By Michael Yudell

Parents of young children should pay close attention to some scary new numbers from the nation's top consumer safety agency: Batteries, particularly the small coin- or button-sized ones that are increasing in popularity, can be a menace to child safety. Too many kids ingest them, and the problem is increasing in frequency. But this warning comes with some good news. Consumer advocates and clinicians believe that we can remedy this problem fairly easily: make it more difficult for kids to remove batteries from household products and packaging, and educate parents about their potential dangers.

The United States Consumer Product Safety Commission's data on these injuries, published  last month in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, shows that nationwide between 1997 and 2010, about 40,000 children under 13 were treated in hospital emergency rooms for swallowing a battery; 14 kids died as a result of battery ingestion over that period. Almost three-quarters of total injuries were in children age 4 and younger, and 10 percent resulted in hospitalization. Fifty-eight percent of the accidents for which a battery type was identified were caused by the small batteries that are often found in watches, calculators, toys and games, hearing aids, cameras, and remote controls and other electronic devices. These were implicated in 12 of the 14 deaths.

Batteries can injure children in several ways. If lodged in the esophagus, the battery may, according to one study, "cause severe tissue damage in just two hours," leading to complications that include damage to the connection between the trachea and esophagus, vocal cord paralysis, a tear in or narrowing of the esophagus, or, most severely, internal bleeding. Ingested batteries can be especially harmful because they can leak an alkaline electrolyte, damaging tissue, or they may generate an electrical current that generates hydroxide, also causing tissue damage.

In other words, doctors generally have less than 2 hours to remove a battery lodged in a child's esophagus before it begins to cause serious injury. Physicians who see cases of battery ingestion can consult the National Capital Poison Center's "National Battery Ingestion Button Battery Ingestion Triage and Treatment Guideline" for more information on how to deal with this potentially deadly injury.

Kids are crafty, and parents need to be aware of the hazards these small batteries potentially pose. The Consumer Product Safety Improvement Act of 2008 mandated that "batteries be inaccessible (e.g., secured in compartments with screws) in all toys intended for children aged <3 years and in all toys using batteries that fit within small parts test cylinder for children aged <12 years." (The cylinder "approximates the size of a fully expanded throat of a child under three years old." Any toys made for kids 12 and under that have batteries that fit into this cylinder must also be secured). This was an important advance in child safety, but one that can't prevent all injuries.

The new study draws attention to practices that can improve child safety around batteries: making battery packing child-resistant and including clear warnings about the dangers of battery ingestion, especially in consumer products using coin-sized batteries. In general, parents should be aware of the potential dangers these batteries pose, and take extra care in their storage and make sure that their young children cannot access them in non-toy products in the home. Congress is currently considering legislation that would require "that child-resistant battery compartment closures are used on all consumer products using button cell batteries."

Legislation of this sort would be unnecessary if the companies that use these batteries in their products made the change voluntarily. That, however, is an unlikely course of action, calling attention not simply to the importance of Congress quickly adopting this new standard (after all, don't we all want to protect children from severe injury and death?), but also to the need for a strong regulatory apparatus that can protect the public's health.

When such simple fixes can protect us, why is there a hesitancy to act?

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