The toxicity of liquid detergent capsules (fabric cleaning liquid tablets)

Objective: To ascertain the toxicity of liquid detergent capsules. Methods: Between 1 March 2008 and 30 April 2009 the UK National Poisons Information Service collected prospectively 647 telephone enquiries relating to liquid detergent capsules. Results: The majority of enquiries (96.1%) concerned children five years of age or less. Exposure to these products occurred mainly as a result of ingestion alone (n = 518; 80.1%), with eye contact alone (n = 61; 9.4%), and skin contact alone (n = 7; 1.1%) being less common; 9.4% (n = 61) of enquiries involved multiple routes of exposure. The most common features reported following ingestion alone were vomiting (n = 124) followed by coughing (n = 21) and nausea (n = 18). Nine patients developed drowsiness and nine a rash, possibly due to topical contact with the capsule. Features that developed following ocular exposure were conjunctivitis with or without eye pain (n = 64), eye pain alone (n = 13) and keratitis (n = 4). Follow up was attempted in all these cases and to the best of our knowledge ocular damage resolved in all. Seven patients aged three or less were exposed via the dermal route alone and developed rash (n = 4), irritation (n = 2), chemical burn (n = 2) and paraesthesiae (n = 1). Conclusions: This is the largest study reported to date and confirms that ocular exposure may lead to conjunctivitis and keratitis, findings reported previously^1–3 and from which recovery is to be expected. Ingestion may also result in drowsiness; CNS depression has been observed previously⁴ though the mechanism is unclear. Parents have a vital role to play in ensuring that these products are stored safely at all times. References: 1. Horgan N, McLoone E, Lannigan B, et al. Eye injuries in children: a new household risk. Lancet 2005; 366:547–8. 2. Fayers T, Munneke R, Strouthidis NG. Detergent capsules causing ocular injuries in children. J Pediatr Ophthalmol Strabismus 2006; 43:250–1. 3. Mathew RG, Kennedy K, Corbett MC. Wave of paediatric eye injuries from liquid detergent capsules. Br Med J 2010; 340:c1186. 4. Wood KL, Thompson JP. Liquitabs - a thorough and comprehensive review of the UK national data. Clin Toxicol 2009; 47:459.