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Zutrauen S, Cheesman J, McFaull SR. Pediatric injuries and poisonings associated with detergent packets: results from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 2011-2023. Inj Epidemiol 2024; 11:31. [PMID: 38992784 PMCID: PMC11238368 DOI: 10.1186/s40621-024-00513-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 06/18/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Detergent packets are common household products; however, they pose a risk of injuries and poisonings, especially among children. This study examined the epidemiological characteristics of pediatric injuries and poisonings related to all types of detergent packets in Canada using emergency department (ED) data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. METHODS The CHIRPP database was searched for ED visit records for injuries and poisonings related to all types of detergent packets between April 1, 2011 and October 12, 2023 (N = 2,021,814) using variable codes and narratives. Data for individuals aged 17 years and younger were analyzed descriptively. Temporal trends in the number of detergent packet-related injuries and poisonings per 100,000 CHIRPP cases were assessed using Joinpoint regression and annual percent change (APC). A proportion ratio and 95% confidence intervals (CI) were calculated to compare the proportion of detergent packet-related cases in CHIRPP during two 34-months periods, pre-COVID-19 pandemic and after the beginning of the pandemic. RESULTS There were 904 detergent packet-related cases among children and youth aged 17 years and younger identified in CHIRPP between April 1, 2011 and October 12, 2023, representing 59.9 cases per 100,000 CHIRPP cases. The majority (86.5%) of cases were among children aged 4 years and younger. Poisonings (58.8%) and eye injuries (30.6%) were the most frequent primary diagnoses. Unintentional ingestion (56.9%) and squeezing/breaking a detergent packet (32.3%) were the most frequent exposure mechanisms. Sixty-five patients (7.2%) were admitted to hospital. The number of detergent packet-related cases per 100,000 CHIRPP cases increased by 5.0% (95% CI 0.8, 10.2) annually between 2012 and 2022. The number of detergent packet-related poisonings per 100,000 CHIRPP cases decreased by 15.3% (95% CI - 22.3, - 10.6) annually between 2015 and 2022, whereas eye injuries showed an average annual percent increase of 16.6% (95% CI 11.2, 23.0) between 2012 and 2022. The proportion of detergent packet-related cases in CHIRPP after the beginning of the pandemic (79.9/100,000 CHIRPP cases) was 1.43 (95% CI 1.20, 1.71) times greater than pre-pandemic (55.7/100,000 CHIRPP cases). CONCLUSIONS Detergent packet-related injuries and poisonings are a persisting issue. Continued surveillance and prevention efforts are needed to reduce detergent packet-related injuries and poisonings in Canada, particularly among children and youth.
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Affiliation(s)
- Sarah Zutrauen
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - James Cheesman
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Steven R McFaull
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
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2
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Zhang AM, Smith GA, Casavant MJ, Kistamgari S, Gaw CE. Longitudinal trends in liquid laundry detergent packet exposures: 2014-2022. Clin Toxicol (Phila) 2023; 61:990-998. [PMID: 38112310 DOI: 10.1080/15563650.2023.2287977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Liquid laundry detergent packet exposures modestly declined in the mid-2010s among children less than 6 years of age due to public awareness and voluntary product safety standards. We aimed to assess longitudinal trends in the number and rate of liquid laundry detergent packet exposures in the United States by age. METHODS Data from the National Poison Data System were analyzed to characterize liquid laundry detergent packet exposures between January 2014 and December 2022. RESULTS From 2014-2022, there were 114,826 single and polysubstance exposures to liquid laundry detergent packets. Children less than 6 years of age (86.8 percent) were most commonly exposed. When evaluating multi-year trends, we found that the annual exposure rate per 1 million children less than 6 years old increased by 16.8 percent from 392.6 in 2018 to 458.7 in 2020. Subsequently, the annual exposure rate in children less than 6 years of age declined by 6.8 percent from 2020 to 2022 (427.4 exposures per 1 million). The annual rate of adolescent exposures increased by 85.4 percent from 2014 (4.1 exposures per 1 million) to 2017 (7.6 exposures per 1 million), with a subsequent increase of 155.3 percent from 2017 to 2018 (19.4 exposures per 1 million). Among adults, the annual exposure rate increased by 147.1 percent from 2014 (1.7 exposures per 1 million) to 2022 (4.2 exposures per 1 million). The number of more serious medical outcomes and hospital admissions among children less than 6 years of age declined by 44.3 percent and 68.6 percent, respectively, between 2014 and 2018. CONCLUSIONS Despite declines in the number, rate, and severity of liquid laundry detergent packet exposures among children less than 6 years old, the exposure burden remains high. Additionally, exposures have increased among older children, adolescents, and adults. Renewed safety efforts are warranted to protect prior public health gains and further reduce exposures.
