2025-06-17

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12 min read

– MagnetSafety.org –

Shihan

1. Executive Summary

The National Electronic Injury Surveillance System (NEISS), operated by the U.S. Consumer Product Safety Commission (CPSC), samples emergency departments nationwide to capture injuries associated with consumer products. Because every case is statistically weighted, NEISS is the only product-injury database that produces nationally representative estimates.

According to the newly released 2024 NEISS dataset, emergency departments treated an estimated 138,000 foreign-body ingestions—a substantial increase over the totals reported in the 2022 data. Over the last 2 years, magnet-related incidents still comprise roughly 6 % of all ingestions. Ingestions of spherical rare-earth magnets (SREMs) fell to a six-year low, accounting for about 0.6 % of total ingestions in 2024, or one-tenth of all magnet cases.

2. Data Overview

Foreign-body ingestion related ED visits have accelerated sharply in the most recent two-year interval. Between 2022 and 2024, estimated cases rose from 114k to 13k – an absolute gain of roughly 23k cases and a compound annual growth rate (CAGR) of ≈ 9.8 %. For comparison, the period 2003-2022 saw a much lower average CAGR of ≈ 2.8 %, with cases increasing from 68k to 114k. Over the full 2003-2024 span, annual ingestions have increased by about 104 %, while the U.S. population expanded by only 17 %. The 2024 estimate carries a 95 % confidence interval of ± 29k cases, the tightest margin of error reported since 2013.

Magnet ingestion incidents show a concerning upward trend, particularly accelerating in the latter half of the data series. After a dip around 2016, incidents surged from 1.7k in 2016 to 7.8k in 2024, highlighting an increasing public health issue related to magnets. This significant rise suggests a combination of a greater supply prevalence of accessible magnets in consumer products or a growing awareness and reporting of such incidents.

Spherical rare earth magnet (SREM) ingestions, as identified according to CPSC’s 2014 methodology of seeking NEISS In-Scope magnet incidents that indicate involvement of a powerful or round magnet, show a volatile pattern. There are significant peaks in 2008, 2012, and then a period of general decline from 2013-2017, and then a dramatic surge to 2.2k in 2020. The subsequent decline to ~844 in 2024 is noteworthy and could potentially correlate with a reduction of supply due to specific regulatory actions and enforcement, or a reduction in demand due to various things such as public awareness regarding the dangers of high powered magnets, which are known for causing severe internal injuries. [Related: SREM Supply side tracking]

Battery ingestion incidents have exhibited a consistent upward trajectory, escalating from approximately 2.7k reported cases in 2003 to over 12.3k in 2024, with a particularly pronounced increase observed from 2016 through 2024. This escalating trend is largely attributable to the widespread proliferation of small, button-style batteries across numerous consumer electronics, presenting substantial health hazards due to their inherent chemical and electrical properties. In clinical contexts, battery ingestions are sometimes compared alongside magnet ingestions due to their significantly elevated potential for causing severe internal injuries compared to other foreign body ingestions.

The share of magnet ingestions relative to all foreign body ingestions has climbed overall since 2003, reaching an early peak of 3.7 % in 2007, even before SREMs entered the market. It has held near 5.5 percent in each of the last three years (2022-2024), confirming that magnets continue to constitute a significant persistent portion of foreign-body injuries and warrant ongoing attention.

SREM ingestions show marked volatility, with an initial surge to 1.2% of all ingestions in 2008, before Buckyballs appeared in 2009. In the 2014 Magnet set ban, CPSC believed Buckyballs (by Maxfield and Oberton) to control over 90% of the US SREM market. CPSC compliance began in 2011, intensified in 2012, and continued through the 2015 magnet-set ban  [CPSC Magnets Enforcement Page, archived Jul 2021]; four of the five years with the lowest SREM ingestion ratios occurred during 2013-2017, mostly after the Buckyballs recall. After spiking to 2.4 percent in 2020, the ratio has fallen for three consecutive years to 0.6 percent in 2024, a decline that coincides with renewed notices of violation starting in 2021 [CPSC Magnets Page archived Aug 2021]. Over the most recent 3 years of data (2022-2024), there’s a clear and substantial decline from 1.8% in 2022 to just 0.6% in 2024, the lowest it’s been since 2017! A portion of this drop is certainly attributable to CPSC compliance efforts affecting supply. Further supply-chain monitoring and buyer-sentiment studies are needed to determine how much of this drop reflects reduced availability versus waning consumer interest.

In Scope 2022 ingestions estimates come from Table 5 of CPSC’s 2022 Magnet set rule and represents incidents the agency believes the rule would prevent. Because CPSC has not released the underlying NEISS records identifying the in scope injuries, the series ends in 2021 and cannot be extended or evaluated for accuracy. Although the 2022 and 2014 rules cover largely overlapping products, the injuries attributed to them differ widely, limiting any assessment of the new rule’s efficacy.

