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Cotton swabs send dozens of children to ERs with ear injuries each day, study finds

Simone D. McCourtie
The most common injury among young children was a tearing, or rupturing, of the tissue that separates the ear canal from the middle ear.

Injuries caused by cotton swabs send dozens of children to hospital emergency rooms in the United States each day, according to a study published recently in the Journal of Pediatrics.

Using data from the National Electronic Injury Surveillance System, researchers found that 263,338 children under the age of 18 showed up at hospital emergency rooms for cotton-swab related ear injuries between 1990 and 2010.

That’s an average of 12,500 injuries annually — or about 34 a day.

Such injuries are preventable, for, as the study’s authors make clear, physicians do not recommend using cotton swabs to clean the ear canal because of the risk of injury.

That recommendation goes for adults as well as for children. 

“The two biggest misconceptions I hear as an otolaryngologist are that the ear canals need to be cleaned in the home setting, and that cotton tip applicators should be used to clean them; both of those are incorrect,” said the study’s senior author, Dr. Kris Jatana of Nationwide Children’s Hospital in Columbus, Ohio, in a released statement. “The ear canals are usually self-cleaning. Using cotton tip applicators to clean the ear canal not only pushes wax closer to the ear drum, but there is a significant risk of causing minor to severe injury to the ear. 

Young children most at risk

More than two-thirds of the injuries reported in the study occurred in children under eight years old, and about 40 percent involved children under the age of three. The most common injury among young children was a tearing, or rupturing, of the tissue that separates the ear canal from the middle ear, which is known as the tympanic membrane, or eardrum.

Other common swab-related ear injuries included bleeding and having some sort of object or “foreign body” stuck in the ear.

In 73 percent of the injuries, the ears had become damaged while being cleaned with the swab. And in most of those cases, the children were using the swabs themselves to clean their ears. The rest of the injuries occurred when the children were playing with the swabs or when they fell while a swab was in their ear.

“Nearly all of the patients with [cotton swab-related] injuries were treated and released, but this does not imply that some of the injuries were not serious,” Jatana and his colleagues write.

Dangers known for decades

The cotton swab was invented in 1923 by Leo Gerstenzang, a Polish-born immigrant who was living at the time in New York City. He got the idea from watching his wife clean their baby’s ears with cotton on toothpicks. Gerstenzang called his swabs “Baby Gays,” but within a few years the brand became re-named “Q-tips.” 

The first medical concerns about the ear-injury risks associated with Q-tips and other cotton swabs were raised in the early 1970s, when reports began to emerge of the swabs leading to perforation of the eardrum, earwax buildup and blockage, and bleeding from cuts and scratches.

Since then, medical guidelines have recommended that people not use cotton swabs to clean wax out of their ears. Instead, doctors recommend using gentle irrigation (ear syringing) or wax-softening drops of mineral oil, baby oil or glycerin. (Commercial wax-softening products are also available.).

If those home treatments don’t work, doctors recommend that you make an appointment with otolaryngologist to have the wax manually removed.

FMI: You can read the study on the Journal of Pediatrics website. You can find more information about earwax and how to care for it on the website of the American Academy of Otolaryngology-Head and Neck Surgery.

Comments (2)

  1. Submitted by Ray Schoch on 05/12/2017 - 11:12 am.

    Bad numbers

    It’s only a guess, but nonetheless, I’d guess that many/most people aren’t going to be willing to pay a couple hundred dollars out-of-pocket for an office visit to have someone (an otolaryngologist) clean the wax out of their ears. If their health insurance (assuming they have health insurance) covers it, perhaps. Otherwise, a lot of people obviously turn to Q-tips, whether they should or not.

    I’m a long way from being a math whiz, but on my calculator, the numbers early in the story about the frequency of injury don’t work. 34 injuries per week add up to only 1,768 injuries per year, not 34,000, so something is off in that calculation. 34,000 annual injuries is more than 650 per day.

    • Submitted by Tom Nehil on 05/12/2017 - 11:44 am.


      Thanks for pointing that out Ray — it should have read 34 per day, not 34 per week. (12,500 annual injuries / 365 days = 34 injuries/day.) The sentence has been corrected.

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