Exposures to automatic dishwashing rinse aids reported to the United Kingdom National Poisons Information Service 2008-2016

• Published in: Clinical toxicology (Philadelphia, Pa.) Vol. 56; no. 6; pp. 427 - 432
• Main Authors: Day, Rachael C, Bradberry, Sally M, Sandilands, Euan A, Thomas, Simon H L, Thompson, John P, Vale, Allister
• Format: Journal Article
• Language: English
• Published: England 03.06.2018
• Subjects: Automatic dishwashing products; rinse aid; household product; non-ionic surfactants
• ISSN: 1556-3650; 1556-9519
• DOI: 10.1080/15563650.2017.1393083

To determine the toxicity of rinse aids which are used as drying aids to remove water from crockery. Enquiries to the UK National Poisons Information Service (NPIS) were analysed retrospectively for the period January 2008 to December 2016. There were 855 enquiries relating to 828 patients; children aged 5 years or less accounted for 91.1%. Most exposures occurred from ingestion alone (n = 778, 94.0%), but 26 involved ingestion and other routes: 21 with skin contact, 3 with eye contact, and two with both skin and eye contact. There were a further 24 cases of eye contact alone (n = 20, 2.4%) or skin contact alone (n = 3, 0.4%) and a single case of inhalation alone. The World Health Organisation/International Programme on Chemical Safety/European Commission/European Association of Poison Centres and Clinical Toxicologists (WHO/IPCS/EC/EAPCCT) Poisoning severity score [PSS] was known in 824 of the 828 exposures: 425 of 824 (51.6%) patients did not develop clinical features, 381 (46.2%) had a PSS of 1 (minor toxicity), 15 (1.8%) developed moderate (PSS 2) and 3 (0.4%) severe (PSS 3) toxicity. Vomiting was the most common feature, occurring in over a third of all ingestions (n = 286, 35.8%), followed by coughing (n = 73, 9.1%). A higher proportion of adults than children developed clinical features (72.7% of 33 vs 46.0% of 767, p = .0026), although vomiting occurred significantly more frequently amongst children (p = .0315). Of the 25 eye contact cases, eye pain (n = 8) and/or eye irritation (n = 8) were reported, with or without abnormal vision (n = 7); there were two cases of corneal abrasion. Dermal contact rarely produced features; only 4 of 26 patients reported symptoms including skin rash or burning or numbness at the contact site. Severe clinical features were uncommon following rinse aid exposure; vomiting was the most frequently reported symptom following ingestion.