97-30555. Requirements for Child-Resistant Packaging; Household Products With More Than 50 mg of Elemental Fluoride and More Than 0.5 Percent Elemental Fluoride; and Modification of Exemption for Oral Prescription Drugs With Sodium Fluoride  

  • [Federal Register Volume 62, Number 224 (Thursday, November 20, 1997)]
    [Proposed Rules]
    [Pages 61928-61933]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 97-30555]
    
    
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    CONSUMER PRODUCT SAFETY COMMISSION
    
    16 CFR Part 1700
    
    
    Requirements for Child-Resistant Packaging; Household Products 
    With More Than 50 mg of Elemental Fluoride and More Than 0.5 Percent 
    Elemental Fluoride; and Modification of Exemption for Oral Prescription 
    Drugs With Sodium Fluoride
    
    AGENCY: Consumer Product Safety Commission.
    
    ACTION: Proposed rule.
    
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    SUMMARY: The Commission is proposing a rule to require child-resistant 
    (``CR'') packaging for household products containing more than the 
    equivalent of 50 mg of elemental fluoride and more than the equivalent 
    of 0.5 percent elemental fluoride (on a weight-to-volume (``w/v'') or 
    weight-to-weight (``w/w'') basis). Examples of such products are some 
    rust removers, toilet cleaners, metal cleaners and etching products. 
    Dental products, such as toothpaste, contain lower levels of fluoride 
    and would not be affected. For consistency, the Commission is also 
    proposing to modify the oral prescription drug exemption for sodium 
    fluoride preparations. Instead of allowing drugs with no more than 264 
    mg of sodium fluoride per package to be in non-CR packaging as the 
    current rule does, the Commission proposes to allow such drugs with 
    only 50 mg or less of the equivalent of elemental fluoride (110 mg or 
    less of sodium fluoride) per package and no more than the equivalent of 
    0.5 percent elemental fluoride on a w/v or w/w basis. The Commission 
    has preliminarily determined that child-resistant packaging is 
    necessary to protect children under 5 years of age from serious 
    personal injury and serious illness resulting from handling or 
    ingesting a toxic amount of elemental fluoride. The Commission takes 
    this action under the authority of the Poison Prevention Packaging Act 
    of 1970.
    
    DATES: Comments on the proposal should be submitted no later than 
    February 3, 1998.
    
    ADDRESSES: Comments should be mailed to the Office of the Secretary, 
    Consumer Product Safety Commission, Washington, D.C. 20207, or 
    delivered to the Office of the Secretary, Consumer Product Safety 
    Commission, Room 502, 4330 East-West Highway, Bethesda, Maryland 20814-
    4408, telephone (301)504-0800. Comments may also be filed by 
    telefacsimile to (301) 504-0127 or by email to cpsc-os@cpsc.gov.
    
    FOR FURTHER INFORMATION CONTACT: Jacqueline Ferrante, Ph.D., Division 
    of Health Sciences, Directorate for Epidemiology and Health Sciences, 
    Consumer Product Safety Commission, Washington, D.C. 20207; telephone 
    (301)504-0477 ext. 1199.
    
    SUPPLEMENTARY INFORMATION:
    
    A. Background
    
    1. Household Products Containing Fluoride
    
        Many types of household products may contain fluoride in one form 
    or another. Fluorides are ingredients in cleaning products for metal, 
    tile, brick, cement, wheels, radiators, siding, toilets, ovens and 
    drains. Fluorides are also found in rust and water stain removers, 
    silver solder and other welding fluxes, etching compounds, laundry 
    sour, air conditioner coil cleaners and floor polishes. The fluorides 
    that may be ingredients in these products and are potentially toxic are 
    hydrofluoric acid (``HF''), ammonium bifluoride, ammonium fluoride, 
    potassium bifluoride, sodium bifluoride, sodium fluoride and sodium 
    fluosilicate.1 [3] 2
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        \1\ The percentage of elemental fluoride in any compound is 
    determined by dividing the molecular weight of fluoride 
    ( 19 grams/mole) by the molecular weight of the compound 
    (e.g., the molecular weight of sodium fluoride = 42 grams/mole). 
    Sodium fluoride contains 45% elemental fluoride (19/42  x  100 = 
    45%).
        \2\ Numbers in brackets refer to documents listed at the end of 
    this notice.
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        Many dental products also contain fluorides, but at lower levels.
    