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Affiliation(s)
- Alice M Zhang
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Gary A Smith
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH, USA
- Child Injury Prevention Alliance, Columbus, OH, USA
| | - Marcel J Casavant
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Section of Toxicology, Nationwide Children's Hospital, Columbus, OH, USA
- Central Ohio Poison Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Sandhya Kistamgari
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Christopher E Gaw
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH, USA
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Pacini A, Tsutaoka B, Lai L, Durrani TS. Unintentional pediatric exposures to household cleaning products: a cross-sectional analysis of the National Poison Data System (2000-2015). J Occup Med Toxicol 2023; 18:16. [PMID: 37568177 PMCID: PMC10422824 DOI: 10.1186/s12995-023-00384-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Household cleaning products are the second most common cause of unintentional poisoning in children < 6 years old in the United States. The aim of this study is to characterize exposures to household cleaning substances in this age group from data collected from the Nation's Poison Control Centers. METHODS This cross-sectional study analyzed all household cleaner calls classified as age < 6 years old made to the American Association of Poison Control Centers between January 1st 2000 and December 31th 2015. RESULTS Significant clinical effects or injury was low, making up only 2.6% of cases with a known medical outcome. Alkali-based cleaning products accounted for the third highest frequency of overall exposures and the highest number of all exposure outcomes determined to have a significant clinical effect or injury. CONCLUSIONS This study demonstrated particular danger of adverse outcomes after exposure to alkali-based cleaning products, specifically alkali-based oven and drain cleaners. Both of which are readily accessible in many households. This study may be a good starting point for further study and poison prevention efforts.
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Affiliation(s)
- Anthony Pacini
- Division of Occupational and Environmental Medicine, University of California, San Francisco, Box 1369, San Francisco, CA, 94143-1369, USA
| | - Ben Tsutaoka
- California Poison Control System, University of California, San Francisco, San Francisco, USA
| | - Leslie Lai
- California Poison Control System, University of California, San Francisco, San Francisco, USA
| | - Timur S Durrani
- Division of Occupational and Environmental Medicine, University of California, San Francisco, Box 1369, San Francisco, CA, 94143-1369, USA.
- California Poison Control System, University of California, San Francisco, San Francisco, USA.
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4
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Alves M, Asbell P, Dogru M, Giannaccare G, Grau A, Gregory D, Kim DH, Marini MC, Ngo W, Nowinska A, Saldanha IJ, Villani E, Wakamatsu TH, Yu M, Stapleton F. TFOS Lifestyle Report: Impact of environmental conditions on the ocular surface. Ocul Surf 2023; 29:1-52. [PMID: 37062427 DOI: 10.1016/j.jtos.2023.04.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed. Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultraviolet light, and allergen or (b) outdoor and indoor pollution: gases, particulate matter, and other sources of airborne pollutants. Temperature affects ocular surface homeostasis directly and indirectly, precipitating ocular surface diseases and/or symptoms, including trachoma. Humidity is negatively associated with dry eye disease. There is little data on wind speed and dewpoint. High altitude and ultraviolet light exposure are associated with pterygium, ocular surface degenerations and neoplastic disease. Pollution is associated with dry eye disease and conjunctivitis. Primary Sjögren syndrome is associated with exposure to chemical solvents. Living within a potential zone of active volcanic eruption is associated with eye irritation. Indoor pollution, "sick" building or house can also be associated with eye irritation. Most ocular surface conditions are multifactorial, and several environmental factors may contribute to specific diseases. A systematic review was conducted to answer the following research question: "What are the associations between outdoor environment pollution and signs or symptoms of dry eye disease in humans?" Dry eye disease is associated with air pollution (from NO2) and soil pollution (from chromium), but not from air pollution from CO or PM10. Future research should adequately account for confounders, follow up over time, and report results separately for ocular surface findings, including signs and symptoms.
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Affiliation(s)
- Monica Alves
- Department of Ophthalmology and Otorhinolaryngology, University of Campinas Campinas, Brazil.
