A new study shows that emergency room visits due to water droplets have increased by more than 130% over the course of a year, and most cases involved children.

Water beads are absorbent, often colorful balls made of polymer that can expand to 100 times their original size when they come into contact with water, according to the U.S. Consumer Product Safety Commission. And while they may look harmless — “almost like candy,” the CPSC says — they can cause internal injury and even death if they expand after ingestion. 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 the Central Ohio Poison Center at Nationwide Children’s Hospital in Ohio say that while there have been product recalls and safety standards set in recent years related to water bead problems, the rapidly increasing number of product-related emergency room visits, particularly during the last two years of the study, demonstrates that current prevention strategies are not enough.

“Regardless of the intended user or the marketing strategy used, a water bead made available to a child has the same high-risk characteristics and potential dangers. This underscores the need for a more comprehensive regulatory approach,” said Dr. Gary Smith, lead author of the study and director of the center.

RELATED STORY | New data shows that more and more children have to go to the emergency room because they have swallowed small batteries

Researchers involved in the study found that between 2007 and 2022, an estimated 8,159 patients under the age of 20 visited an emergency department for water droplet infections, with 55% of patients under the age of 5.

Overall, about 46% of cases were due to ingestion, while others involved putting the beads in their ears or nose or suffering an eye injury. However, among patients under 5 years of age, every emergency room visit involved swallowing a water bead.

Because of their ability to expand, water beads pose a “uniquely increased risk of injury” to children, says Dr. Smith, and are also difficult to detect with X-rays. He points out that while the new toy safety standard ASTM F963 has limited the size of water beads to the narrowest part of the gastrointestinal tract of an 18-month-old child, this does not take into account the serious consequences the beads have caused in younger children.

“To be successful, revisions to the ASTM F693 standard and other policy efforts should focus on the primary property of water beads that makes them dangerous, namely their expansion,” said Dr. Smith.

RELATED STORY | Cannabis-related emergency room visits increased among children during the pandemic

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 50% or more with liquid and would require the CPSC to ban water bead products marketed as toys.

The CPSC is already urging parents and guardians to remove water beads from environments where children are present, and retailers like Target, Walmart and Amazon have taken action to remove the dangerous products from their shelves.

However, until there are appropriate regulations, according to the study researchers, it is imperative to be aware of what is in your child’s toys and to ensure that no toys with water beads are nearby.

“Many parents are unaware that water beads can be harmful to children,” said Dr. Marcel Casavant, co-author of the study. “If children under the age of six or with developmental delays live in or visit your home, keep water beads out of your home and talk to your daycare directors, preschool teachers, therapists and others who may use water beads with young children.”