Dangers of Detergent and Gel Packs

Detergent gel packs pose risk of eye injury in young kids, doctors say

11/08/2005 6:33:00 PM
TORONTO (CP) - Those little gel packs of detergent may be a convenient way to load the dishwasher, but they could pose a serious risk to young children, doctors say.
Over a six-month period last year, doctors at Children's University Hospital in Dublin treated six toddlers who suffered chemical abrasion of their corneas after they squeezed liquid laundry detergent tablets and the contents squirted into their eyes.
"They had been playing around the kitchen, got their hands on these little liquid tablets, squeezed them and the tablets burst and splashed into their face and eyes," said Dr. Noel Horgan, lead author of a report on the cases in Friday's edition of the Lancet.
"They're alkaline detergent and alkali is quite a nasty substance to get into your eye, and it causes a chemical injury or chemical abrasion to the cornea."
All the children, aged 18 months to three years old, were admitted to the Dublin hospital for an average of four days, Horgan said Thursday from Philadelphia, where he has just begun a two-year fellowship in surgical ophthalmology.
Fortunately, said Horgan, the parents had flushed tap water into the children's eyes before bringing them to the hospital - the correct step to take to reduce eye damage, but one that can be tricky to manage with small kids.
"It's difficult for their parents to wash out their eyes because they're so young, they're in pain and they don't even want to open their eyes," he said. "They're just crying and screaming."
Horgan said alkaline detergents can be so caustic that they strip off the layer of cells on the cornea (the clear layer over the iris and pupil) and conjunctiva (the membrane on the white of the eye and underside of the eyelid).
The danger is that the chemical will destroy stem cells "that replenish the surface lining of the cornea and keep it healthy and keep it clear," he said, adding that such damage could leave the vision permanently cloudy.
"And that's a problem with chemical injuries to the eye. You get scarring of the cornea and conjunctiva, and that can lead to long-term visual problems."
Horgan said all six of the Irish toddlers, most of whom injured only one eye, have healed well and appear not to have sustained long-term damage.
"It's really just an awareness thing," he said of the Lancet article. "We wrote to manufacturers and asked them to consider making the warning label more obvious for parents to keep away from kids and to make the packaging child-proof."
The gel packs in question contained laundry detergent, a product that is not sold in Canada. However, at least two gel-pack products are marketed in Canada for automatic dishwashers.
Cascade 2in1 ActionPacs by Proctor & Gamble contain both powdered and liquid detergents, while Electrosol, marketed by Reckitt Benckiser Canada, is a water-soluble capsule enclosing liquid detergent.
Proctor and Gamble spokeswoman Joyce Law said the company has had no reports of adverse incidents related to the Cascade product since its launch last year.
"As with many cleaning products, we recommend to keep these products out of reach of children," said Law. "And on the Cascade 2in1 ActionPacs, there is clear cautionary labelling that we provide that says, 'Keep out of reach of children.' And also we provide steps to follow if eye or skin contact occurs."
Reckitt Benckiser spokeswoman Heather Allen said Electrosol gel packs are clearly marked to be kept out of reach of children.
"Since we launched the product in Canada, which was in the beginning of 2003, we have had no consumer complaints to us of this nature at all."
Dr. Margaret Thompson, head of the Ontario Regional Poison Centre for Toronto, said she is unaware of any instances involving a child injured by gel-pack detergent.
But the centre deals with many cases of children who have ingested or been splashed by any number of household products, many of which are corrosive or poisonous, said Thompson, an emergency medicine specialist and toxicologist at Toronto's Hospital for Sick Children.
"Usually (it's) toddlers, they're the curious age," she said. "Mom is busy or Dad is busy and they bring the child to the laundry room with them or to the kitchen because they're busy doing something there - and the child is busy getting into the cleaning products."
If a child is splashed with a toxic product, Thompson said a parent should take the child into the shower and continually rinse the eyes or skin for 15 minutes, then take the child to the hospital.
The Poison Centre recommends that parents of young children keep all cleaning and personal care products in locked cupboards. And don't think putting things up high will keep young kids safe, she said.
"Even toddlers are very ingenious and can get into high cupboards when you're not looking."

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