January 26, 2018 - A report of two young children with burns of the esophagus caused by swallowed button batteries from "fidget spinners" highlights a risk of severe injuries involving these popular toys, according to a series of reports in the January/February Journal of Pediatric Gastroenterology and Nutrition (JPGN). Official journal of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, JPGN is published by Wolters Kluwer.
The reports add to previous safety hazards from fidget spinners, especially in the hands of toddlers and preschoolers. In an accompanying editorial, Drs. Athos Bousvaros and Paul Rufo of Boston Children's Hospital write, "Having an unlabeled button battery in a toy or product that children can handle and break poses a potential danger to children."
Swallowed Batteries from Fad Toy Lead to Internal Burns
Fidget spinners are a simple but popular toy, consisting of a plastic piece that easily spins around a central bearing. Fidget spinners are sometimes marketed as anxiety-reducing devices for people with attention deficit-hyperactivity disorder, although those claims have not been researched.
Amid last year's fidget spinner fad, reports of young children swallowing fidget spinner parts have appeared. Some but not all fidget spinners have batteries, enabling lights to shine when the toy is spinning. One of the new articles reports on two children--a three-year-old boy and a four-year-old girl--with severe esophageal injuries caused by swallowed lithium batteries from fidget spinners. The lead authors were Dr. Racha Khalaf of Children's Hospital Colorado, Aurora, and Dr. Yoseph Gurevich of Steven & Alexandra Cohen Children's Medical Center, New Hyde Park, N.Y.
One child swallowed the central disk cap of a broken fidget spinner, including a small button battery, while the other swallowed a battery released from a damaged disk. When batteries come into contact with body fluids, they can cause severe burns in a short time. In the hospital, both children were found to have deep burns of the esophagus.
One child required emergency endoscopy to remove an impacted piece of the broken toy, including a one-inch button battery. He remained in the hospital for nearly three weeks due to concern about a possible fistula (connection) between the esophagus and aorta--a life-threatening complication that may develop days to weeks after the battery is removed. (The National Capital Poison Center has more information on the devastating injuries caused by swallowed batteries.)
Two other JPGN reports describe injuries in children who swallowed broken fidget spinner parts, but not batteries. In both cases, the objects were removed from the esophagus by emergency endoscopy, following NASPGHAN guidelines for swallowed objects (PDF link). Swallowed fidget spinner discs "should be presumed to contain a button battery until proven otherwise," Drs. Gurevich and Khalaf and colleagues note.
Button batteries are present in a wide range of household devices, including cameras, watches, and remote controls. While batteries in children's toys are usually well-secured, this may not be the case in devices not specifically designed for children.
Drs. Bousvaros and Rufo encourage pediatricians to report swallowed button batteries to the Consumer Product Safety Commission, which has already recognized this along with other potential hazards of fidget spinners. The editorial authors note that NASPGHAN's advocacy efforts were instrumental in prompting regulatory action in response to swallowing hazards posed by high-powered magnets a few years ago.
About The Journal of Pediatric Gastroenterology and Nutrition
The Journal of Pediatric Gastroenterology and Nutrition provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition.
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