| | - Penny Asbell
- Department of Bioengineering, University of Memphis, Memphis, USA
| | - Murat Dogru
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Cantanzaro, Italy
| | - Arturo Grau
- Department of Ophthalmology, Pontifical Catholic University of Chile, Santiago, Chile
| | - Darren Gregory
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, USA
| | - Dong Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
| | | | - William Ngo
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Anna Nowinska
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Ian J Saldanha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Edoardo Villani
- Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Tais Hitomi Wakamatsu
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, Brazil
| | - Mitasha Yu
- Sensory Functions, Disability and Rehabilitation Unit, World Health Organization, Geneva, Switzerland
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, NSW, Australia
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Chen T, Kistamgari S, Smith GA. Consumer Product-Related Pediatric Eye Injuries Treated in United States Emergency Departments. Ophthalmic Epidemiol 2022:1-10. [DOI: 10.1080/09286586.2022.2129696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Tiffany Chen
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
- New Jersey Medical School, Newark, NJ, USA
| | - Sandhya Kistamgari
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Gary A. Smith
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Child Injury Prevention Alliance, Columbus, Ohio, USA
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6
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Cagil Y, Diaz J, Iskowitz S, Muñiz Crim AJ. Ingested Foreign Bodies and Toxic Materials: Who Needs to be Scoped and When? Pediatr Rev 2021; 42:290-301. [PMID: 34074716 DOI: 10.1542/pir.2018-0327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Yasemin Cagil
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Lucile Packard Children's Hospital Stanford, Palo Alto, CA
| | - Jenna Diaz
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Washington University School of Medicine in St Louis, St Louis, MO
| | - Seth Iskowitz
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, C.S. Mott Children's Hospital Michigan Medicine, Ann Arbor, MI
| | - Alisa J Muñiz Crim
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Nicklaus Children's Hospital, Miami, FL
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Rodgers GB. Evaluation of the impact of the voluntary safety standard for liquid laundry packets on the rate of child exposures reported to Poison Control Centers in the US. Inj Prev 2021; 28:43-48. [PMID: 33833071 DOI: 10.1136/injuryprev-2020-044115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the impact of the voluntary safety standard for liquid laundry packets on the rate of child exposures reported to Poison Control Centers in the US. METHODS The analysis was based on an interrupted time series design. The voluntary safety standard for laundry packets was published at the end of 2015. Data on reported liquid laundry packet exposures involving children under age 6 years were collected for the July 2012 through December 2017 study period. A negative binomial multiple regression model for rate data was used to quantify the impact of the voluntary standard on (1) the rate of total reported exposures and (2) the rate of reported exposures that were medically treated. The analysis controlled for laundry packet sales, time trends and seasonal variations in reported exposures. RESULTS The voluntary safety standard was associated with a 28.6% reduction in the rate of total reported exposures and a 36.8% reduction in the rate of medically treated exposures. The analysis also provides some evidence that these estimated reductions may underestimate overall reductions in the rate of reported exposures if pre-standard packaging improvements and possible caregiver behavioural responses to laundry packet hazard warnings are considered. CONCLUSIONS The analysis suggests that the requirements of the voluntary standard have effectively reduced the rate of injury involving liquid laundry packets.
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Affiliation(s)
- Gregory B Rodgers
- Directorate for Economic Analysis, United States Consumer Product Safety Commission, Bethesda, Maryland, USA
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8
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Reynolds KM, Burnham RI, Delva-Clark H, Green JL, Dart RC. Impact of product safety changes on accidental exposures to liquid laundry packets in children. Clin Toxicol (Phila) 2020; 59:392-399. [PMID: 32960108 DOI: 10.1080/15563650.2020.1817478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the impact of the ASTM International (formerly American Society of Testing Materials) safety standard and associated product safety changes on accidental exposures to liquid laundry packets (LLPs) in children. METHODS The National Poison Data System was queried for reports of accidental exposures to LLPs in children <6 years old received from 01 July 2012 to 31 December 2018. In 2014, ASTM International began developing a standard specifying voluntary product changes to reduce the risk of LLP exposures in young children. Product changes were made between 2013 and 2016. Exposures were grouped into baseline, transition, and post periods based on the timing of the standard's implementation. Exposure counts and sales adjusted rates were compared between the baseline and post period for all exposures and exposures involving healthcare facility (HCF) evaluation, HCF admission, and major medical outcomes. RESULTS A total of 73,942 accidental exposures in children <6 years old were reported (baseline: 10,229, 13.8%; transition: 43,507, 58.8%; post: 20,206, 27.3%). The percentage of exposures involving HCF evaluation (41.5% to 33.8%), HCF admission (4.5% to 1.9%), and major medical outcomes (0.6% to 0.1%) decreased from the baseline to post period. Sales adjusted rates of all exposures decreased 57.4% (4.920-2.094 exposures/1 million packets sold). Decreases also occurred in HCF evaluations (65.0% decrease; 2.026-0.708 exposures/1 million packets sold), HCF admissions (81.4% decrease; 0.218-0.041 exposures/1 million packets sold), and major medical outcomes (90.9% decrease; 0.030-0.003 exposures/1 million packets sold). CONCLUSIONS The morbidity of accidental exposures to LLPs in children decreased substantially following implementation of the ASTM International safety standard. Ongoing monitoring should be performed to determine if additional safety measures are required.
