Investigators from multiple institutions conducted a retrospective study to describe the characteristics and outcomes among pediatric patients with magnet ingestions. They were interested particularly in ingestions of small (<5 mm), high-powered magnets, which have been associated with serious injuries. For the study, the investigators abstracted data from the National Poison Data System (NPDS) on magnet “exposures” from January 2008 to October 2019 in children <19 years old. NPDS includes information on telephone calls to 1 of 35 poison control centers in all 50 US states that are members of the American Association of Poison Control Centers. Data on calls about possible exposures (including ingestions, inhalations, injections, or dermal exposures) were collected in a systematic matter and included demographics of the patient, nature of the exposure, intentionality, management (eg, at home or at a hospital), and clinical effects/outcomes. Clinical effects were categorized as minor (minimal symptoms that resolved quickly), moderate (more significant symptoms that were not life-threatening), or major (life-threatening symptoms or permanent disability). For the analysis, magnet exposures were categorized by time period: 2008–2011, when high-powered magnets were commercially available; 2012–2017, when these magnets were removed from the market; and 2018–2019, when they were reintroduced. Differences in the number of exposures and management during these time periods were assessed with Mann-Whitney or Kruskal-Wallis tests.
Data on 5,738 pediatric magnet “exposures” (ie, ingestions) between 2008 and 2019 were analyzed; 39% of these exposures occurred in 2018 and 2019. The mean age of patients was 5.2 ±4.1 years, and 55.2% were males. Overall, 48.4% of these patients were treated at a hospital or healthcare facility. Among children <5 years old, 99.3% of exposures were unintentional, but for those 13-19 years old, 56.8% were intentional. There were 222 patients (3.9%) who had documented clinical effects, including 182 (3.2%) with minor effects, 34 (0.6%) with moderate effects, and 6 (0.1%) with major effects. Between the 2008–2011 and 2012–2017 time periods, reported magnetic exposure decreased by 33% (P <0.05), corresponding to removal of high-powered magnets from the market. However, there was a 444% increase in cases between the 2012–2017 and 2018–2019 (P <0.05); there was also a 298% increase in magnet exposures between the 2008–2011 and 2018–2019 time periods (P <0.05). A 355% increase in hospital-treated injuries from magnet exposures between the 2012–2017 and 2018–2019 time periods also was noted (P <0.05).
The authors conclude that the number of magnet exposures and injuries in children in the US corresponded to time periods when high-powered magnets were commercially available.
Dr Dubik has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
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