The Last Straw: Trends in Straw-Related Emergency Department Visits

With the recent societal push for eco-sustainability, there has been an increase in the prevalence of reusable utensils, particularly multiuse straws. This study is the first to investigate the epidemiology of plastic, glass, and metal straw-related injuries (SRIs) presenting to the emergency department (ED).

The National Electronic Injury Surveillance System database was examined for SRIs from January 2012 through December 2021. Cases were stratified by sex, age, diagnosis, mechanism of injury, and straw material to monitor epidemiological patterns.

A total of 1,174 SRIs presented to the National Electronic Injury Surveillance System EDs from January 1, 2012 to December 31, 2021. The majority of injuries occurred among males (55.9%) aged 0-3 years old (43.8%). Injuries caused by reusable straws were significantly more common in patients 3 years old or younger ( P < 0.001). Injuries most commonly affect the mouth (45.4%), eyes (22%), and internal structures (13.6%). Lacerations and oral injuries were significantly more common among reusable straw materials ( P < 0.001). A 46.5% increase in injuries was noted from 2012 to 2021. The most common mechanism of injury was poking injury (53.5%), followed by stationary falls (19.4%), foreign body (18.7%), running and falling (5.9%), and other (2.4%). Of these cases, 46.3% of injuries were due to the improper use of straws. Metal straw injuries increased 12.8% over the study period.

Although most injuries occurred as accidental poking while drinking, nearly half of all injuries were sustained while using straws in an off-label manner. Ensuring the proper use of straws and monitoring children when using a straw may help to decrease the incidence of SRI. Among the options for environmentally friendly straw materials, metal straws pose the greatest risk for injuries requiring ED presentation. Thus, their use should be avoided in the pediatric population.