The call from American pediatricians for actions to prevent children from choking on foods such as hot dogs has led to reactions ranging from killer hot dog jokes to blaming the problem on parents.
The American Academy of Pediatrics (AAP) says choking is a leading cause of injury and death among children. Food, toys and coins account for most of the choking-related events because young children put objects in their mouths as they explore new environments.
In 2000, 160 children ages 14 years or younger died from an obstruction of the respiratory tract due to inhaled or ingested foreign bodies. Of these, 41 percent were caused by food items. For every choking-related death, there are more than 100 visits to U.S. emergency departments. In 2001, an estimated 17,537 children 14 years or younger were treated in emergency departments for choking episodes (Centers for Disease Control).
Since 1960 toys have been regulated to prevent child choking incidents but food has not been regulated. The AAP wants to make choking prevention a priority for parents, government agencies and food makers through a new policy statement in the March issue of Pediatrics. Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus,Ohio is the lead author.
Hot dogs have gotten the most attention. "If you were to take the best engineers in the world and asked them to design a perfect plug for a child's airway, you couldn't do better than a hot dog," Smith said. "It's the right size, right shape. It's compressible so it wedges itself in. When they're in that tight [it's] almost impossible, even with the correct training and the correct equipment, to get out. When it's wedged in tightly, that child is going to die."
The policy statement calls for a "mandatory system . . . to label foods with appropriate warnings according to their choking risk, to conduct detailed surveillance and investigate food-related choking incidents, and to warn the public about emerging food-related choking hazards.