Injuries related to cotton tip applicators sent more than a quarter of a million children to emergency rooms over about two decades, according to a new study.

About 34 children were treated at ERs daily for such injuries between 1990-2010, researchers from Nationwide Children’s Hospital found. Kris Jatana, M.D., a pediatric otolaryngologist at Nationwide Children’s Hospital and lead author of the study, said this is the first report that points to the national problem and it might not even show the full scope of the issue.

"This study only captured injuries that were treated in emergency departments," Jatana said in a release. "There were likely a lot more injuries to children who were treated by an ear, nose and throat specialist or a pediatrician.”

The data implies many adults use cotton swabs to clean wax from their ear, which isn't safe or necessary, Jatana told USA TODAY.

"Children are learning these hygiene habits from older siblings or adults," he said.

Ear wax is normal. Jatana said if someone has an excess wax build-up, they may use a wet wipe or washcloth to clean the outside of the ear, but never inside the canal, or seek medical advice.

"There’s a misconception that people need to be cleaning deeper in the ear canal with these products and clearly that has been a source of injuries," he said.

Most children younger than 8 years old who went to the ER suffered from a perforated eardrum. Jatana said he's personally seen a case where a cotton tip applicator broke off in the ear canal, which caused a brain abscess and deafness in one ear.

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