PURPOSE: Food asphyxiation is a common problem whenever and wherever people eat. A knowledge of predisposing factors might help to prevent this problem.

SUBJECTS AND METHODS: We reviewed 34,476 consecutive autopsies done during a 14-year period (1984 to 1997) at the Institute of Forensic Medicine, Vienna. Demographic features and predisposing factors were determined for the 191 cases of fatal foreign body asphyxiation.

RESULTS: Old age, poor dentition, and alcohol consumption were frequent findings. Other risk factors included chronic disease, sedation, and eating risky foods. On 120 (63%) of the 191 occasions, observers were present at the time of the incident and subsequently called the Emergency Service. In 110 (92%) cases, neither the observers nor the majority of the emergency medical technicians and physicians who would have been able to intervene recognized the definite diagnosis. Only 10 cases were correctly identified during cardiopulmonary resuscitation.

CONCLUSIONS: These fatal accidents could be prevented easily. Effective prevention depends on understanding the nature and frequency of accidental deaths due to asphyxiation and the factors that lead to their occurrence and having a high degree of suspicion.