Science
Button batteries pose deadly risks to children. Doctors want them to be made safer
The round batteries, small as buttons and shiny as coins, are prized for the energy they pack at their size. In households, they have become commonplace, powering remote controls, hearing aids, toys, electric tea lights, wristwatches, greeting cards that play music and other familiar items.
But doctors warn that such “button batteries” can maim and kill. Pop one into your mouth and swallow — as thousands of children do annually — and they can quickly cause devastating injuries.
A growing number of medical associations is pushing for battery manufacturers to head off the threat by making a new product: A button or “coin cell” battery that will not lead to catastrophic injuries when swallowed.
“The only real solution to the battery problem is to make the battery itself safer,” said Dr. Toby Litovitz, founder of the National Capital Poison Center.
When button batteries are lodged in the body, their electrical current breaks down water, driving up alkalinity to dangerous levels akin to bleach. Bodily tissues can begin to liquefy. Physicians say serious injury can happen within two hours, sometimes before a parent has even realized that a battery was swallowed.
As button batteries have proliferated in common items, the rate of pediatric emergency visits for battery-related injuries has more than doubled in recent decades, according to a study published in the journal Pediatrics. Some children have ended up relying on tubes to breathe or suffered massive hemorrhaging, doctors said.
“Unfortunately, these batteries cause such severe injuries so rapidly,” some of which are impossible for surgeons to repair, said Dr. Kris Jatana, surgical director of clinical outcomes at Nationwide Children’s Hospital in Ohio.
Jatana became alarmed by the risks after caring for a 2-year-old child who ended up needing a tracheostomy to breathe. “It was a moment that motivated me to try to see what we could do to prevent these injuries from happening in the first place.”
Button battery safety
Here are recommendations from Nationwide Children’s Hospital:
Some battery manufacturers have tried adding bitter coating or saliva-activated dye to tip off parents.
Reese’s Law, a federal statute named for a child who died of serious injuries after swallowing a button battery, now requires compartments for such batteries on consumer products to be harder to open and mandates child-resistant packaging for button batteries.
But advocates say more needs to be done. For instance, Litovitz said that harder-to-open packaging would not address the many injuries caused when children swallow batteries left sitting out or discarded. Among those pushing to develop safer batteries is biotech entrepreneur Bryan Laulicht.
“What makes them really great for devices is also what makes them so dangerous when you swallow them,” Laulicht said of button batteries. “They’re powerful enough to split water … which spikes the pH up to Drano levels in a matter of minutes.”
Doctors began raising alarms about the threat decades ago as more children began to suffer grave injuries. One study found that between 1985 and 2009, the percentage of button battery ingestions that led to serious or deadly injuries had risen more than sixfold.
Reese Hamsmith suffered grave injuries after swallowing a button battery and died less than two months later. Her mother, Trista Hamsmith, vowed to do everything she could to prevent other children from suffering the same fate.
(Trista Hamsmith)
Litovitz and other researchers pointed to the rising popularity of the 20-millimeter diameter lithium coin cell battery: Their analysis found that 12.6% of children under the age of 6 who ingested button batteries around that size suffered serious complications or death.
They’re “just the right size to get stuck in the esophagus of a small child, especially a child younger than four years,” Litovitz said in an email. “Further, these lithium coin cells have twice the voltage of other button cells.”
Doctors may not immediately recognize and diagnose the problem if no one realized a battery was swallowed, because the symptoms can initially look like those of other childhood ailments.
The problem has worsened over time: From 2010 through 2019, an average of more than 7,000 children and teens went to emergency rooms annually for injuries related to batteries, according to the Pediatrics study. The rate of such emergency visits had doubled compared with the period of 1990 to 2009.
Button batteries were implicated in the bulk of cases where the battery type was known. Researchers have tallied more than 70 deaths from ingesting button batteries over time, but Litovitz said the true number could be far higher because that figure only includes cases documented in medical research or the media or reported to the National Button Battery Ingestion Hotline, which stopped operating six years ago.
At Children’s Hospital Los Angeles, doctors see roughly one child a month who has been injured by a button battery, said Helen Arbogast, injury prevention program manager in its division of general pediatric surgery. Children are attracted to shiny things and pick up on the attention that adults pay to electronics, she said.
“Remote controls are really fascinating to them — the buttons, the colors — and part of their natural motor skill development is to learn how to open and close things,” Arbogast said.
