Dramatic drop in children needing operations for items stuck in their nose and mouth, says study

New research, published in The Annals of the Royal College of Surgeons of England, shows a decrease, in the hundreds, of children needing operations to remove objects they’ve swallowed or stuck up their noses.

The study examined Hospital Episode Statistics (HES) from 2000 to 2022, finding that since 2012, procedures to remove objects from children's throats, airways, and noses have seen a ‘significant decline’, of almost 700 cases.
The total number of foreign body removal procedures for the alimentary tract, respiratory tract, and nasal cavity decreased by just over 28% from 2012 to 2022:

• Alimentary (digestive) tract: a decrease of 195 procedures, which equates to a 27.54% reduction over 10 years. 
• Respiratory tract: a decrease of 10 procedures, which equates to a 7.58% reduction.
• Nasal cavity: a decrease of 484 procedures, which equates to a 30.92% reduction.

The move towards cashless payments explains some of the reduction in swallowing incidents, adding a new dimension to the ongoing debate about cash versus contactless payments that focuses on financial inclusion and convenience. Historically, coins accounted for over 75% of objects swallowed by children under six years old, and fewer coins in homes due to contactless payments have likely helped reduce the number of these procedures.

While contactless payments may have contributed, several other factors likely helped – especially for reductions in procedures on the nose. Enhanced parental awareness through public health campaigns, improved child-proof packaging, changes in data collection methods, and shifting behaviours during the COVID-19 pandemic have all contributed.

Concern is rightly shifting towards other potentially dangerous shiny objects, which could be seen as similar to coins by a child, such as button batteries and magnets. These can cause deadly internal complications within hours of ingestion leading to tragic consequences.

If you think a child has swallowed magnets or button batteries, take them straight to A&E. Symptoms may not be obvious. It is important to act fast, even if there are no symptoms. 

Mr Akash Jangan, lead author of the study and Ear, Nose and Throat (ENT) registrar, said:

“Our research shows that using cashless payment methods instead of coins has potentially helped keep children safe and reduced the need for surgery. 

“This unintended finding proves that changes in how we live can make a difference to people's health. It also means healthcare resources can be allocated to helping patients in other ways.”

Mr Ram Moorthy, Council member at the Royal College of Surgeons of England and Consultant Adult and Paediatric Ear, Nose and Throat (ENT) surgeon, said:

“It is positive that fewer children are swallowing coins. This study shows how new technology can make children safer in ways we didn't intend, but there are still hazardous items to be aware of. As doctors, we still worry about other dangerous items, such as button batteries and magnets, that can really cause harm. We must continue to make sure that small items like this are not within a child’s reach.” 

ENDS

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Notes to editors:   

1. Coin-cidence? Have cashless payments reduced the incidence of upper aerodigestive foreign body insertion? A study of UK Hospital Episode Statistics: https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsann.2024.0050
2. NHS surgeons safety plea after surge in kids swallowing dangerous objects: https://www.england.nhs.uk/2022/12/nhs-surgeons-safety-plea-after-surge-in-kids-swallowing-dangerous-objects/.
3. UK Cash and Cash Machines Report 2024 – How we use cash withdrawal in the UK: https://www.ukfinance.org.uk/system/files/2024-11/Cash%20and%20Cash%20Machiness%20Report%20summary.pdf
4. The Royal College of Surgeons of England (RCS England) provides world-class education, assessment, and development to 30,000 surgeons, dental professionals, and members of the wider surgical and dental care teams, at all stages of their career. Our vision is to see excellent surgical care for everyone. We do this by setting professional standards, facilitating research, and championing the best outcomes for patients.  
5. For more information, please contact the RCS England press office: telephone: 020 7869 6053/6054/6047; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 0207 869 6056.