    [[Page 61929]]
    
    Prescription dental products are available with fluoride contents of 
    0.125-0.5 mg/ml for drops, 0.5-1 mg per tablet, 1 mg per lozenge, 0.1-
    0.9 mg/g for topical rinses (0.01-0.09 percent and 5 mg/g (0.5 percent) 
    for topical gels. Prescription vitamin preparations are also available 
    containing 0.25 to 1 mg elemental fluoride per ml. The highest 
    concentration of elemental fluoride in any such dental product 
    available over-the-counter (``OTC'') is 0.15 percent for pastes and 
    powders and 0.5 percent for liquids or gels. In contrast, some 
    household products, particularly metal cleaners and rust removers 
    containing hydrofluoric acid and/or soluble fluoride salts, can have as 
    much as 57 percent elemental fluoride. In general, the concentrations 
    of elemental fluoride in household cleaners and surface preparation 
    agents are 10 to 1,000-fold higher than concentrations found in dental 
    products.[2]
    
    2. Relevant Statutory and Regulatory Provisions
    
        The Poison Prevention Packaging Act of 1970 (``PPPA''), 15 U.S.C. 
    1471-1476, authorizes the Commission to establish standards for the 
    ``special packaging'' of any household substance if (1) the degree or 
    nature of the hazard to children in the availability of such substance, 
    by reason of its packaging, is such that special packaging is required 
    to protect children from serious personal injury or serious illness 
    resulting from handling, using, or ingesting such substance and (2) the 
    special packaging is technically feasible, practicable, and appropriate 
    for such substance.
        Special packaging, also referred to as ``child-resistant (CR) 
    packaging,'' is (1) designed or constructed to be significantly 
    difficult for children under 5 years of age to open or obtain a toxic 
    or harmful amount of the substance contained therein within a 
    reasonable time and (2) not difficult for ``normal adults'' to use 
    properly. 15 U.S.C. 1471(4). Household substances for which the 
    Commission may require CR packaging include (among other categories) 
    foods, drugs, or cosmetics as these terms are defined in the Federal 
    Food, Drug, and Cosmetic Act (21 U.S.C. 321). 15 U.S.C. 1471(2)(B). The 
    Commission has performance requirements for special packaging. 16 CFR 
    1700.15, 1700.20.
        Section 4(a) of the PPPA, 15 U.S.C. 1473(a), allows the 
    manufacturer or packer to package a nonprescription product subject to 
    special packaging standards in one size of non-CR packaging only if the 
    manufacturer (or packer) also supplies the substance in CR packages of 
    a popular size, and the non-CR packages bear conspicuous labeling 
    stating: ``This package for households without young children.'' 15 
    U.S.C. 1473(a), 16 CFR 1700.5.
    
    3. Existing Requirements for Fluoride-Containing Products
    
        The Commission currently requires CR packaging for oral 
    prescription drugs with fluoride, but it exempts those in liquid or 
    tablet form that contain no more than 264 mg of sodium fluoride 
    (equivalent to 120 mg fluoride) per package. 16 CFR 1700.14(10)(vii). 
    In 1977, the Commission first exempted aqueous solutions of sodium 
    fluoride at that level. In 1980, in response to a petition, the 
    Commission extended the exemption to include liquid and tablet forms. 
    When it issued the exemption, the Commission believed that drugs with 
    sodium fluoride below that level would not cause serious personal 
    injury or illness to children under 5 years of age. The Commission 
    based this decision on the lack of serious adverse human experience 
    associated with such drugs at that time. The level was also partly 
    based on a recommendation by the American Dental Association that no 
    more than 264 mg of sodium fluoride should be dispensed at one time. 45 
    FR 78630. Also at that time, the Food and Drug Administration (``FDA'') 
    had determined that an acutely toxic dose of sodium fluoride for a 25 
    pound ( 11.4 kg) child was in the range of 50 to 250 mg/kg 
    (equivalent to  23 to 113 mg/kg of elemental fluoride) (42 
    FR 62363). As discussed below, the Commission is proposing a new level 
    that is based on current information concerning the toxicity of 
    fluoride and would be consistent with the proposed CR requirement for 
    fluoride-containing household products.
        The FDA limits OTC packages of toothpaste and tooth powder to no 
    more than 276 mg total elemental fluoride per package. 21 CFR 310.545. 
    However, preventative treatment rinses and gels sold OTC must contain 
    no more than 120 mg total elemental fluoride per package. 21 CFR 
    355.10.
    
