LI QUI D LAUNDRY DETERGENT PACKET EXPOSURES REPORTED TO THE NATI - PowerPoint PPT Presentation

LI QUI D LAUNDRY DETERGENT PACKET EXPOSURES REPORTED TO THE NATI ONAL POI SON DATA SYSTEM ( NPDS) Surveillance and Evaluation of ASTM Standards Kate M. Reynolds, MPH July 16, 2019

Objectives 1) Describe exposures to liquid laundry detergent packets reported to the NPDS during the post period 2) Compare exposures to liquid laundry detergent packets reported to the NPDS during the baseline and post period

Period Definitions Baseline Transition Post 01 July 2012 to 30 30 July 2013 to 31 01 January 2017 to June 2013 December 2016 ongoing 3

Previous Presentations of Data November • Baseline period summary 2017 • Transition period summary March 2018 • Post period (2017) summary June 2018 • Baseline vs. post period (2017) comparison

Previous Presentations of Data November • Baseline period summary 2017 • Transition period summary March 2018 • Post period (2017) summary June 2018 • Baseline vs. post period (2017) comparison • Post period (2018; 2017 ‐ 2018) summary July 2019 • Baseline vs. post period (2018; 2017 ‐ 2018) comparison

NPDS DATA SUMMARY • Age: <6 years • Reason for Exposure: Unintentional general (reason code used for accidental exposure) • Date Range: 01 July 2012 to 31 December 2018 ( NEW data : 01 January 2018 to 31 December 2018) • Substance: Exposure to ≥ 1 liquid laundry detergent packet with or without other products/substances

NPDS Definitions All Exposures HCF Evaluation HCF Admission Severe Medical Outcomes All exposures Treated/evaluated Admitted to a non ‐ Medical outcome regardless of and release or critical or critical of major effect outcome or level of admitted to a non ‐ care healthcare (life ‐ threatening) or healthcare facility critical or critical facility death care care healthcare facility 7

Exposures by Severity Baseline Period Post Period (July 2012 - June 2013) 2017 Period 2018 Period 2017-2018 All Exposures 10,229 10,821 HCF Evaluations 4,241 (41.5%) 3,570 (33.1%) HCF Admissions 458 (4.5%) 209 (1.9%) Severe Medical Outcomes 64 (0.6%) 19 (0.2%) 8

Exposures by Severity Baseline Period Post Period (July 2012- June 2013) 2017 Period 2018 Period 2017-2018 All Exposures 10,229 10,821 9,376 20,197 HCF Evaluations 4,241 (41.5%) 3,570 (33.1%) 3,250 (34.6%) 6,829 (33.8%) HCF Admissions 458 (4.5%) 209 (1.9%) 178 (1.9%) 391 (1.9%) Severe Medical Outcomes 64 (0.6%) 19 (0.2%) 8 (<0.1%) 26 (0.1%) 9

DEMOGRAPHI CS Baseline Period Post Period (July 2012- June 2013) 2017 Period 2018 Period 2017-2018 (n=10,229) (n=10,821) (n=9,376) (n=20,197) Age Mean (SD), years 2.1 (1.00) 2.3 (1.03) Median, years 2.0 2.0 Age (categorical) <2 years 4,227 (41.3%) 3,468 (32.0%) 2 to <4 years 4,930 (48.2%) 5,886 (54.4%) 4 to <6 years 1,047 (10.2%) 1,444 (13.3%) ≤ 5 years 25 (0.2%) 23 (0.2%) Gender Female 4,899 (47.9%) 4,999 (46.2%) Male 5,307 (51.9%) 5,796 (53.6%) Unknown 23 (0.2%) 26 (0.2%) 10

