title: Too attractive: the growing problem of magnet ingestions in children.
abstract: BACKGROUND
  Small, powerful magnets are increasingly available in toys and other products and pose a health risk. Small spherical neodymium magnets marketed since 2008 are of particular concern.
  
  
  OBJECTIVE
  The objective of this study was to determine the incidence, characteristics, and management of single and multiple-magnet ingestions over time.
  
  
  METHODS
  Magnet ingestion cases at a tertiary children's hospital were identified using radiology reports from June 2002 to December 2012. Cases were verified by chart and imaging review. Relative risk regressions were used to determine changes in the incidence of ingestions and interventions over time.
  
  
  RESULTS
  Of 56 cases of magnet ingestion, 98% occurred in 2006 or later, and 57% involved multiple magnets. Median age was 8 years (range, 0-18 years). Overall, 21% of single and 88% of multiple ingestions had 2 or more imaging series obtained, whereas no single and 56.3% of multiple ingestions required intervention (25.0% endoscopy, 18.8% surgery, 12.5% both). Magnet ingestions increased in 2010 to 2012 compared with 2007 to 2009 (relative risk, 1.9; 95% confidence interval, 1.2-3.0). Small, spherical magnets likely from magnet sets comprised 27% of ingestions, all ingested 2010 or later: 86% involved multiple magnets, 50% of which required intervention. Excluding these cases, ingestions of other magnets did not increase in 2010 to 2012 compared with 2007 to 2009 (relative risk, 0.94; 95% confidence interval, 0.6-1.4).
  
  
  CONCLUSIONS
  The incidence of pediatric magnet ingestions and subsequent interventions has increased over time. Multiple-magnet ingestions result in high utilization of radiological imaging and surgical interventions. Recent increases parallel the increased availability of small, spherical magnet sets. Young and at-risk children should not have access to these and other small magnets. Improved regulation and magnet safety standards are needed.
authors.affiliation: From the *Division of Emergency Medicine, Department of Pediatrics, SeattleChildren's Hospital and University of Washington; †Department ofRadiology, University of Washington; and ‡Division of Pediatric Surgery,Department of Surgery, Seattle Children's Hospital and University of Washington, Seattle, WA.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Brown
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Otjen
authors.forename: George T
authors.initials: GT
authors.lastname: Drugas
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery; D000293:Adolescent; D001062:Appendectomy; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D004630:Emergencies / Q000453:epidemiology; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007813:Laparotomy / Q000706:statistics & numerical data; D059346:Magnets / Q000009:adverse effects*; D008297:Male; D009017:Morbidity / Q000639:trends; D009354:Neodymium; D010538:Peritonitis / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D012306:Risk
chemical_list: D009354:Neodymium