Recently, the Journal of Pediatric Gastroenterology and Nutrition released a collection of papers that outlined the potential health hazards of fidget spinners. The authors call for tighter regulation.

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Fidget spinners are becoming increasingly popular, but should we approach with caution?

Keeping your children safe is always your top priority, but we all know that they’re going to suffer the occasional injury — falling out of a tree, falling off their bike, or falling through a window. Children are their own worst enemy.

However, when it comes to toys, we like to think that manufacturers and lawmakers are on our side, ensuring that products are safe to use.

And — generally speaking — toy companies and legislation work hand-in-hand to make sure that age-appropriate toys are safe when they are used correctly.

Sometimes, though, a toy may seem safe initially but, further down the line, safety concerns appear and legislation has to backfill the cracks. This was the case for high-powered magnets a few years ago.

On the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition‘s website, they write, “About half of all children who swallow these super strong magnets will require surgery for removal, and roughly a one third will suffer bowel perforations. Others will suffer severe injury with life-long complications.”

In 2015, new safety standards for high-powered magnets came into force. The number of injuries presenting at emergency rooms dropped significantly.

According to the latest research, fidget spinners may require a similar intervention.

In recent years, no one can have missed the rise of fidget spinners. A simple toy, with three plastic arms that spin around a central bearing, they are sometimes marketed as an anxiety-reducing device for people with attention deficit-hyperactivity disorder (ADHD).

However, there is no research to back up those claims.

Some, though not all, of these fidget spinners come with light emitting diodes, which necessitate button batteries. It is these batteries that present a risk to children’s health.

The first of the papers — which was published recently in the Journal of Pediatric Gastroenterology and Nutrition — was written by Dr. Racha Khalaf, of Children’s Hospital Colorado in Aurora, and Dr. Yoseph Gurevich, of the Steven and Alexandra Cohen Children’s Medical Center in Queens, NY.

They describe two cases of children swallowing batteries from broken fidget spinners: one of a 3-year-old boy, and the other of a 4-year-old girl.

One swallowed the central disk cap of a broken fidget spinner, which included a button battery. The other swallowed a battery that escaped from a damaged disk.

In both cases, the ingestion of lithium batteries caused deep esophageal burns.

When a lithium battery comes into contact with body fluids, it can cause injury very quickly. The boy needed an emergency endoscopy to remove the 1-inch battery. He stayed in hospital for almost 3 weeks due to concerns that a fistula may have developed between the esophagus and aorta (the largest artery).

A fistula is an abnormal connection between two spaces within the body and, in this region, could be life-threatening.

The second of the papers describes injuries caused by ingesting other parts of the fidget spinners that did not include the battery. As with the cases outlined above, the parts were removed by emergency endoscopy.

As the authors write, when fidget spinner discs are swallowed, they “should be presumed to contain a button battery until proven otherwise.”

Lithium batteries are used in a range of household devices, and swallowing them is a recognized health concern. In fact, according to the National Capital Poison Center, in recent years there has been an increase in reported cases — including 36 deaths.

An accompanying commentary — written by Dr. Paul Rufo and Dr. Athos Bousvaros, from Boston Children’s Hospital in Massachusetts — explains what doctors can do if they are presented with these types of incident.

They recommend notifying the United States Consumer Product Safety Commission; only when multiple examples are brought to the commission’s attention will they be spurred into action.

Drs. Rufo and Bousvaros hope that, at the very least, manufacturers of fidget spinners will be required to label their products with an explanatory warning.

In the meantime, the authors suggest that if a toddler presents “with a history of unexplained sudden abdominal or chest pain, the physician should inquire if any fidget spinners are in the home.”

As for consumers and parents, extra vigilance is recommended. Understanding where the danger lies is the first step to preventing it.