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Pediatrics. 2013 Aug;132(2):275-81. doi: 10.1542/peds.2013-0260. Epub 2013 Jul 29.

Nonfatal choking on food among children 14 years or younger in the United States, 2001-2009.

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Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio 43205, USA.



The objective of this study was to investigate the epidemiology of nonfatal choking on food among US children.


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.


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.


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.


National Electronic Injury Surveillance System–All Injury Program; aspiration; choking; emergency department; epidemiology; injury prevention

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