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Original article
Surveillance of paediatric exposures to liquid laundry detergent pods in Italy
  1. Laura Settimi1,
  2. Felice Giordano2,
  3. Laura Lauria1,
  4. Anna Celentano3,
  5. Fabrizio Sesana3,
  6. Franca Davanzo3
  1. 1National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
  2. 2Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
  3. 3National Poison Control Center in Milan, Niguarda Cà Granda Hospital, Milan, Italy
  1. Correspondence to Laura Settimi, National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Via Giano della Bella 34, Rome 00163, Italy; laura.settimi{at}iss.it

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.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/injuryprev-2016-042263

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    Footnotes

    • Contributors LS developed the research proposal, planned the study design and the analysis, drafted and edited the paper; FG and LL contributed to planning the analysis, carried out data quality control, statistical analysis and contributed to drafting and editing of the paper; AC and FS collected the data and contributed to editing of the paper. FD was responsible for data collection, assessment of clinical effects severity and contributed to developing the research proposal, the study design and edited the paper.

    • Funding The study was partially supported by the Italian Ministry of Health—National Centre for Diseases Prevention and Control (CCM) program for surveillance of domestic incidents (Fasc. 3M61).

    • Competing interests None declared.

    • Ethics approval Ethical committee of the Niguarda Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Further data on patients aged 5+, accounting for about 19% of the detected exposures, are available. These data are included in the analyses presented as abstracts at the International Congress of the European Association of Poisons Centres and Clinical Toxicologists.22 ,2,5