Tape Button Batteries Before Disposing of Them

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. 

The simple intervention of taping batteries prior to disposal may have saved the life of at least one child. In 2023, a Utah TV station reported the story of a 15-month-boy who swallowed a quarter-sized button battery without anyone knowing. He developed symptoms of vomiting and difficulty swallowing. The toddler was initially treated for an ear infection; however, when his symptoms didn’t improve, an x-ray was performed and revealed a  large, circular, object stuck in his esophagus. The child was sent to have the foreign body removed, and doctors discovered that the circular object was a large button battery with a piece of electrical tape wrapped around it. Though this battery was likely lodged in the toddler’s esophagus for weeks, the injury was not as bad as it could have potentially been. The child underwent multiple surgical procedures to treat burned esophageal tissue, but ultimately survived.

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