BfR cautions industry on gum ball choking risk

The Federal Institute for Risk Assessment (BfR) said it has recently reviewed the safety of the long established confectionery product - multi-coloured sugar balls containing a soft chewing gum core - following a request to do so from the German Federal Ministry of Food, Agriculture and Consumer Protection.

The BfR notes cases from the US involving children and the consumption of gum balls where suffocation was only avoided through the application of the Heimlich manoeuvre. However, the agency cautioned though that it has not received any reports of cases of suffocation by hard sugar balls from within Germany.

The federal assessor evaluated hard sugar balls from a range of different manufacturers. It found that, on average, the balls have a diameter of around 5 cm.

“With this size, they can normally not be taken into the mouth. And in order to get to the soft chewing gum core, the giant ball must be reduced by licking and sucking. If a size of around 4cm diameter is reached - this corresponds approximately to the size of a table tennis ball - it fits into the mouth. The remaining sugar layers can then be crunched.​

Through licking and sucking a critical size is reached for the consumer because the sugar balls then fits exactly into the pharynx. If it slips inadvertently, for instance while playing or sucking without full concentration, into the pharynx, the respiratory tract is blocked in the worst case,”​ warns the BfR.

The agency also stressed that a hard sugar ball closely blocked in the pharynx cannot be removed using the fingers and that there is a risk that it is pushed even further into the pharynx during such an attempt.

The European Food Safety Authority (EFSA), in a recent approval for sugar-free gum claims, cautions that the use of chewing gum should be avoided in children less than three years of age owing to a high choking hazard with the product in this age group

Food or small objects can cause choking when they get caught in the throat and block the airway, preventing oxygen from getting to the lungs and the brain.

Top food choking hazards are candy and gum, according to US watchdog ConsumerReports. That group claims foods of all shapes and textures, including fruits and vegetables, present hazards.

Jelly mini cups containing thickening agent konjac (E425) or other additives, though widely available in Japan and the Far East, are banned in the UK and the rest of the EU due to concerns over choking.

And the sale of Ferrero’s Kinder eggs brand is prohibited in the US. The US Consumer Products Safety Commission determined in 2008 that Kinder eggs did not meet the small-parts requirement for toys for children under the age of three, creating a choking and aspiration hazard in young children.

Every child is at risk for choking, says the US Centre for Disease Control and Prevention (CDC). It claims that younger children are particularly at risk because of their tendency to place objects in their mouths, poor chewing ability, and narrow airways compared with those of older children and adults.

The UK’s Child Accident Prevention Trust claims that each year around 25,000 under-14s have to go to the accident and emergency department of UK hopsitals after choking on something or swallowing things that they should not have.