Children at risk as "button" battery use grows: study

Children face a growing risk from "button" batteries, according to a U.S. study showing a near doubling of emergency room visits in the past two decades as the objects can cause electrical or chemical burns if swallowed.

Most of those emergency room trips are due to coin-shaped batteries that have become ubiquitous in toys, remote controls and hearing aids and represent a shiny temptation to curious toddlers, according to a study in Pediatrics, the journal of the American Academy of Pediatrics.

"Button" batteries carry extra risks, experts said, because they can send an electrical current through esophageal tissue, eventually even burning a hole in the trachea or the esophagus - without children showing any signs of immediate injury.

"If a child swallows a button battery, the parent might not see it happen and the child might not have symptoms initially - and the clock is ticking," said Gary Smith, head of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio, one of the authors of the study.

"We've seen children in less than two hours have severe, severe injuries from button batteries getting caught in the esophagus."

Pediatric Battery-Related Emergency Department Visits in the United States, 1990–2009

RESULTS: An estimated 65 788 (95% confidence interval: 54 498–77 078) patients <18 years of age presented to US EDs due to a battery-related exposure during the 20-year study period, averaging 3289 battery-related ED visits annually. The average annual battery-related ED visit rate was 4.6 visits per 100 000 children. The number (P < .001) and rate (P = .002) of visits increased significantly during the study period, with substantial increases during the last 8 study years. The mean age was 3.9 years (95% confidence interval: 3.5–4.2), and 60.2% of patients were boys. Battery ingestion accounted for 76.6% of ED visits, followed by nasal cavity insertion (10.2%), mouth exposure (7.5%), and ear canal insertion (5.7%). Button batteries were implicated in 83.8% of patient visits caused by a known battery type. Most children (91.8%) were treated and released from the ED.

CONCLUSIONS: This study evaluated battery-related ED visits among US children using a nationally representative sample. Batteries pose an important hazard to children, especially those ≤5 years of age. The increasing number and rate of battery-related ED visits among children underscore the need for increased prevention efforts.

Samantha J. Sharpe, BS,
Lynne M. Rochette, PhD, and
Gary A. Smith, MD, DrPH

Using a nationally-representative sample of about 100 U.S. hospitals with 24-hour emergency rooms, Smith and his colleagues calculated that more than 65,000 children under age 18 had a battery-related emergency visit between 1990 and 2009.