sources. Statistics: adjusted odds ratios (AOR) and logistic regressions. Results 492 respondents. Adjusted for significant covariates associations between correct knowledge of CHF and correct parents actions of disallowing CHF: fruit chunks (prior instruction = 42%; correct action = 25%; AOR = 3.51; P < 0.0001), hot dogs (59%; 28%; 1.75; 0.0178), raw vegetables (41%; 47%; 1.28; 0.198) popcorn (67%; 49% 2.64; <0.0001), whole grapes (68%; 51%; 2.2; <0.0001), nuts (73%; 66%; 2.47; <0.0001), chunks of peanut butter (45%; 79%; 2.55; 0.0003), sticky candy (79%; 80%; 2.16; <0.0033), gum (72%; 84%; 1.75; 0.028), seeds (65%; 87%; 1.4; 0.247), 76% always supervise meals, 57% always cut food, 62% know CPR. Knowledge of non-food hazards Coins (97%), marbles (94%), small batteries (93%), small toy parts (93%), dice (92%), pen caps (92%), safety pins (85%), balloons (84%), syringes (40%). Sources of choking hazard knowledge: physicians (67%), family/friends (52%), books/magazines (40%), and the Internet (25%). Conclusions Parental knowledge of CHF is incomplete. The consumption of CHF in children under 4 is significantly associated with decreased parental knowledge. Therefore, more parental education is needed.

The Ecotoxicology of Plastic Marine Debris

The accumulation of plastic in the oceans is an ever-growing environmental concern. Plastic debris is a choking and entanglement hazard for wildlife; plastics also leach toxic compounds into organisms and ecosystems. Educating students about the marine debris problem introduces fundamental concepts in toxicology, ecology, and oceanography. Students will learn about the toxicity of plastics, collect and analyze data on plastic debris, and put their new knowledge to work by writing a congressional bill that addresses the problem of marine debris.

Honey and lozenges for children with non-specific cough.

Chronic non-specific cough is a chronic, dry cough of in the absence of identifiable respiratory disease or known aetiology. Although it is usually not reflective of an underlying severe illness, it does cause significant morbidity, and as such relief from it is often sought. The use of honey and lozenges to soothe upper respiratory tract irritation is common, inexpensive, and potentially more effective in treating the symptoms than pharmacological interventions. To evaluate the efficacy of honey and/or lozenges in the management of children with chronic non-specific cough. The Cochrane Airways Group searched the Cochrane Register of Controlled Trials (CENTRAL), MEDLINE, OLDMEDLINE, and EMBASE databases in October 2008. All randomised controlled trials comparing honey or lozenges with a placebo in treating children with chronic non-specific cough. The results of the searches were assessed according to the pre-determined criteria. None of the trials identified by the searches were eligible for inclusion, leaving no data available for analysis in this review. The search did not provide any applicable randomised controlled trials that investigated the efficacy of honey and lozenges in treating children with non-specific chronic cough. Data from acute studies suggest a potential role for honey in relieving cough, but whether this is applicable to chronic cough is unknown. Clinically, this review was unable to provide any justifiable recommendation for or against honey and/or lozenges due to the lack of evidence. The absence of applicable studies highlights the need for further research into the area of treating children with chronic non-specific coughs with honey and/or lozenges. These treatments are not recommended when managing very young children (as lozenges are a potential choking hazard, and honey may cause infant botulism in children under 1 year of age).

Indicators of choking risk in adults with learning disabilities: A questionnaire survey and interview study

Purpose. Feeding and swallowing impairments are key predictors of increased morbidity and mortality in adults with learning disabilities. This postal survey and interview study sought to identify risk factors in adults with learning disabilities who have histories of choking.Method. A total of 2000 questionnaires were sent to carers of all adults with learning disabilities registered as service users by three local health authorities. (A ‘service user’ may be using any specialist learning disability health or social care facility with day, residential or therapeutic services). Of the 674 service users for whom surveys were returned, 47 were living in hospital, 396 were living in residential or group homes and 208 were living with relatives, or in their own homes. Eighteen subjects who had reported serious or repeated episodes of choking were interviewed in depth in their residences or workplaces. Responses were subjected to frequency analyses. Personal characteristics were analysed. Choking patterns were differentiated by food texture.Results. A total of 34% of questionnaires on 674 service users were returned; 42% of respondents reported one or more choking episodes. There was a significantly greater occurrence of choking among people with more severe learning disability, with Down syndrome, people who had an incomplete dentition or were taking a greater number of psychotropic drugs. Antisocial eating habits learnt in institutional settings presented an additional choking hazard for some individuals.Conclusion. Choking is a serious hazard for many adults with learning disabilities. This study establishes many of the characteristics associated with swallowing problems in this population. Clinicians and carers should benefit from awareness of these predictors, leading to better management of eating behaviours and habits. A choking and swallowing risk assessment should be included in routine health assessments of adults with learning disability, paying especial attention to the condition of a person's teeth; possible side effects from prescribed medication, and abnormal eating behaviour.

