26 / 280
Both food and nonfood items pose choking hazards
in the pediatric population secondary to this cohort’s
underdeveloped anatomy and swallowing function. With
regard to nonfood products, formal legislation to help
prevent FBAs has been established through the Federal
Hazardous Substances Act to regulate the packaging,
labeling, and manufacturing of these items.
1
The Con-
sumer Product Safety Commission regulates the manu-
facturing and labeling of toys, helping to decrease the
dangers associated with bronchial aspiration of toy
parts. Similar guidelines do not exist for food products,
although there has been work directed to establish such
measures.
To date, there is no official federal legislation regu-
lating the production and labeling of food products. Lob-
bying efforts have resulted in the Food Choking
Prevention Act (introduced to Congress in 2005) requir-
ing the Commissioner of Food and Drugs to educate
parents of young children and to designate a week of
increased dissemination of choking information to the
public. The American Academy of Pediatrics released a
policy statement (Prevention of Choking Among Chil-
dren) in 2010 with recommendations for government
agencies, manufacturers, parents, teachers, and health-
care professionals to help prevent FBA.
17
Some of these
include placing warning labels on high-risk foods, recall
of foods that are known to be potentially hazardous, edu-
cation of cardiopulmonary resuscitation and choking
first-aid techniques to parents and child care providers,
and redesigning of existing foods to minimize their chok-
ing risk.
17
Standardized safety guidelines for the produc-
tion and packaging of commonly implicated objects, as
well as developing public health initiatives to raise
awareness about the dangers of bronchial FBA, will help
protect children from potentially catastrophic events.
CONCLUSION
Foreign body aspiration events affect thousands of
pediatric patients and their families annually, and the
incurred charges contribute to the socioeconomic bur-
den.
5
Preventative measures are key.
1,11
Currently,
increasing efforts are underway to promote public health
initiatives and government legislation that help regulate
the manufacturing and labeling of both food and nonfood
objects that pose potential aspiration risks.
1
Educating
primary care physicians, caregivers, and parents about
appropriate eating habits, as well as the risks associated
with particular foods, can help prevent many of these
events. Because most deaths due to FBAs occur in the
home environment, parents and caregivers should be
educated about the signs and symptoms of aspiration, as
well as the importance in taking swift action to present
their children to healthcare professionals for timely eval-
uation.
16
While most children are successfully dis-
charged to home in good condition, a small but
nonnegligible number of patients suffer catastrophic
anoxic brain injury and death.
Acknowledgments
Work was completed at both David Geffen School of Medi-
cine at UCLA, Los Angeles, California, and Harvard Medi-
cal School, Boston, Massachusetts.
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