A.I.S.E.&& · PDF fileA&scientific&study&to&map&and&to&better ... ... seconds,!in!case!of

A.I.S.E.&LLDC&PSP&and&KCFC&Status&Report&8&December&3,&2014& Page&1&of&25&

!

&

!

A.I.S.E.&&

PRODUCT&STEWARDSHIP&PROGRAMME&&

FOR&LIQUID&LAUNDRY&DETERGENT&CAPSULES&

and&

“KEEP&CAPS&FROM&KIDS”&MEDIA&CAMPAIGN&

Status&Report&–&December&3,&2014&!

The& A.I.S.E.& Product& Stewardship& Programme& (PSP)& for& Liquid& Laundry& Detergent& Capsules& (LLDCs)& entails&

commitments& regarding& the& product/packaging;& information& and& communication& (both& on8pack& and& consumer&

communication);&and&engagement&with&Poison&Control&Centres& (PCCs).& &To&date,& the& large&majority&of& the&market& is&

covered,&via&six&companies&that&have&signed&up&to&the&PSP.&

Implementation&of&the&PSP&packaging&measures&and&on8pack&labelling&is&complete.&&By&the&end&of&2014,&with&only&few&

exceptions,&essentially&all&products&on&the&shelf&comply&with&these&requirements.&&&

Communication& has& been& significantly& reinforced& since& April& 2014,& with& a& commitment& to& include& child8safety&

messaging&on&all&LLDC&brand&communication&and&advertising.&&&

For&several&countries&(UK,& IE,&NL,&CZ,& IT),&the&PCC&incident&statistics&over&the&128month&period&until&September&2014&

allow&assessing&one&full&year&following&the&on8shelf&introduction&of&the&PSP&measures&in&mid82013.&&Compared&to&the&

pre8PSP& baseline& situation,& for& all& these& countries,& there& is& a& substantial& reduction& in& the& number& of& reported&

exposures&per&unit&of&product&sold.&&The&decrease&ranges&from&25%&to&45%&and&was&shown&to&be&statistically&significant&

in&all& countries&except& the&Netherlands.& &Considering& the& five&countries& together,& there&was&a&statistically&significant&

decrease&by&on&average&32%.&&

A&scientific&study&to&map&and&to&better&understand&accident&circumstances&(‘accidentology’)&has&been&commissioned&

by&A.I.S.E.& in&partnership&with& five&PCCs&across&Europe.& &The&preparatory&work&was&completed&by&Fall&2014&and& the&

data&collection&is&now&ongoing&in&all&participating&PCCs,&for&a&period&of&6&months.&Initial&(preliminary)&findings&suggest&

that&the&most&important&root&causes&of&exposures&are&when&capsules&are&directly&accessible&to&children&(open&packs,&or&

capsules&left&outside&their&pack),&or&when&the&child&manages&to&open&the&pack.&&

&

As&consumer&awareness&is&so&important,&industry&has&put&further&efforts&into&consumer&education&by&developing&the&

A.I.S.E.& “Keep& Caps& From& Kids”& (KCFK)& communication& campaign.& & KCFK& was& opened& on& August& 1,& 2014,& and& the&

multilingual&web&site&(in&all&EU&languages)&was&launched&in&September.& &Further,&a&specific&digital&media&campaign&is&

being&run&over&Fall&2014.&&This&effort&is&supported&by&several&companies&who&signed&up&to&the&PSP,&as&well&as&additional&

institutional&partners.&&A.I.S.E.&continues&to&look&for&more&partnerships&in&order&to&further&disseminate&the&message.&&

&

This!report!provides!a!status!update!regarding!the!safety!of! liquid! laundry!detergent!capsules! in!2014.! ! It!builds!on!the!previous!status!reports!of!April!10!and!November!6,!2013,!and!on!the!intermediate!update!of!May!26,!2014,!all!of!which!are!available!on!the!A.I.S.E.!web!site:!!

http://www.aise.eu/ourIactivities/productIstewardshipIprogrammes/liquidIlaundryIdetergentIcapsulesI634/aiseIproductIstewardshipIprogrammeIforIliquidIlaundryIdetergentIcapsules.aspx!

For!further!background!not!included!in!this!document,!please!refer!to!the!aboveImentioned!documents.!


Contents!

Contents&.............................................................................................................................................................................&2&

Product&Stewardship&Programme&(PSP)&8&Commitment&and&Status&..................................................................................&3&

Product&and&Packaging&...................................................................................................................................................&3&

Commitment&..............................................................................................................................................................&3&

Status&.........................................................................................................................................................................&3&

Forward&Looking&8&Additional&Measures&on&Product&and&Packaging&under&CLP&........................................................&4&

Product&Information&and&Communication&.....................................................................................................................&5&

Commitment&..............................................................................................................................................................&5&

Status&.........................................................................................................................................................................&6&

Engagement&with&Poison&Control&Centres&.....................................................................................................................&6&

Commitment&..............................................................................................................................................................&6&

Status&.........................................................................................................................................................................&6&

Keep&Caps&From&Kids&(KCFK)&8&Commitment&and&Status&....................................................................................................&7&

Commitment&..............................................................................................................................................................&7&

Status&.........................................................................................................................................................................&7&

Results&......................................................................................................................................................................&10&

Collaboration&with&Poison&Control&Centres&......................................................................................................................&12&

Incident&Statistics&.........................................................................................................................................................&12&

United&Kingdom&.......................................................................................................................................................&13&

Ireland&......................................................................................................................................................................&14&

The&Netherlands&.......................................................................................................................................................&15&

Italy&..........................................................................................................................................................................&16&

The&Czech&Republic&..................................................................................................................................................&17&

Aggregation&..............................................................................................................................................................&18&

Accidentology&..............................................................................................................................................................&19&

Purpose&of&the&Study&................................................................................................................................................&19&

Status&.......................................................................................................................................................................&19&

Project&Description&...................................................................................................................................................&19&

Preliminary&Findings&.................................................................................................................................................&21&

Annex&I&8&Letter&from&ECSA&in&support&of&KCFC&................................................................................................................&22&

Annex&II&8&Accidentology&Questionnaire&...........................................................................................................................&23&


Product!Stewardship!Programme!(PSP)!7!Commitment!and!Status!

The& A.I.S.E.& Product& Stewardship& Programme& (PSP)& for& Liquid& Laundry& Detergent& Capsules& (LLDCs)& is& a& voluntary&

initiative,&open&to&all&companies&(manufacturers&as&well&as&retailers)&placing&LLDC&products&on&the&European&market,&

both&members&and&non8members&of&A.I.S.E.,&including&detergent&producers&and&retailers.&&The&PSP’s&aim&is&to&secure&

safe&use&and&storage&of&these&products,&and&as&a&result&thereof,&a&significant&reduction&of&the&incidence&of&accidental&

exposure,& in& particular& with& small& children.& & The& scope& of& the& programme& covers& all& liquid& laundry& detergent& and&

laundry&additive&capsules&in&Europe.&&

The& following& companies& (in& alphabetical& order)& have& committed& to& the& A.I.S.E.& Liquid& Laundry&Detergent& Capsules&

PSP,&covering&the&majority&of&the&market:&Henkel,&McBride,&Persan,&Procter&&&Gamble,&Reckitt8Benckiser,&Unilever.&

Companies&who&undersigned&the&PSP&commit&to&the&following&requirements,&specified&in&detail&on&the&A.I.S.E.&website:!

http://www.aise.eu/documents/document/20140214115535Iaise_liq_laundrydetercapspsp_final_1dec2012.pdf!

http://www.aise.eu/documents/document/20140512162123Iaise_lldc_complan_mandatorysafetymessage_april2014.pdf!

Product!and!Packaging!Commitment(

• Measures&to&reduce&visibility&of&liquid&laundry&detergent&capsules&through&the&pack,&by&using&opaque&or&obscure&

packaging&(or&equivalent).&

&

• Measures&to&restrict access&to&liquid&laundry&detergent&capsules&by&small&children,&by&means&of&improved&closures&

that&are&more&resistant&to&being&opened&by&children.&

&

Status!

These&packaging&measures&have&been& introduced&over&the&first&half&of&2013,&with&essentially&a&full& transition&by&mid&

2013.&By&December& 2014,& across& Europe,& nearly& all& LLDC&products& on& the& shelf& comply&with& the&PSP& requirements.&&

Generally,&the&few&exceptions&tend&to&be&limited&to&slower8moving&products&in&smaller&stores,&i.e.&where&turnaround&

has&been&insufficiently&fast&to&exhaust&all&older&product&supplies.&

It& should& be& noted& that,& even& if& pre8PSP& products& (i.e.& in& transparent& packaging)& hardly& have& any& remaining& shelf&

presence& across& Europe,& a& substantial& amount& of& these& products&may& still& be& in& use& (or& in& storage)&with& consumer&

households,&depending&on&individual&as&well&as&regional&habits.&

It&should&also&be&noted&that&several&on8line&trade&channels&may&not&yet&have&updated&the&pictures&of&the&products&sold&

on&their&websites,&thus&not&taking&into&account&the&PSP8related&changes.&&In&reality,&however,&these&on8line&stores&no&

longer&have&pre8PSP&products&in&their&assortment&and&are&shipping&the&new&PSP8compliant&packs.&&

Nota!bene:!In!addition!to!the!six!PSP!signatories,!some!other!manufacturers!have!also!made!changes!along!the!lines!of!the!A.I.S.E.!PSP!without!signing!it,!helping!to!further!shift!the!market.!!