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Affiliation(s)
- Kate M Reynolds
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA
| | - Randy I Burnham
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA
| | - Heather Delva-Clark
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA
| | - Jody L Green
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA.,Inflexxion, an IBH Company, Costa Mesa, CA, USA
| | - Richard C Dart
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA.,University of Colorado School of Medicine, Aurora, CO, USA
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9
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Smith GA. Time to Protect Our Children From Liquid Laundry Detergent Packets. Am J Public Health 2020; 110:1119-1120. [PMID: 32639920 DOI: 10.2105/ajph.2020.305787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Gary A Smith
- Gary A. Smith is with the Center for Injury Research and Policy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH; the Department of Pediatrics, The Ohio State University College of Medicine, Columbus; and the Child Injury Prevention Alliance, Columbus, OH
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10
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Hanway SJ, Rodgers GB. Impact of the Voluntary Safety Standard for Liquid Laundry Packets on Child Injuries Treated in US Hospital Emergency Departments, 2012-2018. Am J Public Health 2020; 110:1242-1247. [PMID: 32552030 DOI: 10.2105/ajph.2020.305650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To evaluate the effect of the voluntary safety standard for liquid laundry packets on the rate of injury involving children younger than 5 years in the United States.Methods. Semiannual national estimates of child injuries involving liquid laundry packets treated in US hospital emergency departments were developed for the July 2012 through December 2018 study period. We used a negative binomial regression model to estimate the effect of the voluntary standard on the injury rate following the standard's publication at the end of 2015. The analysis controlled for the rapid growth of laundry packet use during the study period. Results are presented as relative risks and percentage changes in the injury rate.Results. The voluntary standard was associated with a 49.4% to 61.6% reduction in the rate of child injury.Conclusions. The results suggest that the requirements of the voluntary standard have effectively reduced the rate of child injury involving liquid laundry packets and may have prevented 9200 to 23 000 emergency department-treated injuries during the study period.
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Affiliation(s)
- Stephen J Hanway
- Stephen J. Hanway is with the Directorate for Epidemiology, US Consumer Product Safety Commission, Bethesda, MD. Gregory B. Rodgers is with the Directorate for Economic Analysis, US Consumer Product Safety Commission
| | - Gregory B Rodgers
- Stephen J. Hanway is with the Directorate for Epidemiology, US Consumer Product Safety Commission, Bethesda, MD. Gregory B. Rodgers is with the Directorate for Economic Analysis, US Consumer Product Safety Commission
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11
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Affiliation(s)
- Robert S Hoffman
- From the Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York (R.S.H.); the Division of Emergency Medicine, Program in Medical Toxicology, Boston Children's Hospital, Harvard Medical School, Boston (M.M.B.); and Centre Intégré de Santé et de Services Sociaux (CISSS) Montérégie-Centre Emergency Department, Hôpital Charles-Lemoyne, Greenfield Park, QC, the Department of Emergency Medicine, McGill University, Montreal, and Centre Antipoison du Québec, Quebec, QC - all in Canada (S.G.)
| | - Michele M Burns
- From the Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York (R.S.H.); the Division of Emergency Medicine, Program in Medical Toxicology, Boston Children's Hospital, Harvard Medical School, Boston (M.M.B.); and Centre Intégré de Santé et de Services Sociaux (CISSS) Montérégie-Centre Emergency Department, Hôpital Charles-Lemoyne, Greenfield Park, QC, the Department of Emergency Medicine, McGill University, Montreal, and Centre Antipoison du Québec, Quebec, QC - all in Canada (S.G.)
| | - Sophie Gosselin
- From the Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York (R.S.H.); the Division of Emergency Medicine, Program in Medical Toxicology, Boston Children's Hospital, Harvard Medical School, Boston (M.M.B.); and Centre Intégré de Santé et de Services Sociaux (CISSS) Montérégie-Centre Emergency Department, Hôpital Charles-Lemoyne, Greenfield Park, QC, the Department of Emergency Medicine, McGill University, Montreal, and Centre Antipoison du Québec, Quebec, QC - all in Canada (S.G.)
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12
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Banner W, Yin S, Burns MM, Lucas R, Reynolds KM, Green JL. Clinical characteristics of exposures to liquid laundry detergent packets. Hum Exp Toxicol 2019; 39:95-110. [PMID: 31578092 DOI: 10.1177/0960327119874451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Our objective was to describe the characteristics of liquid laundry detergent packet (LDP) exposures and to develop referral and treatment recommendations. METHODS This retrospective cohort study investigated LDP exposures reported to the National Poison Data System from January 1, 2013 through June 30, 2014. Three medical toxicologists reviewed the most significant exposures (n = 450). RESULTS Of 17,857 reported LDP exposures, 13,307 involved only an LDP (no other substance) and were followed to a known medical outcome. The median age was 2 years (range 12 days to 100 years). Approximately 10% of exposures reported a major or moderate effect. The most common symptom was vomiting (51.7%; n = 6875), but stridor or aspiration pneumonia and respiratory depression secondary to central nervous system effects also occurred. Two pediatric and two adult deaths occurred, but no causal mechanism leading to death could be identified in any of the deaths. CONCLUSIONS LDPs occasionally produce a toxidrome of vomiting, stridor, hypoxia, and sedation with metabolic acidosis and respiratory failure. These symptoms and the availability of LDPs highlight the need for referral and treatment recommendations and efforts to minimize unintentional exposures. Review of data from US poison centers may provide referral and treatment recommendations that improve patient outcomes.
