COMMENTARY

Time to Caution Patients Against Laundry Pod Use?

Robert Glatter, MD

Disclosures

December 22, 2014

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I'm Dr Robert Glatter, on the Board of Medscape Emergency Medicine. Today I would like to discuss how laundry pods have become a threat to children.

According to a study over a 2-year period, laundry detergent pods—the brightly colored, swirling objects that we often use for cleaning clothes, which have become very popular—have caused more than 700 US children to become sick and have led to at least one death.[1]

The investigators from the study I am describing looked at data from US poison control centers from 2012 to 2013. They encountered more than 17,000 reports of children under the age of 6 who suffered injuries from these pods. Approximately 80% of the children were injured as a result of ingesting the pods. It turns out that children under the age of 3 years accounted for about three fourths of the cases. Approximately 8% of children were classified as having a moderate or higher level injury. About 700 children had to be admitted to the hospital, many of whom required intensive care, and some of these children fell into a coma.

The laundry pods are often brightly swirling-colored products enclosed in a water-soluble covering that dissolves in the laundry cycle. Of importance, they are rapidly becoming an alternative to traditional laundry liquids and detergents. Therefore, it is important that emergency department clinicians and all other healthcare providers, who may see a child who has ingested a laundry pod, are aware of this phenomenon.

What makes laundry pods particularly dangerous to children is the highly concentrated nature of the detergent that is enclosed in the pods. As many parents already know, young children are curious, and putting things in their mouths is their natural tendency. The pods are certainly no exception. The pods are quite attractive to children because they are brightly colored. They draw them in, and children want to put them in their mouths. The end result is often a squirt of very concentrated detergent right into their mouths, causing them to choke and develop difficulty breathing, with the potential to aspirate the concentrated material right into their lungs. With progressive difficulty breathing, many of the children have required intubation. According to the study, about 100 of the children were intubated as a result of respiratory difficulty.

Overall, it seems that the temptation to put these pods into their mouths is overwhelming, but an even greater risk may be burns to their eyes, especially corneal abrasions or other burns that could lead to vision loss. Some children in the study even went on to develop seizures and became comatose.

I spoke with Dr Al Sacchetti, chief of emergency medicine at Our Lady of Lourdes Medical Center in Camden, New Jersey. He was also a spokesman for the American College of Emergency Physicians. During our discussion he explained that in his experience, the vast majority of the injuries from pods are eye injuries. He sees lots of corneal abrasions and burns. In rare cases, children have aspirated the detergent and required intubation. Dr Sacchetti explained that the severe reactions are rare, contrary to what you may have read in the papers or seen in the news media. The real take-home from this, according to Dr Sacchetti, is that it is not the pods themselves; it's that parents are not recognizing the danger and childproofing their homes. He explained that it's important to get down on your hands and knees, crawl around, see what's in your house, and look into cabinets from a child's eye level. The question is, "How do I prevent my child from getting into this stuff?"

Another physician I recently spoke with was Dr Claire Melin, from the Department of Emergency Medicine at the University of Virginia Health System, who had a similar experience. She recently cared for a young child who ingested the contents of a pod. She explained that although the pods may be convenient, they are really a health hazard when you put them into the reach of young children. Parents need better education about the medical dangers of pods, and it's important that we stress this to them. She added that ideally the pods should have a better childproof design and packaging, and that's something we should really remember going forward. Dr Melin further emphasized the need for immediate medical attention after any possible ingestion.

Parents should be aware that if their child consumes one of these pods and is stable, they should contact their local poison control center immediately and/or bring their child to the closest emergency department. If their child has difficulty breathing or any change in mental status, they should call 911. The bottom line is that these pods pose such a serious risk of poisoning or injury to young children that parents should strongly consider not bringing these objects into their homes if they have young children. It would be much safer to use standard or traditional laundry detergents. The children most at risk in this study were under the age of 4, with those between the ages of 1 and 2 most at risk. If parents choose to use the pods, the pods should be stored in a secure location locked away from where children could access them. At this time, manufacturers of pods have responded to initial concerns about safety by placing latches on the containers of pods as well as making the containers opaque so that children can't see the bright colors. Warning labels are essential, along with other means that must be explored to make these pods more child-resistant.

Thank you again for joining me at Medscape Emergency Medicine. I welcome your feedback.

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