Objective: In Italy, liquid laundry detergents capsules (LLDCs) were initially launched in August 2010. Immediately after, the National Poison Control Centre in Milan (NPCCM) documented an increased number of incidents involving young children [1] and different preventive actions had been undertaken by industry, including precautionary statements on outer packaging and television advertisements, and information campaigns (since January 2011), changes of the lid of outer packaging (in February 2012), and opaque outer packaging (in August 2012). In the present study, LLDC exposure rates during a five year period are reported. These measures are proposed as a basis for evaluating the impact of these preventive measures. Methods: The database of NPCCM was searched to identify all cases of exposure to laundry detergents between 1 September 2010 and 31 December 2014 in children aged <5 years. The quantity of LLDCs sold by month and company, i.e. a major company (MC-LLDCs) and other companies (OCs-LLDCs) was used to calculate exposure rates, i.e. number of cases exposed to LLDCs/millions of units sold/month by year and company. Changes in exposure rates were identified using change-point analysis. A change was considered significant when the confidence interval (CI) was 95% or higher, as estimated by bootstrapping techniques. The mean numbers of cases of exposure to MC-LLDCs and OCs-LLDCs/month observed in the identified pre- and post-change point periods, adjusted by quantity sold, were compared using analyses of variance (ANOVA). Results: There were 1041 patients exposed to MC-LLDCs and 511 to OCs-LLDCs. The average rate of MC-LLDCs exposures changed abruptly in December 2012 (CI for change: 100%), four months after the introduction of opaque outer packaging: in September 2010–November 2012 (pre-change point period) the average rate was 1.9 cases/million units sold, while in December 2012- December 2014 (post-change period) it was 0.9 cases/million units sold. No significant changes were observed for rates of exposure to OCs-LLDCs (average rate 1.0 cases/million units sold). The ANOVA analysis indicated that in the post-change period there was a statistically significant reduction in the mean number of cases exposed to MC-LLDCs, accounting for 19.6 cases/month (95% CI: 23.2 to 16.1, p<0.0001). Conclusion: These observations indicate that reducing visibility of LLDCs can lower exposure rates by 50%. According to the present data, precautionary statements and informative campaigns had no impact when products were sold in transparent outer packaging.
Rate estimates and trends of pediatric exposures to liquid laundry detergent capsules in Italy / Laura, Settimi; Laura, Lauria; Anna, Celentano; Felice, Giordano; Fabrizio, Sesana; Franca, Davanzo. - In: CLINICAL TOXICOLOGY. - ISSN 1556-3650. - ELETTRONICO. - 54:(2016), pp. 374-374. (Intervento presentato al convegno 36th International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) tenutosi a Madrid nel 24-27 maggio, 2016).
Rate estimates and trends of pediatric exposures to liquid laundry detergent capsules in Italy
2016
Abstract
Objective: In Italy, liquid laundry detergents capsules (LLDCs) were initially launched in August 2010. Immediately after, the National Poison Control Centre in Milan (NPCCM) documented an increased number of incidents involving young children [1] and different preventive actions had been undertaken by industry, including precautionary statements on outer packaging and television advertisements, and information campaigns (since January 2011), changes of the lid of outer packaging (in February 2012), and opaque outer packaging (in August 2012). In the present study, LLDC exposure rates during a five year period are reported. These measures are proposed as a basis for evaluating the impact of these preventive measures. Methods: The database of NPCCM was searched to identify all cases of exposure to laundry detergents between 1 September 2010 and 31 December 2014 in children aged <5 years. The quantity of LLDCs sold by month and company, i.e. a major company (MC-LLDCs) and other companies (OCs-LLDCs) was used to calculate exposure rates, i.e. number of cases exposed to LLDCs/millions of units sold/month by year and company. Changes in exposure rates were identified using change-point analysis. A change was considered significant when the confidence interval (CI) was 95% or higher, as estimated by bootstrapping techniques. The mean numbers of cases of exposure to MC-LLDCs and OCs-LLDCs/month observed in the identified pre- and post-change point periods, adjusted by quantity sold, were compared using analyses of variance (ANOVA). Results: There were 1041 patients exposed to MC-LLDCs and 511 to OCs-LLDCs. The average rate of MC-LLDCs exposures changed abruptly in December 2012 (CI for change: 100%), four months after the introduction of opaque outer packaging: in September 2010–November 2012 (pre-change point period) the average rate was 1.9 cases/million units sold, while in December 2012- December 2014 (post-change period) it was 0.9 cases/million units sold. No significant changes were observed for rates of exposure to OCs-LLDCs (average rate 1.0 cases/million units sold). The ANOVA analysis indicated that in the post-change period there was a statistically significant reduction in the mean number of cases exposed to MC-LLDCs, accounting for 19.6 cases/month (95% CI: 23.2 to 16.1, p<0.0001). Conclusion: These observations indicate that reducing visibility of LLDCs can lower exposure rates by 50%. According to the present data, precautionary statements and informative campaigns had no impact when products were sold in transparent outer packaging.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
