Liquid laundry detergent packet exposure burden among young children remains

Researchers call for renewed safety efforts to protect our most vulnerable populations.


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Liquid laundry detergent packet exposures had modestly declined in the mid-2010s, attributed to increased public awareness and the implementation of voluntary product safety standards. A new study aimed to assess longitudinal trends in the number and rate of exposure to liquid laundry detergent packets among children under 6 in the United States.

The study, conducted by researchers at the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s Hospital and the Central Ohio Poison Center, investigated trends in calls to poison centers across the United States related to exposures to liquid laundry detergent packets. The findings indicated declines in the number, rate, and severity of exposure to liquid laundry detergent packets among children younger than six. However, the exposure burden remained high, and there were increases in exposure among older children, teens, and adults.

Previous research has addressed efforts to reduce unintentional exposures to the contents of liquid laundry detergent packets. 2015 ASTM published a voluntary Standard Safety Specification for Liquid Laundry Packets. However, some experts believe that the standard needs to go further in addressing safety concerns. Even with recent updates to the standard in March 2022, there was a perception that the changes did not substantially alter its scope.

The study likely suggests further ways to strengthen the ASTM standard, including considerations such as requiring Poison Prevention Packaging Act-compliant packaging or introducing additional “layers of protection,” such as individual packaging for each laundry packet.

Christopher Gaw, MD, senior author of the study, emergency medicine physician, and faculty of the Center for Injury Research and Policy at Nationwide Children’s said, “The voluntary standard, public awareness campaigns, and product and packaging changes to date have improved the safety of these products, but a high number of children are still exposed each year.”

The study suggests that one reason for the less-than-expected decline in exposure among young children is the flexibility provided by the voluntary safety standard. Manufacturers can meet the requirement for child-resistant containers in six different ways under this standard rather than being mandated to conform to the Poison Prevention Packaging Act (PPPA) of 1970. The PPPA has been demonstrated to be highly effective in preventing child access to poisons.

Gary Smith, MD, DrPH, co-author of the study and director of the Center for Injury Research and Policy at Nationwide Children’s, said, “Requiring that all liquid laundry detergent packet packaging be PPPA-compliant would be an important next step in reducing child access to these products. In addition, each laundry packet should be individually wrapped with child-resistant packaging, providing important layers of protection for this highly toxic product.”

Liquid laundry detergent packets are noted to be more toxic than traditional liquid and powder laundry detergents. The exact reasons for this increased toxicity are not fully understood, and additional research is required to determine how to make the contents of these packets less toxic. Reformulating the contents could reduce exposure severity to liquid laundry detergent packets.

Given these findings, pediatricians and other healthcare providers are encouraged to continue counseling patients and their families about the hazards associated with laundry detergent packet exposures. Emphasizing safe storage practices is crucial. Experts recommend that caregivers of children younger than 6 years old and adults with a history of dementia, Alzheimer’s disease, or developmental disability opt for traditional laundry detergents instead of packets to mitigate the risks associated with exposure.

Dr. Gaw said“Many families don’t realize how toxic these highly concentrated laundry detergent packets can be. If you have young children or vulnerable adults in your home, using traditional laundry detergents is a safer alternative.”

Journal Reference:

  1. Alice M. Zhang, Gary A. Smith et al. Longitudinal trends in liquid laundry detergent packet exposures: 2014–2022. Clinical Toxicology. DOI: 10.1080/15563650.2023.2287977