Trends in pediatric household cleaning product exposures before and during the COVID-19 pandemic: A National Poison Data System analysis (2016–2023)

Background: Unintentional exposures to household cleaning products remain a common cause of pediatric poison center calls in the United States, particularly among children under six. Prior studies show most exposures involve toddlers and rarely result in severe outcomes, but the impact of the COVID-19 pandemic on exposure patterns has not been well characterized. This study evaluates recent trends with emphasis on changes in 2020. Methods: We performed a retrospective analysis of unintentional exposures to household cleaning products reported to the National Poison Data System from 2016–2023 among children aged 0–5 years. Product types were grouped into 14 chemical categories. Descriptive statistics were used to summarize exposure patterns. Interrupted time series analysis using segmented Poisson regression was conducted to evaluate immediate and post-2020 changes in annual exposure trends associated with the COVID-19 pandemic. Results: A total of 640,410 pediatric exposures met inclusion criteria. Most involved children younger than 3 years (84.1%) and occurred at home, with 87.7% managed on site. Significant clinical effects occurred in 2.7% of cases with known outcomes. Soap and bleach products were the most frequent exposures, while alkali-based cleaners accounted for the highest number of significant outcomes. Interrupted time series analysis showed that several chemical classes experienced significant increases in exposures in 2020, most notably pine oil cleaners, bleach, soaps, cationic cleaners, and unknown products. Conclusions: Pediatric exposures to household cleaning products remain frequent and showed a transient increase during the early COVID-19 pandemic. Although severe outcomes were uncommon, alkali-based products posed the greatest risk.