Scale-up approach in CATI surveys for estimating the number of foreign body injuries in the aero-digestive tract in children

Foreign body injuries are a well-known threat to children due to the high risk of ingestion of small objects and choking. In order to depict the epidemiological framework of such injuries, data are mostly available for hospitalizations and partially for emergency room visits. The hidden part of the phenomenon consisting of minor self-resolved injuries is still unknown. The purpose of this paper is to provide an estimate of the overall burden of such injuries in children in Italy. Our paper proposes the use of the scale up technique to overcome most of the pitfalls of classical techniques in the estimation of the number of children aged 0-14 that suffered a foreign body injury in 2004. Our results, based on a CATI survey on 1,081 women, show that the estimated number of children under 15 years that incurred in a foreign body injury was 15,829 (95% CI: 14,376-17,282), of these 12,844 were treated in hospital or in emergency department (95% CI: 11,535-14,153). The scale-up method in conjunction with a CATI survey provides a reliable estimate of the size of hard-to-count populations as those of injured children at lower costs with respect to classical sampling schemes.