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Affiliation(s)
- W Banner
- Oklahoma Center for Poison and Drug Information, Oklahoma University College of Pharmacy, Oklahoma City, OK, USA
| | - S Yin
- Drug & Poison Information Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - M M Burns
- Harvard Medical School, Boston, MA, USA
| | - R Lucas
- Rocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA
| | - K M Reynolds
- Rocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA
| | - J L Green
- Rocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA.,Inflexxion, an IBH Company, Costa Mesa, CA, USA
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13
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Gaw CE, Spiller HA, Casavant MJ, Chounthirath T, Smith GA. Safety Interventions and Liquid Laundry Detergent Packet Exposures. Pediatrics 2019; 144:peds.2018-3117. [PMID: 31160344 DOI: 10.1542/peds.2018-3117] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To investigate exposures to liquid laundry detergent packets among children <6 years old in the United States and to evaluate the impact of the American Society for Testing and Materials voluntary product safety standard. METHODS Data from the National Poison Data System involving exposures to liquid laundry detergent packets from 2012 to 2017 were analyzed. RESULTS From January 2012 to December 2017, there were 72 947 single and polysubstance exposures to liquid laundry detergent packets. Most exposures (91.7%) were documented among children <6 years old. The annual number and rate of exposures for children <6 years old increased by 110.4% and 111.9%, respectively, from 2012 to 2015. From 2015 to 2017, the number and rate of exposures in this age group decreased by 18.0%. Among individuals ≥6 years old, the annual number and rate of exposures increased by 292.7% and 276.7%, respectively, from 2012 to 2017. Annual hospital admissions among children <6 years old increased by 63.4% from 2012 to 2015 and declined by 55.5% from 2015 to 2017. Serious outcomes among children <6 years old increased by 78.5% from 2012 to 2015 and declined by 32.9% from 2015 to 2017. CONCLUSIONS The number, rate, and severity of liquid laundry detergent packet exposures have decreased modestly in recent years among children <6 years old, likely attributable, in part, to the voluntary product safety standard and public awareness efforts. Exposures among older children and adults are increasing. Opportunities exist to strengthen the current product safety standard to further reduce exposures.
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Affiliation(s)
- Christopher E Gaw
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Henry A Spiller
- Central Ohio Poison Center, Columbus, Ohio.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and
| | - Marcel J Casavant
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Central Ohio Poison Center, Columbus, Ohio.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and
| | - Thitphalak Chounthirath
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Gary A Smith
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; .,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and.,Child Injury Prevention Alliance, Columbus, Ohio
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14
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Clinical and Endoscopy Findings in Children With Accidental Exposure to Concentrated Detergent Pods. J Pediatr Gastroenterol Nutr 2019; 68:824-828. [PMID: 30664563 DOI: 10.1097/mpg.0000000000002270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Caustic ingestion with concentrated detergent pods (CDPs) is a common problem encountered in pediatric population. There is insufficient literature about endoscopic findings in CDP ingestion and hence no current consensus or guidelines regarding the need for endoscopic evaluation. OBJECTIVES To review cases of children with exposure to CDPs from 2010 to 2016 at a tertiary care children's hospital and to identifying the possibility of a correlation between clinical presentation and the endoscopic findings. METHODS A retrospective review identified pediatric patients with accidental caustic exposure to CDPs. Data on demographics, type of exposure, clinical symptoms, physical examination, details of the hospital course were collected. Esophagogastroduodenoscopy (EGD) findings and direct laryngoscopy-bronchoscopy findings were also collected. Descriptive statistics were computed for all demographic and clinical variables. The association between EGD findings and clinical presentation were tested using Fisher exact test. RESULTS A total of 23 (28%) cases of CDP ingestion were identified out of 83 total cases of caustic ingestion between January 2010 and June 2016. Median age was 15 months. gastrointestinal symptoms were present in 21 (91%) patients. Examination findings were present in 8 of 23 (35%) patients. EGD (done by gastroenterologists) evaluation was done in 21 (91%) patients and positive findings were seen in 5 of 21 (24%). The proportion of patients with positive examination findings was significantly higher in patients with positive EGD findings (80% vs 20%, respectively; P = 0.0307). Direct laryngoscopy-bronchoscopy (done by otolaryngologists) evaluation was done in 6 (26%) patients and positive findings were seen in 4 of 6 (67%). CONCLUSIONS Our results suggest that oropharyngeal examination findings increase the likelihood of endoscopy findings; hence, we recommend endoscopic evaluation of patients who have examination findings secondary to exposure to CDPs. In other patients, it will be reasonable to evaluate the need for endoscopy on a case-by-case basis.
