Introduction: Recent media reports have described knife injuries sustained while preparing avocados; however, this rise has not been reported in the literature. The purpose of this study is to describe, quantify, and trend emergency department (ED) encounters associated with avocado-related knife injuries.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for avocado-related knife injuries from 1998 to 2017. Patient demographic and injury data was collected and analyzed to describe trends in incidence, patient demographics, and injury patterns associated with an ED encounter for an avocado-related knife injury.

Results: There were an estimated 50,413 (95% Confidence Interval: 46,333-54,492) avocado-related knife injuries from 1998 to 2017. The incidence of avocado-related knife injuries increased over this time period (1998-2002 = 3143; 2013-2017 = 27,059). This increase correlated closely with a rise in avocado consumption in the U.S. (Pearson's Correlation: 0.934, p < 0.001) Women comprised 80.1% of injuries. The most common demographic injured were 23 to 39-year old females (32.7%), while the least common was males under the age of 17 (0.9%). Most ED presentations occurred on Saturdays (15.9%) or Sundays (19.9%) and the majority occurred during the months of April through July (45.6%). Injuries were much more common on the left (and likely non-dominant) hand.

Conclusion: Avocado-related knife injuries are a preventable cause of hand injury. The incidence has risen significantly in recent years, possibly due to an increased consumption of avocados in the United States. Education on safe avocado preparation techniques and public safety initiatives, such as warning labels, could help prevent serious injuries in the future.