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Published on: May 13, 2020
Airway compromise in children exposed to single-use laundry detergent pods: a poison center observational case series
Paul E Stromberg1, Michele H Burt2, S Rutherfoord Rose1
1Division of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA; Virginia Poison Center, Richmond, VA; Department of Emergency Medicine, VCU Medical Center, Richmond, VA.
Insights
Laundry detergent pods (LDPs) can cause serious harm, especially in young children. Accidental exposures, particularly ingestion, may lead to airway compromise and central nervous system depression, requiring prompt medical attention.
Area of Science:
- Toxicology
- Pediatric Emergency Medicine
- Consumer Product Safety
Background:
- Single-use laundry detergent pods (LDPs) have been available since 2001 in Europe and 2010 in the US.
- Previous case reports indicated potential for serious adverse effects including vomiting, ocular and respiratory issues, and central nervous system depression.
- This study summarizes clinical outcomes from unintentional LDP exposures reported to a poison control center.
Purpose of the Study:
- To summarize the clinical effects of unintentional exposures to laundry detergent pods.
- To identify the most common routes of exposure and associated symptoms.
- To inform healthcare providers about the potential toxicity of LDPs, particularly in pediatric populations.
Main Methods:
- A 15-month period of poison center records (January 2012 to April 2013) was retrospectively reviewed.
- Electronic records were searched using product and generic codes for laundry pod exposures.
- Clinical effects were abstracted and summarized using descriptive statistics.
Main Results:
- 131 cases were identified, predominantly in toddlers (median age 2.0 years).
- Ingestion was the most common exposure route (120 cases), with 34% requiring hospital evaluation and 9 pediatric admissions.
- Admitted children frequently experienced emesis (78%), upper airway effects (56%), and central nervous system depression (22%), with 67% requiring intubation.
Conclusions:
- Laundry detergent pod exposure can result in significant toxicity, particularly in infants and toddlers.
- Clinicians must be aware of the potential for airway compromise following LDP exposure, which may be more severe than with traditional detergents.
- Prompt medical evaluation and management are crucial for children with suspected LDP exposure.
Introduction:
Single-use laundry detergent pods (LDPs) were introduced to the United States in 2010 but had been available in Europe as early as 2001. Case reports of unintentional exposures noted vomiting, ocular injuries, respiratory depression, and central nervous system depression. We summarize clinical effects from unintentional LDP exposures reported to a single poison center over 15 months.
Methods:
Electronic poison center records were searched using verbatim field and both product and generic codes to identify laundry pod exposures from January 1, 2012, through April 9, 2013. Clinical effects were abstracted to a database and summarized using descriptive statistics.
Results:
We identified 131 cases between March 2012 and April 2013. Median (interquartile range) age was 2.0 (1.5) years with 4 adult cases; all were coded as unintentional. The most common route was ingestion (120) followed by ocular (14) and dermal (6). Some patients had multiple routes of exposure. Of ingestion exposures, 79 (66%) were managed at home; and 41 (34%) were evaluated in a hospital, of which 9 patients were admitted. The median (interquartile range) age of admitted patients was 1.4 (1.1) years. Relevant findings in these admitted children included emesis (78%), central nervous system depression (22%), upper airway effects (56%), lower respiratory symptoms (33%), seizure (n = 1), and intubation (67%). One child with emesis initially managed at home was subsequently intubated for respiratory distress.
Discussion:
Exposure to LDP can cause significant toxicity, particularly in infants and toddlers. Compared to traditional detergents, clinicians should be aware of the potential for airway compromise following exposure to LDP.
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