title: [Pediatric exposures to laundry pods or capsules: more toxic than traditional laundry products?].
abstract: New concentrated laundry pods, available on the European market for approximately 10 years, are associated with more severe intoxications compared to classic laundry detergents.
  
  
  OBJECTIVE
  To compare symptoms and severity after exposure to classic laundry detergents and new laundry pods in a pediatric population.
  
  
  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).
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service d'accueil des urgences pédiatriques, hôpital des Enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France. Electronic address: claudet.i@chu-toulouse.fr.
authors.forename: I
authors.initials: I
authors.lastname: Claudet
authors.affiliation: Service d'accueil des urgences pédiatriques, hôpital des Enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Honorat
authors.affiliation: Service d'accueil des urgences pédiatriques, hôpital des Enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Casasoprana
authors.affiliation: Service d'accueil des urgences pédiatriques, hôpital des Enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Grouteau
authors.affiliation: Centre antipoison régional, hôpital Purpan, CHU de Toulouse, 31059 cedex 9 Toulouse, France.
authors.forename: N
authors.initials: N
authors.lastname: Franchitto
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000061:Accidents, Home / Q000706:statistics & numerical data*; D001986:Bronchial Spasm / Q000139:chemically induced; D002648:Child; D002675:Child, Preschool; D003231:Conjunctivitis / Q000139:chemically induced; D003371:Cough / Q000139:chemically induced; D003902:Detergents / Q000009:adverse effects* / Q000737:chemistry; D004636:Emergency Service, Hospital; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D007634:Keratitis / Q000139:chemically induced; D007827:Laryngitis / Q000139:chemically induced; D007846:Laundering; D008297:Male; D019064:Product Packaging; D012189:Retrospective Studies; D014839:Vomiting / Q000139:chemically induced
chemical_list: D003902:Detergents