Q&A: Tide Pod Challenge poses numerous health concerns for teens

Henry Spiller, MD
Henry A. Spiller

Consumption of single-load laundry packets has been a point of concern for those caring for children, with more than 50,000 calls to poison control centers made over the last 5 years, according to the American Association of Poison Control Centers.

Despite this danger, a recent viral internet trend — the Tide Pod Challenge — has emerged in which teenagers, a demographic not normally at risk for ingesting these products, intentionally chew on a detergent pod until it breaks. This phenomenon has been promoted on Twitter, Snapchat and other social media accounts.

Henry A. Spiller, MS, D.ABAT, FAACT, director of the Central Ohio Poison Control Center at Nationwide Children’s Hospital and assistant professor in the department of pediatrics at in the College of Medicine at Ohio State University, took the time to speak with Infectious Diseases in Children about the dangers of consuming these products and how pediatricians can intervene.

Q: How common is this behavior in both younger and older children?

A: This is relatively common in younger children. We still get about 15,000 poisonings in the United States annually. In their case, it is an exploratory behavior where they wander around the house and find things that may look pretty and put them in their mouths. This group usually includes preschoolers and 1- and 2-year-old children.

This is a new phenomenon in older children and teenagers. It is always difficult to say exactly where these behaviors originated, but I know the Tide Pod Challenge appears on social media sites. It is really quite dangerous.

Q: What are some of the risks associated with the ingestion of laundry detergent pods?

A: Laundry pods can cause caustic burns, and that is a great risk. With this challenge, you can get the liquid in the back of your throat, and if it gets down the pharynx, the teen can sustain burns to the epiglottis covering the trachea. It can swell, and they can have trouble breathing if it gets into the lungs.

These detergent pods have almost no water in them and are highly concentrated. What used to come in a cup is now condensed into 15 or 20 mL. These liquids dissolve the lipoproteins around your cells. When detergent was poured into a cup, the ingredients were much more diluted. How long the liquid from the detergent pod stays on the tissue is a major concern, though. If a pod will not burst easily, kids may put these in the back of their mouth and get a good, big bite, and it can squirt down their throat.

Not everyone gets these burns. Even when young children consume laundry detergent pods, there is a 10% to 15% injury rate, but the ones who get injured sustain very serious injuries. They are hospitalized, and, in some cases, they are intubated to help them breathe because of injury to the trachea or airway. It is rare, but we have had fatalities from this situation. These are infrequent — maybe only a handful of fatalities — but hundreds are in the hospital every year.

Q: What makes this challenge different from other social media fads?

A: We have not experienced any challenges that present this level of risk. This is the equivalent of thinking you are playing with firecrackers, but someone is handing you a stick of dynamite. The potential injuries and outcomes are quite serious. When I first heard of the challenge, I immediately thought that they had to pick the worst thing to consume, and they do not understand that they have picked the worst thing.

Before the introduction of these single unit pods, we were worried about laundry detergent in the bottle. It tastes bad, and if you drink a lot of it, you are going to vomit. It is unpleasant, to say the least. We did not really think of it as a great danger where we may need to send a child to the intensive care unit. These laundry detergent pods are a great danger.

Q: How concerned should parents be about this challenge, and what are some steps that can be taken to prevent these behaviors in their children?

A: With parents, we have typically focused on prevention methods in young children. If you have a child aged younger than 5 years, we suggest going back to the liquid laundry detergent for a few years. We were not anticipating adolescents ingesting liquid detergent.

The best thing I can say is that we need to let teenagers know that this is really different than consuming liquid laundry detergent. This is one of those challenges where you may put yourself in the ICU. Someone, like a parent, is going to have to talk with these kids because there are no regulation on the purchase of laundry detergent pods. If you are 16 and want to go to a store to by laundry detergent, you can.

If parents see this product in their house and they did not purchase it, I would suggest that they speak with their children.

Q: What is the pediatrician’s role in limiting these behaviors?

A: It is going to have to be another instance of direct education. Let teenagers know the difference between consuming laundry detergent pods and other detergents. This is equivalent to someone asking you to put lye or drain cleaner in your mouth. You would not do it because it presents a greater level of danger. They need to understand that.

Q: Have manufacturers stepped in to prevent the consumption of laundry detergent pods?

A: We have been working with manufacturers for years. We have published several papers in 2014 and 2015, but our efforts were primarily on packaging controls. We were more worried about young children. We promoted childproof containers and opaque packaging so that the kids could not see the pods.

Other prevention methods include a thicker membrane so that the pods do not puncture as easily but are still water soluble so that they dissolve in your laundry. I am not quite sure what they can do to prevent this in adolescents. They are not going to put these products behind the counter the way that you would with cigarettes or alcohol. This is going to be relatively difficult, and we are really going to have to focus on education.

It is advised that if laundry detergent pods are consumed or you are concerned about an exposure, you should call the Poison Help Hotline at 1-800-222-1222. – by Katherine Bortz

Disclosures: Spiller reports no relevant financial disclosures.