She stressed that time is critical. “If a parent suspects their child having swallowed a button battery, it’s important to get them to a hospital right away.”
In Texas, Reese Hamsmith awoke one morning in 2020 congested and wheezing. Her mother, Trista Hamsmith, took the toddler to the pediatrician, who suspected croup. It wasn’t until the next day, after a Halloween night when Reese had remained ill, that her mother realized a button battery was missing from their remote control.
Reese Hamsmith suffered grave injuries after swallowing a button battery and died less than two months later.
(Trista Hamsmith)
Reese underwent emergency surgery, but the damage continued even after the battery had been removed, burning a hole through her esophagus and trachea, her mother said. In the weeks that followed, she underwent more surgeries, sedation and intubation. Less than two months after her injury, Reese died.
She was a year and a half old. After she died, “I held her again, and I promised to her that I would do everything I could that no kid would die this way again,” Trista Hamsmith said.
The Lubbock mother started a nonprofit, Reese’s Purpose, that successfully pushed for federal legislation that imposed new requirements for battery compartments, childproof packaging and warning labels. Hamsmith was glad to see those rules go into effect, but rued that such protections had not been put in place earlier.
“It shouldn’t have to take what we went through” to spur action, she said. “It definitely should not have to take someone like me screaming at the world.”
The group is also funding research into a medical device that could detect a swallowed battery without subjecting a child to radiation, which Hamsmith wants to see used whenever a child shows up with possible symptoms. And it worked with Energizer on safety features including a telltale dye that turns blue with saliva.
“The missing ingredient here … has been the ability to alert the caregiver that something has happened,” said Jeffrey Roth, Energizer’s global category leader for batteries and lights. “That’s really what ‘color alert’ does — it gives the caregiver notification that a child might have put something in their mouth that they shouldn’t have.”
Litovitz cautioned, however, that because not all batteries have the blue dye, doctors and parents should not assume that no battery was swallowed if they don’t see that color.
Roth said that in recent years, Energizer has spent tens of millions of dollars on research and other efforts surrounding button battery safety. “We believe that one day we will solve this,” he said. “But it certainly requires a breakthrough innovation.”
Laulicht, cofounder and chief executive of Landsdowne Labs, said his company has been testing an alternative battery with a different kind of casing, intended to shut down inside the body. Tests that involve sandwiching the battery between two pieces of ham do not show the kind of damage inflicted by commercially available button batteries, he said. (Ham is used as a readily available substitute for human gastrointestinal tissue, Laulicht explained.)
One of their challenges has been getting the same level of battery performance with those alterations, Laulicht said. But as a father of young children, “I would rather a battery that only lasted a year on the shelf … but didn’t kill my kid when they swallowed it.”
Science
Pediatricians urge Americans to stick with previous vaccine schedule despite CDC’s changes
For decades, the American Academy of Pediatrics and the U.S. Centers for Disease Control and Prevention spoke with a single voice when advising the nation’s families on when to vaccinate their children.
Since 1995, the two organizations worked together to publish a single vaccine schedule for parents and healthcare providers that clearly laid out which vaccines children should get and exactly when they should get them.
Today, that united front has fractured. This month, the Department of Health and Human Services announced drastic changes to the CDC’s vaccine schedule, slashing the number of diseases that it recommends U.S. children be routinely vaccinated against to 11 from 17. That follows the CDC’s decision last year to reverse its recommendation that all kids get the COVID-19 vaccine.
On Monday, the AAP released its own immunization guidelines, which now look very different from the federal government’s. The organization, which represents most of the nation’s primary care and specialty doctors for children, recommends that children continue to be routinely vaccinated against 18 diseases, just as the CDC did before Robert F. Kennedy Jr. took over the nation’s health agencies.
Endorsed by a dozen medical groups, the AAP schedule is far and away the preferred version for most healthcare practitioners. California’s public health department recommends that families and physicians follow the AAP schedule.
“As there is a lot of confusion going on with the constant new recommendations coming out of the federal government, it is important that we have a stable, trusted, evidence-based immunization schedule to follow and that’s the AAP schedule,” said Dr. Pia Pannaraj, a member of AAP’s infectious disease committee and professor of pediatrics at UC San Diego.
Both schedules recommend that all children be vaccinated against measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV) and varicella (better known as chickenpox).
