Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA.
Inflexxion, an IBH Company, Costa Mesa, CA, USA.
Clin Toxicol (Phila). 2021 May;59(5):392-399. doi: 10.1080/15563650.2020.1817478. Epub 2020 Sep 22.
To evaluate the impact of the ASTM International (formerly American Society of Testing Materials) safety standard and associated product safety changes on accidental exposures to liquid laundry packets (LLPs) in children.
The National Poison Data System was queried for reports of accidental exposures to LLPs in children <6 years old received from 01 July 2012 to 31 December 2018. In 2014, ASTM International began developing a standard specifying voluntary product changes to reduce the risk of LLP exposures in young children. Product changes were made between 2013 and 2016. Exposures were grouped into baseline, transition, and post periods based on the timing of the standard's implementation. Exposure counts and sales adjusted rates were compared between the baseline and post period for all exposures and exposures involving healthcare facility (HCF) evaluation, HCF admission, and major medical outcomes.
A total of 73,942 accidental exposures in children <6 years old were reported (baseline: 10,229, 13.8%; transition: 43,507, 58.8%; post: 20,206, 27.3%). The percentage of exposures involving HCF evaluation (41.5% to 33.8%), HCF admission (4.5% to 1.9%), and major medical outcomes (0.6% to 0.1%) decreased from the baseline to post period. Sales adjusted rates of all exposures decreased 57.4% (4.920-2.094 exposures/1 million packets sold). Decreases also occurred in HCF evaluations (65.0% decrease; 2.026-0.708 exposures/1 million packets sold), HCF admissions (81.4% decrease; 0.218-0.041 exposures/1 million packets sold), and major medical outcomes (90.9% decrease; 0.030-0.003 exposures/1 million packets sold).
The morbidity of accidental exposures to LLPs in children decreased substantially following implementation of the ASTM International safety standard. Ongoing monitoring should be performed to determine if additional safety measures are required.
评估美国试验与材料协会（ASTM International，前身为美国材料试验协会）安全标准及相关产品安全变更对儿童误触液体洗衣包（LLP）的影响。
通过查询 2012 年 7 月 1 日至 2018 年 12 月 31 日期间，0-6 岁儿童因误触 LLP 向国家毒物数据系统报告的意外暴露数据。2014 年，ASTM International 开始制定标准，规定自愿进行产品变更以降低幼儿 LLP 暴露风险。2013 年至 2016 年期间进行了产品变更。根据标准实施时间，将暴露分为基线期、过渡期和后期。对所有暴露和涉及医疗保健机构（HCF）评估、HCF 入院和主要医疗结果的暴露，比较基线期和后期的暴露计数和销售调整率。
报告了 73942 例 0-6 岁儿童意外暴露（基线期：10229 例，13.8%；过渡期：43507 例，58.8%；后期：20206 例，27.3%）。涉及 HCF 评估（41.5%至 33.8%）、HCF 入院（4.5%至 1.9%）和主要医疗结果（0.6%至 0.1%）的暴露百分比从基线期降至后期。所有暴露的销售调整率下降了 57.4%（4.920-2.094 例/百万包销售）。HCF 评估（减少 65.0%；2.026-0.708 例/百万包销售）、HCF 入院（减少 81.4%；0.218-0.041 例/百万包销售）和主要医疗结果（减少 90.9%；0.030-0.003 例/百万包销售）也有所下降。
ASTM International 安全标准实施后，儿童误触 LLP 的发病率大幅下降。应进行持续监测，以确定是否需要采取其他安全措施。
