Exposure to laundry detergent packets sending few Canadian kids to emergency rooms, new study finds

TORONTO – Despite the growing household presence of Single-Use Detergent Sacs (SUDS) – or laundry pods as they’re commercially known, a new study led by The Hospital for Sick Children (SickKids) reveals a low number of children’s emergency room visits for exposure to the candy-coloured, potentially-poisonous packets.

The five-year multicentre study, published in Pediatric Emergency Care, is the first to identify and compare reported SUDS-exposure cases to traditional detergent-exposure cases in Canada from 2009 to 2014. The study drew from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database and looked at emergency department visits at SickKids in Toronto, Alberta Children’s Hospital in Calgary, and Stollery Children’s Hospital in Edmonton.

Of the 75 detergent-exposure cases, 40 cases were identified as SUDS exposures and 35 as traditional detergent exposures. The overall incidence of SUDS-exposure cases presenting to the tertiary care children’s hospitals was similar to that of traditional detergent exposure, at 3.16 per million children per year compared to 2.78 per million children per year.

“Although the number of reported emergency department cases is very low, especially in comparison to recent reports out of the United States, we need to continue to be vigilant,” says Dr. Daniel Rosenfield, lead author of the study and Trauma Fellow/Emergency Physician at SickKids and University of Toronto. “Parents need to be aware of the dangers: SUDS can cause severe airway, throat and eye burns. Health-care providers need to be aware of the unique risks posed by SUDS: they are more potent than traditional detergent and our study found they required more medical follow-up visits.  Finally, industry needs to be aware that these injuries still occur and need to continue to work with health groups and parents to keep them away from children.”

The majority of exposure cases occurred through ingestion, but eye injuries accounted for 20 per cent of cases, which Rosenfield says can lead to significant corneal burns that require immediate medical attention and long-term management and follow-up. The study found that children required follow-up visits to health-care providers in 22 per cent of SUDS-exposure cases compared to three per cent of traditional detergent-exposure cases.

Since the release of SUDS into the North American market in 2011, reports of poisoning or injuries of the mouth, throat, and eyes have surfaced when children were able to come into contact with the squishy packets, resulting in a range of mild to severe outcomes. Although rare, deaths have occurred due to aspiration, although no deaths were reported in this study.

Rosenfield suggests the following if exposure occurs:

• If a child is found playing with SUDS, immediately take the packet away from the child and place out of sight.
• If it is in their mouth, remove it as best you can but do not induce vomiting.
• If detergent comes into contact with the child's eye, immediately flush the eye out with lukewarm tap water and seek medical attention.
• If your child has trouble breathing, becomes sleepy, is coughing, sputtering, vomiting or complains of pain, seek medical attention.
• If you are concerned, contact the Ontario Poison Centre at 1-800-268-9017 or emergency medical services, or go to your nearest emergency room.

He also suggests tips on how to avoid exposures if SUDS are in the home:

• Keep all SUDS in their original containers, which should have child-resistant locking mechanisms.
• Containers should be stored high up, out of sight and out of children’s reach, in a locked cabinet.
• Children should be supervised when adults are doing laundry and should be taught that the capsules are not toys or candy.
• If the SUDS are individually packaged, keep them in their original packaging until needed.

This study was funded by the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) and the Women and Children’s Health Research Institute at the University of Alberta.

This paper is an example of how SickKids is contributing to making Ontario Healthier, Wealthier and Smarter.