Exposures to traditional automatic dishwashing tablets and a comparison with exposures to soluble film tablets reported to the United Kingdom National Poisons Information Service 2008–2015

Abstract

Introduction: Traditional automatic dishwashing tablets are contained within an external wrapper that requires removal prior to use.

Objective: To determine the toxicity of traditional tablets and to compare this with our previously reported experience of soluble film dishwashing tablets.

Methods: Telephone enquiries regarding traditional tablets were analysed retrospectively for the period January 2008 to December 2015.

Results: Traditional tablets: There were 503 enquiries relating to 492 patients who had been exposed to a traditional tablet. Most involved children aged 5 years or less (87.4%). The majority (78.6%) of patients did not develop symptoms after exposure; 21.1% developed minor (PSS 1) symptoms while one patient developed moderate features. Exposure occurred predominantly as a result of ingestion (n = 476, 96.7%); the most common feature in symptomatic patients (n = 99, 20.8%) was vomiting (70 [14.7%] cases). Significantly (p < 0.0001) more adults (44.9% of 49 adults; 95% CI = 31.9–58.7) were reported with features than children (18.2% of 434; 95% CI = 14.9–22.1). There were five cases of eye contact which resulted in eye pain in two patients and eye irritation in another. Only one of 11 patients exposed dermally developed features (a rash around the mouth).

Comparison with soluble film exposures: The percentage of patients that were reported with clinical symptoms following ingestion of a soluble film dishwashing tablet (31.7% of 473 patients; 95% CI = 27.7–36.0) was significantly greater (p < 0.0001) than that for a traditional tablet (20.9% of 483 patients; 95% CI = 17.5–24.8). Vomiting was the most commonly reported feature and occurred significantly (p < 0.0001) more frequently amongst patients who had ingested a soluble film tablet (25.5%; 95% CI = 21.8–29.6) than a traditional tablet (14.7%; 95% CI = 11.8–18.1).

Conclusions: Exposure to both traditional and soluble film tablets only rarely produced clinically significant symptoms (PSS ≥2). However, ingestion of a soluble film tablet was significantly more likely to result in clinical features than ingestion of a traditional tablet.

Keywords:

• Automatic dishwashing tablets
• dishwashing tablet
• household products
• soluble film tablet
• traditional tablet

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

The UK NPIS has received two unrestricted educational grants from the UK Cleaning Products Industry Association (UKCPI) over recent years to undertake studies on the toxicity of household products.