Forward(Looking(4(Additional(Measures(on(Product(and(Packaging(under(CLP(

A.I.S.E.& and& the& companies& who& committed& to& the& PSP& welcome& the& European& Commission’s& and&Member& States’&

decision& to& introduce& mandatory& safety& measures& for& LLDCs& as& part& of& the& CLP& regulation,& in& line& with& the& PSP&

regarding&on8pack& labelling& and& capsule& visibility.& & This& decision&was& voted&at& the&CARACAL&meeting&of&October&29,&

2014&but&it&has&not&been&published&in&the&Official&Journal&at&this&date.&&Implementation&of&the&measures&under&CLP&will&

be&required&by&June&1,&2015.&

In&summary,&the&following&measures&on&LLDCs&will&be&covered&by&the&Annex&to&the&CLP&regulation:&&

& New!CLP!requirement!for!LLDCs! PSP!Comments!

On8pack&labelling& CLP!precautionary!phrase!P102!"Keep!out!of!reach!of!children"!at!a!visible!place!and!in!a!format!that!attracts!attention.!!!

This! is! in! line! with! the! PSP! requirement! for! the!“Keep! away! from! children”! phrase,! however! a!modification!of!the!actual!wording!will!be!needed!(whilst! aiming! to! keep! the! prominent! yellow!patch).!!!

Capsules&visibility&

through&the&pack&

The! outer! packaging! shall! be! opaque! or!obscure! so! that! it! impedes! the! visibility! of!the!product!or!individual!doses.!

This!is!in!line!with!the!current!PSP!requirements.!

Pack&closure& The! outer! packaging! shall! be! an! easily!reclosable,!selfIstanding!container!and!shall!be! fitted! with! a! closure! that! impedes! the!ability! of! young! children! to! open! the!packaging! by! requiring! coordinated! action!of!both!hands!with!a!strength!that!makes!it!difficult! for! young! children! to! open! it;! and!that! maintains! its! functionality! under!conditions! of! repeated! opening! and! closing!for! the! entire! life! span! of! the! outer!packaging.!

This! principle! is! in! line! with! the! current! PSP!requirements,!but! is!defined!more!specifically!for!the!CLP!Annex.! !Further!guidance!will!need!to!be!developed! to! assess! compliance! with! this! new!requirement.!!A.I.S.E.!plans!to!undertake!research!on! how! to! best! implement! this! measure! in!practice.!

Aversive&agent& The! soluble! packaging! shall! contain! an!aversive! agent! in! a! concentration! which! is!safe,! and! which! elicits! oral! repulsive!behaviour! within! a! maximum! time! of! 6!seconds,!in!case!of!accidental!oral!exposure.!

This! is! a! new! requirement,! currently! not! part! of!the! PSP.! ! This! is! expected! to! effectively! address!situations! were! all! other! preventive! measures!may! have! failed.! ! A.I.S.E.! has! commissioned! a!(currently! ongoing)! research! project! as! proof! of!concept,! to! assess! the! effectiveness! and! oral!rejection! time! with! a! specific! commonly! used!soluble!film!and!aversive!agent.!

Capsules&integrity& The! soluble!packaging! shall! retain! its! liquid!content! for! at! least! 30! seconds! when! the!soluble! packaging! is! placed! in! water! at! 20!°C;! and! shall! resist!mechanical! compressive!strength! of! at! least! 300! N! under! standard!test!conditions.!!

These!are!new!requirements,!currently!not!part!of!the!PSP.!!These!two!requirements!are!expected!to!avoid! exposure! to! the! capsules’! content,! in! case!of!respectively:!

I!oral!contact!prior!to!the!aversive!agent! leading!to!rejection!(see!above),!

I!accidental!forceful!manipulation.!

A.I.S.E.! is!currently!researching!test!methods!and!standards!that!may!be!applied.!

The! soluble! packaging! shall! resist!mechanical!compressive!strength!of!at!least!300!N!under!standard!test!conditions.!

&

!


Product!Information!and!Communication!Commitment(

• On8pack&labelling:&&

o Reinforced&guidance&regarding&the&safe&use&and&storage&of&liquid&laundry&detergent&capsules,&by&means&

of&standardised&A.I.S.E.&safe8use&icons&and&phrases.&&

o A& prominent& “keep& away& from& children”& message& and& guidance& to& close& the& pack& properly,& on& a&

conspicuous&yellow&“safe8use&patch”.&

&

&&

&&

• Advertising&and&communication:&&

o Consumer& communication& campaign& since& early& 2013:& mainly& on& brand& websites,& as& well& as& industry&

association&campaigns&on&a&national&level.&

o Further&commitments& since&April/May&2014,& to&display&a&mandatory& safety&message&on&all& LLDC&brand&

advertising& or& communication& (TV,& radio,& digital,& print/billboards).& & The& mandatory& sentence& being&

”Always&keep&away&from&children”&or&“Always&keep&[BRAND&NAME]&away&from&children”,&in&combination&

with&the&mandatory&A.I.S.E.&“Keep&away&from&children”&icon.&&Specific&mandatory&guidance&is&provided&for&

TV&advertising&regarding&the&size&of&the&visual,&the&duration&and&the&voice8over.&

&

&

&


Status(

Safe8use& icons&and&the&yellow&patch&were& introduced&by&all&companies&who&signed&up&to&the&PSP&since&mid&2013&or&

earlier,&and&are&now&consistently&used&on&packs.&&Essentially&the&market&coverage&is&complete.&&There&may&nevertheless&

be&some&individual&exceptions,&as&described&higher&for&the&packaging&measures.&&Also,&individual&households&may&still&

have&product&at&home&that&pre8dates&the&introduction&of&the&PSP&labelling&requirements.&

In& 2013,& safe8use& guidance& was& already& provided& on& brand& and& company& web& sites& and& social& media& sites& (e.g.&

facebook)& 8& through& web& banners,& educational& graphics,& and& educational& videos.& & Now,& the& safe8use& message& to&

“always&keep&away&from&children”&is&systematically&present&on&all&LLDC&brand&communication&by&the&companies&who&

undersigned&the&PSP.&&This&also&includes&all&TV&advertising&for&LLDC&products.&

Local&industry&association&communication&campaigns,&as&reported&in&earlier&status&reports,&continue&to&be&developed,&

examples& being& the& United& Kingdom,& Ireland,& The& Netherlands,& Italy& (e.g.& leaflets,& maternity& info& packs,& fridge&

magnets,...&in&addition&to&online&information).&

Nota!bene:!in!addition!to!the!PSP,!the!“Keep!Caps!From!Kids”!campaign!was!opened!in!August!2014!I!see!below.!

Engagement!with!Poison!Control!Centres!Commitment(

• Share&composition&of&new&LLDC& formulas&with& the&Poison&Control&Centres&according& to& the&harmonised& format&

defined&by&A.I.S.E.,&based&on&the&proposal&by&the&European&Association&of&Poison&Centres&and&Clinical&Toxicologists&

(EAPCCT)&(under&discussion&at&CARACAL&in&relation&to&CLP&Article&45).&

• Engage&with&Poison&Control&Centres&to&exchange&information&on&incident&statistics&and&market&dynamics.&

• Engage& with& Poison& Control& Centres,& including& the& EAPCCT,& to& develop& a& better& understanding& of& accident&

circumstances&(‘accidentology’).&

Status(

Harmonised&composition&sharing&for&new&formulations&was&implemented&as&of&summer&2013.&&It&should&be&noted&that&

for&practical&reasons&this&is&not&done&retroactively.&Hence,&in&case&no&new&formulations&have&been&introduced&on&the&

market,&no&additional&harmonised&data&on&existing&formulations&was&provided&to&the&PCCs.&

Information&exchange&with&several&PCCs&was&initiated&in&2013&and&continued&over&2014.&&The&most&recent&observations&

are&reported&further&in&this&document.&&&

An& ‘accidentology’&project&was&developed& in&collaboration&with&several&PCCs&across&Europe,&with&guidance& from&the&

EAPCCT.&The&preparatory&work&on&this&project&was&completed&over&summer&2014,&and&data&collection& in&5&PCCs&has&

been&started&in&October&or&November&8&for&a&six8month&period.&Results&and&interpretation&are&targeted&to&be&available&

around&mid&2015.&


Keep!Caps!From!Kids!(KCFK)!7!Commitment!and!Status!

