title: Nonfatal choking on food among children 14 years or younger in the United States, 2001-2009.
abstract: OBJECTIVE
  The objective of this study was to investigate the epidemiology of nonfatal choking on food among US children.
  
  
  METHODS
  Using a nationally representative sample, nonfatal pediatric choking-related emergency department (ED) visits involving food for 2001 through 2009 were analyzed by using data from the National Electronic Injury Surveillance System-All Injury Program. Narratives abstracted from the medical record were reviewed to identify choking cases and the types of food involved.
  
  
  RESULTS
  An estimated 111,914 (95% confidence interval: 83,975-139,854) children ages 0 to 14 years were treated in US hospital EDs from 2001 through 2009 for nonfatal food-related choking, yielding an average of 12,435 children annually and a rate of 20.4 (95% confidence interval: 15.4-25.3) visits per 100,000 population. The mean age of children treated for nonfatal food-related choking was 4.5 years. Children aged ≤ 1 year accounted for 37.8% of cases, and male children accounted for more than one-half (55.4%) of cases. Of all food types, hard candy was most frequently (15.5% [16,168 cases]) associated with choking, followed by other candy (12.8% [13,324]), meat (12.2% [12,671]), and bone (12.0% [12,496]). Most patients (87.3% [97,509]) were treated and released, but 10.0% (11,218) were hospitalized, and 2.6% (2911) left against medical advice.
  
  
  CONCLUSIONS
  This is the first nationally representative study to focus solely on nonfatal pediatric food-related choking treated in US EDs over a multiyear period. Improved surveillance, food labeling and redesign, and public education are strategies that can help reduce pediatric choking on food.
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio 43205, USA. gary.smith@nationwidechildrens.org
authors.forename: Meyli M
authors.initials: MM
authors.lastname: Chapin
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Rochette
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Annest
authors.forename: Tadesse
authors.initials: T
authors.lastname: Haileyesus
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Conner
authors.forename: Gary A
authors.initials: GA
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000453:epidemiology* / Q000628:therapy; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002182:Candy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005502:Food; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D014481:United States
keywords: National Electronic Injury Surveillance System–All Injury Program; aspiration; choking; emergency department; epidemiology; injury prevention