‘Supermagnet’ ingestion injuries remain a concern

ORLANDO – The popularity of powerful neodymium magnets has led to an increase in magnet ingestion–related injuries among young children, especially in recent years.

Of 2,700 ingestion injuries requiring admission or procedural intervention in children aged 0-18 years between April 1, 2001 and Dec. 21, 2012, 94 were ingestions of these "supermagnets," and, although the first such report was in 2004, a significant increase in both single and multiple magnet ingestion occurred over time. The largest increase involved multiple magnet ingestion in the last 3 years of the study, Dr. Daniel Rosenfield of the University of Toronto reported at the annual meeting of the American Academy of Pediatrics.

The ingestion of multiple magnets can be particularly dangerous, because the magnets – neodymium-iron-boron magnets that are 10-20 times stronger than traditional magnets – can link through loops of bowel and cause pressure necrosis.

"Without prompt recognition of multiple-magnet ingestion, bowel perforation, sepsis, and death can result," he said.

In fact, in this case series, 6 patients underwent surgical removal of the magnets and 10 underwent endoscopic removal. No deaths were reported, Dr. Rosenfield said.

The cases involved patients seen at the Hospital for Sick Children in Toronto. The patients ranged in age from 7 months to 13 years, with a mean age of 4.5 years. Most (65%) were boys.

Ingestion of up to 34 of the tiny magnets – which may look like candy to children – has been reported.

The findings confirm what physicians at the Hospital for Sick Children have suspected: that the ingestion of these dangerous toys has been increasing, with a spike in incidence over the past 3 years, Dr. Rosenfield said.

"What we’re seeing is really an epidemic driven by a new technology," he added.

Supermagnets came into the market in the early 2000s in toys, jewelry, and other novelty items, and they surged in popularity in the late 2000s when they were marketed in the form of novelty desk toys for adults. In the wake of several cases involving multiple magnet ingestion that resulted in a number of cases of pediatric bowel perforation, sepsis, and one death, the U.S. Consumer Product Safety Commission began work in 2012 to set industry safety standards and sought to remove certain supermagnet desk toys from the market. Canada also recently implemented a mandatory recall of some of the products and banned their sale, Dr. Rosenfield said.

He applauded the strong stance and action with respect to removing the products from the market but noted that the magnets can still be found in products sold before the recall, raising concerns that ingestion injuries will continue to occur.

Thus, clinicians should be aware of the risk of magnet ingestions and of the potential morbidity associated with ingestion, as well as with the appropriate management of patients who ingest the magnets. Furthermore, given data suggesting that many pediatricians are unaware of the dangers, health organizations should spread the word to physicians, parents, teachers, and the general public about the dangers to help assure that the magnets will be kept away from children, he said.

"These new magnets are vastly more powerful, smaller in size, and seem innocuous – parents just aren’t aware of the potential danger," he said.

Dr. Rosenfield reported having no disclosures.

ORLANDO – The popularity of powerful neodymium magnets has led to an increase in magnet ingestion–related injuries among young children, especially in recent years.

Of 2,700 ingestion injuries requiring admission or procedural intervention in children aged 0-18 years between April 1, 2001 and Dec. 21, 2012, 94 were ingestions of these "supermagnets," and, although the first such report was in 2004, a significant increase in both single and multiple magnet ingestion occurred over time. The largest increase involved multiple magnet ingestion in the last 3 years of the study, Dr. Daniel Rosenfield of the University of Toronto reported at the annual meeting of the American Academy of Pediatrics.

The ingestion of multiple magnets can be particularly dangerous, because the magnets – neodymium-iron-boron magnets that are 10-20 times stronger than traditional magnets – can link through loops of bowel and cause pressure necrosis.

"Without prompt recognition of multiple-magnet ingestion, bowel perforation, sepsis, and death can result," he said.

In fact, in this case series, 6 patients underwent surgical removal of the magnets and 10 underwent endoscopic removal. No deaths were reported, Dr. Rosenfield said.

The cases involved patients seen at the Hospital for Sick Children in Toronto. The patients ranged in age from 7 months to 13 years, with a mean age of 4.5 years. Most (65%) were boys.

Ingestion of up to 34 of the tiny magnets – which may look like candy to children – has been reported.

