119: The Need for Safer Pool Fencing: A 10 Year Retrospective Study of Paediatric Drownings

Abstract

BACKGROUND: Since the introduction of convenient new laundry packets to North American in 2012 there have been more frequent reports of child injuries related to liquid detergent packets. A recent study reported 17,000 cases gathered by poison control centres across the United States including several hundred serious injuries and at least one death. In Canada there have been more than 100 cases seen in paediatric emergency departments. To obtain more information on Canadian children injured in such incidents the Canadian Paediatric Surveillance Program (CPSP) conducted a one-time survey of paediatricians across Canada. OBJECTIVES: To obtain more information on Canadian children injured in such incidents the Canadian Paediatric Surveillance Program (CPSP) conducted a one-time survey of paediatricians across Canada. The survey gathered information on number of cases seen, age groups most affected, types of exposures and injuries sustained point of access, treatment and disposition of the children. DESIGN/METHODS: In August 2014, the CPSP sent a one-time survey to approximately 2,500 active practicing paediatricians and subspecialists enrolled in the Program. RESULTS: CPSP gathered information on 54 children with injuries following exposure to single-load liquid detergent packets treated by paediatricians within the past year (2014). Half (56%) were less than 2 years of age and 43% were aged 2-4 years. All except 2 of the children were treated by reporting physicians in emergency departments (69%) and in-patient settings (28%). Three quarters of the incidents involved exposure to liquid detergent packets for laundry and the remainder were for dishwashers. Among cases where the point of access was known, two thirds of the children accessed detergent packets directly from the manufacturer's original package or container and another 20% found a packet on the floor or lying around. Almost all the children (47 or 88%) were treated following ingestion or had exposure to the gastrointestinal tract, six sustained ocular injuries, four had dermal exposure and three suffered pulmonary exposure. The injuries and symptoms reported in order of frequency include: nausea and vomiting, chemical burns (mouth, esophagus or skin), pulmonary toxicity, conjunctivitis, respiratory distress, corneal ulcer or keratitis, and central nervous system depression. Twenty-five patients (46%) were admitted to hospital and of these, at least six were treated in intensive care units. Another six patients (11%) were treated and released with referral for medical follow up. Twenty-one patients (39%) were not seriously injured and released without need for medical follow up. CONCLUSION: Liquid detergent packets pose a hazard for young children and exposures resulted in serious injuries. Prevention may be enhanced by greater parent and caregiver awareness of the hazard combined with vigilance in safe storage of household chemicals, including detergent packets.