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Toddlers increasingly swallowing liquid detergent capsules

Significant public health issue” which requires rethink on packaging and safety warning

[Liquid detergent capsule ingestion in children: an increasing trend Online First doi 10.1136/archdischild-2012-302662]

Doctors are calling for improved safety warnings and childproof packaging for laundry and dishwasher detergent liquitabs, following a cluster of incidents in which toddlers have inadvertently swallowed the capsules.

The five cases, all of which occurred within the space of 18 months, are reported online in the Archives of Disease in Childhood. The youngest child was just 10 months old, and all the children were under the age of 2.

All five children were admitted to one hospital in Glasgow as emergencies, emitting a high pitched wheeze (stridor) indicative of a blockage in the airway.

All liquitabs contain strong alkaline cleaning agents, which have a powerful solvent action that can destroy tissue and cause intense inflammation and swelling, say the authors.

This can rapidly progress to airway blockage and potentially lung damage as the gullet tissue is eroded, which can be fatal.

The eldest of the five children was treated with antibiotics and steroids, but the other four required intubation for several days to treat swelling and ulceration. In one child the swelling and ulceration was so extensive that surgery was required.

All the children recovered, but the authors point out that the incidents had “a catastrophic impact on the child and family” and wasted valuable intensive care resources.

These five cases are not isolated incidents, they point out. Last year the National Poisoning Information Service received 647 phone calls and almost 4000 online searches about the eating/swallowing of the contents of liquid detergent capsules, from healthcare professionals.

“This is an increase over the previous year’s total and more than double the number of enquiries made for these types of products 5 years ago,” they write.

They highlight other research showing the risk of severe eye injury as a result of young children getting hold of the contents of these capsules.

But most liquitabs do not come in childproof containers, and compliance with packaging safety standards is currently voluntary, say the authors.

“To help prevent future potentially life threatening injuries, improved safety warnings and childproof packaging are urgently required,” they argue, adding that they have written to the manufacturers, alerting them to the problem.

Parents also have their part to play in keeping these products out of the reach of children, they say.

“Dishwasher and washing machine liquitabs are now a common finding in most homes, but unfortunately, seem very attractive to young children due to their bright colouring and soft sweetie-like texture,” they write.

 “We feel that the increasing trend in liquid detergent capsule ingestion poses a significant public health issue,” they add.

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