DEMOGRAPHI CS Baseline Period Post Period (July 2012- June 2013) 2017 Period 2018 Period 2017-2018 (n=10,229) (n=10,821) (n=9,376) (n=20,197) Age Mean (SD), years 2.1 (1.00) 2.3 (1.03) 2.3 (1.04) 2.3 (1.04) Median, years 2.0 2.0 2.0 2.0 Age (categorical) <2 years 4,227 (41.3%) 3,468 (32.0%) 2,990 (31.9%) 6,458 (32.0%) 2 to <4 years 4,930 (48.2%) 5,886 (54.4%) 5,099 (54.4%) 10,985 (54.4%) 4 to <6 years 1,047 (10.2%) 1,444 (13.3%) 1,268 (13.5%) 2,712 (13.4%) ≤ 5 years 25 (0.2%) 23 (0.2%) 19 (0.2%) 42 (0.2%) Gender Female 4,899 (47.9%) 4,999 (46.2%) 4,356 (46.5%) 9,355 (46.3%) Male 5,307 (51.9%) 5,796 (53.6%) 5,002 (53.3%) 10,798 (53.5%) Unknown 23 (0.2%) 26 (0.2%) 18 (0.2%) 44 (0.2%) 11

COMPARI SON OF AGE Baseline Period Post Period (July 2012 - June 2013) 2018 (n=10,229) (n=9,376) p-value Age Mean (SD), years 2.1 (1.00) 2.3 (1.04) Median, years 2.0 2.0 <0.001 IQR, years (1.4, 3.0) (1.6, 3.0) Age (categorical) <2 years 4,227 (41.3%) 2,990 (31.9%) 2 to <4 years 4,930 (48.2%) 5,099 (54.4%) <0.001 4 to <6 years 1,047 (10.2%) 1,268 (13.5%) ≤ 5 years 25 (0.2%) 19 (0.2%) 12

COMPARI SON OF AGE Baseline Period Post Period (July 2012 – June 2013) 2017-2018 (n=10,229) (n=20,197) p-value Age Mean (SD), years 2.1 (1.00) 2.3 (1.04) Median, years 2.0 2.0 <0.001 IQR, years (1.4, 3.0) (1.6, 3.0) Age (categorical) <2 years 4,227 (41.3%) 6,458 (32.0%) 2 to <4 years 4,930 (48.2%) 10,985 (54.4%) <0.001 4 to <6 years 1,047 (10.2%) 2,712 (13.4%) ≤ 5 years 25 (0.2%) 42 (0.2%) 13

DEMOGRAPHI CS 2017 Exposures Exposures Exposures with Involving HCF Involving HCF Severe Medical All Exposures Evaluation Admission Outcomes (n=10,821) (n=3,579) (n=213) (n=18) Age Mean (SD), years 2.3 (1.03) 2.3 (1.05) 1.9 (1.12) 2.2 (1.33) Median, years 2.0 2.0 1.8 2.0 Age (categorical) <2 years 3,468 (32.0%) 1,246 (34.8%) 111 (52.1%) 8 (44.4%) 2 to <4 years 5,886 (54.4%) 1,857 (51.9%) 81 (38.0%) 7 (38.9%) 4 to <6 years 1,444 (13.3%) 470 (13.1%) 21 (9.9%) 3 (16.7%) ≤ 5 years 23 (0.2%) 6 (0.2%) 0 (0.0%) 0 (0.0%) Gender Female 4,999 (46.2%) 1,670 (46.7%) 98 (46.0%) 6 (33.3%) Male 5,796 (53.6%) 1,904 (53.2%) 115 (54.0%) 12 (66.7%) Unknown 26 (0.2%) 5 (0.1%) 0 (0.0%) 0 (0.0%) 14

DEMOGRAPHI CS 2018 Exposures Exposures Exposures with Involving HCF Involving HCF Severe Medical All Exposures Evaluation Admission Outcomes (n=9,376) (n=3,250) (n=178) (n=8) Age Mean (SD), years 2.3 (1.04) 2.3 (1.04) 2.0 (1.01) 1.8 (0.67) Median, years 2.0 2.0 2.0 1.9 Age (categorical) <2 years 2,990 (31.9%) 1,109 (34.1%) 82 (46.1%) 4 (50.0%) 2 to <4 years 5,099 (54.4%) 1,711 (52.6%) 78 (43.8%) 4 (50.0%) 4 to <6 years 1,268 (13.5%) 427 (13.1%) 17 (9.6%) 0 (0.0%) ≤ 5 years 19 (0.2%) 3 (0.1%) 1 (0.6%) 0 (0.0%) Gender Female 4,356 (46.5%) 1,531 (47.1%) 85 (47.8%) 1 (12.5%) Male 5,002 (53.3%) 1,714 (52.7%) 92 (51.7%) 7 (87.5%) Unknown 18 (0.2%) 5 (0.2%) 1 (0.6%) 0 (0.0%) 15

