Laundry detergent packet exposures decreased modestly among young children after voluntary safety standards were introduced, but researchers say they still are too high.
The packets, first sold in the U.S. in 2012, are more toxic than traditional detergent and can cause central nervous system issues, respiratory depression, eye burns and death.
In 2015, standards creation group ASTM International developed voluntary safety standards targeting children under 6, the age group most at risk of mistaking the packets for toys or candy. The standards included making the packaging child resistant, making the individual packets stronger and bitter tasting, and adding warning labels.
To gauge the effectiveness, researchers led by the Research Institute at Nationwide Children’s Hospital analyzed 2012-’17 data from the National Poison Data System covering all ages.
They found 72,947 exposures during that time, about 73% of which were ingestion, 12% multiple routes including ingestion and 11% via the eyes, according to “Safety Interventions and Liquid Laundry Detergent Packet Exposures,” (Gaw CE, et al. Pediatrics. June 3, 2019, https://doi.org/10.1542/peds.2018-3117).
Nearly 92% of exposures occurred among children under 6 years, of which 6.4% resulted in serious medical outcomes. Two young children died along with six adults who had a history of dementia, Alzheimer’s disease or developmental disability.
From 2012-’15, the exposure rate for children under 6 years increased 112% from 263 to 558 per million. It then decreased 18% to 457 per million following the introduction of the voluntary standards. For those 6 and older, the exposure rate increased 277% over the study period from 1.5 to 5.5 per million.
Authors attributed the decrease among young children to the safety standards targeting this group and the public information campaigns launched by the AAP and others, although they noted a major manufacturer of the packets had implemented some of the safety measures several years prior.
In both age groups, the percentage of those exposed who used a health care facility, were admitted to the hospital or experienced serious medical outcomes decreased from 2012-’17. This may be due to prevention efforts or changes in the way health care providers responded, authors wrote. They could not say whether manufacturers have changed their formulas.
While exposures among young children have decreased, the improvements were not as dramatic as those seen after the implementation of the Poison Prevention Packaging Act (PPPA) of 1970 that required certain toxic products to have child-resistant packaging. To further reduce exposure, authors suggested applying PPPA standards to the detergent packaging. They also recommended revising ASTM standards to make individual detergent packets child resistant.
In addition, they called on pediatricians to continue educating families about the dangers of the packets and importance of safe storage practices. The AAP recommends not letting children handle the packets. The detergent should be kept sealed in its original container in a locked cabinet that children can’t access.
To report an exposure to a poison center, call 1-800-222-1222.