Foreign body injury in children in the twentieth century: a modern comparison to the Jackson collection

Objective: To compare two databases of foreign body (FBs) objects causing injury in children (>20 years of age) and record differences in size, shape and material for children at risk over a 70-year period of time. Study design: Retrospective analysis of the Jackson collection (JC) of FBs (1920-1932) and a 12-year modern study (MS) of data taken from 25 children's hospitals in North America over the period 1988-2000. Digital images were obtained of the JC collection. Methods: Identify age, sex, and type of products, size, shape, and consistency of material from the injury-producing FBs. Statistical Processing for Social Sciences was used for analysis of JC versus MS. Results: 5528 children were evaluated from the MS, and compared with 1238 from the JC. Boys remain at greater risk than young girls (53% versus 47%) over the 70-year period of study. Coins have replaced safety pins (31% versus 15%) as the most common offending FBs. Although 99% of FBs causing injury are less than 1.25 in. in greatest diameter in both the JC and MS, 100% of FBs are eliminated when the test size is greater than 1.75 in. Conclusions: Boys remain at greater risk of injury over the last 60 years. However, coins have now emerged as the leading cause of injury in children. Children achieve greater protection from risk by modification of the Small Parts Test Fixture (SPTF) from 1.25 to 1.75 in. diameter. (C) 2003 British Association for Paediatric Otorhinolaryngology. Published by Elsevier Ireland Ltd. All rights reserved.