In&addition&to&the&PSP,&there&is&the&digital&media&campaign&“Keep&Caps&From&Kids”&(KCFK).&&This&is&a&standalone&project,&

related& to& and& complementary&with& the& PSP,& with& the& same& product& scope.& & Beyond& the& detergent& industry& itself,&

partnership& is&open& to&Authorities,&Poison&Control&Centres& (PCCs),&NGOs,& retailers,&etc.& to&help& in&disseminating& the&

message.&

Complementary&to&the&above8mentioned&PSP&technical&measures,&consumer&education&is&key&to&securing&safe&use&of&

this& product& form.& & & KCFK& consists& of& a& multilingual& consumer& website& with& a& multilingual& educational& video&

supplemented&by&safety&tips.&&The&target&audience&for&this&campaign&is&parents&of&young&children,&as&well&as&all&other&

child&care&givers.&&The&tone&is&educational&and&positive,&the&tag&line&“keep&caps&from&kids”&being&a&call&for&action.&&

The& following& companies& committed& to&date& to& the&A.I.S.E.& Industry& campaign& "Keep&Caps& from&Kids"& (as&of&20& July&

2014& onwards),& in& alphabetical& order:& Henkel& (Main& Sponsor);& McBride& (Main& Sponsor);& Procter& && Gamble& (Main&

Sponsor);&Unilever&(Sponsor).&&&

Further,& to&date,& the& following& institutional& partners&have& signed&up& to& the& campaign:& the&Portuguese&Ministries& of&

Consumers& and& Health;& the& Belgian& PCC;& the& Danish& PCC;& the& Milano& PCC/Niguarda& Hospital& of& Milano;& the& Child&

Accident& Prevention& Trust& (CAPT)& in& the& UK;& the& Luxembourg& institute& for& normalization,& accreditation,& safety& and&

quality&(ILNAS).&

A.I.S.E&also&received&strong&support&and&commitment&from&the&European&Child&Safety&Alliance&(see&letter&in&Annex&I)&as&

well&as&from&several&of&its&members&in&the&following&countries:&Denmark&(Børneulykkes&fonden),&Bulgaria&(CPOK),&and&

the&UK&(RoSPA);&the&Cluj&School&of&Public&Health&(Romania).&

The& campaign&was& also& presented& to& the& European& Commission& (DG& Sanco),& as&well& as& to& the& European& Consumer&

Safety&Forum&on&9&October&2014,&where&it&was&well&received.&

Commitment(

A.I.S.E.&committed&to&develop&and&put&online&the&KCFK&website&and&to&conduct&a&digital&media&campaign.&

Companies&signing&up&as&Campaign&Partners&/&Sponsors,&commit&to&place&the&KCFK&material&(video&and/or&web&banner)&

on&all&their&LLDC&brands’&websites,&and&other&digital&communication&opportunities&where&they&are&present& in&the&EU&

28/4&territory,&for&the&whole&Activation&period&of&the&Campaign,&i.e.&at&least&from&1&August&2014&until&30&July&2015.&&

Status(

The& website& www.keepcapsfromkids.eu& was& opened& on& September& 3rd& 2014.& & This& covers& 32& countries& and& 25&

languages.& & In& total& 39& landing& pages& (one& per& country& and& per& language)& and& 225& creative& banners& sets& were&

developed.&&

&

&

&

&

&


& &

In&addition& to& the&KCFK&website& itself,& there& is&amplification&on& the&A.I.S.E.&and&National&Association&websites,& LLDC&

brands’&websites,&as&well&as&on&partners’&websites&(based&on&the&campaign&video&and&web&banners).&&

&

There&is&also&amplification&by&institutional&partners:&

&


Further,&a&specific&digital&media&campaign&is&being&conducted&over&Fall&2014,&through&the&placing&of&web&banners&and&

video& pre8rolls.& & Those& are& being& placed& on& websites& typically& targeting& the& audience& of& parents& and& child& carers.&&

Examples&can&be&seen&in&the&below&screenshots:&

&

&

&

&

&

&


&

&

Campaign&Partners&/&Sponsors&may&also&use&the&KCFK&material&for&use&on&TV&in&Europe.&This&will&be&organized&at&their&

own&discretion,&based&on&material& centrally&available& from&A.I.S.E.,&on&a&voluntary&basis&and&at& the&companies’&own&

cost.&

Results(

To&date,&the&campaign&delivered&260&million&impressions,&reaching&97&million&unique&users.&&Each&unique&user&has&seen&

the&ad&between&2&and&4&times.&&The&campaign&delivered&on&target,&or&over8delivered,&in&each&country:&

KCFC&8&delivered&impressions&per&country&

&

&

Pres

enta

tion

from

01.12.2014

General charts for misc. layouts 17

PLANNED VS. DELIVERED IMPRESSIONS

0% 20% 40% 60% 80% 100% 120% 140%

AustriaBelgiumBulgariaCroatiaCyprus

Czech RepublicDenmark

EstoniaFinlandFrance

GermanyGreece

HungaryIcelandIreland

ItalyLatvia

LiechtensteinLithuania

LuxembourgMalta

NetherlandsNorwayPoland

PortugalRomaniaSlovakiaSlovenia

SpainSweden

SwitzerlandUnited Kingdom

Delivered

Overdelivery

Finally planned Impressions: 253 mio. Delivered Impressions: 260 mio. Impressions delivered on top: 6.85 mio.


A&very&high&“video&view&through“&rate&was&observed,&with&over&80%&of&the&video&being&played&integrally&when&viewed:&

KCFC&8&view&through&rate&of&web&video&

&

The& number& of& unique& users& of& the&web& site&was& compared& to& the& size& of& the& target& audience,& i.e.& the& number& of&

parents&with&children&up&to&5&years&old.&&This&shows&that&in&all&countries,&more&unique&viewers&were&reached&than&the&

size&of&the&target&audience&(i.e.&ratio&in&the&below&chart&greater&than&1).&

KCFK&8&unique&users&versus&number&of&parents&with&children&<&5&years&old&

&

&

&

!

&

Pres

enta

tion

from

01.12.2014


HIGH VIDEO VIEW THROUGH RATES

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

AustriaBelgiumBulgariaCroatiaCyprus

DenmarkEstoniaFinlandFrance

GermanyGreece

HungaryIcelandIreland

ItalyLatvia

LiechtensteinLithuania

LuxembourgMalta

NetherlandsNorwayPoland

PortugalRomaniaSlovakiaSlovenia

SpainSweden

SwitzerlandUnited Kingdom

Video Fully PlayedVideo Played >75% - <100%Video Played >50% - <75%Video Played >25% - <50%Video Played 0% - <25%

Benchmark Europe**: 75% fully played rate

**http://www.sizmek.com/assets/pdf/Sizmek_2014-03_Benchmarks_report.pdf

Pres

enta

tion

from

01.12.2014


UNIQUE USERS VS. AMOUNT OF PARENTS WITH CHILDREN UP TO 5 YEARS

-

1,00

2,00

3,00

4,00

5,00

6,00

7,00

8,00

0

2000000

4000000

6000000

8000000

10000000

12000000

14000000

16000000

unique usersratio

Example: The number of parents with children up to 5 years in Italy is 5.5mio. We reached 8.8 mio. Unique User in Italy.


Collaboration!with!Poison!Control!Centres!!

Incident!Statistics!Incident&statistics&over&the&fourth&quarter&of&2013&and&the&first&three&quarters&of&2014,&collected&in&5&countries,&allow&

assessing&one&full&year&following&the&on8shelf&introduction&of&the&PSP&measures&across&the&EU&in&mid82013.&&Compared&

to&the&pre8PSP&baseline&situation,&there&is&a&substantial&reduction&in&the&market8normalised&reported&exposure&count&

for& all& included& countries:& respectively& 25%& for& the&UK,& 27%& for& Czech&Republic,& 30%& for& The&Netherlands,& 34%& for&

Ireland,&and&45%&for&Italy&(where&initial&measures&had&already&been&introduced&one&year&earlier).& &This&decrease&was&

shown&to&be&statistically&significant&in&all&countries&except&The&Netherlands.&&Considering&these&five&countries&together,&

there&was&a&statistically&significant&decrease&by&on&average&32%.&&

Incident&statistics&until&at&least&September&2014&are&available&for&the&United&Kingdom,&Ireland,&the&Netherlands,&Italy&

and&the&Czech&Republic.& &The& incident&statistics& in& this& report&were&kindly&provided&by&respectively& the&UK&NPIS,& the&

Dublin& PCC,& the& Utrecht& PCC& (NVIC),& the& Milan& Niguarda& PCC,& and& the& Prague& PCC.& & In& principle,& these& statistics&

represent& the& number& of& accidental& exposures& that& led& to& PCC& enquiries& 8& and& are& further& referred& to& a& ‘reported&

exposures’.&

Market& volume& data& (estimates& of& the& total& market& size)1&have& been& obtained& from& several& detergent& companies.&&

These& different& companies& use& different& methods& and& data& providers& to& develop& their& market& estimates.&&

Consequently,& the& estimates& can& vary& between& companies.& & The& individual& company& values& were& subsequently&

averaged& for& use& in& this& report.& & For& confidentiality& and& competition& reasons,& individual& company& values& are& not&

reported&here,&nor&are&the&names&mentioned&of&the&companies&who&provided&data.!!!

