High-powered magnet ingestion and socioeconomic disparities: © Arkady Chubykin - stock.adobe.com.
- Pediatric high-powered magnet ingestion is a serious issue, and it can lead to severe health complications, including tissue damage, perforations, and even death.
- Regulations on high-powered magnet products have fluctuated over the years, with injuries and exposures increasing when regulations are not in place.
- A study conducted from 2017 to 2019 revealed that over 75% of children with high-powered magnet exposures came from higher socioeconomic areas.
- While parental supervision and education about the dangers of these products are important, they alone are not sufficient to prevent injuries. Access to such products plays a critical role in preventing accidents.
- The US Consumer Product Safety Commission re-instituted a rule in 2022 to effectively ban small, high-powered magnetic products, aiming to reduce injuries. The effectiveness of this rule in reducing injuries remains to be seen, but the ultimate goal is to prevent any child from getting injured by high-powered magnet products.
In this Q&A with Contemporary Pediatrics®, Leah K. Middleberg, MD, FAAP, explains her research on magnet ingestion and socioeconomic disparities, which was recently presented at the 2023 American Academy of Pediatrics National Conference & Exhibition.
Contemporary Pediatrics®: Could you tell us about your study and its subsequent findings?
Leah K. Middleberg, MD, FAAP:
So, today talking you about socioeconomic disparities in pediatric high-powered magnet ingestion epidemiology and outcomes. So, pediatric high-powered magnet exposures have been an issue for several decades now that many of us have tried to look at. High-powered magnets are rare earth metals, they're up to 30 times more powerful than ferrite, [which is] kind of your average refrigerator magnet.
They came into the market in children's toys in the early 2000s. In 2008/2009, they actually started showing up marketed as desk toys, or fidget toys. But in sets of 10s, or hundreds, when they're really tiny, loose, powerful magnets, kids get a hold of these they, unfortunately, can eat them, they can stick them places: noses, ears, all very neuro-developmentally typical things that children do.
So, when kids swallow for instance, 2 or more high-powered magnets, these magnets can attract so strongly together, that they can actually trap tissue between them. This tissue can lose its blood supply, cause perforations, holes, which can lead to bleeding and infection, and in the bowel they can actually lead to twisting and blockages of bowels. This can lead to overwhelming infection, things like sepsis, and even death. So, there's been varying regulations on these products over the last decade.
There's periods of time where regulations are in place, and periods of time where regulations have not put in place. What we know from our past data is that the times when regulations are in place, injuries and exposures go down. When regulations are not in place injuries and exposures go up.
Our study looked at over 600 children enrolled throughout the 25 US children's hospitals across the country from 2017 to 2019, a period of time where regulations are not in place. And we really wanted to identify kids who are at the highest risk for injury in order to best target prevention. So, we actually utilized the Child Opportunity Index, which is a Geocode that looks at US census data that looks at a child's neighborhood as a way to identify that that child has access to things that we know improve healthy development in children.
Ultimately, we ended up finding that over 75% of our children that had a high-powered magnet exposure and sock here actually came from high access areas. So these are kids that come from higher socioeconomic areas. But we also found out that the children from higher access areas that have a higher Child Opportunity Index, their parents reported more supervision, and more baseline education about the dangers of these products prior to the injury.
So what this tells us is that supervision and education alone are not going to help prevent injuries. And what we see is access is key. And risk is proportional to access. So if we can limit access to these dangerous products for children, we can help prevent injuries and exposures. In 2022, the US Consumer Product Safety Commission re-instituted a rule set that effectively banned small, high-powered magnetic products. We don't ultimately know what's happened in that year since that that rule set went into a place.
But we do hope that injuries have gone down like they have in the past. But ultimately, our goal is to say that no child can get injured from a high-powered magnet product. So, [there's] always work still to do.
Middelberg LK, Leonard JC, Shi J, et al. High-Powered Magnet Exposures in Children: A Multi-Center Cohort Study. Pediatrics. 2022;149(3):e2021054543. doi:10.1542/peds.2021-054543