Coin-cidence? Have cashless payments reduced the incidence of upper aerodigestive foreign body insertion?

A Jangan, E Watts, M Pankhania

Ann R Coll Surg Engl. 2025 Feb;107(2):125-129.

View Abstract on PubMed

Abstract

Insertions of nasal and oral foreign bodies (FB) are common presentations in the emergency department, with coins frequently implicated among paediatric populations. Contactless payments were first introduced in the UK in 2007, and cash payments significantly declined from 2012. This study aims to explore the potential implications of increasing contactless payments on FB ingestion.

Methods: UK Hospital Episode Statistics (HES) were reviewed between 2000 and 2022. All FB retrieval procedures involving the alimentary tract, respiratory tract and nasal cavity were included. Regression analysis was performed to assess trends in the incidence of FB ingestion before and following the transition to cashless payments in 2012.

Results: Following the decline in cash payments in 2012, the frequency of alimentary tract FB removal procedures decreased significantly by 27.78 procedures per year (p< 0.001). Similarly, respiratory FB removal procedure decreased by 4.83 per year (p= 0.009) and nasal cavity FB removal procedures decreased by 52.82 per year (p< 0.001).

Conclusions: This study suggests a statistically significant decline in the number of procedures for removal of FB performed in the UK from 2012. Although this relationship is multifactorial, our data suggest an association between the introduction of contactless payments and a reduction in the number of FB retrieval procedures from the of upper aerodigestive tract.

Keywords: Cashless payments; Coin foreign body; Contactless payments; Hospital Episode Statistics; Upper aerodigestive tract foreign body.

Figures

Figure 1: Methods of payment (millions) 2011…

Figure 2: Interrupted time series analysis of alimentary tract foreign body removal procedures in 0–14-year-olds.

Figure 3: Interrupted time series analysis of respiratory tract foreign body removal procedures in 0–14-year-olds.

Figure 4: Interrupted time series analysis of nasal cavity foreign body removal in 0–14-year-olds.

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