Normalisation.&&For&each&month,&the&number&of&reported&exposures&is&normalized&to&the&market&size,&resulting&in&the!number!of!reported!exposures!per!million!units!sold,!on!a!monthly2!basis.! !This!is!the!measure!used!to!assess!the!effectiveness!of!the!PSP!measures.&&&

Assessment.&The&number&of&reported&exposures&per&million&units&across&the&past&128month&period&(October&2013&until&

September&2014)&is&then&compared&to&the&128month&baseline&period&(prior&to&the&introduction&of&PSP&measures).&&In&

principle,& the& year& 2012& is& used& as& the& baseline.& &However,& for& Italy& and& The&Netherlands,& a& different& baseline&was&

defined&(cf.&the&November&2013&and&May&2014&reports)&due&to&the&specific&country&situation.&&In&all&cases,&exactly&one&

full&year&is&reflected&in&both&the&baseline&and&the&post8PSP&period,&to&ensure&possible&seasonality&effects&be&cancelled&

out.&&&

Statistical&significance.&To&assess&statistical&significance,&Student’s&t8test&was&used.&&The&significance&level&(p8value)&was&

determined&from&the&one8tailed&distribution:&because&the&PSP&measures&are&expected,&and&were&found,&to&always&lead&

to&a&decrease&in&incidents,&a&‘difference’&is&always&equivalent&to&‘less&than’,&i.e.&one8tailed.&&Whether&a&homoscedastic&

or&heteroscedastic&t8test&was&to&be&used,&was&based&on&an&F8test,&with&which&it&was&determined&whether&the&variances&

of&the&baseline&and&post8PSP&data&sets&were&to&be&considered&equal&or&not.&&A&significance&threshold&of&2%&was&applied&

for&the&t8tests&and&F8tests.&&

Nota!Bene:!Incident!statistics!are!usually!not!comparable!between!different!countries.!!In!some!countries,!only!medical!professionals!have!access! to! the!PCC! I!whereas! in!most!other!countries! the!general!public! can!also!enquire!directly,!which! leads! to!a!higher!number!of! calls.! ! Furthermore,! local! cultural!aspects!may!also!determine! the!percentage!of!exposure!cases!for!which!the!PCC!is!involved!or!contacted.!!Finally,!not!all!PCCs!cover!the!entire!territory!of!a!country,!which!impacts!the!normalisation!of!incident!numbers!per!million!units!sold,!and!makes!this!not!comparable!to!PCCs!in!other!countries.!

&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&1&Aiming!to!use!the!most!accurate!and!consistent!market!volume!estimates!available!today,!the!numbers!reported!for!previous!periods!may!differ!to!some!extent!from!what!was!reported!in!earlier!status!reports.&&2&This! is!a! timeIindependent!measure,! i.e.! irrespective!of!whether! it! is! calculated!on!a!monthly,!quarterly,!or!annual!basis.!!This!is!because!the!time!horizon!is!removed!when![the!number!of!incidents!per!month]!is!divided!by![the!number!of!capsules!sold!per!month]!(as!‘per!month’!appears!both!in!the!numerator!and!the!denominator).!!’Monthly!basis’!only!means!that!each!calculation!refers!to!one!specific!month.!To!derive!the!annual!value,!an!average!of!the!12!data!points!(for!the!12!months)!can!be!calculated.&&&&


United(Kingdom(

On& average,& the& absolute& number& of& reported& exposures& over& the& past& 128month& period& (October& 2013& until&

September&2014)&was&33&per&month.&&This&is&similar&to&the&baseline&year&2012&(35&per&month,&on&average).&&However,&

the&LLDC&market&in&the&UK&has&continued&to&show&steady&growth&over&this&period,&from&76&million&units&per&month&as&

the&2012&average,&to&over&100&million&units&for&the&most&recent&months.&&&

Consequently,&there&has&been&a&decrease&in&the&normalized&number&of&reported&exposures&per&million&capsules&on&the&

market.&&For&the&baseline&year&2012,&this&was&0.47&cases&per&million&units.&&For&the&past&12&months,&a&reduction&by&25%&

is&observed,&down&to&0.35&per&million.& &This&difference,& illustrated&by&means&of&dashed&horizontal& lines& in&the&below&

chart,&was& found&to&be&statistically&significant& (p=0.01&/& t8test,&18tailed,&assuming&equal&variances&as&shown& in&F8test&

with&p=0.23).&

&

It!should!be!noted!that!the!number!of!reported!exposures!differs!slightly!from!earlier!reports.!!This!is!because!the!NPIS!has! reIevaluated! the! data! and! has! retained! only! the! enquiries! that! refer! to! the! first! PCC! consultation! on! a! given!exposure,! in! case!multiple! calls! to! the!PCC!had!been!made! for! that! single!exposure.! ! Furthermore,! compared! to! the!previous! report,! the! estimation! of! the! market! size! has! been! optimised! and! hence,! also! these! values! are! slightly!different.!

&

0.00#

0.10#

0.20#

0.30#

0.40#

0.50#

0.60#

0.70#

0.80#

0#

20#

40#

60#

80#

100#

120#

Jan#

Feb#

Mar#

Apr#

May#

Jun# Jul#

Aug#

Sep#

Oct#

Nov#

Dec#

Jan#

Feb#

Mar#

Apr#

May#

Jun# Jul#

Aug#

Sep#

Oct#

Nov#

Dec#

Jan#

Feb#

Mar#

Apr#

May#

Jun# Jul#

Aug#

Sep#

2012# 2013# 2014#

reported#exposures#E#UK#

reported#exposures#per#month#(leK#axis)#mio#capsules#sold#per#month#(leK#axis)#reported#exposures#per#mio#capsules#sold#(right#axis)#6M#moving#avg#


Ireland(

On& average,& the& absolute& number& of& reported& exposures& over& the& past& 128month& period& (October& 2013& until&

September& 2014)& was& 13.75.& & This& is& a& 25%& reduction& compared& to& the& baseline& year& 2012& (with& 18.3& reported&

exposures&per&month&on&average).&&The&market&size&has&remained&stable&over&2012&and&2013&(on&average&3.8&million&

units&per&month),&but&an&increase&can&be&seen&over&2014&(4.6&million&capsules&per&month&on&average),&up&to&5.4&million&

units&sold&in&September.&&&

With&this&increasing&market,&the&reduction&in&the&number&of&reported&exposures&per&million&capsules&sold&exceeds&the&

absolute&incident&reduction.&&It&went&from&4.8&cases&per&million&units&in&2012&down&to&3.2&per&million&for&the&past&12&

months,& i.e.&a&decrease&by&34%.& &This&difference&(illustrated&by&means&of&dashed&horizontal& lines& in&the&below&chart)&

was&found&to&be&statistically&significant&(p=0.003&/&t8test,&18tailed,&assuming&unequal&variances&as&shown&in&F8test&with&

p=0.013).&

&

&

0"

1"

2"

3"

4"

5"

6"

7"

8"

9"

10"

0"

5"

10"

15"

20"

25"

30"

35"

40"

Jan"Feb"Mar"Apr"May"Jun" Jul" Aug"Sep"Oct"Nov"Dec"Jan"Feb"Mar"Apr"May"Jun" Jul" Aug"Sep"Oct"Nov"Dec"Jan"Feb"Mar"Apr"May"Jun" Jul" Aug"Sep"

2012" 2013" 2014"

reported"exposures"E"Ireland"(Dublin)"

reported"exposures"per"month"(leL"axis)"mio"capsules"sold"per"month"(right"axis)"reported"exposures"per"mio"capsules"sold"(right"axis)"6M"moving"avg"


