November 9, 2010

Button batteries pose serious threat to children

Serious injuries can occur within two hours of swallowing devices

Children who swallow "button" batteries, commonly found in toys and consumer products around the home, can suffer internal injuries within two hours of ingesting one, according to a recent U.S. study.

Further Reading
What to watch for
If a battery is swallowed or placed in the ear or nose
How to protect young children from small batteries
Who else is at risk?
Battery facts at a glance
Related links

As a result, the Winnipeg Health Region injury prevention program IMPACT is reminding parents to be aware of the health threat posed by these batteries, and to take quick action if they suspect that their child has swallowed one.

The U.S. study reported that in the past 18 years there have been over 8,500 cases reported to the American Battery Ingestion Hotline, with 73 cases of serious injuries from battery ingestion and 13 deaths. Sixty-two per cent these cases occurred in children who were younger than 6 years of age. The study also found that serious injuries can occur within two hours of ingesting a battery.

The Winnipeg Health Region's Children's Hospital at Health Sciences Centre treats at least six children every year for ingested button batteries. Button batteries that are not removed and remain in the esophagus can cause burns and even perforation of tissues, causing life-threatening and sometimes fatal injuries. Depending on where the battery is lodged, it may be removed either using a scope or surgery.

These injuries typically occur when a battery becomes stuck in a child's esophagus. Once lodged, the battery can create an electrical current that burns the surrounding tissue. Children have also put small batteries in their noses and ears. This can also cause a burn and so they need to have the battery removed immediately.

Dr. Lynne Warda, a medical consultant with Impact, the Winnipeg Health Region's Injury Prevention Program, says parents need to be aware of the risks, especially as the gift-giving holiday season approaches. "While button batteries pose a health risk to children year-round, with the possibility of more toys, trinkets and electronics around, we would like to remind parents to be cautious," says Warda.

"Within two hours a battery lodged in the esophagus can cause tissue damage as a result of a burn," says Warda, who wants parents to know they should act quickly if they suspect their child has swallowed a battery.

"Our advice is to go immediately to go to Emergency and have an X-ray taken. If the battery is in the esophagus, it needs to be removed as soon as possible," she says.

Button batteries do not all pose equal risk. The smaller batteries may be ingested and passed without a person knowing it. It's the bigger ones that are more likely to become lodged and cause permanent tissue damage - or even death.

"The larger ones, the ones that measure 20mm or greater, pose the greatest risk. They're more likely to get stuck and since they are more powerful, they cause a more severe burn," says Warda.

Parents are encouraged to look for toys that help protect children from batteries by having a compartment for the battery that may only be accessed with a tool or screwdriver.

It's the other uses for button batteries that consumers and parents need to be aware of, says Warda, along with the risk they represent. Button batteries are everywhere. A glance around your house will show the common ways they may be found, in household products like remote controls, garage door openers, cameras, calculators, key chains, jewellery with flashing lights and even greeting cards. And they're much easier to access in these types of products.

That means curious little people need to be carefully watched when they're around these potential health hazards.

"The biggest message is awareness and prevention. If you can prevent it from happening in the first place, you don't have to worry," says Warda.

What to watch for

Chances are you may not see your child swallow a button battery. Parents who suspect that their child has swallowed a battery, should first ask the child where the battery is.

If the child indicates that he has swallowed the battery or inserted in his/her nose or ear, the child should be taken to the Emergency Department right away.

There are no clear visible symptoms of battery ingestion. A child who has swallowed a battery may gag or choke, trying to cough it up. Older children may complain of discomfort when swallowing or a sensation that something is stuck in their throat or neck. Younger children may drool and refuse to drink.

If a battery is swallowed or placed in the ear or nose

  • Act quickly - don't wait for symptoms to develop.

  • If the battery was swallowed, don't eat or drink until directed by a physician.

  • Batteries stuck in the esophagus must be removed as quickly as possible as severe damage can occur in as little as 2 hours.

  • Batteries in the nose or ear also must be removed immediately to avoid permanent damage.

How to protect young children from small batteries

Prevention is the easiest way to sidestep a trip to the emergency department thanks to a button battery. Tips to keep in mind:

  • Store spare batteries safely out of a child's reach. Never leave them sitting out, even if they are in their original package

  • Check all electronic household products to see that the battery compartment cannot be easily opened by a child.

  • When purchasing products, look for those that require a tool or screwdriver to access the battery compartments

  • Don't allow children to play with batteries.

  • Educate family members who wear hearing aids about the hazards of small batteries to children. Help them find safer ways of handling and disposing of the batteries.

Who else is at risk?

People at age extremes are at highest risk for ingesting button batteries: the very young (one to three year olds) and the elderly. Wee ones may be curious and ingest them by accident.

With the elderly, poor vision may contribute to mistaking the button batteries for other objects - a hearing aid, medication or food, for example. A surprising fifteen per cent of people who ingested a button battery mistook it for a pill, according to a US study.

There are accidental reasons adults may ingest button batteries - using your mouth to hold a battery, putting the battery in a glass that you drink out of before properly disposing of it and drinking from the glass to name a few.

Battery facts at a glance

  • The 20mm button batteries are the most hazardous.

  • Top three sources of ingested button batteries: hearing aids or cochlear implants, games or toys and watches.

  • According to a recent US study, 13 deaths have been reported. In other serious cases, children under four years of age required medical follow up because of compromised feeding and/or breathing and required multiple surgeries, tube feedings and/or tracheotomies.

  • Of the batteries ingested by young children, 68 per cent of them were obtained from products (rather than found loose or still in the package).

  • The rate of major or fatal outcomes from ingested batteries in the U.S. was 6.7 times higher in recent years (2007-2009 compared to 1985-87).

Related links

Consumer Watch: Button Battery Danger


Batteries in toys

Consumer caution

Holiday caution

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