Since rulemaking only purports to target “in scope” incidents, looking at “in scope” estimates as a portion of all magnet ingestions is useful for identifying regulatory effectiveness. If the “in-scope” percentage decreases significantly following a ban, it suggests the regulation is successfully impacting the problem it aimed to solve, relative to other magnet ingestion types. It also lets us know if the problem is shifting to out-of-scope magnet products or if the overall magnet ingestion issue remains dominated by the products of concern.

The percentage of spherical rare earth magnet (SREM) ingestions relative to all magnet ingestions has fluctuated significantly. The first magnet ingestion articles emerged in 2004, and 2005 coincides with the expiration of the main NdFeB magnet patent (US No. 4,588,439). SREM incidents reached an all time high in 2008 before the widespread introduction of high-powered magnet sets, and again in 2020. Over the last three years (2022-2024), this proportion has sharply declined from 31.98% to 10.86%. In other words, through the “in-scope” injury identification lens used in the 2014 magnet ban, injuries from these types of magnets have dropped steeply after the 2022 magnet ban.

The proportion of magnet ingestions considered “in-scope” for the 2022 magnet ban relative to all magnet ingestions was remarkably high, often exceeding 80% between 2010 and 2013, indicating that the vast majority of all magnet incidents during that period were claimed to be related to the types of magnets eventually targeted by the ban. This percentage shows a notable decline after 2014, dropping from 82.19% in 2013 to 36.82% in 2021. Only in 2020 and 2021 do the two series essentially overlap.

3. Dataset Definitions

Four primary NEISS datasets are evaluated. Section 4 provides detailed methodology and reproduction instructions.

ALL Ingestions (ALL_Ingest): This comprehensive dataset includes all NEISS incidents coded for ingestion (41) and aspiration (42), the latter’s inclusion justified by potential mislabeling, CPSC criteria, and related magnet hazards.

Magnet Ingestions (MAGN): Extracted from ALL_Ingest, this dataset identifies magnet-related incidents solely through “MAGN” text matches in narratives, ensuring a consistent and objective identification process.

Battery Ingestions (BATT): Similar to MAGN, this dataset identifies battery-related incidents within ALL_Ingest based on “BATT” text matches in narratives, providing a straightforward method for locating these events.

Spherical Rare Earth Magnet Ingestions (SREM): This dataset approximates “in-scope” injuries from the 2014 magnet ban, primarily targeting Spherical Rare Earth Magnets. It utilizes the CPSC’s 2012 draft NPR criteria for “High-Powered and/or Ball-Shaped Magnet Ingestions” based on 72 specific NEISS incidents.

Each of these datasets can be viewed or downloaded below. Annual national estimates, derived from the sum of weights, are also documented in the spreadsheet’s “Analysis” tab. The “ALL_Ingest” sheet includes MAGN and BATT data marked by boolean flags, while SREM identification results are in the “MAGN_Only” tab.

4. Methodology and Data Reproduction

This study aims to demonstrate the straightforward use of publicly available NEISS data. Excluding the SREM dataset, ALL_Ingest, MAGN, and BATT can be generated in approximately 3 minutes using software like Excel or Google Sheets, resulting in unembellished representations of these NEISS datasets.

Collecting NEISS Ingestion Data

ALL_Ingest is a comprehensive catalog of all NEISS incidents with Diagnosis Code 41 (Ingestion) and 42 (Aspiration). Aspiration is included due to: known and potential mislabeling as ingestion, aspirations presence in CPSC’s 2012 SREM-identified incidents, and the aspiration risk associated with magnets adhered to nasal passages.

To compile ALL_Ingest data: access the NEISS Query Builder, filter by desired treatment dates (e.g., “Most Recent 10 Years”), select Diagnosis Codes 41 and 42, customize output by year including Coefficient of Variation, 95% confidence interval, and number of cases, then download in MS-Excel format. For longer data ranges, repeat and concatenate or utilize the pre-compiled spreadsheet available here for older 2003-2022 test data.

Generating National Estimates for All Ingestions

To obtain Annual National Estimates for Ingestion and Aspiration incidents: First, create a “Treatment Year” column using `=YEAR(B2)` (assuming B2 is the date cell) and propagate the formula. Next, list years in a separate column (e.g., AH). Finally, calculate national estimates by summing incident weights using `=SUMIF(C:C,AH2,Z:Z)` (assuming C is Treatment Year, AH2 is index year, and Z is Weights), then propagate for all years, ensuring output matches NEISS Query Builder estimates.

Magnet Ingestions – Identifying and Getting Estimates

The MAGN dataset identifies magnet-related incidents within ALL_Ingest based on “MAGN” text mentions in narratives; filter the provided data by MAGN=1 to view these incidents. To acquire national estimates: Populate a new column (e.g., AA) with `=IF(ISNUMBER(FIND(“MAGN”,W2)),1,0)` (assuming W2 is the Narrative cell) to flag magnet mentions with ‘1’. Then, in a separate column (e.g., AJ), calculate yearly national estimates using `=SUMIFS(Z:Z,C:C, AH2,AA:AA, 1)` (assuming Z is Weights, C is Treatment Year, AH2 is index year, and AA is the MAGN flag), propagating the formula for all years. This deterministic method ensures reproducible results without subjective filtering bias.

