title: Toys in the upper aerodigestive tract: evidence on their risk as emerging from the ESFBI study.
abstract: OBJECTIVE
  Foreign body inhalation/aspiration or ingestion is a relatively common event in young children and, despite many efforts made in several Countries to reach acceptable safety levels for products devoted to children, small toys or toy parts are frequently mentioned among risky foreign bodies. The aim of the present study is to characterize the risk of complications and prolonged hospitalization due to toys inhalation/aspiration or ingestion according to age and gender of patients, FB characteristics and FB location, circumstances of the accident, as emerging from the ESFBI study.
  
  
  METHODS
  A retrospective study in major hospitals of 19 European Countries was realized on children aged 0-14 having inhaled/aspired or ingested a toy, with regard to the characteristics of the child and the FB (shape, volume, consistency), the FB location, the hospitalization's details and the occurrence of complications.
  
  
  RESULTS
  In the years 2000-2003 a total of 2094 FB injuries occurred in children aged 0-14 years. Among them 121 (5.8%) were due to toys (mainly parts of toys) and 95 (4.5%) occurred in the lower/upper aero-digestive tract. 58 children needed hospitalization. The first determinant of a damage requiring hospitalization is the rigid consistence of the object. Almost 27% of toys related injuries happened under adults' supervision.
  
  
  CONCLUSIONS
  Despite the adoption of preventive strategies, including products modification by manufacturers, has resulted in a decrease of children's mortality rate for choking in the last decades, our results seem to testify that preventive strategies imposing a regulation of industrial production, even if fundamental, are not sufficient and need to be integrated with other preventive intervention addressed to improve parents ability to be conscious of FB injuries and attentive toward a proper surveillance of children.
authors.affiliation: Department of Surgery, University of Pisa, via Roma no. 67, Pisa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Foltran
authors.forename: Dario
authors.initials: D
authors.lastname: Gregori
authors.forename: Desiderio
authors.initials: D
authors.lastname: Passàli
authors.forename: Luisa
authors.initials: L
authors.lastname: Bellussi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caruso
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Passàli
authors.forename: Giulio Cesare
authors.initials: GC
authors.lastname: Passàli
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D003679:Deglutition; D004066:Digestive System Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D005547:Foreign Bodies / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D001239:Inhalation; D008297:Male; D010988:Play and Playthings / Q000293:injuries*; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D014947:Wounds and Injuries / Q000150:complications / Q000453:epidemiology / Q000209:etiology*