Rising Pediatric Button Battery Injuries Despite Safety Efforts: An Analysis of National Injury Data

Button battery injuries are emergencies associated with airway and esophageal injury. Despite increased public awareness and recent federal safety legislation, the population-level impact on injury trends remains unclear. This study evaluates national trends in pediatric button battery exposures in the postpandemic era.

The National Electronic Injury Surveillance System was queried for button battery-related ingestions and aspirations presenting to a US emergency department (ED) between January 1, 2020 and December 31, 2024. Cases were identified using product codes and narrative review. Demographics, diagnosis, and disposition were analyzed. Trends and categorical differences were assessed using ANOVA and chi-squared testing, with statistical significance set at p < 0.05.

A total of 24,891 pediatric button battery exposures were identified between 2020 and 2024. Annual cases increased from 3785 in 2020 to 6424 in 2024, representing a 70% rise (p < 0.001). When adjusted for the US pediatric population, the rate increased from 5.1 to 8.8 per 100,000 children. Children aged 13-24 months represented the largest proportion of cases (50.5%), and males comprised 59.8%. Hospitalizations increased from 807 to 1148, although the proportion of cases requiring admission declined after peaking in 2021. Hospitalization rates differed by age and race, with older children and Black children more likely to be admitted (p < 0.001).

Despite a declining pediatric population, button battery-related ED visits rose sharply from 2020 to 2024. Although hospitalization rates declined proportionally after 2021, the overall injury burden and healthcare utilization increased. Persistent demographic disparities require continued surveillance, prevention strategies, and equitable access to care.