The findings confirm what physicians at the Hospital for Sick Children have suspected: that the ingestion of these dangerous toys has been increasing, with a spike in incidence over the past 3 years, Dr. Rosenfield said.

"What we’re seeing is really an epidemic driven by a new technology," he added.

Supermagnets came into the market in the early 2000s in toys, jewelry, and other novelty items, and they surged in popularity in the late 2000s when they were marketed in the form of novelty desk toys for adults. In the wake of several cases involving multiple magnet ingestion that resulted in a number of cases of pediatric bowel perforation, sepsis, and one death, the U.S. Consumer Product Safety Commission began work in 2012 to set industry safety standards and sought to remove certain supermagnet desk toys from the market. Canada also recently implemented a mandatory recall of some of the products and banned their sale, Dr. Rosenfield said.

He applauded the strong stance and action with respect to removing the products from the market but noted that the magnets can still be found in products sold before the recall, raising concerns that ingestion injuries will continue to occur.

Thus, clinicians should be aware of the risk of magnet ingestions and of the potential morbidity associated with ingestion, as well as with the appropriate management of patients who ingest the magnets. Furthermore, given data suggesting that many pediatricians are unaware of the dangers, health organizations should spread the word to physicians, parents, teachers, and the general public about the dangers to help assure that the magnets will be kept away from children, he said.

"These new magnets are vastly more powerful, smaller in size, and seem innocuous – parents just aren’t aware of the potential danger," he said.

Dr. Rosenfield reported having no disclosures.

ORLANDO – The popularity of powerful neodymium magnets has led to an increase in magnet ingestion–related injuries among young children, especially in recent years.

Of 2,700 ingestion injuries requiring admission or procedural intervention in children aged 0-18 years between April 1, 2001 and Dec. 21, 2012, 94 were ingestions of these "supermagnets," and, although the first such report was in 2004, a significant increase in both single and multiple magnet ingestion occurred over time. The largest increase involved multiple magnet ingestion in the last 3 years of the study, Dr. Daniel Rosenfield of the University of Toronto reported at the annual meeting of the American Academy of Pediatrics.

The ingestion of multiple magnets can be particularly dangerous, because the magnets – neodymium-iron-boron magnets that are 10-20 times stronger than traditional magnets – can link through loops of bowel and cause pressure necrosis.

"Without prompt recognition of multiple-magnet ingestion, bowel perforation, sepsis, and death can result," he said.

In fact, in this case series, 6 patients underwent surgical removal of the magnets and 10 underwent endoscopic removal. No deaths were reported, Dr. Rosenfield said.

The cases involved patients seen at the Hospital for Sick Children in Toronto. The patients ranged in age from 7 months to 13 years, with a mean age of 4.5 years. Most (65%) were boys.

Ingestion of up to 34 of the tiny magnets – which may look like candy to children – has been reported.

The findings confirm what physicians at the Hospital for Sick Children have suspected: that the ingestion of these dangerous toys has been increasing, with a spike in incidence over the past 3 years, Dr. Rosenfield said.

"What we’re seeing is really an epidemic driven by a new technology," he added.

Supermagnets came into the market in the early 2000s in toys, jewelry, and other novelty items, and they surged in popularity in the late 2000s when they were marketed in the form of novelty desk toys for adults. In the wake of several cases involving multiple magnet ingestion that resulted in a number of cases of pediatric bowel perforation, sepsis, and one death, the U.S. Consumer Product Safety Commission began work in 2012 to set industry safety standards and sought to remove certain supermagnet desk toys from the market. Canada also recently implemented a mandatory recall of some of the products and banned their sale, Dr. Rosenfield said.

He applauded the strong stance and action with respect to removing the products from the market but noted that the magnets can still be found in products sold before the recall, raising concerns that ingestion injuries will continue to occur.

Thus, clinicians should be aware of the risk of magnet ingestions and of the potential morbidity associated with ingestion, as well as with the appropriate management of patients who ingest the magnets. Furthermore, given data suggesting that many pediatricians are unaware of the dangers, health organizations should spread the word to physicians, parents, teachers, and the general public about the dangers to help assure that the magnets will be kept away from children, he said.

"These new magnets are vastly more powerful, smaller in size, and seem innocuous – parents just aren’t aware of the potential danger," he said.

Dr. Rosenfield reported having no disclosures.