Tape Button Batteries Before Disposing of Them

button battery covered in tape

The Bottom Line

A recent study of battery injuries found that 29.8% of button battery ingestions involved batteries that were discarded or sitting out. Taping button batteries before disposal can decrease or stop button batteries from causing injury and will not affect the ability of the battery to be recycled. 

kids playing

The Full Story

Button battery injuries can be devastating. Despite getting more attention through the media, serious and deadly cases continue to occur. 

Why are button batteries dangerous?

When a battery is swallowed, several types of injury can occur. Batteries lodged in the esophagus can burn the esophagus and cause it to scar and “stricture”, or narrow. Batteries can also burn a hole right through the esophagus, into the airway (trachea) or even into the aorta. A hole in the aorta causes massive hemorrhage which is usually fatal. Batteries placed in the nose or ear can cause permanent damage to these structures, too.

But what causes such serious damage? After a button battery is swallowed, the most important mechanism of injury is generation of an electrical current between the two poles of the battery, through adjacent tissue and tissue fluids. Fluids in the gut are mostly water (H2O), and the electrical current that’s generated causes a hydrolysis reaction. During hydrolysis, one hydrogen atom in each water molecule is lysed or cut away. The hydrogen floats away as gas, and what is left behind is a OH- (hydroxide ion), the simplest form of a base. Hydroxide is an alkaline corrosive substance that can cause chemical burns of the adjacent tissues. As more of this reactive hydroxide is generated, more tissue is damaged. The reaction will not stop until the battery runs out of energy and is no longer able to generate an electrical current.  Another less important cause of injury from a battery is called “pressure necrosis”. It’s from the pressure of having a foreign body stuck in the esophagus. The esophagus is not a rigid “food pipe” as many of us picture it. Instead, it stretches for food and fluids, but there are a few spots where objects tend to get stuck. Unfortunately, it is hard to get something unstuck because the muscle contractions in the area are not strong. Lodged batteries have more time to cause damage from ongoing hydrolysis reactions.

Why is there a bitter coating on button batteries?

Some battery companies have changed their packaging to be difficult to open and/or have added strict warnings or even graphic photos of esophageal injury. Duracell has even coated their size 2016, 2025 and 2032 batteries with a bittering agent (denatonium benzoate, or Bitrex®) to try to stop children from putting batteries in their mouths, and therefore prevent children from swallowing them. There is not enough data yet to know if adding graphic images or bitterants will reduce the number of battery ingestion-related injuries. Despite a number of studies of the efficacy of bittering agents, current evidence suggests that bittering agents don’t work for poison prevention or overdose prevention.

What is the treatment for swallowed button batteries? 

Many researchers have studied serious or fatal battery ingestions to identify potential treatment interventions. Scientists are working on special coatings that can deactivate the battery once it becomes wet.  One such coating was successful in limiting battery conduction in the laboratory, but it has not been adopted by battery manufacturers. 

Current treatment strategies focus on interfering with the conduction of current from the battery through human tissues. For example, some studies have shown that making a barrier between the battery and the tissue can be protective. Giving honey at home, or carafate in a medical setting, can provide a temporary coating around the battery and potentially prevent serious injury.  Based on the dramatic preservation of tissue in one study, and the low risk of giving honey, the current recommendations from the National Capital Poison Center are to give 2 teaspoons (10 mL) of honey by mouth, if the battery was known to be swallowed within the last 12 hours. The child must be greater than 12 months old (honey carries a risk for botulism in children under 12 months old), able to swallow, and the honey must be immediately available (don’t waste time going to the store). Give 2 teaspoons every 10 minutes, for up to 6 doses while you are taking the child to the Emergency Department. Honey is not a substitute for emergency evaluation. 

Are dead button batteries dangerous?

Dead or spent batteries still have enough energy to cause serious damage and even death. In some cases, children have swallowed dead batteries that were left on the counter by a parent or guardian as a reminder to pick up a replacement battery at the store. In other cases, children have taken dead batteries out of garbage cans and swallowed them.  These scenarios highlight the dangers of dead button batteries and reinforce the need for careful disposal of these batteries to prevent children from gaining access to them.

Should you tape batteries to prevent injury?

Two groups of researchers released papers in 2022 looking at wrapping different types of tape around a button battery. The ultimate aim of these studies was to find a way to prevent injury from discarded, spent batteries.   Taping a button battery may make the battery less attractive to children and may limit or stop the battery from conducting a current. 

The first study found that one layer of duct tape or packing tape (the clear type often used to seal boxes) eliminated the conduction of current. The study investigators placed wrapped batteries onto pig esophagus tissue (the esophagus of a pig is very similar to a humans) and there was no tissue damage seen. However, the application of a single layer of masking tape or electrical tape did not significantly stop the conduction of current and resulted in esophageal tissue damage. Wrapping batteries in one layer of tape is typically what is recommended by waste management sites, and the results of this study suggest that this single-layer wrapping practice may not prevent tissue injury after battery ingestion. 

The second research study found that wrapping batteries with two layers of tape - one wrap around horizontally and one wrap around vertically, stopped the conduction of electrical current and prevented esophagus damage for all 6 tapes tested (including Scotch®/clear and Scotch®/Magic tape, masking tape, packing tape/clear, packing tape/brown, black electrical tape). In this study here was no tissue damage and no change in the tissue pH, even when the taped battery was left in the esophagus for 30 days. 

Should you tape batteries before recycling them?