The(Netherlands(

In&The&Netherlands,&LLDCs&were&not&significantly&present&on&the&market&until&early&2012.&&To&take&this&into&account,&the&

baseline&period&was&set&from&April&2012&until&March&2013&8&as&meaningful&numbers&of&exposures&were&only&reported&

as&of&April&2012.&

The& reported&exposure&count& (in&absolute&numbers)& continued& to& fluctuate&quite&heavily&over&2014,& increasing& to&a&

maximum& in& May& (36& cases),& but& going& down& again& towards& September& (21& cases).& & On& average,& there& were& 21&

reported&exposures&per&month&during& the&past& 128month&period,&which& is& similar& to& the&average&over& the&previous&

year&2013&(20&cases&per&month),&but&higher&than&what&was&observed&during&the&baseline&period&(13&cases&per&month).&&

However,&the&LLDC&market&has&grown&substantially&over&2012&and&the&first&half&of&2013,&from&2&million&units&sold&per&

month&up&to&nearly&10&million.&Since&mid&2013,&the&market&appears&to&have&stabilized,&with&substantial& fluctuations,&

averaging&around&7.4&million&capsules&per&month&over&the&past&12&months.&&

Normalized& to& the&market& size,& the& past& 128month& period& shows& 2.9& reported& exposures& per&million& capsules& sold,&

which&is&30%&less&than&the&4.2&cases&per&million&units&observed&over&the&baseline&period.&&The&baseline&and&the&past&128

month&period&are&illustrated&in&the&below&chart&with&dashed&horizontal&lines.&&Due&to&the&strong&oscillations,&there&is&no&

statistically&confirmed&difference&between&the&two&(p=0.063&/&t8test,&18tailed,&assuming&unequal&variances&as&shown&in&

F8test&with&p=0.0007).&

&

&

0"

1"

2"

3"

4"

5"

6"

7"

8"

9"

10"

0"

5"

10"

15"

20"

25"

30"

35"

40"

Jan"

Feb"

Mar"

Apr"

May"

Jun" Jul"

Aug"

Sep"

Oct"

Nov"

Dec"

Jan"

Feb"

Mar"

Apr"

May"

Jun" Jul"

Aug"

Sep"

Oct"

Nov"

Dec"

Jan"

Feb"

Mar"

Apr"

May"

Jun" Jul"

Aug"

Sep"

2012" 2013" 2014"

reported"exposures"E"Netherlands"(Utrecht)"

reported"exposures"(leJ"axis)"mio"capsules"sold"(right"axis)"reported"exposures"per"mio"capsules"sold"(right"axis)"6M"moving"avg"


Italy(

In&Italy,&initial&voluntary&risk&reduction&measures&were&already&implemented&as&of&mid82012,&one&year&prior&to&the&PSP.&&

These&were&followed&by&mandatory&measures&as&of&early&2013.&&Hence,&a&longer&data&series&(as&of&mid82010)&is&shown&

than&for&the&other&countries.&&As&a&pre8PSP&baseline,&the&year&2011&was&used3.&

Overall,&a&steady&decrease&of&the&number&of&reported&exposures&can&be&seen&since&the&mid82012&maximum&of&70&cases&

per&month.&&This&has&continued&over&2013,&and&has&then&levelled&off&over&2014&8&with&on&average&22&cases&per&month&

over& the& past& 12& months.& & There& seems& to& be& an& effect& of& seasonality,& with& an& increase& during& spring& and& early&

summer,& as& seen& in& both& 2013& and& 2014.& & The& apparent& increase& in& September& 2014& (31& cases)& appears& to& be& an&

outlier,&with&the&incident&count&for&October&back&to&18&cases&(not&presented&in&the&chart&below).&

Liquid& laundry& detergent& capsules& sales& in& Italy& across& 2014& were& 15820%& lower& than& the& plateau& that& had& been&

reached&from&mid82011&to&mid82012.&&Previously,&this&market&had&grown&steadily&from&the&time&of&market&introduction&

up& to&mid&2011,& reaching&a&sales&volume&of&about&30&million&units&per&month.& &Sales& remained&at& this& level& for&one&

year,&after&which&a&gradual&decrease&occurred,&reaching&a&stable&volume&of&on&average&of&21.7&million&units&per&month&

during&the&past&12&months.&&&

For&the&pre8PSP&baseline&year&(2011),&the&market8normalized&incident&frequency&is&1.85&reported&exposures&per&million&

units.&&Following&the&introduction&of&the&initial&measures&around&mid82012,&this&went&down&to&1.2&per&million&for&the&

128month& period& from&October& 2012& until& September& 2013.& & Subsequently& a& further& decrease& down& to& 1& reported&

exposure&per&million&units&is&seen&for&the&past&128month&period.&&This&suggests&that&the&downward&trend&is&continuing&

over&time,&albeit&at&a&reduced&rate&compared&to&the&initial&impact&of&the&introduction&of&the&measures.&

Compared&to&the&2011&baseline,&the&past&128month&period&shows&a&reduction&of&45%&(as&shown&in&the&below&chart&by&

the&dashed&horizontal&lines).&&This&is&a&statistically&significant&decrease&(p=0.00006&/&t8test,&18tailed,&assuming&unequal&

variances&as&shown&in&F8test&with&p=0.0002).&&&

Compared&to&the&immediately&preceding&128month&period&(October&2012&until&September&2013)&the&reduction&is&15%,&

not&statistically&significant&(p=0.035&/&t8test,&18tailed,&assuming&equal&variances&as&shown&in&F8test&with&p=0.022).&&&

&

&

&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&3&!It!should!be!noted!that!this!is!different!from!the!18Imonth!baseline!initially!proposed!in!the!November!2013!report,!because!a!baseline!of!exactly!12!months!is!needed!to!avoid!bias!by!seasonality!effects.&

0.0#

0.5#

1.0#

1.5#

2.0#

2.5#

3.0#

3.5#

0#

10#

20#

30#

40#

50#

60#

70#

Aug#

Sep#

Oct#

Nov#

Dec#

Jan#

Feb#

Mar#

Apr#

May#

Jun# Jul#

Aug#

Sep#

Oct#

Nov#

Dec#

Jan#

Feb#

Mar#

Apr#

May#

Jun# Jul#

Aug#

Sep#

Oct#

Nov#

Dec#

Jan#

Feb#

Mar#

Apr#

May#

Jun# Jul#

Aug#

Sep#

Oct#

Nov#

Dec#

Jan#

Feb#

Mar#

Apr#

May#

Jun# Jul#

Aug#

Sep#

2011# 2012# 2013# 2014#

reported#exposures#D#Italy#(Niguarda)#

reported#exposures#to#Niguarda#per#month#(leK#axis)#mio#capsules#sold#in#Italy#per#month#(leK#axis)#reported#exposures#(Niguarda)#per#mio#capsules#sold#in#IT#(right#axis)#6M#moving#avg#


The(Czech(Republic(

Like&the&Netherlands,&the&Czech&Republic&is&a&relatively&new&market&for&liquid&laundry&detergent&capsules,&with&clearly&

increasing&sales&volumes.&&&

With&substantial&oscillations,&the&number&of&reported&exposures&has&increased&from&about&15&per&month&in&early&2012,&

to&on&average&24&per&month&over&2013,&and&further&to&30&per&month&over&the&first&three&quarters&of&2014.&&Within&this&

same&time&frame,&the&market&size&has&nearly&tripled&from&less&than&2.5&million&units&per&month&in&early&2012&up&to&7&

million&per&month&in&summer&2014.&&&

In&2012,&which&is&taken&as&the&pre8PSP&baseline,&there&were&on&average&6.6&reported&exposures&per&million&units&sold.&&

The&situation&over& the&past&12&months,&with&4.8&cases&per&million,& is&27%&below&this&baseline.& &This& is&a& statistically&

significant& reduction& (p=0.0015& /& t8test,& 18tailed,& assuming& equal& variances& as& shown& in& F8test& with& p=0.36).& & The&

baseline&and&the&past&128month&period&are&shown&in&the&below&chart&by&the&dashed&horizontal&lines.&

&

&

Thanks& to& the& accidentology&work& (see& below),& the& observation&was&made& that& a& large& fraction& (40%)& of& the&most&

recent& LLDC& incidents& in& the& Czech& Republic& was& still& with& transparent& packs,& i.e.& product& that& pre8dates& the&

introduction&of&the&PSP&measures.&&It&is&hypothesised&that&this&is&due&to&a&local&old&(but&still&existing)&consumer&habit&to&

acquire& large& quantities& of& product& when& available,& and& store& these& at& home.& & Hence,& it& is& expected& that& the& full&

benefits&of&the&PSP&measures&will&not&become&visible&until&these&consumer&stocks&of&pre8PSP&products&are&exhausted.&

0"

1"

2"

3"

4"

5"

6"

7"

8"

9"

10"

0"

5"

10"

15"

20"

25"

30"

35"

40"

Jan"

Feb"

Mar"

Apr"

May"

Jun" Jul"

Aug"

Sep"

Oct"

Nov"

Dec"

Jan"

Feb"

Mar"

Apr"

May"

Jun" Jul"

Aug"

Sep"

Oct"

