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Dishwasher-related injuries: survey and literature review
Abstract
Domestic injuries are quite common among children aged 0-4 years old. Hazards lurking in the kitchen area can cause serious injuries in children. Through this study, we aim to raise public awareness of the potential and underreported risk of injuries related to dishwashers. Anonymous questionnaires consisting of 12 questions were distributed to adult females with children under 5 years old, including nurses, secretarial staff and outpatients. Commonly used dishwashers were surveyed by visiting high-street stores, and each brand's user manual was studied. A literature search using Medline and Pubmed was conducted for examining reported dishwasher-related sharp injuries. Forty households filled out survey questionnaires. Their responses indicated that 10% and 12.5% of children participate in unloading or loading dishwashers, respectively. Results showed that the incidence of related injuries was 12.5% among adults and 5% among children, and young children are at risk of sharp injuries in households with dishwashers. The dangerous loading and unloading of sharp objects and the direct involvement of toddlers should be discouraged, with the help of manufacturers.
... Injuries sustained in the kitchen during loading and unloading of dishwashers are not uncommon [21], while cases of scalding experienced by infants due to contact with hot dishwasher effluent [22], mucous membrane damage, and reactive airways dysfunction due to inhalation of detergent powder [23][24][25][26] and accidental ingestion of dishwasher detergent by children [24,[26][27][28][29] have also been reported. Manufacturers have responded to these risks by incorporating safe operating practices in manuals, but as reported in many studies, not all users are responsible enough to read, understand, and follow the instructions religiously. ...
An automatic dishwasher is a water-using, energy-demanding contraption with 40–50 different component parts fashioned out of different materials—metals and non-metals—which over the last 70 years has evolved in its role as a comfort-enhancing, convenience-providing, time-saving white good in the kitchen of the modern urban household, especially in the countries of the developed world. Its lifecycle, which spans about 12–13 years on average, lends itself to research in a variety of sustainability aspects—politico-legal/regulatory, economic, environmental, social and techno-functional—and fields—thermodynamics, fluid mechanics, acoustics, economics, chemistry, microbiology, materials science, design engineering, wastewater treatment, energy engineering, consumer behaviour, and, of late, sustainable consumption and production. The end goal of this review is to present the automatic dishwasher—almost ubiquitous and taken-for-granted in the western world these days—as a candidate for progressive research and development, resulting in its continued evolution. The author facilitates this by providing an overview of the different aspects of sustainability addressed by researchers thus far. It at once reinforces the importance of transdisciplinary research, finds answers to a clutch of ‘what’, ‘why’, ‘where’, ‘how’, ‘who’, and ‘when’ questions, and reminds us that improvement/s in one aspect must not undermine or thwart those in any of the others. It is the first of its kind, as far as the automatic dishwasher is concerned; it is a well-structured review of 84 peer-reviewed journal publications focusing on the dishwasher, accessed through Scopus and contacting researchers through ResearchGate, spanning the time period 1980–2021, originating in 21 countries (with Germany leading the pack, with 22% of the publications), and sourced from 63 different journals. Over a 16-year period between 1998 and 2014, both the energy use and water consumption of dishwashers decreased by well over 40%. Consumers in the USA, reportedly, are willing to pay up to 90% more for a higher-rated dishwasher. Interestingly, a publication from Germany states that manual dishwashing, if done in accordance with the Best Practice Tips (recommended by another German study), can have a 20% lower environmental footprint than automatic dishwashers.
... They emphasise the unsafe design of most of the devices that, in itself puts children running around in the kitchen at risk of easily tripping and landing on pointy utensils. Furthermore, these authors point out some common and dangerous practices of dishwasher users, such as not reading the manual prior to using the machine, encouraging the participation of children in loading and unloading dishwashers and the placement of some pointy or sharp utensils with their sharp ends upwards [6]. In our case report, parents were not aware of the dangers of placing pointy and sharp devices upwards and they were never elucidated by a health professional about the dangers and preventive measures. ...
Incidental Stab thoracic lesion with diaphragmatic laceration in a child.
To estimate the incidence of minor injuries and to study the wound care practices of school children.
A fortnightly follow up of urban (n = 112) and rural (n = 110) high school children was done in Chandigarh and rural Haryana between 1990-1992. Initial point prevalence survey was followed by fortnightly follow up survey involving interview for assessing incidence and wound care practices among students.
Government high schools of Chandigarh and rural Ambala in between 1990 to 1992.
Ninth class school children from urban (n = 112) and rural (n = 110) areas.
Average episodes of minor injuries per year were 2.9 in rural and 2.1 in urban area, point prevalence was higher in urban area. First-aid training of teachers or the students was lacking in both the areas. Many of the injuries (41-46%) occurred during the school time. Fingers/hand or feet were affected most. Main sources of injuries were farm implements, thorn, blade and stick in rural area and finger nails, kitchen appliances and furniture in urban area. Rural students were more tolerant to minor injuries. Lesser number of rural students had taken tetanus toxoid. Wound washing with water as the first action was reported by 20-22% students in both the areas. Application of urine or chewed grass was reported by rural students only, whereas use of ointment, tablet, bandage, injection as the first action was observed in urban students only.
Incidence of minor injuries was higher in rural area as compared to urban area. Training of students on elementary hygienic wound care is recommended.
To describe patterns and severity of caustic injuries sustained from dishwasher powder ingestion and highlight need for national safety standards.
Retrospective chart review of admissions for caustic ingestion to Starship Children's Hospital from January 2003 to January 2005 and review of New Zealand National Poisons Centre data.
Between January 2003 and January 2005, the National Poisons Centre recorded 610 dishwashing powder ingestions, with 88% of children less than 2 years old. Twenty-three children were admitted to Starship Children's Hospital following caustic ingestion, of whom 11 were identified as having ingested dishwasher powder (9 boys and 2 girls) and were aged 11 to 30 months (mean 17.5). Five children (45%) were admitted to the Paediatric Intensive Care Unit over 4 months (October 2004 to January 2005), requiring intubation for airway control. Two children needed tracheostomy. Three of the 11 children (27%) required repeated oesophageal dilatation, and two underwent gastrostomy formation. One brand of dishwasher detergent and container type was implicated in over half of the cases.
Dishwasher detergents are highly corrosive substances that cause potentially life-threatening injuries and ongoing morbidity. The recent surge of incidents may be related to change in product constituents or non-compliance with New Zealand safety standards. Efforts to limit product alkalinity, legislative requirement of Child-Resistant Packaging and public education may reduce injuries from these common household substances.
A case is presented where a small girl, when playing in the kitchen, tripped and fell over the opened door of the dishwashing-machine, thereby hitting a sharp knife and acquiring a long, but rather superficial wound at the right side of the neck. It is strongly recommended to be extremely careful when children are playing in the kitchen, and never to leave sharp items in the dishwasher with the pointed end upwards.
Accidents to children, can the home ever be safe?Birmingham: Royal Society for Prevention of Accidents, Home Safety Department
- J W Pickett
Birmingham: Royal Society for Prevention of Accidents, Home Safety Department
- J W Pickett