Household cleaning products poisoning in a pediatric emergency center: A 10- year cross-sectional study and literature review

Abstract

Poisoning by household cleaning products(HCPs) is common in children. Some HCPs are toxic and may cause severe complications. We assessed HCP poisonings treated in a pediatric emergency department(PED). This was a retrospective study of patients aged under 18 years with HCP poisoning admitted to the largest PED in Taiwan from 2011 to 2020 were recruited. The records over a 10-year period from 103 children admitted to the PED because of HCP poisoning(70 boys [68%] and 33 girls [32%]), mean age 3.54 years(standard deviation [SD]=3.15 years) were evaluated. Most poisonings were unintentional(99%, n=102) and occurred at home(96%, n=99). The HCPs included alkaline(74%, n=76), acidic(25%, n=26), and neutral(1%, n=1) agents. Most were orally ingested(86%, n=89). Panendoscopy was performed in 25 patients(24%), and the endoscopic(Zargar) grade was used to determine the severity of injury. Medications(steroids [9%, n=9], antibiotics [10%, n=10], or antacids [30%, n=23]) were prescribed. Alkaline HCP ingestion induced severe esophageal injury(p=0.04) and esophageal stricture(p=0.04). Five patients(5%) exhibited esophageal strictures and required balloon dilation. On multivariate analysis, alkaline HCP ingestion(p=0.04), severe esophageal caustic injury(Zargar grade≥3) (p<0.001), and medications(steroids [p<0.001], antibiotics [p<0.001], and antacids [p=0.001]) were associated with esophageal stricture. Alkaline HCP ingestion and severe esophageal caustic injury(Zargar grade≥3) were associated with esophageal stricture. Physicians tended to prescribe medications(steroids, antibiotics, or antacids) for patients with severe esophageal injuries to reduce the risk of esophageal stricture. The usefulness of these medications requires further study.