title: Are FPCIs a source of increased risk for children? Results of a multicenter, experimental study comparing children's behaviour with FPCIs and toys.
abstract: BACKGROUND
  Food Products Containing Inedibles (FPCIs) are believed to represent a source of higher choking risk in children. The aim of this study was to set up a controlled study, conducted on children aged 3-6 in a laboratory setting, in order to understand their behavior when interacting with FPCIs (with reference to mouthing activities, double nature recognition, and toy assembling ability).
  
  
  METHODS
  The experimental phase was divided into two sessions: a FPCI session and a Toy session, to which 247 children were randomly assigned. During these sessions children were observed in order to catch their mouthing activity according to the two types of objects available to them (FPCIs and Toys).
  
  
  RESULTS
  This study shows that: (a) children's behavior with respect to toys contained in FPCIs and toys presented alone is not significantly different; (b) children's ability to distinguish between the edible and non-edible part of the FPCI was very high; and (c) mouthing episodes of the inedible parts were negligible and comparable between FPCIs and toys presented alone. This strongly suggests that, with respect to choking risk, FPCIs are not per se distinguishable from toys containing small parts.
  
  
  CONCLUSIONS
  Restrictions on the sale of FPCIs with small toys exist in the U.S. market. In Europe, FPCIs are allowed to be on sale, under the condition that, in case, they will follow the general regulatory requirements of small toys packaged and sold alone. In this case, they must provide age warnings and labels. Our findings do not justify the different attention that toys in FPCIs are at times afforded by regulators when compared to "stand alone" toys.
authors.affiliation: Italian Institute of Toy Safety, Como, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Donati
authors.forename: B
authors.initials: B
authors.lastname: Benelli
authors.forename: N
authors.initials: N
authors.lastname: Consonni
authors.forename: M
authors.initials: M
authors.lastname: Fabregant
authors.forename: T
authors.initials: T
authors.lastname: Mantyla
authors.forename: G
authors.initials: G
authors.lastname: Carelli
authors.forename: R
authors.initials: R
authors.lastname: Corradetti
authors.forename: S
authors.initials: S
authors.lastname: Snidero
authors.forename: C
authors.initials: C
authors.lastname: Scarinzi
authors.forename: B
authors.initials: B
authors.lastname: Morra
authors.forename: D
authors.initials: D
authors.lastname: Gregori
mesh_terms: D000402:Airway Obstruction / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003257:Consumer Product Safety; D003679:Deglutition; D019649:Food Industry / Q000592:standards*; D018857:Food Packaging / Q000592:standards; D006801:Humans; D010988:Play and Playthings / Q000293:injuries*; D018570:Risk Assessment; D014481:United States