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Persistence of choking injuries in children
David T Chang1, Kaitlyn Abdo2, Jay M Bhatt1
1Division of Otolaryngology and Head and Neck Surgery, Children's Hospital of Orange County, Orange, CA, 92868, USA.
Insights
Child choking injuries increased nonfatally but decreased fatally overall after 2010 policy changes. However, fatalities in young children and racial disparities persist, requiring continued awareness and targeted interventions.
Area of Science:
- Pediatric Public Health
- Injury Prevention
- Epidemiology
Background:
- Choking injuries pose a significant public health risk, contributing to child morbidity and mortality.
- Evaluating trends and intervention impacts is crucial for public health strategies.
Purpose of the Study:
- To analyze trends in nonfatal and fatal choking injuries in children before and after 2010 American Academy of Pediatrics policy recommendations.
- To assess the impact of policy changes on pediatric choking injury rates.
Main Methods:
- A descriptive study analyzed national data (2001-2016) from CDC's WISQARS™ and WONDER databases.
- Data included unintentional nonfatal and fatal choking injuries in children aged 0-19 years.
- Analysis focused on the periods before and after 2010, categorizing by age, gender, race/ethnicity.
Main Results:
- From 2001-2016, there were 305,814 nonfatal injuries and 2,347 choking deaths.
- Children under five accounted for 73% of nonfatal injuries and 75% of fatalities.
- Nonfatal injury rates increased significantly post-2010, while overall fatality rates decreased, but not for children under five. Racial disparities in injury and fatality rates were observed.
Conclusions:
- The overall rate of nonfatal choking injuries increased, while fatalities decreased post-2010, with notable exceptions.
- Fatality rates for children under five, the highest-risk group, did not change.
- Significant racial disparities persist, highlighting the need for targeted public health efforts and continued awareness campaigns.
Background:
Choking injuries are a significant cause of morbidity and mortality in children and represent a significant public health concern. Evaluating trends and the impact of interventions are essential to highlight whether progress has been made and to target public health efforts.
Objective:
To investigate how rates of nonfatal and fatal choking injuries have changed before and after 2010 when policy recommendations were made by the American Academy of Pediatrics.
Methods:
A descriptive study investigating unintentional nonfatal and fatal choking injuries in children aged 0-19 years using national data from 2001 to 2016 through the Centers for Disease Control and Prevention's WISQARS™ and WONDER databases, focusing on the 6 years prior and 6 years after release of the AAP's recommendations. The data was categorized by age, gender, year, and race/ethnicity for descriptive and statistical analyses.
Results:
From 2001 to 2016, there were a total of 305,814 nonfatal injuries and 2347 choking deaths in children from 0 to 19 years. Children under five years of age accounted for 73% of nonfatal injuries and 75% of choking fatalities. There was a statistically significant increase in the nonfatal injuries rate when comparing 2005-2010 and 2011-2016 (19/100,000 versus 26/100,000, respectively). There was a decrease in the choking fatalities rate in all children (0.18/100,000 versus 0.16/100,000, respectively) but no change in fatalities rate for children under five. White and Black children experience nonfatal choking injuries at a higher rate than Hispanics. Black children had highest rates of choking fatalities over Hispanic, White, Asian, and Alaskan or American Indian ethnicities. The lowest rates of death occurred in Asians.
Conclusions:
Overall rate of nonfatal choking injuries increased, while rate of choking fatalities in children decreased after 2010. However, the choking fatalities rate in 0-4 years olds, the highest risk group, did not change. Racial gaps exist with highest rates of injury in Black children. We must continue to educate and raise awareness of choking injuries, with targeted efforts to address racial disparities.
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