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Toys in the upper aerodigestive tract: new evidence on their risk as emerging from the ESFBI study
  1. F Foltran,
  2. P Berchialla,
  3. D Gregori*,
  4. A Pitkranta,
  5. I Slapak,
  6. J Jakubkov,
  7. L Bellussi,
  8. D Passali
  1. Correspondence University of Padova, Via Loredan 18 Padova, 35100, Italy


Rationale and aim Foreign body (FB) inhalation/aspiration or ingestion are relatively common events in young children and, despite many efforts made in several countries to reach acceptable safety levels for products devoted to children, small toys or toy parts are frequently mentioned among risky FBs. The aim of the present study is to characterise the risk of complications and prolonged hospitalisation due to toys inhalation/aspiration or ingestion according to age and gender of patients, FB characteristics and FB location, circumstances of the accident, as emerging from the ESFBI study.

Methods A retrospective study in major hospitals of 19 European countries was realised on children aged 0–14 having inhaled/aspired or ingested a toy, with regard to the characteristics of the child and the FB (shape volume consistency), the FB location the hospitalisation's details and the occurrence of complications.

Results In the years 2000–2003 a total of 2094 FB injuries occurred in children aged 0–14 years. Among them 121 (5.8%) were due to toys (mainly parts of toys) and 95 (4.5%) occurred in the lower/upper aero-digestive tract. 58 children needed hospitalisation. The first determinant of a damage requiring hospitalisation is the rigid consistence of the object. Almost 27% of toys related injuries happened under adults supervision.

Conclusions Despite the adoption of preventive strategies, including products modification by manufacturers, has resulted in a decrease of children's mortality for chocking in the last decades, our results seem to testify that preventive strategies imposing a regulation of industrial production, even if fundamental, are not sufficient and need to be integrated with other preventive intervention addressed to improve parents ability to be conscious of FB injuries and attentive towards a proper surveillance of children.

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