Single-Use Laundry Detergent Pack Exposures in Children Under 6 Years: A Prospective Study at U.S. Poison Control Centers.

Background: After the widespread introduction of single-use liquid laundry detergent packs (LLDPs), a prospective observational study was initiated among 12 U.S. poison control centers (PCCs), serving 25% of the population.

Objectives: To evaluate qualitative and quantitative data, including demographics, route of exposure, clinical effects, medical outcome, management site, level of care, and circumstantial variables surrounding the LLDP exposure.

Methods: Analysis of LLDP exposures involving children (age < 6 years) reported to PCCs participating in the prospective study (March 2012-February 2016). PCCs captured a detailed exposure history and followed each patient to symptom resolution. Each case narrative was reviewed to isolate key patient, product, and situational variables and to verify accuracy of coded data. Trend and comparative analyses were performed on absolute case counts, relative proportions, and reporting rates normalized using Nielsen consumption data. Separately, the impact of exposure reduction interventions introduced by a single manufacturer were assessed by comparing reporting rate during pre-/postintervention periods.

Results: There were 11,175 childhood exposures reported, with 90.3% involving children aged ≤ 3 years. Ingestion (82.6%) and ocular (14.2%) were the major routes of exposure. The size of the market for LLDPs more than doubled from ∼2.0 to ∼4.6 million LLDPs purchased. Total exposure reports increased from Year 1 (n = 2297) to Year 4 (n = 3206), however, normalized reporting rates dropped by 37% (4.4 to 2.8 exp/million LLDPs purchased). Significant declines (p < 0.0001) were also observed for ingestions and ocular exposures with major/moderate outcome.

Conclusions: There was a significant reduction in exposures that resulted in major/moderate outcomes, and the majority of patients did not require intervention in an emergency department setting.