Since double-wrapped taping can substantially limit serious injury from ingestion of discarded batteries, it’s important to know whether taping will interfere with recycling. The second research study mentioned above addressed this question and found that taping batteries will not affect recycling. Additionally, the researchers hypothesized that the tape wrapping may also prevent electrical fires, though this was not studied. 

How do you dispose of batteries?

How to dispose of batteries varies from state to state. Many states allow button batteries to be thrown in the trash, while some offer recycling or other safe disposal methods. Encasing a button battery in two layers of household tape is easy to do, does not affect recycling, may prevent trash fires and may save a life or prevent serious injury if the battery is swallowed.

What is Reese’s Law?

On August 16, 2022, Reese’s Law was signed by President Biden, becoming Public Law No 117-171. Under the law, the U.S. Consumer Product Safety Commission is now authorized and required to establish mandatory safety standards for products that contain button batteries and for button battery packaging. Specifically, consumer products containing button batteries must have secure battery compartments to prevent access by children. Further, button battery packaging must meet child-resistant packaging standards. Warning labels will also be required. Reese was 16 months old when she swallowed a lithium coin cell battery from a remote control. She died 6 weeks later.

Pela Soto, PharmD, BSHS Pharmacogenomics, BS Microbiology
Certified Specialist in Poison Information

Poisoned?

Call 1-800-222-1222 or

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Prevention Tips

  • Discard dead batteries promptly. Though these spent batteries may not have enough residual charge to power a device, there’s usually  enough charge to cause damage if swallowed, or put in the nose or ear. 
  • Store unused batteries in secure containers out of reach of children.
  • Most button batteries can be purchased in single package versions (only one battery in a package). Try to buy only what you need. 
  • Do not change batteries in front of children. 
  • Tape button batteries all the way around, twice, before disposing.

This Really Happened

An 18-month-old female was coughing and acting fussy. She also had an episode of vomiting and refused to eat. She was taken to the ED where an x-ray revealed a button battery, more than 20 millimeters in diameter, lodged in the esophagus. The family initially had no idea where it came from, but remembered later that they had thrown such a battery away. 

The battery was removed from her esophagus within 24 hours from the time of ingestion. The esophageal injury from the battery was described as superficial, and it did not affect the entire esophagus.  The child was discharged home with the recommendation to drink nutrition shakes only until her follow up appointment in a few days. The next day she developed a fever and refused the nutrition shakes. She was readmitted to the hospital and underwent a test to see if she had any holes in her esophagus. Fortunately, she did not, and she remained under hospital supervision for the next 3 days. A feeding tube was placed into her stomach to rest her esophagus for the next month. After that time period, she was slowly started back on soft, moist foods by mouth, and then regular foods were introduced over time. Within a few months she was back to eating normally and doing well. 


For More Information

United States Environmental Protection Agency - Used Household Batteries

Call2Recycle - Recycling Laws By State

MIT News - New way to make batteries safer


References

Anfang RR, Jatana KR, Linn RL, Rhoades K, Fry J, Jacobs IN. pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury. Laryngoscope. 2019;129(1):49-57. doi:10.1002/lary.27312

Duracell: How We’re Helping. Child Safety Innovation - Duracell Batteries | AA, AAA, Rechargeable, Coin Button 

Jatana KR, Rhoades K, Milkovich S, Jacobs IN. Basic mechanism of button battery ingestion injuries and novel mitigation strategies after diagnosis and removal. Laryngoscope. 2017 Jun;127(6):1276-1282.

Litovitz T, Whitaker N, Clark L. Preventing battery ingestions: An analysis of 8648 cases. Pediatrics 2010; 125: 1178–83.

Malone JC, R AN. Anatomy, Head and Neck, Swallowing. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.

Mubarak A, Benninga MA, Broekaert I, Dolinsek J, Homan M, Mas E, Miele E, Pienar C, Thapar N, Thomson M, Tzivinikos C, de Ridder L. Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper. J Pediatr Gastroenterol Nutr. 2021 Jul 1;73(1):129-136.

Wolter NE, Wolter JK, James AL, et al. Button battery taping prevents oesophageal injury [published online ahead of print, 2022 Apr 20]. J Paediatr Child Health. 2022;10.1111/jpc.15978. doi:10.1111/jpc.15978

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Discard dead batteries promptly. Though these spent batteries may not have enough residual charge to power a device, there’s usually  enough charge to cause damage if swallowed, or put in the nose or ear. 
  • Store unused batteries in secure containers out of reach of children.
  • Most button batteries can be purchased in single package versions (only one battery in a package). Try to buy only what you need. 
  • Do not change batteries in front of children. 
  • Tape button batteries all the way around, twice, before disposing.

This Really Happened

An 18-month-old female was coughing and acting fussy. She also had an episode of vomiting and refused to eat. She was taken to the ED where an x-ray revealed a button battery, more than 20 millimeters in diameter, lodged in the esophagus. The family initially had no idea where it came from, but remembered later that they had thrown such a battery away. 

The battery was removed from her esophagus within 24 hours from the time of ingestion. The esophageal injury from the battery was described as superficial, and it did not affect the entire esophagus.  The child was discharged home with the recommendation to drink nutrition shakes only until her follow up appointment in a few days. The next day she developed a fever and refused the nutrition shakes. She was readmitted to the hospital and underwent a test to see if she had any holes in her esophagus. Fortunately, she did not, and she remained under hospital supervision for the next 3 days. A feeding tube was placed into her stomach to rest her esophagus for the next month. After that time period, she was slowly started back on soft, moist foods by mouth, and then regular foods were introduced over time. Within a few months she was back to eating normally and doing well.