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Archives de pédiatrie
Volume 21, n° 6
pages 601-607 (juin 2014)
Doi : 10.1016/j.arcped.2014.03.020
Received : 16 August 2013 ;  accepted : 19 Mars 2014
Expositions des enfants aux lessives capsules, écodoses ou pods  : plus toxiques que les lessives traditionnelles ?
Pediatric exposures to laundry pods or capsules: More toxic than traditional laundry products?
 

I. Claudet a, , R. Honorat a, A. Casasoprana a, E. Grouteau a, N. Franchitto b
a Service d’accueil des urgences pédiatriques, hôpital des Enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France 
b Centre antipoison régional, hôpital Purpan, CHU de Toulouse, 31059 cedex 9 Toulouse, France 

Auteur correspondant.
Résumé

Sur le marché européen depuis dix ans, les lessives concentrées écodoses sont régulièrement impliquées dans des intoxications plus sévères.

Objectifs

Comparer les symptômes et leur gravité après une exposition à un produit de lessive « traditionnelle » ou à une nouvelle présentation (capsule, écodose ou pod ).

Patients et méthodes

Du 1er janvier 2002 au 30 juin 2013, étude rétrospective comparative des enfants admis au service d’accueil des urgences pédiatriques après une exposition à un produit de lessive à laver le linge. Les données collectées ont été : l’âge, le sexe, la date, l’heure et le lieu de l’accident, le type de produit (poudre, liquide, tablettes, capsules), la quantité ingérée, le délai de survenue et le type de symptômes, la gravité, les complications, le devenir.

Résultats

Sur la période étudiée, 89 enfants ont été inclus. Le sex-ratio était à 1,5, la moyenne d’âge à 2,1±1,5ans. Après exposition à une capsule, les enfants étaient plus symptomatiques (p <0,0001), présentaient plus de vomissements répétés (p =0,001), de bronchospasme (p =0,02), d’atteinte oculaire (p =0,04) et les intoxications étaient plus graves (p =0,0004).

Discussion

La composition des capsules diffère par la proportion des composés chimiques, une viscosité plus élevée et un caractère hygroscopique plus marqué. L’adjonction d’eau pourrait modifier l’alcalinité expliquant les lésions endoscopiques oto-rhino-laryngologiques ou digestives décrites et la fréquence des abrasions cornéennes.

Conclusion

La toxicité des lessives en capsule est plus importante. Ces produits doivent être tenus hors d’atteinte des enfants. Les utilisateurs doivent être mieux informés des risques et les fabricants doivent appliquer certaines modifications sécuritaires (boîte résistante à l’ouverture).

The full text of this article is available in PDF format.
Summary

New concentrated laundry pods, available on the European market for approximately 10 years, are associated with more severe intoxications compared to classic laundry detergents.

Aim

To compare symptoms and severity after exposure to classic laundry detergents and new laundry pods in a pediatric population.

Material and methods

Retrospective study conducted between 1st January 2002 and 30th June 2013 including all laundry detergent exposure patients admitted to our tertiary level pediatric emergency unit. Collected data were age, sex, date, time and location of exposure, type of product (powder, liquid, tablets, pods), estimated ingested quantity, time of admission, clinical symptoms, severity, complications, and progression.

Results

Descriptive analysis: eighty-nine children were included. The mean age was 2.1±1.5 years (range, 36 days to 10 years), 65% of patients were aged less than 2 years. The male:female ratio was 1.5 (males, 60%). After exposure, 57% of children were symptomatic and most frequently developed digestive symptoms (75%). Comparative analysis: compared to classic laundry detergent, children exposed to laundry pods were more symptomatic (96% versus 51%, P <0.0001), had more digestive signs (P =0.003), more frequently had bronchospasm (P =0.02), had a higher risk of ocular lesions (P =0.04), and exposure was more severe (poisoning severity score grade 2, 92% versus 59%, P <0.0001).

Comments

Laundry pod toxicity is more severe. The chemical composition of laundry pods has a higher concentration of surfactants and ethoxylated alcohols; they have a higher viscosity and hydrotropic power. The addition of water seems to modify the alkalinity, which explains the severity of ENT, gastric, and corneal lesions.

Conclusion

The declaration to national poison centers of these intoxications should be pursued by emergency pediatricians, physicians, and pediatric intensivists. Family physicians can encourage parents to declare adverse effects to the National Consumer Product Safety Commission. Parents need to be better informed of the risk of laundry pods and strictly keep this type of product out of the reach of children. Given that it took 7 years after the first warning by the French poison centers to obtain safety recommendations for manufacturers, it is important to maintain pressure on companies to obtain the necessary modification of the physicochemical properties and child-resistant packaging.

The full text of this article is available in PDF format.


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