Resources:

AAPCC: Intentional Exposures Among Teens to Single-Load Laundry Packets

Henry Spiller, MD
Henry A. Spiller

Consumption of single-load laundry packets has been a point of concern for those caring for children, with more than 50,000 calls to poison control centers made over the last 5 years, according to the American Association of Poison Control Centers.

Despite this danger, a recent viral internet trend — the Tide Pod Challenge — has emerged in which teenagers, a demographic not normally at risk for ingesting these products, intentionally chew on a detergent pod until it breaks. This phenomenon has been promoted on Twitter, Snapchat and other social media accounts.

Henry A. Spiller, MS, D.ABAT, FAACT, director of the Central Ohio Poison Control Center at Nationwide Children’s Hospital and assistant professor in the department of pediatrics at in the College of Medicine at Ohio State University, took the time to speak with Infectious Diseases in Children about the dangers of consuming these products and how pediatricians can intervene.

Q: How common is this behavior in both younger and older children?

A: This is relatively common in younger children. We still get about 15,000 poisonings in the United States annually. In their case, it is an exploratory behavior where they wander around the house and find things that may look pretty and put them in their mouths. This group usually includes preschoolers and 1- and 2-year-old children.

This is a new phenomenon in older children and teenagers. It is always difficult to say exactly where these behaviors originated, but I know the Tide Pod Challenge appears on social media sites. It is really quite dangerous.

Q: What are some of the risks associated with the ingestion of laundry detergent pods?

A: Laundry pods can cause caustic burns, and that is a great risk. With this challenge, you can get the liquid in the back of your throat, and if it gets down the pharynx, the teen can sustain burns to the epiglottis covering the trachea. It can swell, and they can have trouble breathing if it gets into the lungs.

These detergent pods have almost no water in them and are highly concentrated. What used to come in a cup is now condensed into 15 or 20 mL. These liquids dissolve the lipoproteins around your cells. When detergent was poured into a cup, the ingredients were much more diluted. How long the liquid from the detergent pod stays on the tissue is a major concern, though. If a pod will not burst easily, kids may put these in the back of their mouth and get a good, big bite, and it can squirt down their throat.

Not everyone gets these burns. Even when young children consume laundry detergent pods, there is a 10% to 15% injury rate, but the ones who get injured sustain very serious injuries. They are hospitalized, and, in some cases, they are intubated to help them breathe because of injury to the trachea or airway. It is rare, but we have had fatalities from this situation. These are infrequent — maybe only a handful of fatalities — but hundreds are in the hospital every year.

Q: What makes this challenge different from other social media fads?

A: We have not experienced any challenges that present this level of risk. This is the equivalent of thinking you are playing with firecrackers, but someone is handing you a stick of dynamite. The potential injuries and outcomes are quite serious. When I first heard of the challenge, I immediately thought that they had to pick the worst thing to consume, and they do not understand that they have picked the worst thing.

Before the introduction of these single unit pods, we were worried about laundry detergent in the bottle. It tastes bad, and if you drink a lot of it, you are going to vomit. It is unpleasant, to say the least. We did not really think of it as a great danger where we may need to send a child to the intensive care unit. These laundry detergent pods are a great danger.

Q: How concerned should parents be about this challenge, and what are some steps that can be taken to prevent these behaviors in their children?

A: With parents, we have typically focused on prevention methods in young children. If you have a child aged younger than 5 years, we suggest going back to the liquid laundry detergent for a few years. We were not anticipating adolescents ingesting liquid detergent.

The best thing I can say is that we need to let teenagers know that this is really different than consuming liquid laundry detergent. This is one of those challenges where you may put yourself in the ICU. Someone, like a parent, is going to have to talk with these kids because there are no regulation on the purchase of laundry detergent pods. If you are 16 and want to go to a store to by laundry detergent, you can.

If parents see this product in their house and they did not purchase it, I would suggest that they speak with their children.

Q: What is the pediatrician’s role in limiting these behaviors?

A: It is going to have to be another instance of direct education. Let teenagers know the difference between consuming laundry detergent pods and other detergents. This is equivalent to someone asking you to put lye or drain cleaner in your mouth. You would not do it because it presents a greater level of danger. They need to understand that.

Q: Have manufacturers stepped in to prevent the consumption of laundry detergent pods?

A: We have been working with manufacturers for years. We have published several papers in 2014 and 2015, but our efforts were primarily on packaging controls. We were more worried about young children. We promoted childproof containers and opaque packaging so that the kids could not see the pods.

Other prevention methods include a thicker membrane so that the pods do not puncture as easily but are still water soluble so that they dissolve in your laundry. I am not quite sure what they can do to prevent this in adolescents. They are not going to put these products behind the counter the way that you would with cigarettes or alcohol. This is going to be relatively difficult, and we are really going to have to focus on education.

It is advised that if laundry detergent pods are consumed or you are concerned about an exposure, you should call the Poison Help Hotline at 1-800-222-1222. – by Katherine Bortz

Disclosures: Spiller reports no relevant financial disclosures.

Resources:

AAPCC: Intentional Exposures Among Teens to Single-Load Laundry Packets