A study released August 2, 2010, by the American Academy of Pediatrics reminds parents to properly lock up their household cleaners, particularly if they have toddlers on the loose.

The study examined trends of household cleaning product-related injuries among children who were treated in U.S. emergency rooms between 1990 and 2006. It is one of the most comprehensive studies on the issue, and it proves that cleaning products continue to pose a significant risk to young, curious toddlers despite companies' efforts to make products with special child-resistant packaging.

The AAP estimates that between 1990 and 2006, 267,269 children ages five and younger were treated for unintentional, nonfatal injuries related to cleaning products such as ammonia, dishwasher detergent and laundry soap.

The majority (72%) of these cases involved children one to three years of age. One-year-olds, alone, made up 45.9% of cases and had the highest injury rate. Boys accounted for 58.8% of all cases. The study found that cleaning products were typically ingested.

The No. 1 product associated with injuries was bleach. But while bleach is corrosive, exposure to bleach did not increase the chances that a child would have to be hospitalized. Still, the study warns that mixing chlorine bleach and ammonia is dangerous because it produces a fatal gas.

Meanwhile, cleansers containing low-molecular weight hydrocarbons, acids and detergents accounted for almost one-third of cases. This broad group includes pine oil cleaners, oven cleaners, toilet bowl products and dishwasher detergents.

"These estimates most likely reflect the ubiquitous nature of household cleaning products and the ease of accessibility to children," the report says. "Household cleaning products are alluring to children because of their color, scent, and brightly colored packaging."

The study is based on a U.S. Consumer Product Safety Commission database on consumer product-related injuries. In what seemed like good news, the report shows that the actual number of injuries attributable to household cleaning products is down 46% over the 17-year period to 11,964 injuries in 2006, from 22,141 in 1990. Also, exposure to toxic cleaning products has not led to high mortality rates. That's because more products have child-resistant packaging, more parents are aware of the effects of toxic products, and poison control centers are doing more to help parents deal with injuries at home, according to the report.

Still, AAP says the figures in the report are nothing to applaud. "Although national rates of household cleaning product-related injuries in children decreased significantly over time, the number of injuries remains high," it said in the report.

Additionally, the AAP found that the spray bottle was the most common container when it came to cleaning-product injuries. The proportions of injuries resulting from products in spray bottles jumped from 30.3% in 1990 to 40.8% in 2006.

"The problem with a spray bottle is that the child can spray it in the face or they can also unscrew the cap and drink out of it," said Heath Jolliff, associate medical director for the Central Ohio Poison Center at Nationwide Children's Hospital in Columbus, Ohio.

He also noted that it's dangerous for parents to store cleaners in food or drink containers, which can confuse children. Jolliff has had patients in the intensive-care unit who have gulped chemicals stored in sports drink bottles. He's had other patients who have been exposed to products that contain low-molecular weight hydrocarbons such as lamp oils or furniture polishes. Jolliff says many parents aren't aware that these kinds of products can lead to serious lung damage if put in the mouth. "I do unfortunately, see a lot of those [cases]," said Jolliff, who recommends that parents put the numbers to local poison control centers in their cell phones. "The poor parents just feel horrible."

The report notes that children under five continue to account for the majority of all poisoning exposures--most likely because children in this age group are curious and mobile and keen on putting things in their mouth. In 2004-2006, unintentional ingestion of a household cleaning product was the second-most common cause of pediatric poisonings. And according to AAP, most poisonings occur in the home.

AAP suggests storing poisonous substances in locked cabinets, buying products with child-resistant packaging, keeping products in their original containers, and properly disposing of leftover products. "Previous studies showed that many families do not adopt the recommended storage practices for household cleaning products," the report says.

To poison proof your home:

Most poisonings occur when parents or caregivers are home but not paying 
attention. The most dangerous potential poisons are medicines, cleaning 
products, antifreeze, windshield wiper fluid, pesticides, furniture polish, 
gasoline, kerosene and lamp oil. Be especially vigilant when there is a change 
in routine. Holidays, visits to and from grandparents’ homes, and other special 
events may bring greater risk of poisoning if the usual safeguards are defeated 
or not in place.

-- Store medicine, cleaners, paints/varnishes and pesticides in their original 
packaging in locked cabinets or containers, out of sight and reach of children.
-- Install a safety latch – that locks when you close the door – on 
child-accessible cabinets containing harmful products.
-- Purchase and keep all medicines in containers with safety caps. Discard 
unused medication.
-- Never refer to medicine as “candy” or another appealing name.
-- Check the label each time you give a child medicine to ensure proper dosage.
-- Never place poisonous products in food or drink containers.
-- Keep coal, wood or kerosene stoves in safe working order.
-- Maintain working smoke and carbon monoxide detectors.

Treatment

If your child is unconscious, not breathing, or having convulsions or seizures 
due to poison contact or ingestion, call 911 or your local emergency number 
immediately. If your child has come in contact with poison, and has mild or no 
symptoms, call your poison control center at 1-800-222-1222

Different types and methods of poisoning require different, immediate treatment:

-- Swallowed poison – Remove the item from the child, and have the child spit 
out any remaining substance. Do not make your child vomit. Do not use syrup of 
ipecac.
-- Skin poison -- Remove the child’s clothes and rinse the skin with lukewarm 
water for at least 15 minutes.
-- Eye poison -- Flush the child’s eye by holding the eyelid open and pouring a 
steady stream of room temperature water into the inner corner.
-- Poisonous fumes – Take the child outside or into fresh air immediately. If 
the child has stopped breathing, start cardiopulmonary resuscitation (CPR) and 
do not stop until the child breathes on his or her own, or until someone can 
take over.


Copyright American Academy of Pediatrics, 3/10