Lithium batteries: common but little-known danger to kids

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As any parent knows, children, especially infants and toddlers, like to put things in their mouths, and the smaller the object, it seems, the more attractive it becomes for tiny appetites.

Writing in the journal Pediatrics, researchers at Georgetown University and George Washington University report on a disturbing rise in youngsters swallowing small button batteries. These are the newer, coin-shaped lithium based power sources that are found in toys and electronic games, hearing aids and watches. The most problematic batteries are those that measure about 20mm, or slightly larger than a penny; these tend to get stuck in young children’s narrower gullets while smaller batteries are able to pass through. And because lithium batteries pack twice the voltage of older versions, the authors report, these 20mm power cells can also pose a more serious threat to children’s health.

In one of two studies on the subject the scientists published in the journal, they analyzed data from the National Poison Data System and the National Battery Ingestion Hotline, a non profit organization associated with the George Washington University Medical Center. Between 1985 to 2009, the researchers recorded a nearly seven fold increase in the percentage of button battery ingestions — the most common being the 20 mm batteries. Severe burns caused by chemical reactions that were activated by the body interacting with the batteries occurred in most cases in less than two hours.

According to the researchers, the danger of the lithium button batteries is not that they leak, as the traditional alkaline batteries often do, but that the body’s electrochemical processes can generate an external current that may cause the battery to release hydroxide at its negative pole (the flat end of the battery), which in turn burns tissues. Disturbingly, the authors also reveal that in 27% of the cases in which the child experienced major injury physicians failed to diagnosis the problem properly as an ingested battery.

In the second of their studies, the same team investigated how children were obtaining the batteries and found that 60% were getting them directly from a product such as a toy or game, with only 30% of children younger than six picking them up because they were loose or left lying around.

Based on their findings, the researchers urge manufacturers of electronic equipment to adopt stricter methods for securing battery compartments so they remain closed and are difficult for young fingers to pry open. They also advise parents to take extra steps in securing such devices by taping battery compartments of toys or games that children are most likely to play with.

The remaining challenge lies with physicians to properly identify children who have swallowed batteries; in more than half of cases, no adult witnesses the act, and doctors don’t always think to order X-rays to rule out the possibility. “To improve outcomes, health professionals must consider the diagnosis (particularly in unwitnessed ingestions), accurately discern batteries from coins, immediately remove batteries that are lodged the in the esophagus because severe injury can occur in just 2 hours, and anticipate delayed complications,” they write.