By Lisa Rapaport

(Reuters Health) – A growing number of American children are being treated in emergency rooms after swallowing foreign objects like coins, toys, and jewelry, a U.S. study suggests.

Researchers examined data on 29,893 kids under six years old who were treated in emergency rooms nationwide for “foreign object ingestion” between 1995 and 2015. On the basis of those cases, researchers estimated that 759,074 young children visited the ER for foreign object injection during this two-decade timespan.

Over that same period, the annual rate of ER visits for these cases surged almost 92 percent, from 9.4 to 17.9 incidents for every 10,000 children, researchers report in Pediatrics.

“The sheer number of these injuries is cause for concern,” said lead study author Dr. Danielle Orsagh-Yentis of Nationwide Children’s Hospital in Columbus, Ohio.

“While coins were the most frequently swallowed object, batteries are of particular risk because they can do considerable damage when ingested,” Orsagh-Yentis said by email.

Nine in ten kids treated in emergency rooms for swallowing foreign objects were treated and released without being admitted to the hospital, the study found.

Coins accounted for 62 percent of cases in the ERs, followed by toys at about 10 percent. Jewelry and batteries each accounted for another seven percent of cases.

Across all age groups, pennies accounted for two-thirds of coin ingestions. Kids who swallowed coins were more likely to be hospitalized than children who ingested other objects – and quarters led to more hospitalizations than smaller coins.

Button batteries – the diminutive size often used in watches and hearing aids – accounted for 86 percent of all cases when children swallowed batteries.

Other objects kids swallowed included nails, screws, tacks, bolts, hair products, Christmas decorations, kitchen gadgets, and desk supplies.

Almost all of these foreign object ingestions happened in the home, according to the subset of cases that had data on the location where incidents occurred.

Roughly one-third of the cases involved kids under two years old, the study also found.

The study wasn’t a controlled experiment designed to prove whether or how any specific factors might have impacted the surge in ER visits for foreign object injections.

Another limitation of the study is that it only included children seen in ERs, not kids who were treated in other settings or who weren’t injured badly enough to require care. Researchers also lacked data on the exact objects swallowed by individual children or outcomes for specific patients.

Even so, the results should serve as a fresh reminder to parents that young kids can and do put all sorts of objects in their mouths, said Dr. Pamela Okada, medical director of the emergency department at Children’s Health Plano and professor at the University of Texas Southwestern Medical Center.

“Coins, jewelry, small toys, button batteries, and magnets are commonly ingested because they are small enough to fit in a child’s mouth,” Okada, who wasn’t involved in the study, said by email. “Children are constantly exploring and understanding their environment by feeling things with their lips and mouths.”

Parents need to be especially cautious with button batteries and powerful magnets, said Dr. Lois Lee, an emergency medicine physician at Boston Children’s Hospital and Harvard Medical School.

“Ingesting a button battery or high-powered magnet can potentially be lethal,” Lee, who wasn’t involved in the study, said by email.

Button batteries need to be stored out of reach of children, and disposed of where kids can’t get to them, Lee said.

“And I tell families with young children not to have any high-powered magnet toys in the house,” Lee continued. “These are often very small, and if dropped on the ground, may not be very visible.”

SOURCE: Pediatrics, online April 12, 2019.