ÎÚÑ»´«Ã½

The following statement was developed by the ÎÚÑ»´«Ã½ (ACS) Committee on Trauma (COT) Injury Prevention and Control Committee to educate surgeons and other healthcare professionals on the significance of lithium battery-related injuries. The ÎÚÑ»´«Ã½Board of Regents approved the statement at its June 2017 meeting in Chicago.

The ÎÚÑ»´«Ã½recognizes the following facts:

• Lithium ion batteries differ from other batteries in that they contain flammable organic solvents, such as ethylene carbonate and ethyl methyl carbonate.¹
• When lithium batteries short-circuit, they are at risk of causing a fire.
• Causes of short-circuits include, but are not restricted to, the following:¹
  • Manufacturing process problems (micrometer-sized metal particle accumulation and short circuiting)
  • Overcharging a battery
  • Exposure to high voltage (wrong charger/failed charger)
  • Damage to the battery
• Mechanical failure rate of lithium batteries is 1 in 10 million.
• Approximately 4 billion are manufactured annually.
• Lithium battery incidents have occurred in smartphones, e-cigarettes, laptop computers, hoverboards, and electric cars powered by lithium batteries.²
• The U.S. Consumer Product Safety Commission has recalled millions of devices due to lithium battery safety issues, including hoverboards and laptops.
• The Federal Aviation Administration has banned selected electronic devices from airplanes.³
• Reported e-cigarette injuries are rising and include burn injury, face fractures, head injury, mouth trauma, and tooth loss.^4-12

The ÎÚÑ»´«Ã½supports efforts to promote, enact, and sustain legislation and policies that encourage the following:

• Manufacturing a lithium battery that does not use a flammable solvent
• Promoting safe manufacturing processes for lithium batteries
• Supporting regulations that ensure safe use and storage of lithium battery products
• Reporting and tracking injuries due to lithium battery injuries in a national database to further inform epidemiology and prevention efforts

References

1. Mikolajczak C, Kahn M, White K, Long RT. Lithium-Ion Batteries Hazard and Use Assessment. Fire Protection Research Foundation. July 2011. Available at: . Accessed August 25, 2017.
2. Battery University. Lithium-ion safety concerns. Available at: . Accessed August 25, 2017.
3. U.S. Consumer Product Safety Commission. Press statement from the U.S. Consumer Product Safety Commission regarding the Samsung Galaxy Note 7. Available at: . Accessed August 25, 2017.
4. Bohr S, Almarzouqi F, Pallua N. Extensive burn injury caused by fundamental electronic cigarette design flaw. Ann Burns Fire Disasters. 2016;29(3):231-233.
5. Jiwani AZ, Williams JF, Rizzo JA, Chung KK, King BT, Cancio LC. Thermal injury patterns associated with electronic cigarettes. Int J Burns Trauma. 2017;7(1):1-5.
6. Sheckter C, Chattopadhyay A, Paro J, Karanas Y. Burns resulting from spontaneous combustion of electronic cigarettes: A case series. Burns Trauma. 2016. Available at: . Accessed August 21, 2017.
7. Archambeau BA, Young S, Lee C. E-cigarette blast injury: Complex facial fractures and pneumocephalus. West J Emerg Med. 2016;17(6):805-807.
8. Harrison R, Hicklin D Jr. Electronic cigarette explosions involving the oral cavity. J Am Dent Assoc. 2016;147(11):891-896.
9. Anderson H, Richie C, Bernard A. A surprisingly volatile smoking alternative: Explosion and burns as risks of e-cigarette use. J Burn Care Res. October 12, 2016 [Epub ahead of print].
10. Brownson EG, Thompson CM, Goldsberry S, et al. Explosion injuries from e-cigarettes. N Engl J Med. 2016;375(14):1400-1402.
11. Meernik C, Williams FN, Cairns BA, Grant EJ, Goldstein AO. Burns from e-cigarettes and other electronic nicotine delivery systems. BMJ. 2016;354:i5024.
12. Rogér JM, Abayon M, Elad S, Kolokythas A. Oral trauma and tooth avulsion following explosion of e-cigarette. J Oral Maxillofac Surg. 2016;74(6):1181-1185.