Clinical Outcomes After Expanding Water Bead Ingestion in Children

INTRODUCTION. Foreign body ingestions are a common problem among children, especially young ones, and although usually benign, can pose significant health risks.1 Reports of concerning ingestions often correlate with newer products introduced into the market which present a potential hazard to children if ingested.2 For example, after their introduction in 2004, there has been an increasing number of expanding water bead ingestions with an 1820% increase between 2018 and 2023.3 Expanding water beads, polymer crystals that can expand in liquid to 100 times their size, pose a unique risk to children as they are capable of causing gastrointestinal obstruction, lung damage if aspirated, and other adverse clinical sequalae.4–8 As ingestions of expanding water beads have become more prevalent, there’s a growing body of literature characterizing ingestions using national hospital encounter based databases.9,10 We aim to contribute to this literature through utilization of the National Poison Data System (NPDS), which captures a broader representation of reports of water bead ingestions made both inside and outside the hospital setting (through all 55 poison control centers in the United States), and contains more granular clinical data. Details of data availability and methodology of collection via NPDS are available in their annual report.3 Our goal is to characterize patient-level clinical effects following water bead ingestions in a large nationally representative sample from poison centers. We hypothesize that the youngest children in our sample were at highest risk for more severe clinical effects.