Chemical risk at home: Hydro soluble unit-dose laundry pods

A warning on accidental exposure to hydro soluble unit dose laundry pods has been issued by the French Ministry for Health on June 17th 2014 to inform and give recommendations on this matter of public health.1 It follows the publication of an epidemiological study on the subject lead by the anti-poison and toxicovigilance centers in which the risk of chemical injuries and burns by ingestion of those pods by children is highlighted.[2]

These hydro soluble laundry detergent pods (or unit dose liquid laundry detergents) are made of a hydro soluble envelope containing liquid detergent.

Most of the time, they are of small size and display colors that are very attractive to children. Therefore, they tend to have them mixed up with candies.

Such a pod usually contain between 15 and 32ml of liquid detergent. The detergents used in these pods contain surfactants at a very high concentration (twice to three times more concentrated that classical liquid detergents). The pH of this viscous detergent is slightly basic, around 8.

Those laundry pods have been commercialized in 2005 in France, earlier than in other countries. For example, in Italy they came on the market in 2010 and in 2012 in the US only.

The envelope of the pod is designed to break when it enters in contact with water in order to deliver the laundry detergent. When a child takes a laundry pod to his mouth, the contact with saliva will break the envelope and release the laundry detergent. Moreover, the breaking is facilitated by the internal pressure of the pod due to the manufacturing process and handling of the child.

Laundry detergent will then be released and contaminate the mouth mucosa and even the esophagus and the stomach in case of ingestion. Some detergent can also be splashed to the eyes of the child and enter in contact with his skin.

The laundry detergent contained in these pods is usually irritant especially when time of exposure is prolonged. Indeed, surfactants of the detergent will react with mucosa and skin, provoking irritations and chemical injuries that can even lead to burns.

Compared to accidental exposure to classical liquid detergent, laundry pods ingestion provoke more digestive, ocular and respiratory injuries.

An epidemiological study on the subject has been led by French anti-poison and toxicovigilance centers between 2005 and 2012.[2]

In the context of a European program on the subject, similar studies have be done in other European countries such as the UK.[3] In Italy, a study is currently underway (starting July 2010). First results show the same tendencies as in France.

The study report displays the following results:

• 7562 accidental exposures to detergent contained in hydro soluble laundry pods have been reported between 2005 and 2012.
• Among them, 104 severe cases have led to severe respiratory complications or ocular lesions (83 keratitis reported)
• Children under 5 years old represent 92% of the reported cases
• 7% of the children affected are under 1 year old.
• Oral exposure is reported in 86% of cases
• Accidental exposure to unit dose liquid detergent are twice more frequent than exposure to classical liquid detergents.
  
  In Italy, between July 2010 and October 2012, 1143 cases of exposure have been reports. Children under 5 were involved in 94% of the cases and 92.4% resulted in ingestion or mouth mucosa exposure.[4]

Depending on the contact area and the duration of contamination, symptoms of the chemical injuries vary a lot.

• Digestive symptoms: vomiting, irritation of the mouth and esophageal mucosa
• Respiratory symptoms: Couching, respiratory distress and chemical pneumonitis
• In case of ocular contact: conjunctivitis, cornea injuries
• In case of cutaneous contact: irritation, chemical injuries

Hazardous chemical and household detergents should be kept out of the reach of children

Most household detergents are corrosive or irritant. The labelling of the flask informs of the danger of each chemical. Cleaning products, laundry detergents and other detergents can provoke burns and chemical injuries when entering in contact with the skin, the eye or a mucosa (by ingestion or inhalation for example).

Industrials started to take measures to make the use and storage of those laundry pods safer and limit the risk of accident. They modified the pods to make them less attractive to children and their envelope more resistant to breaking in contact with water. They also reinforced the locking of the buckets of bags of laundry pods. However, an Irish study of 2013 showed that those changes in the appearance of the pods did not manage to reduce significantly the number of accidents among children.[5]

According to the French Ministry of Health, regulations could be issued at a European level on this matter of public health.

Time of contact of the chemical with the human tissue is an aggravating factor of the induced injury. The longer the tissue stays in contact with the chemical, the deeper and more severe the injuries will be. Decontamination, washing and emergency treatment of the exposed tissues should be performed as fast as possible.

In case of contact with the detergent contained in laundry pods, the French Ministry for Health issued recommendations of management of accidental exposures that depend on the exposed body area.

• In case of contact with the skin: undress the victim if necessary and rinse immediately and thoroughly with water for about 10 minutes.
• In case of contact with the mouth and mouth mucosa: clean thoroughly the mouth with a washcloth or a clean humid fabric to remove most of the product. Avoid drinks for 2 hours after contamination but give fruit puree, cream dessert bread or biscuits to eat in order to absorb the product and cover the mucosa.
• In case of ocular splash: wash the eye with water, warm if possible, including under the lids for about 10 minutes.
  
  Decontamination with water will mechanically wash away the chemical and dilute it. However, water irrigation do not have any action on the aggressiveness of the chemical.

Medical advice is recommended in any cases. In cases of respiratory difficulties, call the emergency services immediately.

More information on chemical risk at home: Detergents and chemical danger

References

1. Ministère de la Santé et de la Prévention
2. Rapport CCTV Dosettes Hydrosolubles
3. Exposure to liquid detergent capsules: a study undertaken by the UK National Poisons Information Service., Clin Tox 2012, 776-780
4. Severe respiratory and oesophageal effects resulting from ingestion of unit dose liquid detergents : a case report, Celentano A. ; Sesana F.; Settimi L.; Milanesi G.; Assisi F.; Bissoli M.; Borghini R.; Della Puppa T.; Dimasui V.; Ferruzzi M.; Moro P.; rebutti I.; Travaglia A.; Severgnini P;; Georgatos J.; Davanzo F.; In XXXIII International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) 28-31 May 2013, Copenhagen, Denmark
The impact of changes to packaging and labelling on exposures to liquid laundry detergent gel capsules, P.B. Casey, F. O’Connor, E. Duggan Clin. Tox. 2014, 52, 4, 344