If you’re an avid pen chewer, or even just a diehard fan of writing by hand, you’re probably well acquainted with the small hole that tops off most ballpoint pen caps, particularly those classic Bic Cristal pens. The reason it’s there has nothing to do with pen function, it turns out. As Science Alert recently reported, it’s actually designed to counter human carelessness.
Though it’s arguably unwise—not to mention unhygienic—to chomp or suck on a plastic pen cap all day, plenty of people do it, especially kids. And inevitably, that means some people end up swallowing their pen caps. Companies like Bic know this well—so they make pen caps that won’t impede breathing if they’re accidentally swallowed.
This isn’t only a Bic requirement, though the company’s Cristal pens do have particularly obvious holes. The International Organization for Standardization, a federation that sets industrial standards for 161 countries, requires it. ISO 11540 specifies that if pens must have caps, they should be designed to reduce the risk of asphyxiation if they’re swallowed.
It applies to writing instruments “which in normal or foreseeable circumstances are likely to be used by children up to the age of 14 years.” Fancy fountain pens and other writing instruments that are clearly designed for adult use don’t need to have holes in them, nor do caps that are large enough that you can’t swallow them. Any pen that could conceivably make its way into the hands of a child needs to have an air hole in the cap that provides a minimum flow of 8 liters (about 2 gallons) of air per minute, according to the standard [PDF].
Pen cap inhalation is a real danger, albeit a rare one, especially for primary school kids. A 2012 study [PDF] reported that pen caps account for somewhere between 3 and 8 percent of “foreign body aspiration,” the official term for inhaling something you’re not supposed to. Another study found that of 1280 kids (ages 6 to 14) treated between 1997 and 2007 for foreign body inhalation in Beijing, 34 had inhaled pen caps.
But the standards help keep kids alive. In that Beijing study, none of the 34 kids died, and the caps were successfully removed by doctors. That wasn’t always the case. In the UK, nine children asphyxiated due to swallowing pen caps between 1970 and 1984. After the UK adopted the international standard for air holes in pen caps, the number of deaths dropped precipitously [PDF]. Unfortunately, it’s not foolproof; in 2007, a 13-year-old in the UK died after accidentally swallowing his pen cap.
Even if you can still breathe through that little air hole, getting a smooth plastic pen cap out of your throat is no easy task for doctors. The graspers they normally use to take foreign bodies out of airways don’t always work, as that 2012 case report found, and hospitals sometimes have to employ different tools to get the stubbornly slippery caps out (in that study, they used a catheter that could work through the hole in the cap, then inflated a small balloon at the end of the catheter to pull the cap out). The procedure doesn’t exactly sound pleasant. So maybe resist the urge to put your pen cap in your mouth.