Authorities call for care over button batteries in Japan

Authorities are on the alert amid a continuing stream of incidents in which children have accidentally swallowed button batteries.

Experiments conducted in Tokyo have shown that ingesting these batteries can cause acute esophageal inflammation and gastritis with a risk of perforation, leading to calls for parents and guardians to take greater precautions when storing the batteries.

Button-shaped batteries are smaller than a ¥10 coin and are widely used in toys and other electronics. An accidentally swallowed battery reacts chemically with the lining of the esophagus and stomach, producing an alkaline fluid that can cause serious health damage.

According to the Tokyo metropolitan government, there have been 157 visits to medical facilities due to accidental ingestion or suspected ingestion by children aged 5 and under since 2010. Twenty-three of these cases required admission to the hospital.

In the United States, 35 deaths have been reported.

The string of incidents prompted an expert-led advisory committee in the Tokyo metropolitan government to conduct simulations and surveys earlier this year. The experiment simulated accidental ingestion by using pieces of chicken soaked in saline solution in place of a digestive tract, and four kinds of batteries, including an unused, coin-shaped three-volt lithium ion battery and a 1.5-volt alkaline button battery.

Immediately after the lithium-ion battery was placed on the poultry, a chemical reaction occurred. The surface of the meat began to dissolve 10 minutes later. Other batteries caused the meat to dissolve within 30 minutes.

Even a drained battery resulted in similar damage after half an hour.

In a survey of 1,046 parents and guardians conducted by the Tokyo metropolitan government this August, approximately 20 per cent of respondents reported cases of attempted ingestion by their children. Five reported actual ingestion.

In contrast, a full 30 per cent reported being unaware of ingestion, or knowing their child had ingested a button battery but not considering it serious. The latter response showed many people are unaware of the inherent dangers.

The Tokyo government's Safety and Living Section is calling attention to the issue and compiling household safety guidelines (see Gist).

"Coin-shaped batteries have become more common in recent years, and they easily get caught in digestive tracts," said Tatsuhiro Yamanaka, director of the Ryokuen Children's Clinic in Yokohama and an expert in child-related accidents.

"They're currently the most dangerous product for children," Yamanaka said. "Any parent or guardian with even the slightest suspicion of an accidental ingestion should consult a medical professional immediately."

Based on its simulations and surveys, the Tokyo metropolitan government is to make proposals to manufacturers within the year to make battery packaging more difficult to open, and for products that employ the batteries to have built-in safety features.

Medications also a risk

Greater caution is also being called for regarding the accidental ingestion of medication.

According to hospital reports collected by the Health, Labor and Welfare Ministry in fiscal 2013, drugs and quasi-drugs were the most common items to be accidentally ingested by children, with 96 cases. This represented the first time for medicines to overtake tobacco (of which there were 94 cases of accidental ingestion) since reporting began in 1979.

In one incident, a 3-year-old boy mistook anticonvulsant pills for candy and swallowed them when his mother wasn't looking, resulting in impaired consciousness.

Within a total of 531 accidental ingestions, the largest number - 147 cases - involved children aged from 6 to 11 months old, followed by 130 incidents among children aged 12 to 17 months old. Incidents involving plastic objects and toys were also numerous, with 60 cases of ingested plastic objects and 51 involving toys.

The Japan Poison Information Center in Tsukuba, Ibaraki Prefecture, offers information on noteworthy cases of child-related accidental ingestion. Recently, the centre is calling increased attention to items such as water soluble laundry detergent pods and water-absorbing silica beads.

Home safety steps for button batteries

- Keep devices with battery storage compartments that can be opened without tools, or that are easily breakable, away from small children

- Keep batteries in locked drawers or in places children can't access. Change batteries where children cannot see you do it and do not leave them out in the open for even a short time

- Wrap used batteries in vinyl tape for insulation

- If you suspect accidental ingestion, consult a medical professional or the Japan Poison Information Center immediately (Osaka: 072-727-2499, Tsukuba, Ibaraki Pref.: 029-852-9999)