Public Release: 

Suffocation risk from small hard sugar balls

BfR Opinion No. 025/2017 of Sept. 7, 2017

BfR Federal Institute for Risk Assessment

The critical size for schoolchildren is roughly a diameter of 40 mm, as a hard sugar ball of this size is still too big to be swallowed.

Based on these prior findings, the BfR has now assessed the size at which small hard sugar balls are still large enough that accidental or intentional swallowing can result in blocking of the airways in children from the age of 5. Under certain circumstances, spherical objects can slip to the lowest part of the throat or into the upper esophageal constriction and become lodged there because this area is too narrow for them to pass through. If spherical objects become lodged in this area, this can result in almost complete or total blockage of the airways and therefore to a life-threatening event. Although the probability of such an incident occurring is very low, it is nevertheless relevant due to the potential severe health impairments that can ultimately be fatal.

In the case of children from 5 years of age, a ball diameter of a maximum 14 mm can be assumed to be safe in such a case with a high degree of probability. It can be expected that, at this age, spherical objects with a smooth surface up to this size can pass through the anatomic "bottlenecks" in the throat without risk.

The BfR has not assessed the risk to younger children resulting from specific sizes of the hard sugar balls. Children under the age of 5 should generally refrain from consuming any spherical sweets that cannot be crushed by the first bite.


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