Early childhood injuries from household cleaning products dropped by almost half over the past two decades, largely due to child-resistant packaging -- but the number of injuries still remains high, according to an analysis of a national database.
Overall, the number of kids age 5 and younger treated in emergency departments for household cleaning product-related injuries fell 46 percent from 22,141 in 1990 to 11,964 in 2006, Lara B. McKenzie of Nationwide Children's Hospital in Columbus, Ohio, and colleagues found.
Child-resistant packaging mandated for the most dangerous products -- furniture polish, drain cleaners, and oven cleaners -- appears to be partly responsible for the overall drop, McKenzie's group reported online ahead of print in the September issue of Pediatrics.
At the same time, injuries in young children sustained from cleaners contained in spray bottles did not decline; spray bottles were the most common source of exposure at 40.1 percent. The most common mechanism of injury was ingestion.
One reason is that spray bottles don't feature the same degree of safety mechanisms that other types of bottles and containers do, McKenzie noted in an interview.
"The locking mechanism on spray bottles isn't really child-resistant, and it may be easy for [children] to manipulate," she told MedPage Today.
McKenzie recommended that household cleaners and other poisonous substances be stored in locked cabinets after every use -- out of sight and out of reach.
"Simply having a safety mechanism on a product is not going to guarantee a child is not going to get into that product," she said. "It's resistant but not impossible to get into."
The researchers examined household cleaner-related injuries treated from 1990 through 2006 at the network of roughly 100 hospitals that form the nationally-representative sample that reports to the National Electronic Injury Surveillance System (NEISS).
They narrowed the search to cases that occurred among children age 5 and younger -- since most poisonings occur in this age group -- largely because of small children's curiosity, mobility, and desire to put things in their mouths, McKenzie's group noted.
Household Cleaning Products Still Pose Risk to Kids
In the analysis, 1-year-olds accounted for 45.6 percent of cases, while children 1 to 3 accounted for 72.0 percent of injuries.
Cleaning products are consistently in the top five causes of pediatric poisoning exposure, given the amount of time young children spend in the home, the researchers noted.
In the current analysis, bleach represented the most common culprit at 37.1 percent of cases.
The next most common source of injurious exposure, accounting for 30.4 of the cases in the research, was from low- molecular weight hydrocarbons such as those found in pine oil products and spot removers; acids and alkalis, such as oven cleaners and toilet bowl cleaners; and dish or laundry detergents.
Ammonia products accounted for 2.5 percent of cases.
The analysis excluded exposures outside the home, those that involved submersion or allergic dermatitis, and those that resulted from shampoo and other personal cleaning products, boric acid, methacrylic acid, battery acid, or ammonia inhalants.
Overall, the rate of injuries from household cleaners dropped by 50.3 percent over the study period from 9.83 cases per 10,000 Americans age 5 and under in 1990 to 4.88 in 2006. One-year-olds had the highest injury rate, at 3.08 per 10,000.
Most household product injuries -- 62.7 percent -- came from ingestion. Not surprisingly, then, poisoning was the most common type of injury at 68.4 percent of cases, followed by chemical burns (15.9 percent) and dermatitis or conjunctivitis (10.4 percent).
Only 5.6 percent of cases required hospitalization. The one case fatality was excluded from the study since, McKenzie's group explained, NEISS is generally regarded as a poor source for identifying fatal injuries.
The researchers cautioned that their study was likely underestimated the number of injuries sustained by young children from household cleaners because it did not include injuries treated outside of emergency departments.
Also, the data on the mechanism of injury, the source, and container came from case narratives, which may have been subject to reporting or interpretation errors, they noted.