Round batteries, small like buttons and shiny like coins, are valued for the energy they contain given their size. In homes, they have become commonplace, powering remote controls, hearing aids, toys, electric tea lights, wristwatches, greeting cards that play music, and other familiar objects.
But doctors warn that these “button batteries” can maim and kill. Put one in your mouth and swallow it – as thousands of children do every year – and it can quickly cause devastating injuries.
A growing number of medical associations push for battery manufacturers to stave off the threat by creating a new product: a button cell or “coin cell” that will not cause catastrophic injury if swallowed.
“The only real solution to the battery problem is to make the battery itself safer,” said Dr. Toby Litovitz, founder of the National Capital Poison Control Center.
When button batteries are lodged in the body, their electrical current breaks down water, increasing alkalinity to dangerous levels, comparable to bleach. Body tissues may begin to liquefy. Doctors say serious injuries can occur within two hours, sometimes before a parent even realizes a battery has been swallowed.
As button batteries have proliferated in everyday items, the rate of pediatric emergency room visits for battery-related injuries has more than doubled in recent decades, a study finds. study published in the journal Pediatrics. Some children ended up relying on tubes to breathe or suffered massive hemorrhages, doctors said.
“Unfortunately, these batteries cause serious injuries so quickly,” some of which are impossible for surgeons to repair, said Dr. Kris Jatana, surgical director of clinical outcomes at Nationwide Children’s Hospital of Ohio.
Jatana was alarmed by the risks after caring for a 2-year-old who ended up needing a tracheotomy to breathe. “It was a moment that motivated me to try and see what we could do to prevent these injuries from happening.”
Button cell battery safety
Here is recommendations from the National Children’s Hospital:
Some battery manufacturers have tried adding a bitter coating or saliva-activated dye to warn parents.
Reese’s Lawa federal law named in honor of a child who died of serious injuries after swallowing a button battery, now requires that compartments intended for these batteries on consumer products be more difficult to open and requires packaging to be Childproof for button batteries.
But advocates say more needs to be done. For example, Litovitz said harder-to-open packaging wouldn’t solve the many injuries caused when children swallow left-behind or discarded batteries. Among those working to develop safer batteries is biotechnology entrepreneur Bryan Laulicht.
“What makes them really great for devices is also what makes them so dangerous when you swallow them,” Laulicht said of button batteries. “They are powerful enough to split water…raising the pH to the Drano level in minutes.”
Doctors have started to sound the alarm about the threat decades ago as more and more children began to suffer serious injuries. A study found that between 1985 and 2009, the percentage of button cell ingestions resulting in serious or fatal injuries increased more than sixfold.
Reese Hamsmith was seriously injured after swallowing a button battery and died less than two months later. His mother, Trista Hamsmith, vowed to do everything she could to prevent other children from suffering the same fate.
(Trista Hamsmith)
Litovitz and other researchers noted the growing popularity of 20-millimeter-diameter lithium button batteries: their analysis found that 12.6 percent of children under 6 who ingested button batteries of that size suffered harm. serious complications, even death.
They are “just the right size to get stuck in the esophagus of a small child, especially a child under four years old,” Litovitz said in an email. “In addition, these lithium button batteries have twice the voltage of other button batteries.”
Doctors may not immediately recognize and diagnose the problem if no one realizes that a battery has been swallowed, because symptoms may initially resemble those of other childhood illnesses.
The problem has gotten worse over time: From 2010 to 2019, an average of more than 7,000 children and teens went to emergency rooms each year for battery-related injuries, according to the Pediatrics study. The rate of these emergency visits has doubled compared to the period 1990 to 2009.
Button batteries were involved in most cases where the battery type was known. The researchers counted more than 70 deaths of button cell battery ingestion over time, but Litovitz said the real number could be much higher because that figure only includes cases documented in medical research or the media or reported to the hotline. national assistance for button cell ingestion, which stopped working six years ago.
At Children’s Hospital Los Angeles, doctors see about one child a month injured by a button battery, said Helen Arbogast, manager of the injury prevention program in its division of pediatric general surgery. Children are drawn to shiny objects and notice adults’ attention to electronics, she said.
“Remotes really fascinate them — the buttons, the colors — and part of their natural motor skill development is learning how to open and close things,” Arbogast said.
She stressed that time is running out. “If a parent suspects their child has swallowed a button battery, it is important to take them to the hospital immediately.”
In Texas, Reese Hamsmith woke up one morning in 2020 cluttered and wheezing. His mother, Trista Hamsmith, took the child to the pediatrician, who suspected croup. It wasn’t until the next day, after a Halloween night when Reese was sick, that her mother realized that a button cell battery was missing from their remote control.
Reese Hamsmith was seriously injured after swallowing a button battery and died less than two months later.
(Trista Hamsmith)
Reese underwent emergency surgery, but the damage continued even after the battery was removed, burning a hole in his esophagus and windpipe, his mother said. In the weeks that followed, she underwent additional surgeries, sedation and intubation. Less than two months after her injury, Reese died.
She was a year and a half old. After her death, “I held her in my arms again and promised her that I would do everything I could to make sure no child died this way,” Trista Hamsmith said.
The Lubbock mother founded a nonprofit organization, Reese’s Purpose, which successfully passed federal legislation imposing new requirements for battery compartments, child-resistant packaging and product labels. warning. Hamsmith was happy to see these rules go into effect, but lamented that such protections had not been put in place sooner.
“It shouldn’t be necessary to use what we’ve experienced” to spur action, she said. “It certainly shouldn’t make someone like me yell at the world.”
The group is also funding research into a medical device that can detect a swallowed battery without subjecting a child to radiation, which Hamsmith wants to see used whenever a child shows possible symptoms. And it worked with Energizer on safety devices including a revealing dye that turns blue with saliva.
“The missing ingredient here…has been the ability to alert the caregiver that something has happened,” said Jeffrey Roth, global category leader for batteries and lights at Energizer. “That’s really what ‘color alert’ does: it alerts the caregiver that a child may have put something in their mouth that they shouldn’t have.”
Litovitz cautioned, however, that because not all batteries contain blue dye, doctors and parents should not assume that no batteries have been swallowed if they do not see that color.
Roth said that over the past several years, Energizer has spent tens of millions of dollars on research and other efforts regarding the safety of coin-cell batteries. “We believe that one day we will solve this problem,” he said. “But it certainly requires revolutionary innovation.”
Laulicht, co-founder and CEO of Landsdowne Laboratoriessaid his company was testing an alternative battery with a different type of casing, intended to turn off inside the body. Tests that involve placing the battery between two pieces of ham don’t show the type of damage inflicted by commercially available button batteries, he said. (Ham is used as a readily available substitute for human gastrointestinal tissue, Laulicht explained.)
One of their challenges has been getting the same level of battery performance with these modifications, Laulicht said. But as a father of young children, “I would prefer a battery that only lasted a year on the shelf…but didn’t kill my child when he swallowed it.”