Tri-State Hospital Supply Corp. Recalls Oral Swabs Due to Potential Choking Hazard

Tri-State Hospital Supply Corp. Recalls Oral Swabs Due to Potential Choking Hazard

Nonfatal Choking-Related Episodes Among Children—United States, 2001

Food and nonfood substances can present a choking hazard for children, particularly younger children. During 2000, the latest year for which national mortality data were available, 160 children aged < or = 14 years died from obstruction of the respiratory tract associated with inhaled or ingested foreign bodies (International Classification of Diseases, Tenth Revision, codes W79-W80); food and nonfood substances were associated with 41% and 59% of these deaths, respectively (CDC, unpublished data, 2002). To characterize nonfatal choking-related episodes in children treated in U.S. hospital emergency departments (EDs) during 2001, CDC analyzed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP). This report summarizes the results of this analysis, which indicate that an estimated 17,537 children aged < or = 14 years were treated in EDs for choking-related episodes in 2001. Many of these episodes were associated with candy/gum (19.0%) and coins (12.7%). Parents and caregivers should be aware of the types of foods and objects that pose a choking risk for children, become familiar with methods to reduce this risk, and be able to treat choking in children.

Potential Choking Hazard when Using a Scented Pen

Trident Medical International, Inc., Indianapolis, IN. brichmond@parholdings.comIn Reply:—The T5000 Mask-Ease scented pens were purchased from an outside vendor of Trident Medicals and sold to a few specific customers in the European Market only. After receiving the initial complaint from the University Children's Hospital in Zurich, Switzerland, a thorough investigation into the root cause of the problem was performed by the Trident Medical quality assurance department.The conclusions drawn from this investigation and analysis led to the immediate recall of all Mask-Ease scented pens from the market and a discontinuation of any and all future sales of the Mask-Ease scented pens by Trident Medical International.

Colorado Pikeminnow with a Channel Catfish Lodged in Its Throat in the San Juan River, Utah

the decline of the Colorado pikeminnow and other native fish species (McAda, 1983; Pimental et al., 1985). Populations of Colorado pikeminnow remain in the Green, White, Yampa, Colorado, and San Juan rivers (Minckley and Carothers, 1979; Holden and Wick, 1982; Platania et al., 1991; Tyus, 1991; Ryden and Ahlm, 1996). Colorado pikeminnow was listed as endangered by the United States Fish and Wildlife Service in 1974 (Federal Register 39:1175, 1974) and is protected by all states in its historic range (Propst, 1999). Colorado pikeminnow begin to feed on fish at 50 mm total length (TL; Vanicek and Kramer, 1969). Adult Colorado pikeminnow, which can achieve 948 TL in the San Juan River (Ryden and Ahlm, 1996), can take prey 1/3 to 1/2 their body length (Osmundson et al., 1998). Prior to the establishment of nonnative fishes, soft-rayed fishes were the only prey available to Colorado pikeminnow (Holden and Wick, 1982; Pimental et al., 1985). Establishment of nonnative, hardand spiny-rayed fishes, including channel catfish, (Ictalurus punctatus), exposed Colorado pikeminnow to a potential choking hazard which was previously nonexistent. Anecdotal reports of Colorado pikem nnow with channel catfish lodged in their throats (e.g., Vanicek and Kramer, 1969) were undocumented until 1983. McAda (1983) collected an adult Colorado pikeminnow (550 mm TL) from the Green River in 1974 with a channel catfish (120 mm TL) lodged in its throat. Three similar incidents subsequently were reported from the Green River in 1982 and 1983 (Pimental et al., 1985). Our collection of a juvenile Colorado pikeminnow with a channel catfish lodged in its mouth from the San Juan River offers a new perspective on this phenomenon, especially as it relates to recovery efforts for Colorado pikeminnow in the San Juan River. On 1 October 1999, at approximately 1145 h while electrofishing at river kilometer (RK) 138.4, 12.1 km downstream of the bridge at Montezuma Creek, Utah, we collected a subadult Colorado pikeminnow (346 mm TL) with a channel catfish (111 mm TL) firmly lodged in its mouth anterior to the gills. The channel catfish was alive and struggling, with spines extended. The dorsal spine had penetrated the roof of the Colorado pikeminnow's mouth and had entered the right eye socket causing distention and hemorrhagic swelling. Both pectoral spines had penetrated the sides of the Colorado pikeminnow's mouth. The posterior end of the channel catfish, from just anterior to the adipose fin, protruded from the Colorado pikeminnow's mouth. A strip of flesh about 10 mm wide was worn from the body of the channel catfish, where the Colorado pikeminnow's mouth would normally close. We photographed the fishes, then removed the channel catfish from the Colorado pikeminnow's mouth by severing the spines and backing the fish out of the mouth. Both fish were weighed and measured. The channel catfish was removed from the river and the Colorado

