Single-Use Laundry Detergent Pack Exposures in Children Under 6 Years: A Prospective Study at U.S. Poison Control Centers

Yin, Shengyan; Colvin, Jonathan; Behrman, Alysha

doi:10.1016/j.jemermed.2018.05.016

Cited by 12 publications

(12 citation statements)

References 22 publications

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“…In our study, ocular exposure produced more serious (PSS ! 2) features compared with other exposure routes, which is a similar finding to a recent North American study [8]. Conjunctivitis/eye irritation was the most common ocular feature, though there were 21 (3.4%) cases of corneal damage/keratitis in our study, which in one patient, was still present 9 d following exposure.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 53%

“…Endoscopic examination was undertaken less commonly in our study than in a North American study (0.2% versus 1%) [8]. However, Yin et al [8] found that almost all (96%) endoscopic examinations were unremarkable or revealed only minor injury. Vohra et al [9] reported esophageal or gastric lesions in 59% (13 of 22) of endoscopies conducted in those exposed to these detergents, but they did not describe the endoscopic findings or their severity.…”

Section: Discussioncontrasting

confidence: 53%

“…However, it is not known whether the number of exposures was decreasing anyway prior to these changes, as accurate data from earlier years are not available. In addition, data from the US and Canada for a single manufacturer's branded product demonstrated a reduction in pediatric exposures reported to 12 US Poison Control Centers when normalized to sales (4.5-3.2 cases per million units sold) following implementation of manufacturing changes similar to the voluntary changes in the UK [8]. These changes included enhanced warning icons and alterations to the container to make them more child-impeding.…”

Section: Discussionmentioning

confidence: 99%

“…The toxicity of liquid laundry detergent capsules has been reported previously by us [1,2] and others [3][4][5][6][7][8][9][10]. Following concerns over the number of pediatric exposures to liquid laundry detergent capsules, all leading manufacturers within Europe voluntarily changed their packaging with the aim of reducing the number of accidental exposures.…”

Section: Introductionmentioning

confidence: 96%

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A review of 4652 exposures to liquid laundry detergent capsules reported to the United Kingdom National Poisons Information Service 2008–2018

Day

Bradberry

Jackson

et al. 2019

Clinical Toxicology

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Introduction: Liquid laundry detergent capsules contain concentrated liquid laundry detergent in a water-soluble polyvinyl alcohol membrane. Objective: To review 4652 exposures reported to the United Kingdom National Poisons Information Service (NPIS) and to assess the impact of regulatory changes on potential toxicity. Methods: Telephone enquiries to the NPIS and returned questionnaires for these products were analyzed for the period January 2008 to December 2018. Results: Data on 4652 exposures were reported by telephone or questionnaire, of which 95.4% involved children aged 5 years. Overall, 1738 of 4594 patients remained asymptomatic (Poisoning Severity Score [PSS] 0), 2729 developed minor (PSS 1) features, 107 suffered moderate features (PSS 2), 19 were graded as severe (PSS 3) and one died. Ingestion was involved in most exposures (n ¼ 4175): vomiting occurred in 46.5%, coughing occurred in 4.3% and central nervous system depression in 3.2%. Nine (0.2%) children were intubated and ventilated. The eye was exposed in 646 cases: 371 (59.8%) suffered conjunctivitis or eye irritation and 21 (3.4%) had keratitis/corneal damage, which persisted in one patient for 9 d. The skin was involved in 364 cases; in 127 (35.5%) minor dermal features developed including erythema, irritation and rash. The most commonly reported features in the 127 cases with PSS !2 were vomiting (n ¼ 75), stridor (n ¼ 34), CNS depression (n ¼ 22), keratitis/corneal damage (n ¼ 21), coughing (n ¼ 18), conjunctivitis (n ¼ 13), hypersalivation (n ¼ 12), foaming from the mouth (n ¼ 11) and hypoxemia (n ¼ 11). However, respiratory features (stridor, hypoxemia, bronchospasm, respiratory distress, dyspnea, pulmonary aspiration and tachypnea) were the reason for grading 56 of 127 cases as PSS !2. Conclusions: This large data set of 4652 exposures is reassuring in that 97.2% of exposures resulted in no or only minor features, only 107 patients suffered moderate features (PSS 2) and 19 severe (PSS 3) features; one patient died.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 53%