Laundry Detergent Pods Can Be Lethal To Kids

Marcel J Casavant MD FACEP FACMT Chief of Toxicology, Nationwide Children's Hospita Medical Director, Central Ohio Poison Center Clinical Professor, The Ohio State University Colleges of Medicine & Pharmacy Columbus OH USA 43205-2696MedicalResearch.com Interview with:
Marcel J Casavant MD FACEP FACMT

Chief of Toxicology, Nationwide Children’s Hospita
Medical Director, Central Ohio Poison Center
Clinical Professor, The Ohio State University Colleges of Medicine & Pharmacy
Columbus OH USA 43205-2696

Medical Research: What is the background for this study? What are the main findings? 

Dr. Casavant: Laundry detergent pods reached the US market shelves in early 2012; almost immediately parents started calling poison control centers about their children’s exposures to these products. Since then the CDC, the CPSC, the American Association of Poison Centers, and others have issued warnings about these products. Several papers and numerous abstracts have described injuries to various groups of children; we therefore chose to analyze and describe what happened to all US children with exposure to one of these products reported to a poison control center in 2012 and 2013. The main finding: these products are dangerous to children! Over those two years we found more than 17,000 young children exposed to pods, more than 6,000 seen in an emergency department, more than 700 admitted to a hospital, and among these, more than half required intensive care. Two young children died, both in 2013. Our study was published online on November 10, 2014 (http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Laundry-Detergent-Pods-Can-Be-a-Serious-Poisoning-Risk-in-Children.aspx) and will appear in the December 2014 print edition of Pediatrics (volume 134 number 6).

Medical Research: What should clinicians and patients take away from your report?

Dr. Casavant: Clinicians need to take seriously every one of these exposures. Exposure to traditional laundry detergent powder or liquid is generally a benign event, especially an exploratory exposure by a young child. Exposure to the laundry detergent pods, however, is potentially life-threatening event two children died due to exposure to laundry pods. Many of the children in our study were sent to the ED for evaluation of significant symptoms, and when children needed to be admitted to hospital, more than half required the critical care unit. Breathing trouble, vomiting, and CNS depression were common findings.

Parents need to be extra vigilant with these laundry detergent pod products. Really, parents of young children should stick to the traditional laundry detergent liquids or powders; the extra convenience of the pods comes at a very high price of danger to children. If parents choose to have these laundry pods in their home, the pods should be stored both out of sight and out of reach of children. However, this is not enough. Many children in our study were poisoned when the parent had removed a pod from the package while doing the laundry. In the process of loading the washer a good parent can be distracted just long enough for a “helping” child to grab the pod from the countertop.

Medical Research: What should parents do if a child gets into a pod?

Dr. Casavant: Many of these children will require an emergency department visit; of these some will require hospital admission. The best thing for a parent or caregiver to do is to immediately call the local poison control center. In the USA, we all share the same telephone number: 1-800-222-1222. That call will immediately put the parent in touch with a nurse, pharmacist, or physician who is skilled at assessing all sorts of poison exposures and providing free, confidential, immediate, expert advice.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Casavant: The most important research needed here is for manufacturers to find safer chemicals for doing the laundry, safer pods which make it more difficult for children (and adults – though we didn’t include them in this study) to be poisoned, safer packaging so fewer children can access the pods. After an exposure to one of these pods has occurred, the emergency physician can usually determine which patients need endotracheal intubation (due to airway or lung injury, or for airway protection after CNS depression), hospital observation, or critical care unit admission, but we need more research into the role and timing of interventions including endoscopy and bronchoscopy. On a cellular and tissue level, it’s not yet clear which specific ingredients of these pods are causing the various clinical effects, such as the coma and intracranial bleeding, but also the extent of tissue injury.

Citation:

Pediatric Exposure to Laundry Detergent Pods

Amanda L. Valdez, Marcel J. Casavant, Henry A. Spiller, Thiphalak Chounthirath, Huiyun Xiang, and Gary A. Smith

Pediatrics peds.2014-0057; published ahead of print November 10, 2014, doi:10.1542/peds.2014-0057