Two-year-old Joey had been playing in the basement near the laundry room while his mom was cleaning up in the kitchen after dinner. About a half an hour later, he started throwing up while in the bath. His mom smelled laundry detergent in his vomit. Then she found an empty packet of an All laundry detergent pod – a small, single-use concentrated packet – on the laundry room floor. While being cleaned up, he could barely stand up and became unresponsive within a few minutes. His mom called the Poison Control Center hotline and his dad called 911.
On arrival to the Emergency Department, Joey was very drowsy and barely breathing. A tube was placed in his airway and he was hooked to a ventilator. He spent the night in the pediatric intensive care unit. The next day, specialists performed an endoscopy and found no damage to his breathing tube or to the lining of his esophagus and stomach. Later that day, he became more alert and was breathing on his own. He spent another day in the hospital and when he was able to eat and drink without difficulty, he was discharged home without any anticipated long-term problems.
Household cleaning products, such as laundry detergent and bleach, rank in the top five most common exposures for children 5 years and younger. Until 2012, although about 6,500 cases of young children per year came into contact or swallowed liquid or powdered laundry detergent, injuries were minor, such as mouth irritation or mild vomiting. Children often swallowed very little or would immediately spit them out because of these products’ foul taste.
The landscape changed in 2012 when increasing reports of young children who became significantly ill from exposure to laundry detergent pods began to surface like the case that I saw with Joey. Since then, United States poison centers counted more than 14,000 instances of young children eating or otherwise coming into contact with detergent pods. Thousands of children received medical attention, and some had breathing difficulties that hospitalized them for days, reported a Wall Street Journal article last November.
Laundry detergent pods have been available in Europe for over a decade, but were not introduced into the U.S. market until 2010. Although they are currently used in only about 7 percent of US households, their use has been gaining popularity because of convenience. Procter and Gamble’s Tide Pods have 70 percent of the market share. Other brands include Henkel AG’s Purex, and Sun Products’ All. Tide’s product is brightly colored; other common brands are plain blue or clear. All brands can be easily mistaken by young children for candy or snack. The packaging tends to burst when bitten into, potentially shooting the detergent down a child’s throat.
Ingestion is the most common method of exposure, and can cause:
- sores in the mouth, throat, esophagus and stomach
- breathing difficulty
- low oxygen level
- swelling of the breathing tube
- acute respiratory distress syndrome
- metabolic abnormality (acidosis)
- profound drowsiness.
Eye exposure can cause eye pain, irritation, and inflammation and scratches in the cornea.
The first reported death from swallowing the contents of a detergent pod involved a 7-month-old infant from Florida in August 2013. The exact reasons why laundry detergent pods, compared to the traditional kind, are so much more toxic, are unclear. Moreover, leading toxicologists couldn’t find an explanation for the profound drowsiness sometimes seen in laundry detergent pod ingestion.
Recently, manufacturers have taken steps to try to make these products safer by modifying their containers – making them opaque, placing warning stickers to keep them away from children, and applying multiple latches on the lids. Time will tell if these modifications work to better protect our children.
Keep laundry detergent pods out of children’s reach. If a child swallows or his or her eyes get exposed to a pod, call the Poison Control help line (1-800-222-1222) immediately.