AAP urges families to also routinely vaccinate their kids against hepatitis A and B, COVID-19, rotavirus, flu, meningococcal disease and respiratory syncytial virus (RSV).
The CDC, on the other hand, now says these shots are optional for most kids, though it still recommends them for those in certain high-risk groups.
The schedules also vary in the recommended timing of certain shots. AAP advises that children get two doses of HPV vaccine starting at ages 9 to12, while the CDC recommends one dose at age 11 or 12. The AAP advocates starting the vaccine sooner, as younger immune systems produce more antibodies. While several recent studies found that a single dose of the vaccine confers as much protection as two, there is no single-dose HPV vaccine licensed in the U.S. yet.
The pediatricians’ group also continues to recommend the long-standing practice of a single shot combining the measles, mumps and rubella (MMR) and varicella vaccines in order to limit the number of jabs children get. In September, a key CDC advisory panel stocked with hand-picked Kennedy appointees recommended that the MMR and varicella vaccines be given as separate shots, a move that confounded public health experts for its seeming lack of scientific basis.
The AAP is one of several medical groups suing HHS. The AAP’s suit describes as “arbitrary and capricious” Kennedy’s alterations to the nation’s vaccine policy, most of which have been made without the thorough scientific review that previously preceded changes.
Days before AAP released its new guidelines, it was hit with a lawsuit from Children’s Health Defense, the anti-vaccine group Kennedy founded and previously led, alleging that its vaccine guidance over the years amounted to a form of racketeering.
The CDC’s efforts to collect the data that typically inform public health policy have noticeably slowed under Kennedy’s leadership at HHS. A review published Monday found that of 82 CDC databases previously updated at least once a month, 38 had unexplained interruptions, with most of those pauses lasting six months or longer. Nearly 90% of the paused databases included vaccination information.
“The evidence is damning: The administration’s anti-vaccine stance has interrupted the reliable flow of the data we need to keep Americans safe from preventable infections,” Dr. Jeanne Marrazzo wrote in an editorial for Annals of Internal Medicine, a scientific journal. Marrazzo, an infectious disease specialist, was fired last year as head of the National Institute of Allergy and Infectious Diseases after speaking out against the administration’s public health policies.
Science
‘We’re not going away’: Rob Caughlan, fierce defender of the coastline and Surfrider leader, dies at the age of 82
Known by friends and colleagues as a “planetary patriot,” a “happy warrior” and the “Golden State Eco-Warrior,” Rob Caughlan, a political operative, savvy public relations specialist and one of the early leaders of the Surfrider Foundation, died at his home in San Mateo, on Jan. 17. He was 82.
His wife of nearly 62 years, Diana, died four days earlier, from lung cancer.
Environmentalists, political operatives and friends responded to his death with grief but also joy as they recalled his passion, talent and sense of humor — and his drive not only to make the world a better place, but to have fun doing it.
“He’d always say that the real winner in a surfing contest was the guy who had the most fun,” said Lennie Roberts, a conservationist in San Mateo County and longtime friend of Caughlan’s. “He was true to that. It’s the way he lived.”
“When he walked into a room, he’d have a big smile on his face. He was a great — a gifted — people person,” said Dan Young, one of the original five founders of the Surfrider Foundation. The organization was cobbled together in the early 1980s by a group of Southern California surfers who felt called to protect the coastline — and their waves.
They also wanted to dispel the stereotype that surfers are lackadaisical stoners — and show the world that surfers could get organized and fight for just causes, said Roberts, citing Caughlan’s 2020 memoir, “The Surfer in the White House and Other Salty Yarns.”
Before joining Surfrider in 1986, Caughlan was a political operative who worked as an environmental adviser in the Carter administration. According to Warner Chabot, an old friend and recently retired executive director of the an Francisco Estuary Institute, Caughlan got his start during the early 1970s when he and his friend, David Oke, formed the Sam Ervin Fan Club, which supported the Southern senator’s efforts to lead the Watergate investigation of President Nixon.
According to Chabot, Caughlan organized the printing of T-shirts with Ervin’s face on them, underneath the text “I Trust Uncle Sam.”
“He was an early social influencer — par extraordinaire,” he said.
Glenn Hening, a surfer, former Jet Propulsion Laboratory space software engineer and another original founder of the Surfrider Foundation, said one of the group’s initial fights was against the city of Malibu, which in the early 1980s was periodically digging up sand in the lagoon right offshore and destroying the waves at one of their favorite surf spots.
