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239 Surveillance of toxic exposures to liquid laundry detergents in pods in Italy
  1. Franca Davanzo1,
  2. Laura Settimi2,
  3. Felice Giordano3,
  4. Laura Lauria2,
  5. Anna Celentano1,
  6. Fabrizio Sesana1
  1. 1National Poison Control Centrein Milan, Niguarda Cà Granda Hosptal, Italy
  2. 2Italian National Institute of Health (ISS), Rome, Italy
  3. 3Department of Public Health and Infectious Diseases, Sapienza University, Rome


Background Previous investigations have shown that liquid laundry detergents in pods have the potential to cause corrosive eye damages, pulmonary toxicity and serious laryngopharyngeal injuries. In Italy, different actions had been undertaken to prevent hazardous exposures in young children. The present study is mainly aimed at providing a preliminary evaluation of impact of these preventive measures.

Methods Exposures to laundry detergents involving children aged <5 years occurred during 2010–2014 were extracted from the National Poison Control Centre in Milan (NPCCM). The main characteristics of cases exposed to the two main categories of laundry detergents, i.e., liquid laundry detergents in pods (LDPs) and traditional laundry detergents (TLDs) were compared by means of Pearson’s X2 test or Fisher’s exact test. The mean daily number of exposure to main category of laundry detergents by month and year, and quantity of LDPs sold by month and company, i.e., MC and OCs, as provided by industry, were used to calculate exposure rates, i.e., number of cases exposed to LDPs/millions of units sold/month by year and company. Change-point analysis was used to determine significant changes in exposure occurrence during the study period. A change was considered significant when the level of confidence that the change actually occurred was 95% or higher, as estimated by bootstrapping technics. Significant change points were used to define pre- and post-change point periods.

Results In comparison to cases exposed to TDLs (n = 1,203) those exposed to LDPs (n = 1,551) were more frequently treated at an hospital (68% vs 41%, p < 0.001), and suffered moderate/high severity clinical effects (13% vs <1%, p < 0.0001). During the study period, the number of cases exposed to pods changed from an average of 1.3 cases/day, observed in September 2010–November 2012, to an average of 0.6 cases/day, observed in December 2012–December 2014. The observed change was specifically driven by products from a major company whose average rates were 2.10 cases/million units sold before December 2012, and 0.97 cases/million units sold in the following period. The rate change occurred four months after this company started selling its brands in obscure outer-packaging.

Conclusions The present study indicates that reducing visibility of LDPs could be associated with about a 50% decrease of incidents among young children. However, considering that these products are strongly associated with severity of poisoning, further efforts should be devoted to prevent hazardous exposure and reduce the intrinsic toxicity of mixtures in pods.

  • Surveillance
  • liquid laundry detergents in pods
  • poisonings
  • prevention

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