Since a peak of 13,112 in 2015, calls to poison control centers about children's exposure to liquid laundry detergent packets have consistently declined. Laundry pod manufacturers, led by Procter & Gamble, have pointed to this data as proof that their six-year safety intervention for the products—which are small, brightly colored, and may be mistaken for candy—is working.
But new data show that the number of calls is rising again.
According to the American Association of Poison Control Centers, in the first seven months of 2019, there were 5,768 calls linked to laundry pods. That's an increase of 347, or 6.4%, when compared to the same period in 2018—and marks the first time that the number of "exposures," as such calls are known, has risen year-over-year during that seven-month period since 2016.
Poison control calls for the year had dropped by 2,121, or 16.3%, between 2016 and 2017, and again by 1,438, or 13.2%, between 2017 and 2018.
The recent increase suggests that safety efforts may have reached their limit in further reducing exposures. The number of calls to poison control each month in 2019 has exceeded the number of calls from its corresponding month in 2018. If that trend continues through the end of this year, and exposures follow historical monthly trends, the total amount of exposures in 2019 is likely to exceed last year’s—which would be the first time the annual count has risen from the previous year since 2015.
Most people know about the dangers of laundry pods because of the Tide Pod Challenge, a viral phenomenon that emerged in late 2017 when teenagers started posting online videos of themselves eating laundry packets. But these incidents only made up a small amount of overall exposures.
The larger hazard began back in 2012, when Tide Pods launched in the U.S. Fortune reported earlier this year on how liquid laundry packets quickly caused a public health epidemic—with all laundry detergent-related annual emergency-room visits for young children tripling between 2011 and 2013 and remaining elevated since. The overwhelming majority of incidents involve children under age 6, and there have been isolated incidents of seniors with dementia dying from exposure.
Consumer advocates and child psychologists argue that the packets, most of which are colorful and squishy, are especially attractive to young children and cognitively impaired adults—and have called on the industry to change their design. P&G, whose Tide and Gain brands control 79% of the market, according to 2018 data from market research provider Euromonitor International, cites studies that it says show pods’ appearance does not play a role in exposures. Fortune’s investigation in February, however, found that these studies only looked at correlational data, rather than testing whether children were attracted to pods in real-world scenarios.
Brian Sansoni, senior vice president for communications at the American Cleaning Institute, which represents the cleaning industry, says it’s too early to evaluate the 2019 numbers mid-year.
“We don’t know the numbers behind the numbers,” he says. “We’ll have to wait and see what happens the rest of the year.”
For Aravella Simotas, a New York State Assembly member from Queens, that approach isn’t fast enough.
“Procter & Gamble has been allegedly working on this issue since 2013,” says Simotas, who has introduced legislation that would force manufacturers to make all packets a uniform color and enclosed in individual wrappers. “How much longer are we going to rely on the industry to police itself? Clearly the measures they’ve taken have not led to a product that is safe for consumers.”
An additional study on 2018 data, which was presented to the ASTM subcommittee on laundry packet safety in July 2019, underscores the lack of progress.
“It’s remarkable how similar the data were,” says Rocky Mountain Poison & Drug Safety's Kate Reynolds, the principal investigator on the study, of the exposure numbers between 2017 and 2018. She says this may indicate that the drop in exposures is leveling out. “We may be getting close to the true north with these exposures.”
Further complicating the situation is the fact that laundry packet sales continue to rise—providing more opportunities for injury. In the 52 weeks preceding June 29, 2019, pod unit sales jumped from 143 million to 157 million, or 10.2%, according to data provided by Nielsen. Units sold increased 2.7%, 16.9%, and 15.1% over the previous three consecutive 52-week periods.
Laundry-packet manufacturers have recently touted the fact that when adjusted for product sales, the rate of exposures has dropped in the period since the safety intervention was fully implemented. According to the surveillance data recently reported to the ASTM subcommittee, the number of exposures per 1,000,000 packets sold dipped from 4.92 in the 2012-2013 pre-intervention period to 1.901 in 2018, or 61.4%. (Cases involving health care facility admission dropped 83.5% and several medical outcomes dropped 94.5% over the same period.)
Yet Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital, writes in an email to Fortune that using sales-adjusted data "is not an appropriate metric for evaluating the public health benefit of the standard.”
The right measurement, he contends, is to divide exposures by the population size (which is largely constant)—and that number is barely budging.
“The change in the rate of exposure among children younger than six years from before the standard to after the standard was less than 1% to about 8% (depending on which post-period is used for comparison), which is woefully inadequate,” he writes, referring to the six-year safety intervention. “This demonstrates the clear need to strengthen the standard to protect children from exposure to this toxic product.”
Further changes, though, do not appear to be forthcoming.
According to P&G spokesperson Petra Renck in an email, the 2018 data presented to the ASTM subcommittee "shows major progress." She declined to comment on the 2019 poison control numbers.
If you believe you or someone you are with has been exposed to a poisonous substance, please call Poison Control at 800-222-1222 or visit www.poisonhelp.org.