Magnet ingestion in children in the United Kingdom: A national prospective observational surveillance study
Neville, Jonathan J; Messahel, Shrouk; Parkar, Shabnam; Mytton, Julie; Lyttle, Mark D; Hall, Nigel J; Study collaborators, Magnet Ingestion in Children (MAGNETIC); (PERUKI), Paediatric Emergency Research in the UK and Ireland Group
Magnet Ingestion in Children (MAGNETIC) Study collaborators
Paediatric Emergency Research in the UK and Ireland Group (PERUKI)
Abstract
Background
Magnet ingestion in children and young people (CYP) associates with significant harm. The incidence and circumstances of magnet ingestions in CYP are unknown in the United Kingdom (UK). We aimed to determine these and report associated outcomes.
Methods
The Magnet Ingestion in Children (MAGNETIC) study was a UK-wide prospective multicentre observational surveillance study of CYP ≤16 years of age, who ingested at least one magnetic foreign body. On presentation to hospital, data were collected regarding demographics, the circumstances surrounding ingestion, clinical features, and management. Further management and outcome data were collected at day seven and 28 post-presentation. The primary outcome was incidence of magnet ingestion in the UK. This study is registered with ClinicalTrials.gov (NCT05375981).
Findings
Between 1st May 2022 and 30th April 2023, 366 cases of magnet ingestion were recorded, of which 314 met the inclusion criteria (median age 8.7 years [IQR 5.1 – 12.0]). The incidence of magnet ingestion in the UK is ≥2.4 per 100,000 (95% CI 2.2 – 2.7) CYP per year. CYP source magnets from toys (38%), commonly purchased by parents or caregivers (19%). Surgery was undertaken in 32 (10%) children and magnet-related injuries were identified in 23 (7%). No magnet-related injuries occurred in children ingesting one magnet. Children were asymptomatic in 75%, however clinical features on presentation associated with an increased risk of injury (OR 3.8 [95% CI 1.4 – 10.3], p = 0.008). Swallowing greater numbers of magnets associated with an increased risk of harm (OR 1.1 [95% CI 1.0 – 1.2], p = 0.002).
Interpretation
These results highlight that magnet ingestion in CYP is a significant issue and greater public and clinician awareness of the associated risks is warranted. Improved understanding of the epidemiology, circumstances and outcomes of paediatric magnet ingestion can inform future public health interventions and evidence-based guidelines.
