title: Pediatric magnet ingestions: the dark side of the force.
abstract: BACKGROUND
  Pediatric magnet ingestions are increasing. Commercial availability of rare-earth magnets poses a serious health risk. This study defines incidence, characteristics, and management of ingestions over time.
  
  
  METHODS
  Cases were identified by searching radiology reports from June 2002 to December 2012 at a children's hospital and verified by chart and imaging review. Relative risk (RR) regressions determined changes in incidence and interventions over time.
  
  
  RESULTS
  In all, 98% of ingestions occurred since 2006; 57% involved multiple magnets. Median age was 8 years (range 0 to 18); 0% of single and 56% of multiple ingestions required intervention. Compared with 2007 to 2009, ingestions increased from 2010 to 2012 (RR = 1.9, 95% confidence interval 1.2 to 3.0). Intervention proportion was unchanged (RR = .94, 95% confidence interval .4 to 2.2). Small spherical magnets comprised 26.8% of ingestions since 2010; 86% involved multiple magnets and 47% required intervention.
  
  
  CONCLUSIONS
  Pediatric magnet ingestions and interventions have increased. Multiple ingestions prompt more imaging and surgical interventions. Magnet safety standards are needed to decrease risk to children.
authors.affiliation: Division of Pediatric Emergency Medicine, Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Brown
authors.affiliation: Department of Radiology, University of Washington, Seattle, WA, USA.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Otjen
authors.affiliation: Division of Pediatric Surgery, Seattle Children's Hospital, 4800 Sand Point Way, NE M/S OA.9.220 Seattle, WA 98105, USA; Department of Surgery, University of Washington, Seattle, WA, USA. Electronic address: george.drugas@seattlechildrens.org.
authors.forename: George T
authors.initials: GT
authors.lastname: Drugas
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004435:Eating; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000601:surgery; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D007813:Laparotomy; D059346:Magnets; D008297:Male; D011859:Radiography; D014861:Washington / Q000453:epidemiology
keywords: Emergency; Foreign body; Gastrointestinal; Magnet ingestion; Pediatric; Prevention