Nov"

Dec"

Jan"

Feb"

Mar"

Apr"

May"

Jun" Jul"

Aug"

Sep"

2012" 2013" 2014"

reported"exposures"E"Czech"republic"(Prague)"

reported"exposures"(leM"axis)" mio"capsules"sold"(right"axis)"

reported"exposures"per"mio"capsules"sold"(right"axis)" 6M"moving"avg"

average"baseline" average"last"12M"


Aggregation(

In&addition&to&the&individual&country&assessments,&an&aggregated&assessment&was&performed&including&all&5&countries&

for&which&data&are&available.&&&

As&explained&above,&the&absolute&values&of&the&‘reported&exposures&per&million&capsules’&are&not&directly&comparable&

between& countries.& & Instead,& for& the& purpose& of& aggregation,& these& values& were& normalised& against& the& baseline&

situation&per&country.& & In&other&words:& for&each&country,& the&average& incident& frequency&during& the&baseline&period&

was&set&as&unity&8&and&the&individual&monthly&data&were&re8scaled&proportional&to&this&new&unity.&&E.g.&for&the&UK,&0.47&

cases&per&million&capsules&is&set&as&unity;&whereas&for&Ireland,&the&unity&is&set&to&4.8&cases&per&million&capsules.&

Across&all&countries,&with&the&baseline&value&now&being&100%,&the&average&value&for&the&past&128months&is&68%.&&This&is&

a&decrease&by&32%&versus&the&baseline,&and&this&difference&is&statistically&significant&(p=9E89&/&t8test,&18tailed,&assuming&

unequal&variances&as&shown&in&F8test&with&p=0.75E86).&&&

The&average&and&variance&of&the&normalised&baseline&situation&and&the&past&128month&(P12M)&situation&are&shown&in&

the&below&chart.&

&

&

60%$

70%$

80%$

90%$

100%$

110%$

120%$

Baseline$ P12M$

rela%ve'plot'of'reported'exposures'per'million'capsules'sold'(baseline'situa%on'='unity)'


Accidentology!A.I.S.E.&has&commissioned&an&“accidentology”&study&with&5&PCCs&across&Europe,&aiming&to&better&understand&accident&

circumstances&with&liquid&laundry&detergent&capsules.&&The&preparatory&work&was&completed&by&Fall&2014&and&the&data&

collection&was& initiated& in&October/November.& & The& study&will& run& for& 6&months.& &Data& interpretation&by&A.I.S.E.,& in&

collaboration&with&the&participating&PCCs,&will&take&place&during&the&second&quarter&of&2015,&with&a&Final&Report&to&be&

ready&in&summer&2015.& & Initial&findings&(October&2014,&from&3&PCCs)&suggest&that&the&most& important&root&causes&of&

incidents&are&when&capsules&are&left&directly&accessible&to&children&(open&packs,&or&capsules&left&outside&of&their&pack),&

or&when&the&child&manages&to&open&the&pack.&

Purpose(of(the(Study(

The& study& aims& to& achieve& a& better& understanding& of& the& root& causes& and& circumstances&why& accidental& exposures&

occur&with& liquid& laundry&detergent& capsules,& especially& involving& young& children.& &Both&exposures& to& liquid& laundry&

detergent&capsules&themselves,&and&exposures&to&other&(non8laundry)&detergent&capsules,&are&within&the&scope&of&the&

study.&&With&these&findings,&the&effectiveness&of&the&risk&mitigation&measures&and&consumer&education&campaigns&that&

are& currently& implemented& through& A.I.S.E.’s& product& stewardship& programme& will& be& assessed& and& refined& as&

appropriate.& & Furthermore,& this& information&will& also& be& used& to& help&with& the& development& of& additional& targeted&

measures&as&needed.&&&

The& specific&outcome&expected& from& the&accident& circumstances&data& collection,& is& a&data& set& containing&a&detailed&

description& (as& defined&below)& of& the& accident& circumstances& of& exposures& to& detergent& capsules,& for& a&meaningful&

number&of&cases&(i.e.&at& least&several&hundreds&in&total&across&all&participating&centres).& &As&a&final&deliverable&of&the&

project,& A.I.S.E.&will& develop& a& Final& Report& in&which& the& collected& data& are& reported& in& an& aggregated&way,& and& in&

which& A.I.S.E.’s& interpretation& is& presented& as& well& as& its& overall& conclusions& and& recommendations& regarding& risk&

reduction&measures.& The& draft& Report& and& study& conclusions&will& be& reviewed&with& the& participating& PCCs& prior& to&

publication.&&

Status(

A.I.S.E.&has&commissioned&the&project,&to&which&several&Poison&Control&Centres&across&Europe&are&participating:&Dublin,&

Göttingen,& Milan,& Prague,& and& Utrecht.& & & In& addition,& the& European& Association& of& Poisons& Centres& and& Clinical&

Toxicologists& (EAPCCT)& has& provided& guidance& regarding& the& set8up& of& the& collaboration,& and& regarding& the&

methodology.&

The& preparatory& work& has& been& completed& before& and& over& summer& 2014.& & This& included& the& establishment& of&

bilateral&collaboration&agreements&between&A.I.S.E.&and&the&participating&PCCs,&alignment&with&the&PCCs&on&the&scope&

and&methodological&aspects,&and&the&development&of&a&standardised&questionnaire&and&data&tracking&format.&

The&participating&PCCs&have&submitted&the&study&protocols&to&their&Ethical&Review&Committees&during&or&shortly&after&

summer.&&&

Following&the&respective&formal&approvals,&each&PCC&has&now&initiated&the&data&collection&phase,&which&will&run&until&

the&end&of&the&first&quarter&of&2014.&

Project(Description(

At& the& participating& Poison& Control& Centres,& enquiries& regarding& accidental& exposure& to& detergent& capsules& will& be&

specifically& monitored.& & For& each& case,& where& possible,& further& follow8up& will& be& conducted& regarding& the& exact&

product& involved& and& the& circumstances& under&which& the& exposure& occurred.& & Other& potentially& important& aspects&

(e.g.& regarding& laundry& habits,& family& situation,& etc.)& will& also& be& included.& In& addition,& for& symptomatic& cases&with&

moderate& or& severe& effects,& the& toxicological& aspects& (symptoms,& severity,& treatment& and& recovery)& should& be&

included&when&feasible.&

Data(Collection(Protocol(Questionnaire:&A&questionnaire&and&a&data&collection&format&were&developed&jointly&by&the&PCCs&and&A.I.S.E.,&to&ensure&

consistency& between& the& different& participants,& and& homogeneity& of& the& collected& data.& & This& questionnaire& is&

presented&in&Annex&II.&

Follow8up:& Usually,& follow8up& with& the& caller& after& the& initial& enquiry& to& the& PCC& will& be& required& to& collect& the&

necessary&information.&&This&should&be&done&soon&after&the&initial&call&(e.g.&typically&within&days).&&How&the&follow8up&

process& is&managed&will& depend& on& the& applicable& procedures& in& the& individual& PCCs,& and& on& the& fact&whether& the&

initial&enquiry&was&by&a&medical&professional&or&by&the&parent&/&care&giver.&&


The& actual& data& collection& protocols,& including& the& approach& how& to& manage& follow8up& calls,& are& defined& by& the&

individual& PCCs,& to& ensure& an& optimal& fit&with& the& existing&work& processes& and& resources& in& place& at& the& individual&

centre.&&

Products(within(scope:((8 All& unit& dose& detergent& products& contained& in& a& soluble& film& (laundry,& automatic& dishwashing,& other& cleaners).&&

These& products&may& either& be& entirely& liquid,& or& partially& liquid& /& partially& solid,& or& entirely& solid& (i.e.& powder8

based).& & To! note,! powderIbased! automatic! dishwashing! tablets! that! are! individually! packed! in! a! nonIsoluble!disposable!wrapper!are!not!within!the!scope!I!whereas!powderIbased!automatic!dishwashing!tablets!contained!in!a!soluble!film!that!is!not!to!be!removed!before!use,!and!that!are!not!individually!packed!in!a!disposable!wrapper,!are!within!the!scope.&

8 A.I.S.E.& has&provided&a& list& of&brand&and&variant&names& to&help& the&PCCs& identify& the& relevant&products& in& their&

national&markets.&&This&list&does&not&include&EAN&codes,&as&this&level&of&detail&is&not&required,&and&this&information&

is&typically&not&easily&traceable&during&a&PCC&enquiry.&&Ultimately,&the&decision&to&include&a&case&shall&be&based&on&

the&PCC&expert’s&judgment,&based&on&the&caller’s&description&of&the&product.&

Inclusion(Criteria(8 All&human&exposures&with&patients&of&all&ages&and&genders&are&to&be&included.&

