Big drop in child surgery for objects swallowed or stuck up nose

Society’s move to cashless payments may have had an unintended positive side effect, surgeons say – fewer children needing operations or procedures to remove swallowed coins.

The Ear, Nose and Throat (ENT) experts looked back over hospital records in England since the Millennium.

Procedures to remove foreign objects, including coins, from children’s throats, airways and noses saw a “significant decline”, of almost 700 cases by 2022.

Historically, coins had accounted for over 75% of objects swallowed by under-sixes, they told a medical journal.

According to the UK Payments Markets Survey, cards began outstripping cash in 2012.

And that is when the researchers say a decade-spanning drop in patient cases began.

But other factors – such as child-proof packaging and safety campaigns – probably also helped reduce cases, especially of objects stuck up the nose.

Common objects lodged in children’s nostrils include beads, pins, baby teeth, screws and food, the researchers say

Peanuts and peas can sometimes get inhaled and stuck in the airways.

But concern is shifting towards other potentially dangerous shiny objects, such as button batteries and magnets, which are now sometimes swallowed by children.

These can cause deadly complications within hours and need urgent medical attention, Akash Jangan and colleagues say in The Annals of the Royal College of Surgeons of England.

An open-access web version made available in June 2024 shows, from 2012-22:

• a 29% drop in foreign-body removal procedures, from 2,405 to 1,716
• 195 fewer procedures to remove swallowed objects, from 708 to 513
• 484 fewer retrievals from the nose, from 1,565 to 1,081
• 10 fewer and respiratory-tract procedures, from 132 to 122

ENT surgeon Mr Ram Moorthy, who was not involved in the study but is a member of Royal College of Surgeons of England, said: “It is positive that fewer children are swallowing coins.

“This study shows how new technology can make children safer in ways we didn’t intend – but there are still hazardous items to be aware of.

“As doctors, we still worry about other dangerous items, such as button batteries and magnets, that can really cause harm.

“We must continue to make sure that small items like this are not within a child’s reach.”

Removing foreign objects from ears and noses costs NHS hospitals in England around £3m a year, according to data for 2010 to 2016.

Children were responsible for the vast majority of cases – 95% of objects removed from noses and 85% from ears.

In adults, cotton buds are thought to be the leading problem.