ROUTE OF EXPOSURE Baseline Period (July 2012- June Post Period 2017- 2013) 2017 Period 2018 Period 2018 (n=10,229) (n=10,821) (n=9,376) (n=20,197) Route of Exposure a Ingestion 9,248 (90.4%) 8,900 (82.2%) Aspiration (with ingestion) 45 (0.4%) 24 (0.2%) Inhalation/Nasal 30 (0.3%) 30 (0.3%) Ocular 1,357 (13.3%) 2,370 (21.9%) Dermal 1,047 (10.2%) 1,810 (16.7%) Parenteral 0 (0.0%) 0 (0.0%) Other 1 (<0.1%) 11 (0.1%) Unknown 2 (<0.1%) 6 (0.1%) a A single exposure may involve more than one route. 16

ROUTE OF EXPOSURE Baseline Period (July 2012- June Post Period 2017- 2013) 2017 Period 2018 Period 2018 (n=10,229) (n=10,821) (n=9,376) (n=20,197) Route of Exposure a Ingestion 9,248 (90.4%) 8,900 (82.2%) 7,649 (81.6%) 16,549 (81.9%) Aspiration (with ingestion) 45 (0.4%) 24 (0.2%) 22 (0.2%) 46 (0.2%) Inhalation/Nasal 30 (0.3%) 30 (0.3%) 41 (0.4%) 71 (0.4%) Ocular 1,357 (13.3%) 2,370 (21.9%) 2,214 (23.6%) 4,584 (22.7%) Dermal 1,047 (10.2%) 1,810 (16.7%) 1,620 (17.3%) 3,430 (17.0%) Parenteral 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Other 1 (<0.1%) 11 (0.1%) 7 (0.1%) 18 (0.1%) Unknown 2 (<0.1%) 6 (0.1%) 12 (0.1%) 18 (0.1%) a A single exposure may involve more than one route. 17

COMPARI SON OF ROUTE Baseline Period (July 2012- June Post Period 2013) 2018 Route a (n=10,229) (n=9,376) p-value Ingestion 9,248 (90.4%) 7,649 (81.6%) <0.001 Aspiration (with ingestion) 45 (0.4%) 22 (0.2%) 0.014 Ocular 1,357 (13.3%) 2,214 (23.6%) <0.001 Dermal 1,047 (10.2%) 1,620 (17.3%) <0.001 Other/ Unknown 33 (0.3%) 60 (0.6%) 0.001 a A single exposure may involve more than one route. 18

COMPARI SON OF ROUTE Baseline Period (July 2012- June Post Period 2013) 2017-2018 Route a (n=10,229) (n=20,197) p-value Ingestion 9,248 (90.4%) 16,549 (81.9%) <0.001 Aspiration (with ingestion) 45 (0.4%) 46 (0.2%) <0.001 Ocular 1,357 (13.3%) 4,584 (22.7%) <0.001 Dermal 1,047 (10.2%) 3,430 (17.0%) <0.001 Other/ Unknown 33 (0.3%) 107 (0.5%) 0.077 a A single exposure may involve more than one route. 19

ROUTE OF EXPOSURE 2017 Exposures Exposures Exposures with Involving HCF Involving HCF Severe Medical All Exposures Evaluation Admission Outcomes (n=10,821) (n=3,579) (n=213) (n=18) Route of Exposure a Ingestion 8,900 (82.2%) 2,669 (74.6%) 193 (90.6%) 12 (66.7%) Aspiration (w/ ingestion) 24 (0.2%) 15 (0.4%) 5 (2.3%) 2 (11.1%) Inhalation/Nasal 30 (0.3%) 8 (0.2%) 1 (0.5%) 0 (0.0%) Ocular 2,370 (21.9%) 1,187 (33.2%) 35 (16.4%) 8 (44.4%) Dermal 1,810 (16.7%) 516 (14.4%) 24 (11.3%) 3 (16.7%) Parenteral 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Other 11 (0.1%) 6 (0.2%) 0 (0.0%) 0 (0.0%) Unknown 6 (0.1%) 2 (0.1%) 1 (0.5%) 0 (0.0%) a A single exposure may involve more than one route. 20