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Day R, Bradberry SM, Thomas SHL, Vale JA. Liquid laundry detergent capsules (PODS): a review of their composition and mechanisms of toxicity, and of the circumstances, routes, features, and management of exposure. Clin Toxicol (Phila) 2019; 57:1053-1063. [DOI: 10.1080/15563650.2019.1618466] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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16
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Day R, Bradberry SM, Jackson G, Lupton DJ, Sandilands EA, H. L. Thomas S, Thompson JP, Vale JA. A review of 4652 exposures to liquid laundry detergent capsules reported to the United Kingdom National Poisons Information Service 2008–2018. Clin Toxicol (Phila) 2019; 57:1146-1153. [DOI: 10.1080/15563650.2019.1590586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Rachael Day
- NPIS (Birmingham Unit), City Hospital, Birmingham, UK
| | | | | | | | | | - Simon H. L. Thomas
- NPIS (Newcastle Unit), Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
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Wang M, Tan G, Eljaszewicz A, Meng Y, Wawrzyniak P, Acharya S, Altunbulakli C, Westermann P, Dreher A, Yan L, Wang C, Akdis M, Zhang L, Nadeau KC, Akdis CA. Laundry detergents and detergent residue after rinsing directly disrupt tight junction barrier integrity in human bronchial epithelial cells. J Allergy Clin Immunol 2018; 143:1892-1903. [PMID: 30500342 DOI: 10.1016/j.jaci.2018.11.016] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/31/2018] [Accepted: 11/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Defects in the epithelial barrier have recently been associated with asthma and other allergies. The influence of laundry detergents on human bronchial epithelial cells (HBECs) and their barrier function remain unknown. OBJECTIVE We investigated the effects of laundry detergents on cytotoxicity, barrier function, the transcriptome, and the epigenome in HBECs. METHODS Air-liquid interface cultures of primary HBECs from healthy control subjects, patients with asthma, and patients with chronic obstructive pulmonary disease were exposed to laundry detergents and detergent residue after rinsing. Cytotoxicity and epithelial barrier function were evaluated. RNA sequencing, Assay for Transposase Accessible Chromatin with high-throughput sequencing, and DNA methylation arrays were used for checking the transcriptome and epigenome. RESULTS Laundry detergents and rinse residue showed dose-dependent toxic effects on HBECs, with irregular cell shape and leakage of lactate dehydrogenase after 24 hours of exposure. A disrupted epithelial barrier function was found with decreased transepithelial electrical resistance, increased paracellular flux, and stratified tight junction (TJ) immunostaining in HBECs exposed to laundry detergent at 1:25,000 dilutions or rinse residue at further 1:10 dilutions. RNA sequencing analysis showed that lipid metabolism, apoptosis progress, and epithelially derived alarmin-related gene expression were upregulated, whereas cell adhesion-related gene expression was downregulated by laundry detergent at 1:50,000 dilutions after 24 hours of exposure without substantially affecting chromatin accessibility and DNA methylation. CONCLUSION Our data demonstrate that laundry detergents, even at a very high dilution, and rinse residue show significant cell-toxic and directly disruptive effects on the TJ barrier integrity of HBECs without affecting the epigenome and TJ gene expression.
