Injuries associated with... magnets

1993-2003, 13 years and under

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SOURCE OF THE STATISTICS

Injury data were obtained from the database of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). CHIRPP is an injury surveillance system operating in the emergency departments of 10 pediatric and 4 general hospitals in Canada. Data collection began in April 1990 at the pediatric hospitals and between 1991 and 1995 in the general hospitals. CHIRPP is a program of the Injury and Child Maltreatment Section of the Health Surveillance and Epidemiology Division, Public Health Agency of Canada.

Briefs and reports are updated when there is reason to believe the injuries or circumstances surrounding the injuries have changed. For example, the report of injuries associated with a specific product would be updated if the manufacturing regulations for the product are changed to include a new safety elem ent. There is no need to update reports on a regular basis because the data collection sites are not a representative sample of all Canadian hospitals. Frequent updates would simply increase the number of records included in the report but not necessarily result in any change in the patterns and distributions found.

LIMITATIONS

It is important to note that the injuries described do not represent all injuries in Canada, but only those seen at the emergency departments of the 14 hospitals in the CHIRPP network. Since most of the data comes from the pediatric hospitals, which are in major cities, injuries suffered by the following people are under-represented in the CHIRPP database: older teenagers and adults, who are seen at general hospitals; native people; and people who live in rural areas. Fatal injuries are also under-represented in the CHIRPP database because the emergency department data do not capture people who died before they could be taken to hospital or those who died after being admitted.

INCLUSION AND EXCLUSION CRITERIA

A May 2006 search of the CHIRPP database for injuries associated with magnets was conducted (13 years and under; 855,753 records total). Cases were retained if the injury occurred in association with a m agnet between 1993 and 2003.

RECOMMENDED CITATION

Injury briefs and reports and data from them may be copied and circulated freely provided that the source is acknowledged. The following citation is recommended:

Health Surveillance and Epidemiology Division (Public Health Agency of Canada).
Injuries associated with magnets: Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database, 1993-2003, 13 years and under, 181 records.

FOR MORE INFORMATION

Please contact the Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, by PHONE at (613) 957-4689, by FAX at (613) 941-9927 or visit our website at
http://www.phac-aspc.gc.ca/inj-bles/index-eng.php

Overall Pattern

Overall there were 181 cases identified where the injury was associated with magnets, in children 13 years of age and under. These cases represent 0.02% of all CHIRPP cases in the same age group and over the same time period. Figure 1 illustrates the increase in injuries associated with magnets over time, as measured by the number of cases per 100,000 CHIRPP records.

Figure 1. Number of injuries associated with magnets per 100,000 CHIRPP records, 1993-2003, CHIRPP, 13 years of age and under.

Age and Sex Distribution

Table 1 details the age and sex distribution. Although children aged 2-4 presented the largest percentage (32%) of all cases, when expressed as a proportion of all same-aged cases in CHIRPP, 1 year olds were most frequent (33.9/100,000).

Table 1. Injuries associated with magnets, age and sex distribution, CHIRPP, 13 years and under, 1993-2003.

Age Group (Years)	# cases overall (%)	#/100,000 CHIRPP 1	% male	% male CHIRPP2
Less than 1	11 (6.1)	25.1	54.5	53.7
1	31 (17.1)	33.9	58.1	56.0
2-4	58 (32.1)	27.7	70.7	57.4
5-9	46 (25.4)	17.8	52.2	58.4
10-13	35 (19.3)	13.8	45.7	60.5
Total	181 (100.0)	21.2	58.0	58.3
1 Because CHIRRP collects information from ten children's hospitals and only five of the general hospitals, there is a high number of young children in the database. Using cases per 100,000 with in an age group (instead of percentage by age group) ad justs for this uneven distribution. 2 The proportion of males in the entire CHIRPP database for the given age group.

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Circumstances

Table 2 describes the circumstances surrounding the injuries. Overall, 73% of injuries occurred in the patient's own home. W here the type of magnet involved was noted on the record (94 cases); 40% were plastic toy magnets (e.g. alphabet m agnets), 30% were magnetic earrings/nose rings and 17% were part of a magnetic toy set (e.g. building toy, travel games). Over half of the cases involved ingestion (52.4%), in one case the child indicated that they mistook the magnet for a chocolate. Of the 63 cases where a magnet was inserted up the nose, 40% of these cases involved magnetic earrings/nose rings.

Table 2. Circumstances, injuries associated with magnets, CHIRPP, 13 years and under, 1993-2003.

Circumstance	# cases (%)
Ingestion of magnet3	95 (52.4)
Magnet inserted up nose	63 (34.8)
External injury due to magnet, no ingestion	15 (8.3)
Possible ingestion of magnet	5 (2.8)
Magnet inserted into ear	3 (1.7)
Total	181 (100.0)
3 There were 4 cases involved ingestion of more than 1 magnet.

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Time of day

Table 3 illustra tes that nearly 40% of injuries associated with magnets occurred between 4 and 8 p.m.

Table 3. Time of day, injuries associated with magnets, CHIRPP, 13 years and under, 1993-2003.

Time of day	# cases (%)
Midnight to 7:59 a.m.	12 (7.8)
8 a.m. - 11:59 a.m.	21 (13.7)
Noon - 3:59 p.m.	27 (17.7)
4 p.m. - 7:59 p.m.	57 (37.3)
8 p.m. - 11:59 p.m.	36 (23.5)
Total4	153 (100.0)
4 28 cases were missing time of day.

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Injuries

Table 4 lists the nature of injuries by body part. Overall, 82.8% of all cases involved a magnet(s) as a
foreign body.

Table 4. Nature of injury in association with magnets, CHIRPP, 13 years and under, 1993-2003.

Nature of injury body part	# cases (%)
Foreign body abdomen nose thorax other ear respitory system eye throat	150 (82.8) 66 60 8 5 3 3 3 2
Other specified injuries	9 (5.0)
Superficial - perineum Open wound† Fracture‡	1 7 1
None determined Unknown‡‡	13 (7.2) 9 (5.0)
Total	181 (100.0)
† These injuries involve running, dropping, tripping while carrying magnet or while in mouth. ‡ Patient dropped large magnet. ‡‡ When analyzed these incidents appear to involve child playing with magnets, where an ingestion or possible ingestion occurred, but no treatment required or patient left.

Treatment in emergency department Table 5 shows the treatment the patient received in the emergency department (ED) for injuries associated with magnets; 55.2% of patients were treated with medical follow-up only if needed and an additional 28.2% received advice only. Patients were admitted to hospital 3.9% of the time, slightly below the CHIRPP rate of 5.5% for the same age group and timeframe.

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Table 5. Treatment received in emergency departments, injuries in association with magnets, CHIRPP, 13 years and under, 1993-2003.

Disposition	# cases (%)	% cases CHIRPP5
Left without being seen	3 (1.7)	1.2
Advice only	51 (28.2)	21.7
Treated, medical follow-up if necessary	100 (55.2)	37.1
Treated, medical follow-up required	20 (11.0)	32.7
Short stay, observed in ED	0 (0.0)	1.8
Admitted to hospital	7(3.9)	5.5
Fatal	0 (0.0)	< 0.1
Total	181 (100.0)	100.0
5 The proportion of cases in the entire CHIRPP database for the given disposition, in children 13 years of age and under, over the same time period.