8 All&routes&of&exposure&(oral,&eye,&skin,&combined)&are&to&be&included.&

8 All& cases& with& exposure& to& the& products& within& scope& are& to& be& included,& irrespective& of& whether& a& causal&

relationship&between&this&exposure&and&the&reported&effects&has&been&established.&&

8 Consent:&only&cases&where&informed&consent&can&be&obtained&shall&be&included.&

Exclusion(Criteria(8 Completeness:& sufficient& information&about& the&accident& circumstances&must&be&available& in&order& to& include&a&

case.&&The&reporting&of&cases&with&only&partially&completed&accident&circumstances&information&will&be&acceptable.&&

However,&as&a&minimum,&the&identification&of&the&product&(see&further&in&the&proposed&questionnaire)&and&a&clear&

description&of&how&the&accident&occurred&are&essential.&&&

8 It&is&recognized&that&follow8up&on&cases&reported&by&a&medical&professional,&instead&of&directly&by&the&parents&or&

care& givers,& may& be& challenging.& & The& PCC&may& decide,& on& a& case8by8case& basis,& to& exclude& incident& enquiries&

where&follow8up&on&accident&circumstances&is&not&expected&to&be&productive.&

8 The& number& of& cases& that& are& excluded& (either& because& productive& follow8up& was& not& possible,& or& because&

appropriate&consent&was&not&obtained)&needs&to&be&tracked.&

Cases(Requiring(Toxicological(Follow4up(In8depth&toxicological&follow8up&regarding&the&evolution&of&the&effects,&treatment,&recovery&8&is&only&to&be&considered&

for&cases&with&a&PSS&(Poisoning&Severity&Score)&of&2&or&higher.&&In&principle,&this&follow8up&should&be&continued&until&the&

case& is& resolved.& & No& such& follow8up& is& required& for& asymptomatic& cases& or& for& cases& with& mild,& transient& and&

spontaneously& resolving& symptoms.& & Furthermore,& toxicological& follow8up& is& only& to& be& progressed& when& this& is&

practically&feasible&without&disproportionate&additional&effort.&&&

Data(Processing(The& PCC& shall& ensure& that& the& patients& and/or& their& treating& doctors& are& adequately& informed& about& the& data&

collection,&and&shall&ensure&that&data&are&only&collected&once&informed&consent&by&the&patient&has&been&appropriately&

received&and&documented.&

Data&related&to&the&patient&contact&details,&their&treating&doctor,&and&to&the&patient’s&consent,&shall&be&kept& internal&

and&confidential&to&the&PCC,&and&shall&not&be&shared&either&with&A.I.S.E.&or&with&any&of&the&project’s&partners.&&The&PCC&

continues&to&be&responsible,&on&an&individual&basis,&for&safe&storage&of&the&original&raw&data&including&the&confidential&

and&patient&consent&information.&

The&anonymised&accident&circumstances&data&(with&any&personally& identifiable&information&removed&by&the&PCC)&are&

tracked& using& an& ExcelTM& spreadsheet& template& (as& made& available& by& A.I.S.E.& to& all& participating& PCCs).& & The& data&

should&be&entered&into&this&spreadsheet&in&English.&&These&data&will&be&made&available&by&the&PCC&to&A.I.S.E.&for&further&

analysis&and&interpretation,&on&a&monthly&basis.&&

Final(Report(After&the&end&of&the&data&collection&phase,&A.I.S.E.&will&prepare&a&Final&Report&with&an&overview&of&the&collected&data,&

an&overall&interpretation,&and&conclusions&regarding&the&correlation&between&capsule&/&packaging&aspects&and&accident&

circumstances.& & Prior& to&making& this& public,& a& draft& of& this& Final& Report&will& be& shared&with& the& participating& PCCs.&&

These&PCCs&will&review&and&provide&input&on&this&report&via&a&joint&workshop&(expected&timing:&shortly&before&summer&

2015),&and&will&be&asked&for&approval&prior&to&publication.&&&


Preliminary(Findings(

From&the&PCCs&of&Dublin,&Prague&and&Utrecht,&the&findings&for&the&month&of&October&have&already&been&made&available&

to&A.I.S.E.& (40& cases&with& liquid& laundry&detergent& capsules&were& reported).& &Whereas& the&data& set& is& too& limited& to&

draw&any&conclusions&8&both&in&terms&of&period&covered&and&in&terms&of&number&of&cases&8&some&initial&observations&

can&already&be&mentioned.&&It&is&emphasized&that&these&findings&are&very&preliminary&and&may&or&may&not&be&confirmed&

as&the&data&collection&proceeds.&&Therefore,&no&conclusions&should&be&drawn&from&these&results.&

The&most& important& root& causes&observed& to&date&are&on& the&one&hand& situations&where& capsules&were& left& readily&

accessible&to&the&child&(i.e.&kept&outside&of&the&pack,&or&inside&an&open&pack),&and&on&the&other&hand&cases&where&the&

child&had&access&to&the&closed&pack&and&managed&to&open&this.&&

PSP(Compliance(For&the&Netherlands&and&Ireland,&nearly&all& laundry&cases&occurred&with&PSP8compliant&packs.&&This&is&in&line&with&the&

fact&that&the&market&has&shifted&already&mid&2013.& &However,&for&the&Czech&Republic,&over&40%&of&the&laundry&cases&

were&with&product& in& transparent&packs.& &As& in& the&other& countries,& the&Czech&market&has& shifted& to&PSP8compliant&

products&since&mid&2013.&&But&in&the&Czech&Republic&there&is&still&an&old&habit&to&acquire&large&quantities&of&product&and&

to& store& these&at&home.& &This&may&have&been&especially& important&when&LLDCs& first&became&available&on& the&Czech&

market& in&2012.& &Consequently,&a&substantial&fraction&of&the&LLDC&products&currently& in&use&by&consumers& likely&pre8

dates&the&PSP&measures.&&Without&quantitative&data,&it&is&however&not&possible&to&assess&whether&pre8PSP&transparent&

packs&are&associated&with&a&disproportionally&larger&number&of&incidents&compared&to&compliant&product.&

Access(to(the(Capsule(Across&all&reported&cases,&the&most&frequently&occurring&root&cause&was&when&a&child&had&access&to&the&capsule&either&

because& the& pack& had& been& left& open,& or& because& the& capsule& had& been& put& outside& of& the& pack& (e.g.& in& a& laundry&

basket).&&Overall&this&was&reported&for&2&out&of&3&cases.&However,&there&was&a&difference&between&the&Czech&Republic,&

where& this& represented&4&out&of&5&cases,&versus& the&Netherlands&and& Ireland,&where& this& led& to&1&out&of&3& reported&

exposures.&

In&the&Netherlands&and&Ireland,&half&of&the&exposures&took&place&when&a&child&had&gained&access&to&the&original&pack&

(that&was&closed),&and&then&opened&this&pack&and&took&a&capsule&out&of&it.&&For&the&Czech&Republic,&on&the&other&hand,&

no&such&cases&were&reported.&&

In&nearly&all&cases&where&a&child&either&took&a&capsule&from&an&open&pack,&or&opened&the&pack&to&gain&access,&the&pack&

had&been&easily&accessible& to& the&child& (i.e.&not& stored& in&a&high&cabinet&or& shelf,&not& in&a&cabinet&with&an&activated&

child8safe& lock).& &Only&2& cases&were& reported&where&a& child&managed& to& climb&and&grab&a&pack& from&a&high& storage&

location&that&was&deemed&child8safe.&

In&1&out&5&cases&overall,&a&child&found&a&capsule&that&had&previously&been&lost&or&misplaced,&and&that&was&lying&on&the&

floor,&in&a&cabinet,&etc.&&Situations&where&the&parents&knowingly&gave&a&capsule&(or&the&pack)&to&a&child&were&rare&(only&

1&case&reported&so&far).&

Packaging(Type(95%&of&the&reported& incidents&with&LLDCs&occurred&with&plastic&boxes,&the&remaining&5%&with&bags.& &This& is&more&or&

less& in& line& with& the& relative& market& presence& of& both& packaging& forms& (i.e.& predominantly& boxes).& However,& the&

dataset& is& still& too& small& to& assess&whether& there&may& be& an& influence& of& the& ‘outer& packaging’& type& on& accidental&

exposure&frequency.&&

Capsule(Color(Across& the& reported& cases,& there& was& an& equal& split& between& multi8color& capsules& and& green& capsules,& each&

representing&about&40%&of& the& reported&exposures.& &Blue& capsules& led& to&about&10%&of& the& incidents.& & These& initial&

findings&seem&to&suggest&that&the&number&of& incidents&with&each&color&type&is&related&to&the&market&size,&not&to&the&

color& itself.& &This& is& to&be& further&assessed,&also&using&detailed&market& information&per&color,&as&more&accidentology&

data&become&available.&

Family(situation(There&seems&to&be&no&correlation&between&family&size&and&the&occurrence&of&incidents.&&

(&


Annex!I!7!Letter!from!ECSA!in!support!of!KCFC!

