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Making Super Bowl Guacamole? Be Careful To Avoid The Pits Of An Avocado Hand Injury

Is it your turn to make the guacamole at the Super Bowl party this year?

If so, be careful. You don't want to join the thousands of people who've ended up in an emergency room for avocado-related injuries.

"These injuries are exceedingly common," says Dr. Matt Aizpuru of the Mayo Clinic.

Aizpuru is the co-author of a 2019 study published in The American Journal of Emergency Medicine that found that as avocado consumption has gone up in America, so too have avocado-related knife injuries.

Aizpuru and his colleagues looked at emergency room data and found that between 1998 and 2017 an estimated 50,413 people paid a visit to the emergency room for an avocado-related knife mishap. Aizpuru says that in 1998 there were around 650 such injuries. By 2017, there were nearly 6,000, close to a 10-fold increase.

The most common demographic injured were women aged 23-29, according to the study, and injuries were most common on the left — and likely nondominant — hands of patients.

"When you're trying to free the pit up, it's just too easy to slip the knife off and catch yourself on the hand," he says.

He would know. While in medical school at Emory University, Aizpuru sliced his left thumb cutting an avocado for his own guacamole. The accident inspired him to study how common this injury is.

"I thought, if this is happening to me, it's surely happening to other people who are cutting avocados way more often than I do," he says.

A trend emerged when Aizpuru and his colleagues looked at that dataset alongside the U.S. Department of Agriculture's data on avocado consumption.

"We theorized that avocado-related injuries aren't happening more frequently or less frequently — just that people are eating more avocados," he says.

Since completing the study, Aizpuru takes extra precaution. Whenever he cuts an avocado now, he protects his left hand by covering it with a heavy dish rag. He also recommends the plastic cutting alternatives out there.

Assuming people are eating more guacamole this Super Bowl Sunday, Maria Raven, chief of emergency medicine at the University of California, San Francisco, expects a rise in visits. She says patients come in for the injury about once a week.

That may sound like a lot, but according to a separate study published in the January issue of the American Journal of Health Behavior, avocado mishaps account for only 2% of all knife-related injuries.

Only in rare cases do these types of injuries require surgery, Raven says.

Ryan Endress, a hand surgeon with the University of Kansas Health System, wishes his patients were more careful.

"It's best to just avoid holding whatever item you're cutting, and if you are going to hold what you're cutting, always cut away from yourself," he says.

Wilmer Carcamo, the executive chef of Rosa Mexicano, a restaurant in Washington, suggests a different approach.

Carcamo says he has never cut himself handling avocados, even though his technique involves whacking the pit with a knife. The restaurant, which prides itself on its guacamole, goes through about 2,000 avocados a week.

He says kitchen staffers are trained to follow the same method:

  • Once the knife sticks to the pit, wiggle the knife in a right-left motion to loosen up the pit — just enough so it slips easily out of the fruit
  • With the knife still attached, knock the pit against a disposal container
  • Use a spoon to scoop out that buttery, green good stuff
  • But Carcamo does have some crucial "don'ts" to impart on those making guacamole: Don't mask the avocado's natural flavor.

    "No garlic. No limes."

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    Melissa Gray is a senior producer for All Things Considered.