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Paul D. Blanc M.D., M.S.P.H.
Paul D. Blanc M.D., M.S.P.H.
Fear

Invasion of the Pods

Hazards of new liquid detergents

Two days before Thanksgiving the U.S. Consumer Product Safety Commission released a Safety Alert pithily titled “Single-Load Liquid Laundry Packets: Harmful to Children." Well, maybe not so pithy. This relatively new-on-the-U.S.-market product is better known as “detergent pods.”

“Single-load liquid packet” sounds like some kind of weapon. Then again, that inference might not be misdirected. Of course, it could be argued that pods conjures up the image of a sinister alien species, which also has a ring of truth given that laundry pods come to us after already having invaded the U.K. More on that experience later.

Ironically, the Consumer Product Safety Commission (CPSC) seems to have come up with its convoluted pod-free phraseology bending over backwards to avoid any reference to one of the main products out there on supermarket shelves. Here’s a slogan that gives a hint: Tide’s reinventing the way you do laundry!

The Centers for Disease Control (CDC) was not so circumspect in titling the lead Morbidity and Mortality Weekly Report article for its October 19 issue: “Health Hazards Associated with Laundry Detergent Pods – United States, May-June 2012” (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6141a1.htm). Limiting itself two just two months of data and only two regional Poison Control Centers, the CDC detailed four cases of severe illness in very young children (aged 10, 15, 17, and 20 months) who had ingested or bitten into pods containing concentrated detergent. All were hospitalized; three of the four required intubation. In addition to gut irritation, vomiting, and respiratory tract compromise, another notable complication (and an uncommon one for detergents) was central nervous system toxicity. The CDC delved deeper into Poison Control Center data nationally, finding that over a one month period from mid-May to mid-June, 485 pod detergent exposures had been reported. Even before the CDC report, the Consumers Union had written to CPSC calling for action on this problem (http://www.consumersunion.org/pub/core_product_safety/018481.html).

It was nearly two months before the CPSC responded with its November 20th Safety Alert (http://www.cpsc.gov/cpscpub/pubs/390.pdf) . The one page flyer is seasonably colored red and green (the latter coming from a small green pod picture in the upper right; a larger pod illustration is almost completely obscured by a large print balloon summarizing the CPSC’s take-home message). The CPSC cogently highlights why toddlers might get in trouble with pods: “Liquid laundry packets are attractive to children as play items because they are soft and colorful and they resemble familiar items like candy, toys, and teething products.” The alert contains no mandate for any change to product packaging (nor, heaven forbid, any recall threat) and does not even a suggest relabeling, however modest. Rather, the CPSC instructs, “Do NOT let Children Handle; Keep Locked Up & Out of a Child’s Sight and Reach.” If single-load detergents can be a weapon, then this is the equivalent of arguing for armed guards as the solution to the problem.

Six days after it released its alert, the CPSC received a consumer injury report forwarded on from a manufacturer (http://www.saferproducts.gov/ViewIncident/1280239): “I use Tide Pods to do my laundry. My 3-year-old got a hold of one of the Pods, squeezed it, and it went directly into her eye….Her eye suffered a severe corneal abrasion. She basically burned off the top layer of her cornea and the Doctor said it was similar to a chemical burn. With some treatment and a weeks worth of pain, she will be fine. However, people should be aware, and the labeling which states "May cause some eye irritation" should be changed to seek medical attention immediately. These pods are fairly new, and even Doctors are not aware of the damage they can cause.”

The CPSC website also includes the official response from the Procter & Gamble Company, which reads in part, “We’re very sorry about your daughter’s experience and glad to hear she is feeling better. As a company, we’re deeply committed to the health and well being of our consumers. We understand you want safe products to use in your home; we want the same for our families, too. Nothing is more important to us than the safety of those who use our products and we take reports of accidental contacts with household cleaners seriously.” Proctor and Gamble goes on to delineate a few changes it will make, including changing the latch on the pods dispenser from single to double release to require more dexterity to open it (a kind of safety trigger). They end their comments, “Again, we’re really sorry to hear of your daughter’s experience and we’re appreciative of your efforts to help us gain a better understanding. If we can be of additional assistance, please let us know.” One can learn further about P&G’s concerns by tuning into their 1.12 minute instructional video Clean Routine to learn better that “A Safe Home is a Happy Home!” (http://www.tide.com/en-US/article/Quick-and-easy-steps-to-a-safe-clean-…)

Arguably, it does take time to make post-marketing adjustments. The particular problem of eye injury should not have come as a surprise, however. As early as 2005, the British Medical Journal published a letter highlighting six cases of eye injury from such products in young children. Nor has the problem gone away. In 2010, a similar report appeared in the Lancet. It’s hard to argue obscurity here – this is the equivalent of the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine both publicizing the same hazard.

In the 1978 remake of Invasion of the Body Snatchers, Dr. Bennell, re-invented as a public health physician, at one point warns (with a premonitory wink at the audience), “You don't have any secrets from the Department of Health.” We might all benefit from a little Invasion of the Body Snatchers-style paranoia at the CPSC. Or at least maybe they could just stay awake.

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About the Author
Paul D. Blanc M.D., M.S.P.H.

Paul D. Blanc, M.D., M.S.P.H., is a professor of medicine and the endowed chair in Occupational and Environmental Medicine at the University of California San Francisco.

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