Battery Ingestions – Identifying and Getting Estimates

BATT identifies battery-related incidents in ALL_Ingest using “BATT” text mentions in narratives; filter by BATT=1 to view. To obtain national estimates: In a new column (e.g., AB), use `=IF(ISNUMBER(FIND(“BATT”,W2)),1,0)` (assuming W2 is the Narrative cell) to flag battery mentions with ‘1’. Then, in a separate column (e.g., AK), compute yearly national estimates using `=SUMIFS(Z:Z,C:C, AH2,AB:AB, 1)` (assuming Z is Weights, C is Treatment Year, AH2 is index year, and AB is the BATT flag), propagating the formula. This narrative-based search is more inclusive than product category searches.

SREM Ingestions – LLM Automated Approach

Unlike MAGN and BATT, SREM incident identification is subjective, emulating CPSC’s 2012 selection method for “in-scope” high-powered and/or ball-shaped magnet products based on their 72 identified incidents. These 72 incidents are the sole publicly available “in-scope” selections from the CPSC; subsequent rulemaking incident lists have not been published, preventing audits of their consistency or efficacy.

The SREM Identification Blueprint details a GPT-4 augmented process to determine prevailing criteria despite inconsistencies and project national estimates. A generalized method for identifying SREM incidents involves pre-matching specific keywords in MAGN narratives, subjectively excluding false positives (e.g., non-magnetic items or irrelevant contexts), and for uncensored data, including matches referring to known SREM brands.

5. Dataset Limitations

The limitations of the All Ingestions from the NEISS database are primarily those inherited from the design of NEISS database, and apply to all NEISS data:

• Sampling: NEISS is based on a sample of hospitals, not all hospitals in the U.S. The data is then weighted to make national estimates. This means there’s potential for sampling error. As noted by CPSC, estimates cannot be relied upon if:

1. Estimate is less than 1,200
2. Number of cases is less than 20
3. CV exceeds 33%

To calculate the CV for any set of NEISS incidents in a manner that takes into account the probabilities of selection, stratification, and weighting, see instructions on Pg.13 of the current NEISS Sample Design and Implementation Documentation. 

• Detail Limitations: NEISS reports often contain brief narratives which can lack sufficient detail to understand the complete context of the injury. 
• Public NEISS Data: The data available to the public may have reasonable redactions several reasons: including patient privacy, brand confidentiality, and ongoing CPSC investigations. 
• Accuracy and Consistency: As with any large-scale data collection effort, there can be inconsistencies and inaccuracies in the data due to differences in reporting practices among hospitals or mistakes during data entry.
• Inpatient Data: NEISS mainly captures data from emergency departments, so injuries that are treated in other parts of the hospital or other medical facilities might not be recorded. This is why ICM estimates are also used for rulemaking.

For Magnet Ingestions – The simple text search for “MAGN” within NEISS narratives is effective and deterministic, but is not perfect. Searching for “MAGN” is more effective and encompassing than searching for the whole word “MAGNET”, as it catches many misspellings, such as “MAGNATIC” (For example NEISS ID# 50331618, 120214592), “MAGNECTIC” (80210439), “MAGNATIX” (81051740), “MAGNTIC” (150145260, 200918403), “MAGNITIZED” (190205851), “MAGNENT” (201246351). Matching for “MAGN” does not catch all misspellings, such as “MAGENT” (200537546), and there is no additional filter for false positives such as “NON-MAGNETIC” (130564667), or unrelated words such as “MAGNESIUM” (180804422). From a manual reading of MAGN incidents, this simple deterministic method is at least 97% accurate in identifying incidents that may involve magnets. 

For Battery Ingestions – Similarly, this simple text search for “BATT” within NEISS narratives that highly correlates with ingestions that involve batteries. It can catch a few misspellings of battery such as “BATTRY” (130953519), but is not immune to negative descriptors like “NOT A BATTERY”, or unrelated words like “BATTLESHIP” (120942905).  It also doesn’t include misspellings of Battery that don’t start with “BATT”. Similar to MAGN, searching for “BATT” appears to be over 97% accurate in flagging Battery related incidents.

For SREM Ingestions – The SREM Identification Blueprint follows 2012 analysis, but there is significant evidence its criteria are not consistently effective at identifying SREMs. For example, the method identified more “in-scope” injuries in 2006-2008 (2,200) before SREMs were prevalent than in 2009-2011 (1,700), raising questions about its accuracy and the CPSC’s assumption of 100% correlation between ban scope and prevented injuries. While “SREM” set of incidents represents the CPSC’s best effort to select incidents correlating with a high likelihood of involving the ingestion of Sets of Rare Earth Magnet, the CPSC’s failure to test their search strategy on pre-2009 data for later rulemakings further highlights this limitation.

Submissions for Comments, Suggestions and Corrections are welcome. Please email outreach (@) magnetsafety.org.

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