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Published on: June 20, 2020
Single-Use Laundry Detergent Pack Exposures in Children Under 6 Years: A Prospective Study at U.S. Poison Control
Shan Yin1, Jonathan Colvin1, Alysha Behrman1
1Drug & Poison Information Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Insights
Liquid laundry detergent pack (LLDP) exposures in children decreased significantly, with fewer severe outcomes reported despite increased product use. Safety interventions appear effective in reducing serious poison control center cases.
Area of Science:
- Toxicology
- Public Health
- Consumer Product Safety
Background:
- Single-use liquid laundry detergent packs (LLDPs) have become widespread.
- A prospective observational study was conducted across 12 U.S. poison control centers (PCCs).
Purpose of the Study:
- To evaluate qualitative and quantitative data on LLDP exposures in children under 6 years old.
- To assess clinical effects, outcomes, and contributing factors of LLDP exposures.
- To analyze the impact of manufacturer-led interventions on exposure rates.
Main Methods:
- Analysis of 11,175 childhood LLDP exposures reported between March 2012 and February 2016.
- Detailed case history capture, including demographics, exposure route, and clinical outcomes.
- Trend analysis of reporting rates normalized by consumption data and comparison of pre/post-intervention periods.
Main Results:
- Over 90% of exposures involved children aged 3 years or younger.
- Ingestion (82.6%) and ocular (14.2%) were the primary exposure routes.
- Despite a market increase and rise in total reports, normalized reporting rates decreased by 37%, with significant declines in severe ingestions and ocular exposures.
Conclusions:
- A significant reduction in LLDP exposures leading to major or moderate outcomes was observed.
- The majority of pediatric LLDP exposure cases did not necessitate emergency department intervention.
- Safety initiatives appear to correlate with decreased severe outcomes from LLDP exposures.
Background:
After the widespread introduction of single-use liquid laundry detergent packs (LLDPs), a prospective observational study was initiated among 12 U.S. poison control centers (PCCs), serving 25% of the population.
Objectives:
To evaluate qualitative and quantitative data, including demographics, route of exposure, clinical effects, medical outcome, management site, level of care, and circumstantial variables surrounding the LLDP exposure.
Methods:
Analysis of LLDP exposures involving children (age < 6 years) reported to PCCs participating in the prospective study (March 2012-February 2016). PCCs captured a detailed exposure history and followed each patient to symptom resolution. Each case narrative was reviewed to isolate key patient, product, and situational variables and to verify accuracy of coded data. Trend and comparative analyses were performed on absolute case counts, relative proportions, and reporting rates normalized using Nielsen consumption data. Separately, the impact of exposure reduction interventions introduced by a single manufacturer were assessed by comparing reporting rate during pre-/postintervention periods.
Results:
There were 11,175 childhood exposures reported, with 90.3% involving children aged ≤ 3 years. Ingestion (82.6%) and ocular (14.2%) were the major routes of exposure. The size of the market for LLDPs more than doubled from ∼2.0 to ∼4.6 million LLDPs purchased. Total exposure reports increased from Year 1 (n = 2297) to Year 4 (n = 3206), however, normalized reporting rates dropped by 37% (4.4 to 2.8 exp/million LLDPs purchased). Significant declines (p < 0.0001) were also observed for ingestions and ocular exposures with major/moderate outcome.
Conclusions:
There was a significant reduction in exposures that resulted in major/moderate outcomes, and the majority of patients did not require intervention in an emergency department setting.
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