Global incidence of foreign body aspiration among children ages <5 years decreased from 164 per 100,000 to 110 per 100,000 during the period 1990-2019.[6]Wu Y, Zhang X, Lin Z, et al. Changes in the global burden of foreign body aspiration among under-5 children from 1990 to 2019. Front Pediatr. 2023;11:1235308.
https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1235308/full
http://www.ncbi.nlm.nih.gov/pubmed/37727616?tool=bestpractice.com
The risk of foreign body aspiration is higher in older people, especially in and after the seventh decade, probably due to the higher prevalence of age-associated degenerative neurologic and cerebrovascular disorders that can cause dysphagia and/or impaired cough reflex.[4]Boyd M, Chatterjee A, Chiles C, et al. Tracheobronchial foreign body aspiration in adults. South Med J. 2009 Feb;102(2):171-4.
http://www.ncbi.nlm.nih.gov/pubmed/19139679?tool=bestpractice.com
[7]Hammond CAS, Goldstein LB. Cough and aspiration of food and liquids due to oral-pharyngeal dysphagia: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 suppl):S154-68.
https://www.doi.org/10.1378/chest.129.1_suppl.154S
http://www.ncbi.nlm.nih.gov/pubmed/16428705?tool=bestpractice.com
[8]Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med. 1990 Apr 15;112(8):604-9.
http://www.ncbi.nlm.nih.gov/pubmed/2327678?tool=bestpractice.com
Studies indicate that more than 50% of patients with acute food asphyxiation are ages 71-90 years.[9]Wick R, Gilbert JD, Byard RW. Café coronary syndrome-fatal choking on food: an autopsy approach. J Clin Forensic Med. 2006 Apr;13(3):135-8.
http://www.ncbi.nlm.nih.gov/pubmed/16356749?tool=bestpractice.com
In the US in 2022, unintentional suffocation (including obstruction of the respiratory tract by a foreign object) accounted for 10% (n=124) of all deaths resulting from unintentional injury in children ages 1-4 years.[10]Centers for Disease Control and Prevention WISQARS™. 10 Leading causes of death, United States 2021. 2021 [internet publication].
https://wisqars.cdc.gov/lcd/?o=LCD&y1=2021&y2=2021&ct=10&cc=ALL&g=00&s=0&r=0&ry=0&e=0&ar=lcd1age&at=groups&ag=lcd1age&a1=0&a2=199
Death by unintentional suffocation was less common among people ages 15-65 years (1.3% [n=1928] of all deaths resulting from unintentional injury; 2022 data), but more prevalent in people ages 66-84 years (6.3% [n=2796]; 2022 data).[10]Centers for Disease Control and Prevention WISQARS™. 10 Leading causes of death, United States 2021. 2021 [internet publication].
https://wisqars.cdc.gov/lcd/?o=LCD&y1=2021&y2=2021&ct=10&cc=ALL&g=00&s=0&r=0&ry=0&e=0&ar=lcd1age&at=groups&ag=lcd1age&a1=0&a2=199
Deaths due to object-related aspiration in children and adolescents (<18 years) decreased from 1.02 per 100,000 children (719 deaths) in the US in 1968 to 0.25 per 100,000 children (184 deaths) in 2017.[11]Cramer JD, Meraj T, Lavin JM, et al. Object-related aspiration deaths in children and adolescents in the United States, 1968 to 2017. JAMA. 2019 Nov 26;322(20):2020-22.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902204
http://www.ncbi.nlm.nih.gov/pubmed/31769817?tool=bestpractice.com
Aspiration of food and liquids is more common in patients:[7]Hammond CAS, Goldstein LB. Cough and aspiration of food and liquids due to oral-pharyngeal dysphagia: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 suppl):S154-68.
https://www.doi.org/10.1378/chest.129.1_suppl.154S
http://www.ncbi.nlm.nih.gov/pubmed/16428705?tool=bestpractice.com
With oropharyngeal dysphagia (especially when due to stroke or cervical spine surgery)
Who are older taking sedative medications
Fed by gastric tube
Dependent on others for feeding
Who currently smoke
Taking more than eight medications
Aspiration of teeth and dental devices is more common in the elderly; children may aspirate a deciduous (primary) tooth.[12]Susini G, Pommel L, Camps J. Accidental ingestion and aspiration of root canal instruments and other dental foreign bodies in a French population. Int Endod J. 2007 Aug;40(8):585-9.
http://www.ncbi.nlm.nih.gov/pubmed/17532776?tool=bestpractice.com
Serious complications subsequent to aspiration occur in 20% of low-income and 10% of high-income countries.[13]Foltran F, Ballali S, Rodriguez H, et al. Inhaled foreign bodies in children: a global perspective on their epidemiological, clinical, and preventive aspects. Pediatr Pulmonol. 2013 Apr;48(4):344-51.
http://www.ncbi.nlm.nih.gov/pubmed/23169545?tool=bestpractice.com
There is a lack of awareness in parents and clinicians in terms of recognizing choking risks.