Photo for illustration purpose only. Photo: wasserstrom.com
BY SOON LI WEI

This is the final of a two-part article on the use of staple pins in food packaging that can pose safety issues for consumers.

Incidents involving the accidental swallowing of staple pins from food packaging may not be very common but when it does occur it can lead to harmful consequences as the sharp object may cause perforations in the gastrointestinal (GI) tract.

Those thin and tiny pieces of metal may look harmless but when they fall into food items, they can be swallowed easily, with children more prone to such incidents.  

Dr Ho Hon Lian, a ear, nose and throat consultant at Kajang Plaza Medical Centre in Kajang, Selangor, said most of the time, swallowed foreign bodies are easily passed out in the stool. 

Ear, Nose and Throat consultant Dr Ho Hon Lian from Kajang Plaza Medical Centre in Kajang. Photo: Bernama

However, if a person experiences any discomfort, they must immediately seek medical attention as any delay can lead to a serious risk to their health, he said.

In some cases, it can also lead to bleeding in the gum or throat and may cause injury to the food pipe. 

“Some might have to be referred to the dentist if they have painful and swollen gums as it (impacted foreign object) might also cause infection with pus collecting in their gum.”

He said while foreign bodies pass spontaneously through the GI tract, sharp or pointed objects that are retained inside the body may cause gastrointestinal erosions and abrasions that result in bleeding or other injuries.

Safety precautions

What will happen if a person swallows a staple pin while eating?

According to Dr Ho, the danger posed by the pin will depend on where it is lodged and whether it is still intact or has opened up.   

“Since the staple is very small, it usually won’t cause any immediate problem (when swallowed).

“Most of the time, it gets stuck in the tonsil or throat and if it is still closed and intact, it will go down easily into the oesophagus and stomach and will pass out in the stool,” Dr Ho said.  

However, swallowing a staple pin that has either one or both its sharp prongs prised open can be problematic as the sharp end can cut or cause abrasion in the throat area and cause bleeding. Or it may get stuck and impacted inside the tissues followed by infection and pus collection.

“In such a case, one might experience a prickly or tingly sensation in the throat when swallowing or sharp pain in the area impacted by the pin. The person may also cough non-stop or have a choking sensation in the throat.  He/she sometimes may spit out blood which suggests that the pin has caused an impact and he/she must immediately seek emergency treatment,” he explained.

Food stapling example. Photo: Bernama

Dr Ho also said that there are several potential methods to remove a foreign object stuck in the throat without medical intervention.

“If the problem (accidental swallowing of a staple) occurs, stop eating and try to drink some water. Wait and see whether drinking water or sometimes coughing can remove the pin from the throat spontaneously. But if this fails, then better see a doctor as soon as possible,” he said.

He said some patients may feel as if the pin is stuck in the throat when, in reality, it has already passed through the oesophagus. The sensation in the throat may be caused by a small abrasion/puncture wound and it usually heals by itself.

“Most foreign objects that do not cause symptoms will pass through the digestive tract in one or two days without causing any harm.

“However, if a person experiences pain in the throat or chest, excessive drooling of saliva, swelling or bruising on their neck, or is having difficulty in eating or drinking, they should seek immediate medical attention.

“A doctor can often remove the pin quickly to prevent further complications. In some cases, they may use rigid or flexible endoscopy instruments to find the pin and remove it. During an endoscopy removal procedure, a doctor uses a long, thin tube with a camera at one end to examine the throat. In some cases, a doctor may have to use an X-ray or CT scan imaging studies to help locate the foreign body,” he added.

Safer options

In 2017, the US Food and Drug Administration (FDA) directed food business operators to immediately stop the use of staple pins to pack food.

The ban came following complaints from consumers over the health hazards posed by the accidental consumption of the tiny and inconspicuous pins. Food vendors in the United States were urged to pack food items in paper bags sealed with adhesive tapes.

In Malaysia, staples are still widely used in food packaging although there have been calls by consumer groups to ban the practice.

Universiti Putra Malaysia Food Safety Research Centre head Prof Dr Jinap Selamat said instead of using staples, food operators can resort to other alternatives, such as laminating plastic packaging and using edible gum to seal other types of packaging like banana leaves.  

“The use of edible gum is a good alternative (to using staples) but research will have to be done to determine the effectiveness of the gum towards different types of packaging,” she said.

Jinap said food manufacturers, restaurants and traders who wish to do their own research on the edible gum can refer to the YouTube video titled ‘Bioplastic: Water-resistant Casein Glue. Milk glue’ produced by the US-based GEO-sustainable, a company that specialises in making environmentally-friendly sustainable products.

Jinap, who is a food safety lecturer, told Bernama Malaysia’s Food Act 1983 and its regulations have sufficient provisions to act against food operators who prepare and sell food that contains “any matter foreign to the nature of such food, or is otherwise unfit for human consumption” but the authorities cannot take action against them unless they receive complaints from consumers.

She said since a staple is categorised as a foreign material and is a physical hazard, it is, therefore, an offence to use staples in food packaging under Section 13A of the Food Act 1983, as well as under the Food Hygiene Regulations (2009).

Any person who prepares or sells any food containing “any matter foreign to the nature of such food” shall be liable, upon conviction, to a fine not exceeding RM30,000 or to imprisonment not exceeding five years or both. – Bernama