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Affiliation(s)
- Ming Wang
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland; Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, and the Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Ge Tan
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland; Functional Genomics Center Zurich, ETH Zurich/University of Zurich, Zurich, Switzerland
| | - Andrzej Eljaszewicz
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland; Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
| | - Yifan Meng
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland; Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, and the Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Paulina Wawrzyniak
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Swati Acharya
- Sean N Parker Center for Allergy and Asthma Research at Stanford University, Department of Medicine, Stanford University School of Medicine, Stanford, Calif
| | - Can Altunbulakli
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Patrick Westermann
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Anita Dreher
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | | | - Chengshuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, and the Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, and the Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Kari C Nadeau
- Sean N Parker Center for Allergy and Asthma Research at Stanford University, Department of Medicine, Stanford University School of Medicine, Stanford, Calif
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, and the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
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Yin S, Colvin J, Behrman A. Single-Use Laundry Detergent Pack Exposures in Children Under 6 Years: A Prospective Study at U.S. Poison Control Centers. J Emerg Med 2018; 55:354-365. [DOI: 10.1016/j.jemermed.2018.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/10/2018] [Accepted: 05/30/2018] [Indexed: 10/28/2022]
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19
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McKenzie LB, Roberts KJ, Clark R, McAdams R, Abdel-Rasoul M, Klein EG, Keim SA, Kristel O, Szymanski A, Cotton CG, Shields WC. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions. Inj Epidemiol 2018. [PMID: 29527644 PMCID: PMC5845911 DOI: 10.1186/s40621-018-0133-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Many unintentional injuries that occur in and around the home can be prevented through the use of safety equipment and by consistently following existing safety recommendations. Unfortunately, uptake of these safety behaviors is unacceptably low. This paper describes the design of the Make Safe Happen® smartphone application evaluation study, which aims to evaluate a mobile technology-based safety behavior change intervention on parents’ safety knowledge and actions. Methods Make Safe Happen® app evaluation study is a randomized controlled trial. Participants will be parents of children aged 0–12 years who are recruited from national consumer online survey panels. Parents will complete a pretest survey, and will be randomized to receive the Make Safe Happen® app or a non-injury-related app, and then complete a posttest follow-up survey after 1 week. Primary outcomes are: (1) safety knowledge; (2) safety behaviors; (3) safety device acquisition and use, and (4) behavioral intention to take safety actions. Results Anticipated study results are presented. Conclusions Wide-reaching interventions, to reach substantial parent and caregiver audiences, to effectively reduce childhood injuries are needed. This study will contribute to the evidence-base about how to increase safety knowledge and actions to prevent home-related injuries in children. Trial registration number NCT02751203; Pre-results. Electronic supplementary material The online version of this article (10.1186/s40621-018-0133-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lara B McKenzie
- Center for Injury Research and Policy, Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Research Building 3, WB5409, Columbus, OH, 43205, USA. .,College of Medicine, Department of Pediatrics, The Ohio State University, Columbus, OH, USA.
| | - Kristin J Roberts
- Center for Injury Research and Policy, Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Research Building 3, WB5409, Columbus, OH, 43205, USA
| | - Roxanne Clark
- Center for Injury Research and Policy, Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Research Building 3, WB5409, Columbus, OH, 43205, USA
| | - Rebecca McAdams
- Center for Injury Research and Policy, Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Research Building 3, WB5409, Columbus, OH, 43205, USA
| | | | - Elizabeth G Klein
- College of Public Health, Division of Health Behavior and Health Promotion, The Ohio State University, Columbus, OH, USA
| | - Sarah A Keim
- College of Medicine, Department of Pediatrics, The Ohio State University, Columbus, OH, USA.,Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | | | | | | | - Wendy C Shields
- Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Lee VR, Connolly M, Calello DP. Pediatric Poisoning by Ingestion: Developmental Overview and Synopsis of National Trends. Pediatr Ann 2017; 46:e443-e448. [PMID: 29227519 DOI: 10.3928/19382359-20171121-01] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The American Association of Poison Control Centers' National Poison Data Surveillance System provides real-time toxico-surveillance and epidemiologic trends, and pediatric ingestions comprise most of those reports. The sequences in social and physical developmental milestones from young childhood to adolescence reveal the vulnerability of these age groups to a wide variety of potential poisonous ingestions. Most pediatric ingestions are exploratory. Some common agents associated with pediatric fatalities include disc batteries, laundry detergent "pods," opioid analgesics, acetaminophen, benzodiazepines, and amphetamines. The pediatric provider can be a valuable resource at all points throughout a child's life, offering anticipatory guidance to caregivers targeting developmental changes associated with poisonous ingestions. [Pediatr Ann. 2017;46(12):e443-e448.].
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22
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Abstract
Children inevitably swallow foreign material accidentally or intentionally. Each type of ingestion carries their own set of risks and complications, short and long term, some requiring immediate attention while others close monitoring. Alkalotic household cleaning products and lithium button batteries are increasingly common and damage the esophagus quickly. While many toys with rare-earth metals are banned, they are already present in many households and can cause necrosis of bowel that is between the magnets. This article reviews the incidence and assessment along with current literature to provide guidelines for management of pediatric patients with suspected caustic or foreign body ingestion.
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Affiliation(s)
- Jacob A Kurowski
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Dept A111, Cleveland, OH 44195-0001, USA.
