More Children Swallowed Powerful Magnets After Federal Ban Blocked

By Linda Carroll

November 25, 2020

(Reuters Health) - After a federal rule banning powerful rare-earth magnets was blocked by a judge, increasing numbers of children have been turning up in U.S. emergency rooms having swallowed the tiny objects, a new study finds.

During the roughly four years that sales of the magnets were limited or banned, the number of children swallowing them dropped off. But since the Consumer Product Safety Commission rule was blocked in late 2016, the numbers have been rising steadily to a level higher than before the rule was put in place, researchers report in JAMA.

"We've seen a significant uptick since the rule was removed," said lead author Dr. Michael Flaherty, a pediatric critical care physician and co-director of the trauma and injury prevention program at Massachusetts General Hospital in Boston. "Thus, the federal regulations seem to have worked and we need to find a way, working with industry, to bring back some form of federal regulations on these magnets."

"The problem with these magnets is that they are so powerful, if a child swallows two or one with another metal object, their intestines can literally become stuck together and twist," Dr. Flaherty said. "There have been many injuries to the bowel and some deaths due to these magnets."

The rare-earth magnets are 10 times more powerful than traditional ones, Dr. Flaherty explained. Some are as small as a centimeter in diameter, he said, adding that their attraction to other magnets and metal objects is so powerful that it's not diminished by human tissue.

To look at the impact of the U.S. Consumer Product Safety Commission rule on the number of kids showing up in emergency rooms due to a swallowed magnet, Dr. Flaherty and his colleagues analyzed 17 years of data, from January 1, 2009 through December 31, 2019, in the National Electronic Injury Surveillance System (NEISS), a national sample of U.S. injury-related emergency department visits.

The researchers examined trends in three time periods: from 2009, when the magnets came on the market, through 2012; from 2013 to 2016, when the CPSC rule was in effect; and from 2017 to 2019, after the rule was vacated.

The team identified 1,421 cases of children who had ended up in the ER after ingesting a magnet over the entire 17-year study period. Children aged 5 and younger had the highest number of ED visits at 847, and a rate of 7 per 100,000.

In the years prior to the CPSC rule, the aggregate mean rate of magnet admissions for all ages was 3.58 per 100,000. It fell during the years CPSC restricted sales to a mean of 2.83 per 100,000, then rose again in the final period to 5.16 per 100,000.

The NEISS database has limited information about severity of injury and outcomes, the authors note, so further study into those questions is needed.

Dr. Flaherty suggests that pediatricians tell parents this is one of several products that shouldn't be on the market. "They were not intended for children, and parents need to be aware of this," he said.

The new research underscores the need to protect kids from potentially dangerous products, said Dr. Emily F. Boss, an associate professor of otolaryngology, pediatrics, and health policy and management Johns Hopkins Medical Institutions in Baltimore, who wasn't involved in the study.

"This study shows a powerful message of how awareness, advocacy, and legislation can truly impact and reduce the occurrence of a serious problem in children - and how law reversal can result in increased harm," Dr. Flaherty said in an email. "In this scenario, an industry-initiated challenge allowing for resumption of sales for this product resulted in an influx of pediatric neodymium magnet ingestions. It's likely the study underestimates the health impact on children, as known severe clinical outcomes including bowel perforation and death were not available in the database reviewed."

SOURCE: JAMA, online November 24, 2020.