Potential medical hazards are involved in the procedure of dropping the "pull-tab" into an aluminum beverage can before drinking the contents. We have seen two cases of inadvertent ingestion and one of inadvertent aspiration of the pull-tab. One of the patients who had ingested a pull-tab required endoscopic extraction of the pull-tab from the esophagus, and the patient who had inhaled a pull-tab required an open thoracotomy for removal of the foreign body from the bronchus. Aluminum is not as dense or radiopaque as other metals and is, therefore, frequently difficult to identify on standard roentgenograms.
(JAMA 233:345-348, 1975)
Rogers LF, Igini JP. Beverage Can Pull-TabsInadvertent Ingestion or Aspiration. JAMA. 1975;233(4):345–348. doi:10.1001/jama.1975.03260040039021