Evaluating Choking Child Pictorial Symbols

Two experiments evaluated pictorial symbols intended to warn consumers of a child choking hazard. In Experiment 1, participants used the Zwaga (1989) comprehension estimation procedure to estimate the percentage of the U.S. population they felt would understand the intended meaning of 15 symbols designed to depict a choking hazard. For the symbol with the highest comprehension estimate, participants indicated that 74% of the population would correctly interpret the intended meaning: choking. All of the top-rated symbols contained similar combinations of features, including crossed hands, a protruding tongue, and a frontal face orientation. But interestingly, symbols with lower comprehension estimates also contained a different set of similar features. In Experiment 2, small groups of participants constructed multiple panel choking hazard symbols from the set of 15 symbols in the first experiment. As in the first experiment, there was a high degree of consistency among participants' responses. Unexpectedly, the first and last symbols selected for this three-panel sequence were among symbols that received the lowest comprehension estimates in the first experiment. These findings seem to confirm that symbol comprehensibility can be influenced by context. Implications of this study for future research are discussed.

Airway Obstruction by a Ball

A toddler died as the result of choking on a toy ball that occluded his upper airway. The size of this toy was within the federal safety standards for use by children under the age of three years. Though it has been recognized since 1987 that the minimum safe diameter set by the Federal Hazardous Substances Act may be too small, no change has been made to the regulation (1). In 1995 a comprehensive review of asphyxia related to the size of the foreign object found 4.44 cm diameter and 7.62 cm length a more comprehensive standard (1). Currently federal warning labels are required on some items that contain balls smaller than 4.44 cm to prevent use by children less than three years of age (2). The small parts fixture test in use by the federal government is available as a safety tool for parents to use at home. Unfortunately the "safe" diameter of 3.17 cm is too small to provide assurance that a toy is not a choking hazard.

Clear plastic cups: a childhood choking hazard

The disposable plastic beverage cup is not usually regarded as hazardous to young children. Certain varieties of these products, however, are manufactured from a brittle, clear plastic that easily cracks and fragments. While most conscientious parents keep their children safe from peanuts, balloons, and other known choking hazards, a child can surreptitiously bite a cup edge and aspirate the fragment. We report two cases of foreign body aspiration involving clear plastic cups that went undetected, one of which remained 21 months following a negative rigid bronchoscopy. Diagnostic difficulties are related to the transparency and radiolucency of these objects. When suspicious of foreign body aspiration in children, otolaryngologists should inquire about the availability of clear plastic cups in the household and be mindful of the diagnostic pitfalls. Further investigations including CT scanning and repeat bronchoscopy may be helpful in cases of suspected missed foreign bodies. An educational campaign aimed at prevention and placement of product package warning labels should be established.

A statewide survey of hazards in child care centers.

The purpose of this study was to determine adherence to selected recommended safety standards in North Carolina child care centers. A self administered questionnaire eliciting information about safety practices in child care was mailed to a randomly selected sample of 409 North Carolina child care centers. One hundred and ninety five usable questionnaires were returned from child care centers in 75 counties. Results indicated that all of the standards included in the state's child regulations were being adhered to by at least 80% of the centers. However, adherence to recommended standards not included in the state's regulations was quite variable, with one standard implemented by less than 5% of the centers. The lowest rates of adherence were found for standards specifying that resilient surface material be used under playground equipment (4%) and that certain foods that may present a choking hazard to small children not be served (27%). Many hazards not addressed in North Carolina child care regulations are present in child care centers. Some safety standards are not adhered to due to lack of knowledge or limited resources. Inclusion of national standards in state child care regulations appears to reduce, but not eliminate, the likelihood of hazards being reported. Further research should include on-site inspections and attention to safety in family child care.

A Potential Choking Hazard

A Potential Choking Hazard

Legislating Choking Hazard Labels for Toys — The Human Factors Perspective

The Federal Small Parts regulation banned toys with small parts intended for children less than three years old because of the hazard of choking. However, choking incidents continued to occur because children had access to older children's toys. To address this problem, Congress recently passed an Act requiring choking hazard labels for balloons, small balls, marbles, and toys containing small parts intended for children between three and six years old. This paper discusses the analysis of choking incidents, the development of labels, the events leading to passage of the Act requiring labels for toys, and a critique of the final labels. Balloons and toys most likely to be given to children less than three will now be labeled with an explicit warning about choking. However, these labels would have been more effective had they followed standardized labeling format. This deficiency has negative implications for other labels.

The Impact of Specific Toy Warning Labels

According to the 1980 Consumer Product Safety Commission's small parts standard, toys with small parts that pose a choking hazard cannot be marketed for children under the age of 3 years. To comply with the standard, toy manufacturers place age labels on packaging to indicate the ages for which toys with small parts are recommended. We conducted a survey of 199 toy buyers to determine the degree to which they understood such labels as warnings and whether more explicit warning labels would affect toy buyers' willingness to purchase toys with small parts for children between 2 and 3 years of age. Forty-four percent of respondents said they would buy for a child between 2 and 3 years of age a toy with the label "Recommended for 3 and up"; only 5% said they would buy for a young child a toy with the label "Not recommended for below 3--small parts." These findings indicate that a change in the small parts standard to require more specific labeling might substantially reduce potentially hazardous toy purchases.