Parents can prevent ocular injuries from household chemicals to young children

Young children, not working adults who might handle chemicals on the job, are at the highest risk for eye injuries from chemical burns, according to a surprising study by researchers at Johns Hopkins University.

Researchers looked at data, collected from the Nationwide Emergency Department Sample, between Jan. 1, 2010, and Dec. 31, 2013, at emergency departments (ED) nationwide. A total of 144,149 chemical ocular burns were sampled.

The highest incident rates for individual years was among 1-year-olds and 2-year-olds, averaging 28.6 and 23.5, respectively, compared to the highest rate for adults (24-year-olds) at 19.1. The findings were published in an Aug. 4 article, "Epidemiologic Trends of Chemical Ocular Burns in the United States," in JAMA Ophthalmology.

Accessible household cleaning chemicals—containing alkali and acid—were often at fault.

"This study highlights an important opportunity for effective injury prevention efforts," the study's authors wrote. "Chemical ocular injuries among young children are almost entirely preventable if dangerous agents are properly stored."

Among other findings by researchers: 56.6% of ED visits for chemical burns were by men.

• Most injuries for various age groups occurred in residential settings (14,722).
• Per 100,000 people, the age group (by the decade) most likely to be injured was between 20 to 29 years of age.

The study also reported that, on average annually, these injuries were resulting in 36,000 ED visits at a cost of $26.6 million in billing charges. Other researchers were affiliated with Brigham and Women's Hospital, Harvard Medical School and the University of Iowa.

Among their recommendations:

• Avoid storing household chemicals under sinks, in ground-accessible cabinets or other low-level areas.
• Install cabinet locks.
• Educate parents, other caregivers, police officers and paramedics on how to prevent these accidents and how to treat them if they occur. Proper and timely treatment can help minimize the injury.

In the workplace, the researchers also recommended that prevention should be a priority of corporate leadership and government regulators. Learn more about protecting your eyes in the case of a chemical burn.

Significance of study

"This study points out a shift in current thinking about chemical eye burns, especially in young children," says Glen Steele, O.D., chair of AOA's InfantSEE^® and Children's Vision Committee and professor of pediatric optometry at Southern College of Optometry in Memphis, Tennessee.

"The previously held belief was that most chemical eye burns were work related. However, when the ages were narrowed to incidence during a single birth year, surprisingly children between one and two years had significantly greater incidence of chemical eye burns than any other age."

Dr. Steele called the study very well planned—based on his reading of the research's methodology. But, he says, there's plenty for parents to mull and act on.

The first step is prevention.

"The doctor of optometry should provide advice to all new parents during the infant's first eye examination regarding precautions to take in storage of such chemicals," Dr. Steele says. "Any chemical that is within easy reach of a curious infant and toddler is an accident waiting to happen."

For instance, to young children, dishwashing pods stored under sinks might look enticingly like pieces of candy. Biting into a pod, getting it on their hands and then rubbing their eyes leads to the chemical burn. Parents should not let their guards down until their curious children are of an age when they can appreciate the danger, Dr. Steele says.

The next step is knowing what to do in an emergency.

"The superficial chemical eye burns are usually not blinding but the location of the burn is critical," Dr. Steele says. "Central burns interfere more with visual acuity than peripheral burns. The key for any chemical eye burn is for the parent to flush immediately with water. The longer the chemical stays in the eye, the greater the potential damage.

"The key is to begin flushing immediately and get the child to care right away," he says.