Health & Safety Watch - Button batteries pose a serious hazard to children and the elderly

Severe injury can occur within 2 hours of ingestion

December 19, 2011 - Health & Safety Watch - Button batteries pose a serious hazard to children and the elderly - Should be treated as an emergency

Health Canada and other health authorities report that cases of people swallowing button batteries reported to manufacturers and health officials that result in serious internal injury and death are on the rise. These small disc-shaped button batteries store lots of energy in a tiny space. They are commonly found in a wide range of products around the home that children have access to, such as remote controls, musical greeting cards, watches, calculators, flashing jewellery and shoes, key fobs, books, and other small electronic devices.

The size, shape and energy storage properties of button batteries make them hazardous if swallowed. A swallowed button battery can block an airway or can cause serious internal chemical burns in the oesophagus in as little as two hours. The 20 to 25 mm diameter lithium button batteries result in the most serious injuries, especially where young children are involved. In cases of swallowing, the batteries were found loose on the floor by young children, in garbage bins, or on countertops, taken directly from a package, or removed from household products. Even adults, particularly seniors, have unintentionally confused button batteries with pills or food and been injured.

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.

A review of button battery safety by the Winnipeg Regional Health Authority summarizes the risks and provides parents and caregivers with advice on what to do if a child swallows a battery or places one in the ear or nose, and how to best protect children from small batteries. Highlights of the WRHA article and the original US study are provided here.

A 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 percent of these cases occurred in children who were younger than 6 years of age. Injuries (e.g., severe burns, esophageal stenosis, bilateral vocal cord paralysis) occurred as soon as 2 hours after ingestion. The study also found that at least 27% of serious outcomes and 54% of fatal cases were initially misdiagnosed, usually because of nonspecific presentation.

[Foreign body lodged in oesophagus] Injuries typically occur when a battery becomes stuck in a child's oesophagus. 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. Button batteries that are not removed and remain in the oesophagus 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.

"Our advice is to go immediately to go to Emergency and have an X-ray taken. If the battery is in the oesophagus, it needs to be removed as soon as possible," says Dr. Lynne Warda, a medical consultant with Impact, the Winnipeg Health Region's Injury Prevention Program.

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.

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. But 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.

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 15% 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. Store button batteries away from food and medicine. Take care when changing the button batteries in a product that they do not get mixed in with any pills, medicine or food. Realize that to anyone with poor eyesight, button batteries look just like pills or candy.

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