(NEW YORK) — The number of emergency room visits by children due to water pearls increased by more than 130% in one year, according to a new study published in The American Journal of Emergency Medicine shows.

Water beads are small polymer beads that can expand to 100 to 1,500 times their size when they come into contact with water, according to the National Capital Poison Center.

From 2021 to 2022, an estimated 8,159 emergency room visits by patients under the age of 20 involved water pearls, the study found. In 46 percent of cases, the issue was water pearl ingestion.

Researchers from Ohio and Missouri analyzed data collected between January 1, 2007, and December 31, 2022, and found that children under the age of five were the most common patients treated in emergency departments.

The data showed that in all emergency department visits due to water beads, children under five years of age had swallowed a water bead, while in emergency department visits, patients in other age groups had sustained an eye injury caused by water beads or had a water bead inserted into other areas of the body, including the ear canal or nose.

“The number of emergency department visits by children due to fluid retention is increasing rapidly,” said Dr. Gary Smith, one of the study’s lead authors and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital, in a press release.

“Although swallowing objects or placing them in ears or noses is common in children, water beads pose a particularly increased risk of injury due to their expansion properties and are difficult to detect with X-rays,” Smith said.

Smith and the study’s co-authors called for stricter federal regulation of water beads and a revision of toy safety standards.

In May, three U.S. senators introduced Esther’s Law, a bill that would ban the sale of water beads marketed as toys, require warning labels on water bead packaging, and direct the Consumer Product Safety Commission to consider further water bead regulations. The bill, which has been referred to the Senate Committee on Commerce, Science, and Transportation and has not yet been voted on, is named after the late Esther Jo Bethard, who died in July 2023 at the age of 10 months after swallowing a loose water bead.

Major retailers such as Amazon, Target and Walmart announced that they would stop selling water beads at the end of 2023 due to the risk of injury and death to children.

The CPSC also warned in March that water beads pose two growing risks, along with narcotics, especially to young children. The federal agency recommends removing water beads from all settings where young children are present, not letting children play with them unsupervised, and storing water beads in containers and locations where children cannot easily access them.

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