According to Hening, it was Caughlin’s unique ability to persuade and charm politicians and donors that put Surfrider’s efforts on the map.
Caughlan served as the foundation’s president from 1986 to 1992.
The foundation grabbed the national spotlight in 1989 when it went after two large paper mills in Humboldt Bay that were discharging toxic wastewater into an excellent surfspot in Northern California. The foundation took aim and in 1991 filed suit alongside the U.S. Environmental Protection Agency; the paper mills settled for $5.8 million.
Hening said the victory would never have happened without Caughlan.
The mills had tried to brush off the suit by offering a donation to the foundation, Hening said. But Caughlan and Mark Massara — an environmental lawyer with the organization — rebuffed the gesture.
“The paper mill guys said, ‘Well, what can we do here? How can we make this go away?’” said Hening, recalling the conversation. “And Rob said, ‘It’s not going to go away. We’re not going away. We’re surfers.”
Roberts said Caughlan’s legacy can be felt by anyone who has ever spent time on the San Mateo County coastline. In the 1980s, the two spearheaded a successful ballot measure still protects the coast from non-agricultural development and ensured access to the beaches and bluffs. It also prohibits onshore oil facilities for off-shore facilities.
The two also worked on a county measure that led to the development of the Devil’s Slide tunnels on Highway 1 between Pacifica and Montara, designed to make that formerly treacherous path safer for travelers.
The state had wanted to build a six-lane highway over the steep hills in the area. “It would have been dangerous because of the steep slopes, and it would be going up into the fog bank and then back down out of the fog. So it was inherently dangerous,” Roberts said.
Chad Nelsen, the current president of the Surfrider Foundation, said he was first drawn into Caughlan’s orbit in 2010 when Surfrider got involved with a lawsuit pertaining to a beach in San Mateo County. Silicon Valley venture capitalist Vinod Khosla purchased 53 acres of Northern California coastline for $32.5 million and closed off access to the public — including a popular stretch known as Martin’s Beach — so Surfrider sued.
Nelsen said that although Caughlan had left the organization about 20 years before, he reappeared with a “sort of unbridled enthusiasm and commitment to the cause,” and the organization ultimately prevailed — the public can once again access the beach “thanks to ‘Birdlegs.’”
Birdlegs was Caughlan’s nickname, and according to Nelsen, it was probably coined in the 1970s by his fellow surfers.
“He had notoriously spindly legs, I guess,” Nelsen said.
Robert Willis Caughlan was born in Alliance, Ohio, on Feb. 27, 1943. His father, who was a parachute instructor with the U.S. Army, died when Caughlan was 4. In 1950, Caughlan moved with his mother and younger brother to San Mateo, where he saw the ocean for the first time.
He rode his his first wave in 1959, at the age of 16, from the breakwater at Half Moon Bay.
Science
LAUSD says Pali High is safe for students to return to after fire. Some parents and experts have concerns
The Los Angeles Unified School District released a litany of test results for the fire-damaged Palisades Charter High School ahead of the planned return of students next week, showing the district’s remediation efforts have removed much of the post-fire contamination.
However, some parents remain concerned with a perceived rush to repopulate the campus. And while experts commended the efforts as one of the most comprehensive post-fire school remediations in modern history, they warned the district failed to test for a key family of air contaminants that can increase cancer risk and cause illness.
“I think they jumped the gun,” said a parent of one Pali High sophomore, who asked not to be named because she feared backlash for her child. “I’m quite angry, and I’m very scared. My kid wants to go back. … I don’t want to give him too much information because he has a lot of anxiety around all of these changes.”
Nevertheless, she still plans to send her child back to school on Tuesday, because she doesn’t want to create yet another disruption to the student’s life. “These are kids that also lived through COVID,” she said.
The 2025 Palisades fire destroyed multiple buildings on Pali High’s campus and deposited soot and ash in others. Following the fire, the school operated virtually for several months and, in mid-April of 2025, moved into a former Sears department store in Santa Monica.
Meanwhile, on campus, the U.S. Environmental Protection Agency and the U.S. Army Corps of Engineers cleared debris from the destroyed structures, and LAUSD hired certified environmental remediation and testing companies to restore the still-standing buildings to a safe condition.
