The Ill of the Grill

If you experience searing pain after searing a steak on the grill, a small wire grill brush bristle may be to blame. Tristin Beck of Mount Lake Terrace, Washington and Brittany Berg of Coeur d’Alene, Idaho, were among the most recent cases to hit the news. Both teens wound up in a hospital operating room after accidentally ingesting a filament of grill brush wire embedded in the food they had been eating.

This phenomenon gained prominence last year, after U.S. Senator Charles E. Schumer and Consumer Reports joined together to call on the U.S. Consumer Product Safety Commission to determine whether grill brushes were safe and to warn consumers of the potential hazard, based on incidents that occurred in New Jersey and Washington State. The Centers for Disease Control followed up with an item in its Weekly Morbidity and Mortality Report (WMMR) authored by a team of Rhode Island emergency room doctors and radiologists documenting the not-so-rare occurrence of grill brush wire ingestion.

Last July, Dr. David Grand, a radiologist with Rhode Island Hospital’s diagnostic imaging department, and three other physicians from Brown University’s Warren Alpert School of Medicine reported 12 cases of grill brush wire ingestion seen in two emergency rooms serving the greater Providence, Rhode Island area from July 2009 and June 2012. Since then, the team has seen three more cases. Other doctors have offered up their own experiences with grill brush wire ingestion at meetings and through emails, Grand said.

“We were very surprised that there were so many, so we knew that this was part of a larger problem and we wanted to get it out there,” Grand said.

Since 2007, the U.S. Consumer Products Safety Commission has identified 17 cases, but has not tied them to a specific brand or type of brush.

“It’s an issue where we take the approach of consumer awareness and education,” says Scott Wolfson, CPSC spokesman. “We have monitored the marketplace, but, at this point, it has not risen to a pattern of a defect. We are aware of incidents and we are aware of the research. We will try to use social media and work with mainstream media to create awareness. We certainly take it seriously. The incident reports we seen have been concerning and have resulted in the immediate need for medical care.”

While the vast majority of foreign object ingestion cases seen in hospital emergency rooms –80,000 in 2010 – involve children, grill brush wire ingestion seems to affect mainly adults. For example, the patients in the cases described in WMMR ranged in age from 31 to 64 years; all reported having eaten grilled food after the grate was cleaned with a wire brush. Their injuries included punctures of the soft tissues of the neck and perforation of the gastrointestinal tract. The two most common symptoms are severe pain when swallowing or severe abdominal pain. A typical case was described thus:

A man aged 50 years arrived at the ED with abdominal pain that had begun after eating steak at a backyard barbeque. Computed tomography (CT) scan of the abdomen and pelvis revealed a linear object extending through the wall of a loop of small intestine into the omentum. Laparotomy was performed to remove the foreign body, which appeared to be a wire bristle from a grill-cleaning brush. The patient fully recovered and was discharged the next day.

Grand believes that wire brush ingestion happens more frequently than is reported. Sometimes the patient passes the wire fragment without incident. In smaller locales without a sizeable enough population to develop a pattern, doctors might not make the connection between grill cleaning and abdominal pain.

“These injuries are very hard to diagnose if you are not looking for them,” Grand said. “They are easy to miss. The other problem is: when you see them they can be mistaken for fish or chicken bones. It can be challenging to tell the difference, unless the surgeon pulls it out and carefully examines it.”

Grand says it might be best to switch to other methods like grill cleaning stones, or forego cleaning the grates altogether.

“Think about it – you heat up the grill to 500 degrees.”