The American Academy of Pediatrics reports that cases of battery-ingestion with severe or fatal consequences have increased by 670 percent since 1985. Two studies in the academy’s medical journal “Pediatrics” warn that as batteries become smaller and look more like common household objects, doctors and parents are finding it harder to detect their presence in homes and in the bodies of the children and elderly who commonly swallow them.

In the “Official Journal of the American Academy of Pediatrics,” researchers from the National Capital Poison Center surveyed over 8,648 battery ingestions reported to the National Battery Ingestion Hotline in the last decade, and found that 91 percent of major and fatal battery ingestions involved the 20-mm coin cell “button” battery, which resembles a small silver coin — about 62 percent of children who had ingested batteries obtained the batteries directly from a product, while almost 40 percent of children who ingested the 20-mm button battery took them from remote controls.

The second study concluded that fatalities and severe injuries from battery consumption are on the rise. Of the 13 deaths that have occurred since 1977, nine occurred in the last five years. All 13 fatalities were children under the age of three, while 85 percent of reported cases resulted in severe injuries such as ulcers in the walls of the esophagus and trachea, vocal cord paralysis and esophageal perforation into the aorta. The batteries create hydroxide when they come into contact with tissue fluids, which can burn through the walls of the esophagus and trachea, resulting in vocal cord paralysis and internal bleeding.

The studies warn that current mechanisms for detecting batteries lodged in the esophagus are inadequate, and recommend that manufacturers redesign battery compartments so that they are more difficult to open. Doctors failed to detect 27 percent of the cases that resulted in drastic outcomes and 54 percent of the fatal cases, and 92 percent of the fatal ingestions went unwitnessed by parents. Children who had swallowed batteries often exhibited nonspecific symptoms like vomiting, fever, lethargy, irritability, cough and dehydration.

Researchers also found that the window of opportunity for an injury-free removal of an esophageal battery is two hours within swallowing, which is a smaller window than previously reported.