Toddler and Preschool  |  Infants  |  Cleaning products

My Child Swallowed Automatic Dishwashing Detergent!
Now what do I do?

The Bottom Line

Automatic dishwashing detergents (ADDs) are available as powders, liquids, tablets, and pods. Exposure to ADDs is common and often results in irritation. Severe effects, such as burns and tissue damage, can also occur depending on the type of ADD, the amount, and the duration of exposure.

The Full Story

Exposure to automatic dishwashing detergents (ADDs) is common. In 2016, US poison control centers handled over 18,000 exposures involving ADDs; the majority of cases were curious toddlers exploring their environment.

Automatic dishwashing detergents are available in many forms: powder or granules, liquid/gel, unit-of-use tablets (powder blocks), and pods. ADDs have specific ingredients that make them different from hand dishwashing detergents, including strong alkalis, corrosion inhibitors that protect the metal parts of the dishwasher, enzymes that break down food, perfumes that help mask food odors, and foam suppressors so that too much foam does not interfere with the cleaning action.

The same ingredients that make ADDs so effective against fats, proteins, and other types of food grime also make them dangerous if they are swallowed, inhaled, or come into contact with eyes or skin. These special qualities of ADDs make them strong irritants capable of causing chemical burns. Whether someone swallows some ADD, gets it on their skin or eyes, or inhales it, the resulting effects depend on three important factors: the product itself, the amount, and the duration of exposure.

ADDs are alkaline and have a pH of at least 10-11 (neutral pH, or the pH of pure water, is around 7). Their alkalinity gives them the corrosive action against food grime, but also makes them capable of causing tissue injury and burns (see Caution with Caustics from The Poison Post®). Liquid ADDs tend to cause the most injury when compared to powders and tablets. This is because their pH tends to be higher, sometimes as high as 13, making them more likely to cause chemical burns ranging from mild irritation to significant tissue damage. Powder/granular ADDs can cause mechanical injury in additional to chemical irritation. Their gritty texture can scratch the surface of the eye.

The amount or "dose" is also important in whether a person who is exposed to an ADD will have no symptoms, mild symptoms, or severe effects. The majority of exposures are unintentional and by children who are curious and exploring their environment. It is common for kids to get hold of an ADD from the dishwasher itself. The dishwasher door, where the dispenser usually sits, is at eye level and accessible for a crawling child. Luckily, most unintentional ingestions tend to be very small, probably because ADDs have strong, unpleasant tastes. A lick or taste is unlikely to cause anything beyond a little icky taste in the mouth. Nausea and vomiting are very common from a sip or swallow or two.

Finally, the duration of exposure also contributes to the outcome. Don't let a corrosive liquid or powder sit on your skin or in your eye for a long time. Time allows the product to penetrate the tissue and eat away at it. The longer the duration - the more severe the injury, regardless of whether the pH of the ADD is 10 or 13.

If swallowed, ADDs can irritate the mouth, throat, and stomach resulting in a bad taste, throat burning, or nausea and vomiting. Severe outcomes, such as severe burns and swelling of the throat, food pipe, and stomach can also result from swallowing an ADD, depending on the type and amount. Someone might choke when they swallow an ADD, causing some of it to slip into the airway resulting in symptoms such as coughing, chest pain, wheezing, and shortness of breath.

If an ADD touches the eye, it can cause discomfort and pain, redness, tearing, and sometimes a scratch or burn on the surface of the eye. If left on the skin for a prolonged time, ADDs can cause skin burns of varying degrees resulting in redness and pain, peeling, and blistering.

If someone has swallowed an ADD, do NOT make them vomit! Rinse the mouth with water by swishing and spitting a few times. If it just happened, offer sips of water to drink. This will help dilute the product in the stomach, making it less irritating. If an ADD products gets in the eye or on the skin, immediately rinse gently with cool or comfortable-temperature water. Then, get help from Poison Control by checking the webPOISONCONTROL® online tool or calling Poison Control at 1-800-222-1222.

Serkalem Mekonnen, RN, BSN, MPH
Certified Specialist in Poison Information


For More Information

The Poison Post®: Caution with Caustics [internet]. Washington DC: National Capital Poison Center. Oct 2008 [accessed Feb 1, 2018].

The Poison Post®: Goodbye Winter Grime, Hello Safe Spring Cleaning! [internet]. Washington DC: National Capital Poison Center. Mar 2015 [accessed Feb 1, 2018].

Understanding Automatic Dishwashing [Internet]. Washington DC. American Cleaning Institute [Accessed Feb 1, 2018]. 

References

Cornish LS, Parsons BJ, Dobbin MD. Automatic dishwasher detergent poisoning: opportunities for prevention. Aust N Z J Public Health. 1996;20:278-83.

Davis MG, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Pediatric exposures to laundry and dishwasher detergents in the United States: 2013-2014. Pediatrics 2017;137:e20154529.

Day R, Eddleston, M, Thomas SH, Thompson JP, Vale JA. Toxicity of soluble film automatic dishwashing products as reported to the United Kingdom National Poisons Information Service 2008-2015. Clin Toxicol 2016;54:862-6.

Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol 2017;55:1072-254.

Hannu TJ, Riihimäki VE, Piirilä PL. Reactive airways dysfunction syndrome from acute inhalation of a dishwasher detergent powder. Can Respir J 2012;19:e25-7.

Understanding Automatic Dishwashing [Internet]. Washington DC. American Cleaning Institute [Accessed Feb 1, 2018].

Wheeler DS, Bonny AE, Ruddy RM, Jacobs BR. Late-onset respiratory distress after inhalation of laundry detergent. Pediatr Pulmonol. 2003;35:323-5.

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Store automatic dishwashing detergents (ADDs) out of reach and sight of children, preferably in cabinets with child-resistant closures.
  • Keep ADDs in their original container.
  • Store ADDs away from food.
  • Use ADDs only as recommended by the manufacturer and for their intended purpose.
  • Wash hands after handling an ADD. 

This Really Happened

Case 1. A 2 year old put an ADD packet in her mouth and swallowed some of the liquid inside. She vomited immediately. Her mother called Poison Control for advice. She was told that the product is very irritating, but that the child should tolerate this small amount. The mother had already given a little milk to drink, and the child drank it without any difficulty. Poison Control asked the mom to watch for worsening symptoms or continued vomiting and to call back if they developed. The next day, Poison Control followed up with the mother and learned that the girl vomited once more but was fine thereafter.

Case 2. A 48-year-old woman mistakenly washed her hands with automatic dishwashing gel and immediately experienced redness and irritation. By the time she called Poison Control for advice, she had already thoroughly rinsed her hands with water. Poison Control told her to call back with any worsening pain or signs of burns such as blistering. Upon follow-up with the patient, Poison Control learned that the redness and irritation had resolved.