P3.S376: Water Bead Injuries in Children Presenting to Emergency Departments 2013-2022: An Expanding Issue

Background:

Background: A 2023 recall from the United States (US) Consumer Product Safety Commission (CPSC) has described the risk for morbidity and mortality for children ingesting water beads. Typically marketed as sensory toys or for plant hydration, water beads are made of water absorbent polymers which can expand inside the in gastrointestinal tract or other orifices causing obstruction, tissue perforation, and death. The aim of this study is to describe trends in the number of water bead exposures, according to the route of exposure, and management patterns in emergency departments in the US from 2013 to 2022.

Methods:

Methods: We identified water bead injuries from 2013 to 2022 utilizing the National Electronic Injury Surveillance System (NEISS) database which capture emergency department (ED) encounter data. NEISS was queried to capture suspected water bead injury cases in subjects 0–17 years of age using ‘‘ingested object’’ (diagnosis code= 41) or “foreign body” (diagnosis code=56). Cases were included as a “water bead injury” if the word(s) “water bead”, “waterbead”, “water-bead” appeared in the narrative section. NEISS supplied weights and variance variables used in all analyses. Taylor series linearization was used to generate national estimates with 95% confidence interval (CI).

Results:

Results: There were an estimated 2,216 water bead injuries (CI 2,216-3,865) in children (median age 3.2 ± 1.8 years, 57% male) from 2013-2022, derived from an unweighted count of 90 water bead injuries. There was an annual increase in water bead injury over the course of the study period (Figure 1). Of the total water bead ingestion encounters, children aged 2 years and younger accounted for 46% (estimated N=543) of cases. WBs were also inserted into the ear (72% insertions) or nose (28% insertions) (combined estimated N=1,046) with 53% of insertion injuries occurring in children aged 6-12 years (table 1). Fifty-three percent (estimated N=1,175) of water bead encounters reported multiple water beads ingested or inserted. Ninety-one percent (estimated N=2,169) of water bead injuries were treated and released with only 5 cases warranting escalation of care. Of the captured cases warranting a higher level of care, 80% (n=4) were children aged less than 5 years.

Conclusion:

Conclusions: Water bead injuries occurred at an increasing rate in the 10-year study period. Injuries appear to affect children of all ages. Children under age 5 years were more likely to ingest water beads and require escalation of care. Most injuries can be released from the ED but younger children are at risk for a need of escalation of care. Prevention and injury detection will be key to avoiding these outcomes in the future.