Statement on Lithium Batteries

The following statement was developed by the American College of Surgeons (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 ACS Board of Regents approved the statement at its June 2017 meeting in Chicago.

The ACS recognizes 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 ACS supports 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: www.prba.org/wp-content/uploads/Exponent_Report_for_NFPA_-_20111.pdf. Accessed August 25, 2017.
2. Battery University. Lithium-ion safety concerns. Available at: http://batteryuniversity.com/learn/archive/lithium_ion_safety_concerns. 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: www.cpsc.gov/Newsroom/Press-Statements/Press-Statement-from-the-US-Consumer-Product-Safety-Commission-Regarding-the-Samsung-Galaxy-Note7/. 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: www.ncbi.nlm.nih.gov/pmc/articles/PMC5151131/. 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.