LIQUID DETERGENTS PODS POSE RISK TO CHILDREN'S EYE HEALTH
Liquid laundry and
dishwasher detergent pods are an emerging source of chemical exposure in children.
When squeezed or bitten into, these pods can burst and send detergent into the
mouth, nose, and eyes. A new report published in the current issue of the Journal of the American
Association for Pediatric Ophthalmology and Strabismus (AAPOS) cautions that these products should be kept
away from children because the bursting detergent pods can cause significant
corneal injury.
Detergent pods may
offer a simpler way to do laundry, but they represent a source of potential
danger when in the hands of a young child. Available in the European market for
over a decade and first introduced to the American market in 2010, liquid
detergent pods are brightly colored, which makes them attractive to young
children who mistake them for toys.
Michael E. Gray, MD,
and Constance E. West, MD, from the Abrahamson Pediatric Eye Institute at
Cincinnati Children’s Hospital Medical Center, began tracking ocular injuries
from detergent pods after noticing an increase in patients over the course of
several months beginning in 2012. Ten children, all under 4 years of age, were treated
for eye injuries stemming from burst detergent pods. Over the same time frame,
21 other children were seen in the emergency room for injuries caused by
ingestion of the detergent contained in the pods.
For the children with
eye injuries, two cases involved the child biting down on the pod, seven cases
resulted from children squeezing the pod in their hands, and in the last case,
the cause was unknown. All ten children with eye injuries presented with
significantly bloodshot eyes, although no limbal ischemia or clinically
significant conjunctival chemosis was found. Corneal abrasions were found in
all of the cases, with defect sizes ranging from 3 mm in diameter to a nearly
complete corneal epithelial defect. In addition, three children also had mild periorbital
edema or erythema ipsilateral to the corneal abrasion.
During ophthalmologic
examination, the ocular surface pH was measured and found to be neutral in all
cases, but as study co-author Dr. Gray, Pediatric Ophthalmologist and Assistant
Professor, Division of Pediatric Ophthalmology at Cincinnati Children’s and UC
Department of Ophthalmology, points out, the pH levels among different brands
can vary. “Alkaline injury should also be suspected in association with the
ocular cases. However, reported pH from Material Safety Data Sheets (MSDS) of
different brands of pods is variable. The pH of some brand name pods is close
to neutral (6.8 – 7.6), whereas other brands are considerably alkaline (8.0 –
11.0).”
The report also
explains that because these pods are designed to be concentrated, they often
contain higher levels of surfactants than traditional detergent, making them
more likely to cause injury when they are ingested or when the chemicals enter
the eye.
In the study, all
affected subjects were treated with irrigation and topical antibiotic ointment.
The recovery period for the children averaged just under four days, and none of
the patients experienced additional complications or relapse.
While makers of these
detergent pods have made changes to packaging to try to keep children out, not
all brands adhere to the same safety standards. “Manufacturers have taken steps
to prevent such injuries, such as warning labels and container lid safety
features,” states Dr. West, Pediatric Ophthalmologist and Associate Professor,
Cincinnati Children’s and UC Department of Ophthalmology. “These safety
features are not always present, however, particularly with off-brand or
generic laundry pods that might be sold at discount stores.”
As convenient as
detergent pods may be, families with young children need to take safety
precautions. As Dr. Gray concludes, “This consecutive case series highlights
the risk of ocular injuries from laundry detergent pods in the United States.
Parents or caregivers must be aware of the potential for ocular injury from
these pods and prevent access to these chemicals by young children.”
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