Toddlers Choking On Liquid Detergent Capsules

A growing number of toddlers are inadvertently swallowing liquid detergent capsules, known as Liquitabs, doctors from the Royal Hospital for Sick Children, Glasgow, UK, Scotland reported in Archives of Childhood Diseases. In what the authors describe as a "significant public health issue", they urge detergent makers and packagers to review their packaging and safety warnings.

Laundry and dishwasher detergent Liquitabs should have childproof packaging and better safety warnings, after several reports have come in of young children swallowing contents of the capsules, the authors explained.

Over a period of 18 months, five children had to be treated for swallowing the liquitab capsule contents in one hospital in Glasgow alone; they ranged in age from 10 months to 24 months. When they were hospitalized they had a high pitched wheeze (stridor), which is usually a sign of some airway blockage.

Liquitabs contain alkaline cleaning agents which have a strong solvent action that can damage tissue, cause inflammation and painful swelling.

In severe cases the airways can become completely blocked; there is also the risk of lung damage as tissue in the esophagus is eroded - a potentially fatal complication.

The oldest patient, a 24-month old child, was treated with steroids and antibiotics. The other four younger ones needed to be intubated for several days to treat ulceration and swelling. One of them required surgery because the swelling and ulceration was so extensive.

Although all the patients in Glasgow made full recoveries, the authors wrote that the incidents had "a catastrophic impact on the child and family", as well as using up valuable intensive care resources.

In 2011, in the United Kingdom alone, 647 phone calls were received at the National Poisoning Information Service regarding the swallowing or eating of liquid detergent capsules. The Service also received 4,000 website visits on this theme.

The authors explained that over the last five years, the number of inquiries regarding children swallowing washing machine or dishwasher Liquitabs has more than doubled.

Detergent capsules are not childproof

Liquitabs do not currently come in childproof containers. At the moment, manufacturers and packaging companies are encouraged to comply to safety standards, but the whole scheme is voluntary, there is nothing legally binding them to adhere to any strict national standards. The doctors said that the contents of these capsules also place young children at risk of severe eye injury.

The authors, who have written to manufacturers alerting them to the current problems, said:

"To help prevent future potentially life threatening injuries, improved safety warnings and childproof packaging are urgently required."

It is not only the manufacturers' responsibility to keep these products out of children's reach, parents should also be extremely careful.

They wrote "Dishwasher and washing machine Liquitabs are now a common finding in most homes, but unfortunately, seem very attractive to young children due to their bright colouring and soft sweetie-like texture. We feel that the increasing trend in liquid detergent capsule ingestion poses a significant public health issue."