&

&

…2

RoSPA House

28 Calthorpe Road, Edgbaston

Birmingham, B15 1RP

United Kingdom

Tel: 0121 248 2000

Fax: 0121 248 2001

www.childsafetyeurope.org

!September!29,!2014!!!To!the!attention!of!Susanne!Zänker,!Director!General!A.I.S.E.!(International!Association!for!Soaps,!Detergent!and!maintenance!products)!15!A!Avenue!Herrmann!Debroux!BL!1160!Brussels!!!!Dear!Mrs!Zänker,!!!As!you!may!already!know,!the!European!Child!Safety!Alliance!was!launched!in!2000!with!the!ambition!to!make!the!lives!of!children!living!in!Europe!safer.!Today,!more!than!30!countries!across!Europe!are!working!together!towards!this!objective,!through!the!support!from!our!child!safety!experts!in!a!broad!scope!of!topics!including!medicine,!public!health,!psychology,!education,!engineering!and!government.!!!The!issue!of!children!misusing!liquid!laundry!detergent!capsules!was!brought!to!our!attention!by!several!of!our!members!last!year!and!we!have!subsequently!noted!the!move!from!transparent!to!opaque!packaging!and/or!altering!of!packaging!to!reduce!the!risk.!You!informed!us!recently!about!the!launch!of!A.I.S.E’s!panLEuropean!"Keep!Caps!from!Kids”!campaign!for!Liquid!Laundry!Detergent!Capsules!and!partnership!possibilities!and!we!thank!you!for!this.!!!We!have!reviewed!the!information!on!the!campaign!portal!www.keepcapsfromkids.eu!and!have!decided!that!your!campaign!provides!a!wonderful!opportunity!to!support!action!already!underway.!We!appreciate!the!factual!presentation!of!the!safety!information!as!communicated!on!the!site!for!consumers,!particularly!your!making!it!availability!in!the!major!EU!languages,!and!congratulate!you!for!this!work.!We!have!also!looked!at!the!partnership!agreement!you!have!provided!to!us!and!we!are!glad!to!confirm!that!ECSA!is!happy!to!support!the!campaign!as!a!European!NGO.!!We!will!also!publicly!support!the!campaign!by!adding!the!European!Child!Safety!Alliance!logo!to!the!portal!to!indicate!our!support!and!will!undertake!to!spread!the!campaign!further!via!social!media!(e.g.!our!Facebook!page).!!!In!addition,!given!that!the!information!is!available!in!each!EU!language,!we!will!also!distribute!the!information!and!suggest!that!our!national!partners!consider!joining!the!campaign!at!the!national!level,!lending!further!weight!to!the!campaign.!We!will!leave!it!to!them!though!to!decide!individually!their!level!of!participation.!!

Making life safer for children

Hosted by the Royal Society for the Prevention of Accidents, UK

As!we!strongly!believe!that!the!more!partners!that!help!to!relay!this!campaign,!the!more!powerful!it!will!be!in!reaching!consumers!and!ultimately!reducing!the!number!of!incidents,!we!encourage!and!support!you!in!continuing!to!promote!the!campaign!to!stakeholders,!authorities,!poison!control!centers!–!at!EU!and!national!levels!–!and!remain!available!to!discuss!the!initiative!and!monitoring!of!its!evolution.!!Yours!sincerely,!!

!!Morag!MacKay!Programme!Manager!!!!!!!!


Annex!II!7!Accidentology!Questionnaire!!

Topic& Information&required& Response&options&&

• Single&option&to&be&selected&

o Multiple&options&allowed&

Occurrence&of&the&incident&

&

Date& [dd/mm/yy]&

Time&of&the&day& [hh:mm]&

Location:&which&house& • At&home&

• Grandparents&

• Friends&

• School,&day&care&

• Other&

Location:&which&room& • Laundry&room&

• Kitchen&

• Bathroom&

• Playroom,&child’s&room&

• Other&

Identification&of&the&patient&

(no&personally&identifiable&

information&to&be&included!)&

Age& [nn]&years&

Gender&& • M&

• F&

Accident&description& Route&of&exposure& o Ingestion&

o Eye&

o Skin&

How&was&the&capsule’s&content&released?& o Capsule&leaked&

o Squeezing&

o Biting&&

o Licking&

o Cutting&or&piercing&

o Handling&with&wet&hands&

o Other&

Any&other&relevant&information& Free&text&

Symptoms&

&

Severity&PSS&&

(initial&estimate,&or&final&if&different)&

• 0&=&Asymptomatic&

• 1&=&Minor&

• 2&=&Moderate&

• 3&=&Severe&

Description&of&the&symptoms&&

(please&select&none,&one,&or&several&8&as&

appropriate)&

o vomit&

o diarrhoea&

o drooling&

o oral&mucosae&irritation&

o oral&mucosae&inflammation&

o pharyngodynia&

o dyspnea&

o cough&

o edema&of&the&glottis&

o laryngospasm&

o bronchospasm&

o abdominal&pain&

o heartburn&

o drowsiness&

o first8degree&burns&

o second8degree&burns&


o third8degree&burns&

o itch&

o petechiae&

o cutaneous&edema&

o palpebral&edema&

o eye&irritation&

o eye&inflammation&

o conjunctivitis&

o corneal&abrasion&

o impaired&vision&

o photophobia&

o corneal&ulcer&

o eye&pain&

Any&other&relevant&information& Free&text&

Assessment&of&causality&&

(best&judgment&based&on&available&

information)&

• Certain&

• Uncertain&

• None&

Identification&of&the&product&

&

Type&of&capsule:&Purpose&

&

• Laundry&

• Fabric&conditioner&

• Automatic&dishwashing&

• Cleaning&product&

Type&of&capsule:&Form&& • Entirely&liquid&

• Part&liquid,&part&solid&

• Entirely&solid&(powder&tablet)&

Brand&and&Variant&name&& Free&text&

Packaging&type&

&

• Plastic&Box&/&Tub&

• Bag&

• Carton&

Visibility&of&the&capsules&through&the&

packaging&&

• Opaque&pack&(capsules&not&visible)&

• Obscure&pack&(reduced&capsules&

visibility)&

• Transparent&pack&(capsules&visible)&

• Unknown&

Colour(s)&of&the&capsule& • Transparent&

• White&

• Green&

• Blue&

• Purple&

• Pink&

• Yellow&

• Red&

• Orange&

• Black&

• Multiple&colours&

• Other&

Colour(s)&of&the&capsule&8&other&information& Free&text&

Any&other&relevant&information&about&the&

packaging&or&the&capsule&

Free&text&

Accessibility&of&the&product:&

&

Where&was&the&capsules&pack&stored?& • In&a&high&cabinet&or&shelf&

• Under&the&sink&

• On&the&washing&machine&&


• On&the&kitchen&counter&

• On&the&floor&

• Unknown&

Was&the&capsules’&pack&stored&in&a&cabinet&

with&a&child8safe&lock&/&latch?&

• Yes&

• No&

• Unknown&&

• N.A.&(because&not&in&cabinet)&

Was&the&capsule&stored&in&its&original&

packaging?&&&

• Yes&

• No&

• Unknown&

IF&in&the&original&packaging:&&

Had&the&pack&been&left&open&or&was&it&closed?&

• Left&open&

• Closed&

• N.A.&(because&not&in&original&pack)&

IF&in&the&original&packaging:&&

How&did&the&child&open&the&packaging?&

Free&text&

Was&product&ready&for&use&(i.e.&already&taken&

out&of&its&packaging)&when&the&accident&

happened?&

• Yes&

• No&

• Unknown&

Any&other&relevant&information&regarding&the&

circumstances&

Free&text&

Other&information& Number&of&children&in&the&household& • One&

• Two&

• More&than&two&

Any&suggestions&how&the&product&might&be&

made&safer?&&

Free&text&

Toxicological&aspects&&

Only&for&cases&with&PSS&>=&2&

(for&medical&staff)&

&

What&treatment&did&the&patient&receive?&& Free&text&

Did&the&patient&recover&completely?& • Yes&

• No&

• Unknown&

How&long&did&the&recovery&take?& • Recovery&within&a&day&

• Several&days,&<&1&week&

• Up&to&1&month&

• Longer&than&1&month&

• Unknown&

Any&other&relevant&information&about&the&

symptoms,&the&treatment,&relevant&medical&

history&of&the&patient&

Free&text&

&

!

A.I.S.E.&& · PDF fileA&scientific&study&to&map&and&to&better ... ... seconds,!in!case!of

Documents

Transcript of A.I.S.E.&& · PDF fileA&scientific&study&to&map&and&to&better ... ... seconds,!in!case!of