Nov. 30, 2009 (Chicago) -- The aluminum can manufacturers' move to make the tabs on cans harder to ingest is apparently too easy to swallow.
The so-called stay-tabs were developed to prevent accidental ingestion of the pull-tabs that preceded them. But young people are still swallowing them, says Lane F. Donnelly, MD, director of biodiagnostics at Cincinnati Children's Hospital Medical Center.
If you fiddle with the stay-tab, it can easily break off," he said, while demonstrating how the tabs are easily separated from the cans with a couple of twists.
"Then, you may place it in the can, forget, and end up swallowing it," he tells WebMD.
Swallowing foreign objects, be it a penny or a can tab, can injure the GI tract, causing bleeding or other problems. Surgery is sometimes required.
About three decades ago, manufacturers began refitting beverage cans with the stay-tabs, after research showed that children were swallowing pull-tabs. One study revealed two cases of accidental ingestion and one case of aspiration after children swallowed pull-tabs that had been dropped into the cans.
The new study, presented here at the annual meeting of the Radiological Society of North America (RSNA), suggests that the new tabs "have not reduced the number of ingestions," Donnelly says.
Children Still Swallowing Stay-Tabs
Donnelly and colleagues identified 19 cases of inadvertent stay-tab ingestion at Cincinnati Children's Hospital Medical Center from 1993 to 2009.
"If we have 19 cases at one institution, it's probably a much bigger problem nationwide," he says.
The children's ages ranged from 1 to 18 years. "We were surprised that most of them were teenagers," Donnelly says.
Of the 19 cases in the study, only four of the stay-tabs could be spotted on X-rays.
Donnelly showed a series X-rays, demonstrating how a penny that had been accidently ingested was easily viewed, but how it was nearly impossible to see the aluminum tabs.
Connelly says that none of the 19 youths suffered breathing problems or vomiting or required further treatment. But there is always a risk of internal bleeding because of the sharp edges on the breakaway tabs, he says. There's also a risk of the tab causing obstructions, he says.
One of the children was sent home with instructions "not to suck on can tabs" when drinking beverages.
"A better education campaign is needed," Connelly says.
Joseph Tashjian, MD, president of St. Paul Radiology in Minnesota and moderator of a news briefing, says that the new tabs are "a substantial step forward" from the old pull-tabs.
"They are rounded -- not as sharp," he says. With the original pull-tabs, surgery was sometimes required to remove the devices after accidental ingestion, he notes.
Still, further research is needed to make them safer, Tashjian says.
"We probably need some changes in can design -- cans that keep the tabs better attached," Donnelly says.