Preventing Laundry Detergent Pod Toxicity

CLINICAL QUERIES

Preventing laundry detergent pod toxicity

I recently cared for a child who exposures. Fifty-three of these inten- 2. Proctor & Gamble: Product Safety & Compliance. Safety Data Sheet, & Ingredients. 2018. www. was poisoned after biting into a tional adolescent exposures were re- pgproductsafety.com/productsafety. laundry detergent pod. I’ve also ported in 2017. In the first 2 months 3. American Association of Poison Control Centers heard that some teenagers have of 2018, 196 adolescents intention- (AAPCC). Keep highly concentrated packets of laundry detergent locked up and out of the reach of been harmed by doing the same ally exposed themselves to laundry kids. https://aapcc.s3.amazonaws.com/pdfs/topics/ thing intentionally. What makes pods.7,10 Laundry_packet_factsheet_5.2012.pdf. these pods so attractive—and This increase in adolescent expo- 4. AAPCC. Annual Reports for Years 2012-2016. www.aapcc.org/annual-reports. dangerous?—R.B., COLO. sures has been attributed to social 5. Valdez AL, Casavant MJ, Spiller HA, Chounthirath media platforms on the Internet T, Xiang H, Smith GA. Pediatric exposure to laundry M. Thomas Quail, MS Ed, RN, LNC, promoting the so-called “Tide Pod detergent pods. Pediatrics. 2014;134(6):1127-1135. 6. Centers for Disease Control and Prevention. replies: Laundry detergent pods are Challenge,” which encourages ado- Health hazards associated with laundry detergent single-use products containing pre- lescents to bite or ingest a pod, pods—United States, May-June 2012. MMWR measured ultraconcentrated liquid video the associated effects, and post Morb Mortal Wkly Rep. 2012;61(41):825-829. 7. AAPCC. Intentional exposures among teens to detergent encased in a water-soluble the videos over social media plat- single-load laundry packets. 2018. www.aapcc.org/ packet.1,2 The detergent accounts for forms.5,6,9 The AAPCC, CDC, Con- alerts/intentional-exposures-among-teens-single- 90% of the pod; the remaining 10% sumer Product Safety Commission, load-laun. 8. AAPCC. Laundry Detergent Packets (unit dose is water. Because these multicolored and state poison control centers have liquid) Data. December 31, 2017. https://aapcc. pods resemble candy, toys, or teeth- all issued warnings against this dan- s3.amazonaws.com/fi les/library/Laundry_Pack_ Web_Data_through_12.2017_z2dtIpf.pdf. ing products, some children have gerous practice, calling it an emerg- 9. AAPCC. Position statement on single-load liquid 6,9,10,13 bitten into or ingested them acciden- ing public health concern. laundry packets. 2018. https://aapcc.s3.amazonaws. tally.3-6 Ingestion or other exposure to Proctor & Gamble (PG), the manu- com/fi les/library/AAPCC_Laundry_Packet_Position_ Statement.pdf. the pod’s contents can cause poten- facturer of Tide products, has issued 10. AAPCC. HIGH ALERT: intentional exposures tially serious adverse reactions such multiple consumer alerts over various among teens to single-load laundry packets con- as vomiting, aspiration, cardiac dys- media platforms and has promoted tinue to rise. AAPCC News Release. January 22, 2018. https://aapcc.s3.amazonaws.com/pdfs/ rhythmias, pulmonary edema, respi- public service announcements de- releases/Laundry_Packets_High_Alert.pdf. ratory distress, dermal and ocular nouncing the Tide Pod Challenge and 11. O’Donnell KA. Pediatric toxicology: household 1,6,10 product ingestions. Pediatr Ann. 2017;46(12): caustic burns, seizures, and alterations warning of its dangers. Recently e449-e453. in level of consciousness including PG added a bittering agent to the 12. Russell JL, Wiles DA, Kenney B, Spiller HA. coma.1-13 Two pod-related fatalities pods to dissuade people from ingest- Signifi cant chemical burns associated with dermal 3-6 exposure to laundry pod detergent. J Med Toxicol. have been reported in toddlers. ing them. They’ve also partnered with 2014;10(3):292-294. The American Association of Poi- Facebook and YouTube to remove 13. Morran C. CPSC issues safety alert on detergent son Control Centers (AAPCC) re- Tide Pod Challenge posts because pods. 2012. https://consumerist.com/2012/11/20/ cpsc-issues-safety-alert-on-detergent-pods. ports that toddler exposure to all such posts encourage behavior that poisonous substances constitutes may lead to injury or death.1,6,7 Author’s Disclaimer: This article references Proctor over 45% of its annual U.S. call vol- If anyone has ingested or is sus- & Gamble Tide laundry products; however, the author ume. AAPCC defines an exposure as pected of ingesting a pod, immedi- is aware of other manufacturers of laundry detergent pods and automatic dishwashing pods whose ingredi- contact with a substance by way of ately contact the National Poison ents are just as dangerous when used inappropriately. As described in this article, Proctor & Gamble has ingestion, inhalation, dermal or ocu- Help Hotline at 1-800-222-1222 been proactive in addressing the Tide Pod Challenge. lar contact, or other means. Not all for treatment guidelines from a exposures are poisonings or consid- poison control center expert. For M. Thomas Quail is the clinical coordinator for the Massachusetts Department of Public Health, ered an overdose.7 From 2013 to more information, go to www. Bureau of Environmental Health, in Boston, Mass. This article is Mr. Quail’s own work and doesn’t 2017, annual laundry pod exposures poison.org. ■ represent the opinions of the Massachusetts Department of Public Health or the Commonwealth have ranged from 10,145 to 12,616 of Massachusetts. 8,9 cases. REFERENCES Besides these accidental exposures, 1. Beuhler MC, Gala PK, Wolfe HA, Meaney PA, The author has disclosed no fi nancial relationships Henretig FM. Laundry detergent “Pod” ingestions: related to this article. the AAPCC reports a dramatic annual a case series and discussion of recent literature. increase in intentional adolescent pod Pediatr Emerg Care. 2013;29(6):743-747. DOI-10.1097/01.NURSE.0000531886.37396.ac

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