Are FPCIs a source of increased risk for children? Results of a multicenter, experimental study comparing children's behaviour with FPCIs and toys

An Epistemological View on Risk Exposure Assessment: A Case Study

Background:

Research in Health Risk Assessment is increasingly covering a preeminent role in health care studies. However, risk assessment faces the issue of properly measuring risk exposure.

Objective:

The aim of the study has been to tackle some methodological issues regarding the risk assessment analysis in the health field, giving more emphasis to a philosophical and epistemological approach in order to show the difficulties in adopting suitable exposure assessment techniques.

Method:

Here, we present a methodological review and a critical discussion of foreign body injuries articles in child population as a case study. A Medline, Econlite and CIS bibliographic search was conducted considering the term “foreign bodies” only in “children” and “risk”. Only English papers are considered. Further research on CDC, CPSC, DGSANCO databases has been performed. Different approaches in risk assessment are reviewed using four case-study papers with the purpose of pointing out their limitations.

Result:

Ten papers are retrieved though literature review reporting risk estimate of foreign bodies injuries in children.

Conclusion:

Considering that different variables affecting the risk of choking injuries, like intrinsic characteristic of a product or the intensity levels at which children are exposed, and then it seems very difficult to correctly evaluate risk of injuries. For this reason, we have argued for an epistemological and holistic approach toward risk assessment.

Ear, nose and throat foreign bodies: the experience of the Pediatric Hospital of Turin

AIM

Ear, nose and throat (ENT) foreign body (FB) injuries represent an emerging problem in the paediatric population because of their human and social costs. The aim of the study is the site-specific evaluation of FB injuries in the paediatric population referred to the emergency department of the Pediatric Hospital of Turin.

METHODS

This retrospective analysis was carried out sifting medical reports between 2002 and 2011. We collected information about 338 patients' FB characteristics, complications and hospitalisation.

RESULTS

The mean age was 4.2 ± 2.9 years. Nose and ear are the most involved anatomical sites, followed by pharynx, oesophagus and trachea-bronchi. The most common FBs are balls, beads and toys parts (29.6%), followed by fishbones (13.6%). A lower mean age is observed in tracheo-bronchial and oesophageal FBs. The 9.2% of cases reported complications.

CONCLUSIONS

A quick and proper diagnosis followed by an effective treatment of FB injuries and their complication is mandatory. Surveillance registries have a key role in prevention and management of FB injuries; useful information can be obtained also for nurse and ENT specialist training in order to create professionals ready to recognise and manage FB injuries in the most effective way.

Magnetic FB injuries: an old yet unresolved hazard

RATIONALE AND AIM

Among foreign bodies causing injuries in children, magnets have been reported to cause serious complications and being life-threatening. The aim of this study is to design a risk profile and an epidemiological figure of such injuries, for being used for prevention.

METHODS

Data on 366 injuries have been collected from public surveillance databases and from published scientific literature, and compared with the data of the Susy Safe registry, which is a pan-European registry of foreign bodies injuries co-funded by the European Commission.

RESULTS

A median age of 48 months was observed, with a 63% prevalence of males is characterizing the injuries. Magnets have a median volume of 87.9 mm(3) vs the median volume of 41.86 mm(3) of the overall foreign bodies of the Susy Safe registry). Only 43% of the magnets were involving only on piece or objects, with a median number of two objects per injury, up to a maximum of 32 objects. Children are referred to the medical care system with a median delay of 3 days after onset of symptoms. Median length of stay in the hospital was 7 days with respect to 1 day as in the Susy Safe registry.

CONCLUSION

Most of complications, and event the death of a child can be eventually re-conducted to either or both a delay in patient referral or appropriate diagnosis. Thus, it is an absolute priority that an information initiative is taken toward families and emergency doctors to avoid unnecessarily delays respectively in patient referral and in diagnosis.