The perils of poison

It’s vital for parents, carers and community practitioners (CPs) to be aware of the potential hazards for children when it comes to wrongly consumed objects: choking on small objects, accidental poisoning from hazardous substances and internal injuries from ingesting magnets or button batteries. Ultimately, ingestions can cause death. In fact, children under five are among those most at risk from an accident in the home. Yet the prevention measures for many types of ingestion injury are often the same.

Beware button batteries

The Safe and Secure campaign from the Royal Society for the Prevention of Accidents (RoSPA) aims to reduce the number of incidents involving the ingestion of button batteries by children. It was launched in conjunction with the Nil by Mouth safety campaign from the Office for Product Safety and Standards (OPSS) in March 2022.

Button batteries – also known as button cell batteries or coin batteries – are small, flat circular batteries that are used to power many objects, such as watches, electronic toys, LED lights, key fobs and remote controls. They come in various sizes, but most are 1cm to 2cm in diameter. This means that they are of a similar size and shape to some sweets and can easily be swallowed.

These batteries have the potential to seriously harm or prove fatal if swallowed. When combined with saliva, the electrical current from the battery produces caustic soda that can burn through the throat or stomach and can cause damage to other internal organs.

The main symptom to look out for is vomiting fresh, bright red blood (Great Ormond Street Hospital NHS Foundation Trust, 2018). This requires immediate medical help. Other signs can include children suddenly developing a cough, gag or drooling a lot; appearing to have a stomach upset or a virus; being sick; pointing to their throat or stomach; having a pain in their tummy, chest or throat; being lethargic, quieter or more clingy than usual or otherwise ‘not themselves’; and not wanting/being unable to eat solid food.

If it is suspected that a child has swallowed a button battery, they should be taken to the nearest A&E department immediately.

So how can the risk be reduced? CPs should advise parents and carers to look around them for items containing button batteries. Although toys are legally required to have lockable compartments, checks should be made to ensure that they are secure. Other products are not legally required to have lockable compartments, so these items should be moved out of reach and sight of young children. Toys and other equipment should only be bought from reliable sources as they are more likely to have passed safety regulations.

Care should be taken when changing batteries to make sure the compartment is secured afterwards and the old battery is kept out of reach of children until it can be disposed of safely. New batteries should be kept in their original blister packaging, preferably out of reach or in a locked cupboard.

Stay alert to magnets

The NHS issued a patient safety alert in 2021 after revealing that at least 65 children had been admitted to hospital for urgent surgery in the previous three years after swallowing magnets (NHS, 2021). Product safety alerts have also been issued by the OPSS (2021).

High-strength magnets can be found in toys, puzzles and some craft and fashion items, and can cause horrific damage to the body if swallowed.

During 2022 RoSPA partnered with the OPSS to launch #SafeFashion, a campaign that aims to raise awareness of the dangers of magnets when used as fake tongue or face piercings and jewellery.

Instances where the magnets have detached and been swallowed have led to the need for surgery and can cause serious infections, lifelong digestive disorders or even death. When two or more of the small ball magnets are swallowed, they can stick together, causing damage to the digestive system. A magnet in one loop of the bowel will be attracted to another in a different loop and pull the two together. This traps parts of the digestive system, cutting off blood flow and rapidly killing intestinal tissue.

The biggest problem is that people just don’t know how dangerous magnets are, so it’s crucial that the safety message reaches parents, carers, CPs and young people themselves.

The symptoms of someone swallowing magnets are similar to those with button batteries: stomach pain, nausea or vomiting, and the person may not be able to keep down fluids. If you suspect that someone may have swallowed magnets, take them straight to A&E or call an ambulance.

‘The biggest problem is that people just don’t know how dangerous magnets are’

All products containing high-strength magnets should be kept out of reach of young children, and older children should be made aware of the dangers.

Supervision key to prevent poisoning

Hospital admissions data reveals that, on average, 10 children under five are admitted to hospital each day because of suspected poisoning in England alone (Office for Health Improvement and Disparities, 2023).

As ever, supervision is one of the best ways to prevent this kind of accident. However, the following steps can also help to keep children safe:

• All household chemicals – including liquid laundry capsules – should be kept out of the sight and reach of children, preferably high up in a locked cupboard
• Cupboard latches should be used to keep small children away from potentially dangerous products
• Household cleaning chemicals should be kept in their original containers
• Lids should be replaced, and all products put away immediately after use
• Unwanted household cleaning products should be disposed of safely
• All medication should be stored in a lockable cupboard out of reach of children
• If it is believed that a child has accidentally ingested medication or household chemicals then medical treatment should be sought immediately.

Through its Take Action Today, Put Them Away campaign launched back in 2013, RoSPA has worked with the cleaning products industry and local practitioners to highlight how children can be kept safe from the dangers of household cleaning products. The programme has been delivered across 80 local authority areas of the UK, and CPs working with their local communities to share the key safety messages with families have been a vital part of its success.

Ashley Martin is public health adviser and policy lead for home and product safety for RoSPA.

Resources

RoSPA’s Safe and Secure campaign rospa.com/safe-and-secure

The #SafeFashion campaign rospa.com/safe-fashion

RoSPA’s child safety resource hub, with advice on keeping children safe in all areas, both at home and out and about rospa.com/keeping-kids-safe

Take Action Today, Put Them Away rospa.com/home-safety/advice/household-cleaning-products

References

Great Ormond Street Hospital NHS Foundation Trust. (2018) Button batteries – using them safely. See: gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/button-batteries-using-them-safely/ (accessed 16 February 2023)

NHS England. (2021) National patient safety alert – urgent assessment/treatment following ingestion of ‘super strong’ magnets. See: england.nhs.uk/publication/national-patient-safety-alert-urgent-assessment-treatment-following-ingestion-of-super-strong-magnets/ (accessed 3 February 2023).

Office for Health Improvement and Disparities. (2023) Public health profiles. See: https://fingertips.phe.org.uk/search/poisoning (accessed 3 February 2023).

Office for Product Safety and Standards. (2021) UK safety alert issued for small high-powered magnetic products. See: gov.uk/government/news/uk-safety-alert-issued-for-small-high-powered-magnetic-products (accessed 3 February 2023).

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