title: Serious injuries from dishwasher powder ingestions in small children.
abstract: OBJECTIVE
  To describe patterns and severity of caustic injuries sustained from dishwasher powder ingestion and highlight need for national safety standards.
  
  
  METHODS
  Retrospective chart review of admissions for caustic ingestion to Starship Children's Hospital from January 2003 to January 2005 and review of New Zealand National Poisons Centre data.
  
  
  RESULTS
  Between January 2003 and January 2005, the National Poisons Centre recorded 610 dishwashing powder ingestions, with 88% of children less than 2 years old. Twenty-three children were admitted to Starship Children's Hospital following caustic ingestion, of whom 11 were identified as having ingested dishwasher powder (9 boys and 2 girls) and were aged 11 to 30 months (mean 17.5). Five children (45%) were admitted to the Paediatric Intensive Care Unit over 4 months (October 2004 to January 2005), requiring intubation for airway control. Two children needed tracheostomy. Three of the 11 children (27%) required repeated oesophageal dilatation, and two underwent gastrostomy formation. One brand of dishwasher detergent and container type was implicated in over half of the cases.
  
  
  CONCLUSIONS
  Dishwasher detergents are highly corrosive substances that cause potentially life-threatening injuries and ongoing morbidity. The recent surge of incidents may be related to change in product constituents or non-compliance with New Zealand safety standards. Efforts to limit product alkalinity, legislative requirement of Child-Resistant Packaging and public education may reduce injuries from these common household substances.
authors.affiliation: Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand. amybertinelli@hotmail.com
authors.forename: Amy
authors.initials: A
authors.lastname: Bertinelli
authors.forename: James
authors.initials: J
authors.lastname: Hamill
authors.forename: Murali
authors.initials: M
authors.lastname: Mahadevan
authors.forename: Fiona
authors.initials: F
authors.lastname: Miles
mesh_terms: D000061:Accidents, Home / Q000517:prevention & control / Q000706:statistics & numerical data*; D002057:Burns, Chemical / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002424:Caustics / Q000506:poisoning*; D002675:Child, Preschool; D003902:Detergents / Q000506:poisoning*; D005247:Feeding Behavior; D005260:Female; D041981:Gastrointestinal Tract / Q000293:injuries*; D006776:Hospitals, Pediatric; D006795:Household Products / Q000506:poisoning*; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D009520:New Zealand / Q000453:epidemiology; D011039:Poison Control Centers; D011208:Powders / Q000506:poisoning
chemical_list: D002424:Caustics; D003902:Detergents; D011208:Powders