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Water bead-related emergency room visits increased nearly 131% in 1 year

Of the total patient data analyzed in the study, each child under 5 that had been admitted to the ER because of water beads did so because they ingested the products.
A child plays with water beads.
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Water bead-related emergency room visits increased more than 130% over the course of one year, and most cases involved children, a new study found.

Water beads are absorbent, often colorful balls made of polymer that can grow 100 times their original size when exposed to water, according to the U.S. Consumer Product Safety Commission. And although they may look harmless — "almost like candy," CPSC says — they can cause internal injuries and even death when they expand after being ingested. Plus, some contain the known carcinogen acrylamide.

In the new study published in the American Journal of Emergency Medicine, researchers from the Center for Injury Research and Policy and Central Ohio Poison Center at Ohio's Nationwide Children's Hospital say that although there have been product recalls and safety standards set related to water bead issues in recent years, rapidly increasing rates of emergency department visits related to the product, particularly during the study's last two years, show the current prevention strategies are not enough.

"Regardless of the intended user or marketing strategy used, a water bead that becomes accessible to a child has the same high-risk characteristics and potential harms. This underscores the need for a more comprehensive regulatory approach," said Dr. Gary Smith, senior author of the study and the center's director.

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From 2007 to 2022, the researchers involved in the study found an estimated 8,159 patients under the age of 20 visited an ER because of water beads, and 55% of the patients were under the age of 5.

Overall, about 46% of the admitted cases were due to ingestion, while others inserted the beads into their ears or nose or suffered an eye injury. But for the patients under 5, each ER visit involved the ingestion of a water bead.

Because of their expanding abilities, Dr. Smith said water beads pose a "unique increased risk of harm" to kids along with being difficult to detect with an X-ray. He notes that although a recent toy safety standard, ASTM F963, has limited the size of water beads to the narrowest part of an 18-month-old's gastrointestinal tract, that doesn't account for the serious outcomes the beads have caused younger kids.

"To be successful, revisions of the ASTM F693 standard and other policy efforts should focus on the primary characteristic of water beads that makes them hazardous, which is their expanding nature," Dr. Smith said.

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In May 2024, three U.S. senators introduced Esther's Law, named after 10-month-old Esther Jo Bethard who died after swallowing a water bead. The bill, which has yet to be voted on, would ban water beads that can expand by 50% or higher with liquid and would require the CPSC to ban water bead products that are marketed as toys.

The CPSC already urges parents and guardians to take any water beads out of an environment in which there are children. And retailers like Target, Walmart and Amazon have acted to remove the dangerous products from their shelves.

But until regulations are in place, the researchers of the study say it's imperative to be aware of what's inside your child's toys and to ensure any with water beads are nowhere close.

"Many parents are not aware that water beads can be harmful to children,” said Dr. Marcel Casavant, co-author of the study. "If children younger than six years or with developmental delays live in or visit your home, keep water beads out of your home and talk with your childcare directors, preschool teachers, therapists and others who may be using water beads with young children."