As a member of the American Academy of Pediatrics’ Council on Injury, Violence, and Poison Prevention, I am writing to clear up some misrepresentations in the May 11, 2016 op-ed by Ernie Rosenberg, “Making laundry packets safer around kids.” Colorful, candy-like packets of concentrated laundry detergent have become popular in recent years. However, studies have shown that these packets, while marketed as a convenience to consumers, can be very hazardous to children, and the incidents of children being harmed by these packets are going up.

According to a new study I co-authored, laundry detergent packets are significantly more dangerous to children than other types and forms of detergent. We analyzed 2013 and 2014 data from the National Poison Data System for children younger than 6 years and broke products into four categories of detergents used for laundry (packet and liquid) and dishwashing (packet and liquid).

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The results were revealing. We found that child exposures to laundry detergent packets rose 17% from 2013 to 2014. Children exposed to laundry detergent packets were 5 to 23 times more likely to be hospitalized and 8 to 23 times more likely to have a serious medical outcome than children exposed to other detergent types or forms. In addition, two children died, and both deaths were associated with laundry detergent packets. The laundry packets also were the only product tied to coma, cessation of breathing, and excess fluid in the lungs. In other words, laundry detergent packets are uniquely hazardous and exposures are on the rise, and so efforts to protect children from poisoning must be uniquely tailored as well.

In his op-ed last week, Mr. Rosenberg, CEO of the American Cleaning Institute, references the standards development process run by ASTM International. The AAP has participated in this process, but we have concerns about the voluntary standard published by ASTM last fall, which does not include a number of elements urged by pediatricians and consumer advocates. For example, the ASTM voluntary standard does not require the laundry packets to be individually wrapped to keep children from easily accessing them if a caregiver drops one or if a container is left open momentarily.

While the ASTM voluntary standard is a good first step for all manufacturers to take in making their products safer for children, it will be important to look at the number of children still being harmed by these packets after the ASTM standard goes into effect. Mr. Rosenberg’s use of the term “rate” of exposures going down must not be confused with a true incidence rate, which is the proper measure of risk that has been used by public health experts for more than 150 years. 

He is referring to a ratio that divides the number of incidents of children exposed by the number of laundry packets sold, which is akin to dividing the number of cases of opioid overdose by the number of opiate pills sold. If the number of overdoses is increasing, we would take no comfort just because opiate sales were increasing even faster. This way of thinking implies that child poisoning from laundry detergent packets is simply an expected outcome of selling these products. The American Academy of Pediatrics emphatically rejects this viewpoint.

Children getting poisoned by laundry detergent packets is not the result of neglectful parenting, but rather is the result of a product that was put on the U.S. market without adequate consideration given to child safety. At a minimum, we strongly urge households with children younger than 6 years of age to skip using laundry packets altogether, a recommendation supported by Consumer Reports. Should the ASTM voluntary standard not prove sufficient to keep children safe from poisoning, the AAP urges Congress to pass the “Detergent PACS Act,” introduced by Senators Bill NelsonClarence (Bill) William NelsonTrump's NASA nominee advances after floor drama Senate blocks bill that opponents say weakens water pollution rules The Hill's 12:30 Report MORE (D-Fla.) and Richard DurbinRichard (Dick) Joseph DurbinDHS watchdog to investigate whether children are being separated from asylum seekers: report Senate Dems press Trump on legal justification for potential Syria strike US needs to respect Latin American leadership on Venezuela crisis MORE (D-Ill.), and Congresswoman Jackie Speier (D-Calif.). The legislation would require the Consumer Product Safety Commission to set a mandatory safety standard for laundry detergent packets.

Laundry detergent packets are dangerous to young children and should be packaged and sold in a way that protects children from poisoning.


Gary A. Smith, MD, DrPH, FAAP, Member, American Academy of Pediatrics Council on Injury, Violence and Poison Prevention