60% of food choking cases occur in children less than four years old

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1. An estimated 111,914 children presented to emergency departments in the United States for non-fatal, food-related choking episodes from 2001-2009. 

2. Children ages 0-4 years experienced the highest rate of choking episodes during the study period. 

Evidence Rating Level: 2 (Good)

Study Rundown: Choking is one of the leading causes of death in children, and the majority of these events are contributable to food.  Recently, the safety surrounding hazardous, non-food objects has been improved; however, little progress has been made in the prevention of children choking on high-risk food items.  Researchers in this study aimed to address this problem by providing a detailed analysis of non-fatal, food-related choking episodes in the United States during a nine year period. It was estimated that around 12,000 children were treated for non-fatal choking episodes annually. Children ages 0-4 years had the highest rate of choking events. Hard candy, other candy, meat (other than hot dogs), and bone accounted for more than half of all choking incidents. Estimates may not be fully representative of all food-related, non-fatal choking events in the United States, but it highlights a significant need for improvement in the safety of high-risk food items for children.

Click to read the study published in Pediatrics

Relevant Reading: Characteristics of objects that cause choking in children

Study Author, Dr. Gary Smith, MD, DrPH, talks to 2 Minute Medicine: President of the Child Injury Prevention Alliance and Professor of Pediatrics in The Ohio State University College of Medicine. 

“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.”

“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. Physicians and future physicians can become involved to help implement these prevention strategies at local to national levels.”

In-Depth [retrospective cohort study]: Results were based on 2953 children, ages 0-14, from the National Electronic Injury Surveillance System-All Injury Program. All included children visited the emergency department (ED) for a non-fatal, food-related choking episode during the nine year study period from 2001-2009. Researchers further evaluated cases by the type of food involved and age of the patient at the time of the event. It was estimated that an average of 12,435 (20.4 per 100,000) children presented to EDs in the United States for non-fatal food-related choking episodes each year during the study period. The highest rate of choking was seen in children 0-4 years at 37.6 episodes per 100,000. Hard candy, other candy, meat (other than hot dogs), and bone accounted for 52.5% of all food-related choking episodes.

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