| | - Marsha Kay
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Dept A111, Cleveland, OH 44195-0001, USA
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Settimi L, Giordano F, Lauria L, Celentano A, Sesana F, Davanzo F. Surveillance of paediatric exposures to liquid laundry detergent pods in Italy. Inj Prev 2017; 24:5-11. [PMID: 28188147 PMCID: PMC5800340 DOI: 10.1136/injuryprev-2016-042263] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/11/2017] [Accepted: 01/18/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To analyse paediatric exposures to pod and traditional laundry detergents in Italy and changes in exposure trends. METHODS Analyses of a series of patients aged <5 years and exposed to laundry detergents between September 2010 and June 2015, identified by the National Poison Control in Milan. RESULTS In comparison with patients exposed to traditional laundry detergents (n=1150), a higher proportion of those exposed to pods (n=1649) were managed in hospital (68% vs 42%), had clinical effects (75% vs 22%) and moderate/high severity outcomes (13% vs <1%). Exposure rates were stable over time for traditional detergents (average 0.65 cases/day), but an abrupt decline in major company pods was seen in December 2012, 4 months after the introduction of opaque outer packaging (from 1.03 to 0.36 cases/day and from 1.88 to 0.86 cases/million units sold). The odds of clinical effects was higher for exposure to pods than for traditional detergents (OR=10.8; 95% CI 9.0 to 12.9). Among patients exposed to pods, the odds of moderate/high severity outcomes was four times higher for children aged <1 years than for the other age groups (OR=3.9; 95% CI 2.2 to 7.0). Ten children exposed to laundry detergent pods had high severity outcomes while no children exposed to traditional laundry detergents developed high severity effects. CONCLUSIONS The study confirms that exposure to laundry detergent pods is more dangerous than exposure to traditional detergents. In Italy, 4 months after the introduction of opaque outer packaging by a major company, product-specific exposure rates decreased sharply, suggesting that reducing visibility of laundry detergent pods may be an effective preventive measure. Further efforts are needed to improve safety.
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Affiliation(s)
- Laura Settimi
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Felice Giordano
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Laura Lauria
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Anna Celentano
- National Poison Control Center in Milan, Niguarda Cà Granda Hospital, Milan, Italy
| | - Fabrizio Sesana
- National Poison Control Center in Milan, Niguarda Cà Granda Hospital, Milan, Italy
| | - Franca Davanzo
- National Poison Control Center in Milan, Niguarda Cà Granda Hospital, Milan, Italy
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Day R, Eddleston M, Thomas SHL, Thompson JP, Vale JA. The impact of an international initiative on exposures to liquid laundry detergent capsules reported to the United Kingdom National Poisons Information Service between 2008 and 2015. Clin Toxicol (Phila) 2017; 55:213-216. [DOI: 10.1080/15563650.2016.1267359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rachael Day
- NPIS (Birmingham Unit), City Hospital, Birmingham, UK
| | | | - Simon H. L. Thomas
- NPIS (Newcastle Unit), Regional Drug and Therapeutics Centre, Newcastle, UK
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25
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Swain TA, McGwin G, Griffin R. Laundry pod and non-pod detergent related emergency department visits occurring in children in the USA. Inj Prev 2016; 22:396-399. [PMID: 27339062 DOI: 10.1136/injuryprev-2016-041997] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/04/2016] [Accepted: 05/15/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Previous studies have reported that children are at risk of severe injuries from exposure to laundry detergent pods. For the first time, this study sought to compare demographic and exposure characteristics and risk among children exposed to pod and non-pod laundry detergents presenting to emergency departments (EDs). METHODS Data from the National Electronic Injury Surveillance System (NEISS) from 2012-2014 were used. All observations with injuries involving laundry detergent (NEISS code 0949) were included in this study. The χ2 test was used for bivariate analysis and logistic regression was used to determine the OR and 95% CI of hospitalisation for pod related versus non-pod laundry detergent exposures. RESULTS From 2012-2014, there were an estimated 26 062 non-pod and 9814 pod laundry detergent related exposures among those aged 18 years and younger. For pod detergent, children aged 0-5 years had the most injuries. Poisoning (71.3%) was the most common diagnosis for pod detergent while contact dermatitis (72.2%) was most common for non-pod detergent. Hospitalisation occurred in 12.5% of pod detergent cases and just 3.0% of non-pod cases. Compared with non-pod detergent, those exposed to pod detergent were 4 times as likely to be hospitalised (OR 4.02; 95% CI 1.96 to 8.24). CONCLUSIONS A greater effort should be made to appropriately educate the public about the dangers of laundry detergents, specifically pods, so a safe home environment can be established. While new regulations such as childproof containers, opaque packaging, and less appealing and colourful pods could reduce the number of pod related ED visits for children, caregivers should store detergents, along with other chemicals, in a secure location where children cannot easily access them.
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Affiliation(s)
- Thomas A Swain
- Division of General Surgery, Department of Surgery, The Center for Injury Sciences and Section of Trauma, Burns, and Surgical Critical Care, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,The Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gerald McGwin
- Division of General Surgery, Department of Surgery, The Center for Injury Sciences and Section of Trauma, Burns, and Surgical Critical Care, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,The Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Russell Griffin
- Division of General Surgery, Department of Surgery, The Center for Injury Sciences and Section of Trauma, Burns, and Surgical Critical Care, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,The Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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