The first case involved an 18-month-old child who had swallowed 10 small magnetic spheres and the second involved an eight-year-old who had swallowed two 2-cm long magnetic strips. In both cases, the magnets were from small children's toys. Both of the children had mild stomach pain and on further examination and investigation were found to have the magnets lodged in their digestive systems.
Single small objects occasionally swallowed by young children can usually pass through their digestive system without causing any illness or internal damage. However, when several magnetic elements are ingested this becomes a totally different scenario. The multiple magnets can become attracted to each other inside the body, trapping internal soft tissues between them and causing fistulas to develop. A fistula is a condition whereby an abnormal connection is formed between soft tissues inside the body (in these cases, between different segments of bowel), and if left untreated, may lead to serious illness. Notably, the children who swallowed magnets would initially have felt no pain or discomfort, making it difficult for parents to know when their children might be at risk.
According to Dr George, "We are particularly concerned about the widespread availability of cheap magnetic toys where the magnetic parts could become easily detached. Parents should be warned of the risk of magnet ingestion, particularly in small children. We believe that improvement in public awareness about this risk will be key in preventing such incidents".
Similar concerns have already been raised the US and Canada in recent years, leading to numerous public alerts and product recalls, but to date there have been no such national alerts in the UK. As magnetic toys become increasingly popular and cheaper, the Lancet correspondents warn that the problem of accidental ingestion of magnetic elements could be set to become more common.
"While we understand that it may be impossible to prevent small children from occasionally swallowing objects, we would highlight to parents the potential harm that could arise from multiple magnet ingestion. We would advise parents to be more vigilant and take extra care when giving their children toys that may contain magnets small enough to swallow. We would also welcome an increased awareness of this problem among toy manufacturers, who have a responsibility to alert parents to the presence of magnets in their products."*
Dr Anil Thomas George and Dr Sandeep Motiwale, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, UK, T) +44 (0)115 924 9924 x 61975 E) nuhcommunications@nuh.nhs.uk
Note to editors: *Quote direct from author and cannot be found in text of letter
Journal
The Lancet