An estimated 240,000 children aged 5 years or younger received care in the emergency department for injuries from household cleaning products, according to a new analysis of national data.

A little over one third of these injuries were from detergent packets, which include pods for laundry or dishes. The data showed that the youngest children were the most vulnerable demographic. One-year-old children accounted for 43.3% of all injuries, followed by 2-year-olds at 25.6%.

“You always have to get the message out to new parents because they won’t know that there was a big push a few years ago about laundry pods if they didn’t have a child,” said Karen Sheehan, MD, MPH, professor of pediatrics, medical education, and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago, who was not involved in the research.

Clinicians should emphasize to parents that the risk for accidental exposure peaks significantly when a child reaches their first birthday, often coinciding with increased mobility and curiosity, said Lara McKenzie, PhD, MA, principal investigator at the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio, and an author of the study.

“Kids are curious and explore their environments by tasting, touching, and mimicking adults,” McKenzie said. “Packaging is usually colorful and attractive to kids, and they are able to operate dispensing systems that are not child-resistant easily.”

McKenzie and her colleagues analyzed data from a national monitoring system that gathers reports of children presenting to the emergency department due to contact with common household products such as drain cleaners, disinfectants, and toilet bowl cleaners.

During a period from 2007 to 2022, the findings showed bleach was the most common chemical cause of injury (30.1%), commonly stored in a spray bottle. Detergents were the second most frequent cause of injury (28.6%).

For the source of injuries, detergent packets (33.4%) accounted for the majority of vessels accessed by children that led to injury. Detergent packets, sometimes known as pods, were introduced in the US in 2012, and injuries from these peaked in 2015 but eventually declined gradually through the end of the study period. Detergent pods can cause chemical burns in the mouth, Sheehan said.

Injuries after contact with cleaners in spray bottles (28.2%) and non-spray containers (19.7%) followed in number of cases.

Clinicians should advise caregivers of children younger than 6 years to use liquid or powder detergents in containers, instead of in packet form, McKenzie said.

Most injuries were poisonings (64%), followed by chemical burns (14%) and eye or skin irritation (11.2%). Children who were poisoned were nearly four times as likely to be hospitalized. As children aged, poisonings declined while chemical burns and dermatitis or conjunctivitis increased.

Sheehan said she rarely sees children with severe complications or long-term consequences from ingesting household cleaning chemicals. But ingesting some products, such as those containing hydrocarbon or caustic agents, can lead to esophageal injury or fatality.

Getting messages to caregivers to properly store cleaning products is a “constant challenge,” Sheehan said. Not all cleaning products are subject to child-resistant packaging requirements, or caregivers may forget to switch the features on after they use the product.

Clinicians should counsel parents to store cleaning products out of reach and sight of children, preferably in a locked cabinet, McKenzie said. Containers should be kept closed and put away immediately after use.

McKenzie advised clinicians to tell caregivers to call the National Poison Help Line immediately after exposure and not wait for symptoms to appear.

The study received no outside funding. Neither source reported having disclosures or conflicts of interest.

Brittany Vargas is a journalist covering medicine, mental health, and wellness.