LAUSD serves as the charter school’s landlord and took on post-fire remediation and testing for the school. The decision to move back to the campus was ultimately up to the charter school’s independent leadership.
The Los Angeles Department of Water and Power tested the drinking water for a slew of contaminants, and environmental consultants tested the soil, HVAC systems, indoor air and surfaces including floors, desks and lockers.
They tested for asbestos, toxic metals such as lead and potentially hazardous organic compounds often unleashed through combustion, called volatile organic compounds, or VOCs.
“The school is ready to occupy,” said Carlos Torres, director of LAUSD’s office of environmental health and safety. “This is really the most thorough testing that’s ever been done that I can recall — definitely after a fire.”
Construction workers rebuild the Palisades Charter High School swimming pool.
(Allen J. Schaben / Los Angeles Times)
A handful of soil samples had metal concentrations slightly above typical post-fire cleanup standards, which are designed to protect at-risk individuals over many years of direct exposure to the soil — such as through yard work or playing sports. An analysis by the environmental consultants found the metals did not pose a health risk to students or staff.
On indoor surfaces, the consultants found two areas with lead and one with arsenic, spaces they recleaned and retested to make sure those metals were no longer present.
The testing for contamination in the air, however, has become a matter of debate.
Some experts cautioned that LAUSD’s consultants tested the air for only a handful of mostly non-hazardous VOCs that are typically used to detect smoke from a wildfire that primarily burned plants. While those tests found no contamination, the consultants did not test for a more comprehensive panel of VOCs, including many hazardous contaminants commonly found in the smoke of urban fires that consume homes, cars, paints, detergents and plastics.
The most notorious of the group is benzene, a known carcinogen.
At a Wednesday webinar for parents and students, LAUSD’s consultants defended the decision, arguing their goal was only to determine whether smoke lingered in the air after remediation, not to complete more open-ended testing of hazardous chemicals that may or may not have come from the fire.
Andrew Whelton, a Purdue University professor who researches environmental disasters, didn’t find the explanation sufficient.
“Benzene is known to be released from fire. It is known to be present in air. It is known to be released from ceilings and furniture and other things over time, after the fire is out,” Whelton said. “So, I do not understand why testing for benzene and some of the other fire-related chemicals was not done.”
For Whelton, it’s representative of a larger problem in the burn areas: With no decisive guidance on how to remediate indoor spaces after wildland-urban fires, different consultants are making significantly different decisions about what to test for.
LAUSD released the testing results and remediation reports in lengthy PDFs less than two weeks before students plan to return to campus, while the charter school’s leadership decided on a Jan. 27 return date before testing was completed.
At the webinar, school officials said two buildings near the outdoor pool have not yet been cleared through environmental testing and will remain closed. Four water fixtures are also awaiting final clearance from the Los Angeles Department of Water and Power, and the school’s food services are still awaiting certification from the L.A. County Department of Public Health.
For some parents — even those who are eager to ditch the department store campus — it amounts to a flurried rush to repopulate Pali High’s campus that is straining their decisions about how to keep their kids safe.
Torres stressed that his team acted cautiously in the decision to authorize the school for occupancy, and that promising preliminary testing helped school administrators plan ahead. He also noted that the slow, cautious approach was a point of contention for other parents who hoped their students could return to the campus as quickly as possible.
Experts largely praised LAUSD’s efforts as thorough and comprehensive — with the exception of the VOC air testing.
Remediation personnel power washed the exterior of buildings, wiped down all surfaces and completed thorough vacuuming with filters to remove dangerous substances. Any soft objects such as carpet or clothing that could absorb and hold onto contamination were discarded. The school’s labyrinth of ducts and pipes making up the HVAC system was also thoroughly cleaned.
Crews tested throughout the process to confirm their remediation work was successful and isolated sections of buildings once the work was complete. They then completed another full round of testing to ensure isolated areas were not recontaminated by other work.
Environmental consultants even determined a few smaller buildings could not be effectively decontaminated and consequently had them demolished.
Torres said LAUSD plans to conduct periodic testing to monitor air in the school, and that the district is open to parents’ suggestions.
For Whelton, the good news is that the school could easily complete comprehensive VOC testing within a week, if it wanted to.
“They are very close at giving the school a clean bill of health,” he said. “Going back and conducting this thorough VOC testing … would be the last action that they would need to take to determine whether or not health risks remain for the students, faculty and visitors.”
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