    B. Toxicity of Fluoride
    
        Most available toxicity information on fluoride relates to acute 
    toxicity of hydrofluoric acid (``HF''). However, other water soluble 
    fluoride-containing compounds can cause fluoride poisoning. The 
    fluoride ion is systemically absorbed almost immediately. It is highly 
    penetrating and reactive and can cause both systemic poisoning and 
    tissue destruction. Fluoride ions, once separated from either HF or 
    fluoride salts, penetrate deep into tissues, causing burning at sites 
    deeper than the original exposure site. The process of tissue 
    destruction can continue for days.[2]
        Systemic fluoride poisoning after ingestion or inhalation occurs 
    very rapidly as the fluoride is absorbed into the gastrointestinal 
    (``GI'') tract and lungs. Systemic fluoride poisoning can also result 
    from dermal exposure if the exposure is massive or the skin barrier has 
    been destroyed, as with severe burns. Fluoride absorption can produce 
    hyperkalemia (elevated serum potassium), hypocalcemia (lowered serum 
    calcium), hypomagnesemia (lowered serum magnesium), and metabolic and 
    respiratory acidosis. These disturbances can then bring on cardiac 
    arrhythmia, respiratory stimulation followed by respiratory depression, 
    muscle spasms, convulsions, central nervous system (``CNS'') 
    depression, possible respiratory paralysis or cardiac failure, and 
    death. Fluoride may also inhibit cellular respiration and glycolysis, 
    alter membrane permeability and excitability, and cause neurotoxic and 
    adverse GI effects.[2]
        When exposure is through inhalation, fluorides can cause severe 
    chemical burns to the respiratory system. Inhalation can result in 
    difficulty breathing (dyspnea), bronchospasms, chemical pneumonitis, 
    pulmonary edema, airway obstruction, and tracheobronchitis. The 
    severity of burns from dermal absorption can vary depending on the 
    concentration of fluoride available, duration of the exposure, the 
    surface area exposed, and the penetrability of the exposed tissue. 
    Dermal exposure to 6 to 10 percent HF is the lowest concentration range 
    known to cause skin injury in humans. Destruction of tissue under the 
    skin may occur, as may decalcification and erosion of bone. Death from 
    systemic fluoride toxicity has resulted from dermal exposure to 70 
    percent HF over 2.5 percent of the body surface.[2]
        Ocular exposure can result in serious eye injury. Exposure to 
    concentrations of 0.5 percent can lead to mild conjunctivitis and 
    greater concentrations can lead to progressively severe results such as 
    immediate corneal necrosis (20 percent solution).
        Ingestion of fluoride can result in mild to severe GI symptoms. 
    Reports suggest that ingesting 3 to 5 milligrams per kilogram of 
    fluoride causes vomiting, diarrhea, and abdominal pain. Ingestion of 
    more than 5 mg/kg may produce systemic toxicity. A retrospective poison 
    control center study of fluoride ingestions reported
    
    [[Page 61930]]
    
    that symptoms, primarily safely tolerated GI symptoms that tended to 
    resolve within 24 hours, developed following ingestions of 4 to 8.4 mg/
    kg of fluoride.[2]
        According to the medical literature, a safely tolerated dose 
    (``STD'') and a certainly lethal dose (``CLD'') were determined from 
    600 fluoride poisoning deaths. The CLD was determined to be 32 to 64 
    mg/kg and the STD was estimated at one fourth that, or 8 to 16 mg/kg. 
    These values were statistically determined and do not correspond to the 
    actual lowest toxic or lethal levels of fluoride. The lowest documented 
    lethal dose for fluoride is 16 mg/kg in a 3-year-old child. There were 
    complicating factors in this death. The child may have taken other 
    medications and he suffered from Crohn's disease (an inflammatory 
    disorder of the GI tract) that may have contributed to his death.[2]
    
    C. Injury Data
    
    Medical Literature
    
        There are many reports in the medical literature of deaths and 
    injuries involving fluoride-containing products. A retrospective study 
    conducted by the American Association of Poison Control Centers 
    (``AAPCC'') of hydrofluoric acid burns from rust stain removers applied 
    to clothing found 619 such cases in 1990. Five of these required 
    hospitalization. Some of the burns occurred even after the clothing had 
    been washed.[2]
        Other reports included that of a 14-month-old child who developed 
    hypocalcemia and hyperfluoridemia (elevated blood fluoride level) and 
    went into cardiac arrest after exposure to a rust remover containing 
    HF. A 2\1/2\-year-old child developed respiratory failure and repeated 
    episodes of ventricular tachycardia (rapid heart beat) and fibrillation 
    after ingesting a laundry sour (used in laundry operations to 
    neutralize alkalis or decompose hypochlorite bleach) with sodium 
    fluosilicate. A 28-year-old man died after accidentally drinking floor 
    polish that contained fluosilicate. A 56-year-old man died after 
    ingesting a spoonful of glass etching cream (20% ammonium bifluoride 
    and 13% sodium bifluoride). He had severe burns in his esophagus and 
    stomach, and he suffered cardiac arrest 5 hours after the ingestion.[2]
    
    CPSC Databases
    
        CPSC has several databases for poison incidents. The staff reviewed 
    cases from 1988 to May 1997 in the National Electronic Injury 
    Surveillance System (``NEISS''), the Injury or Potential Injury 
    Incident (``IIPI'') files, Death Certificate (``DCRT'') database, and 
    In-Depth-Investigation (``INDP'') files. From 1988 to 1996, NEISS had 
    reports of 31 incidents involving products documented to contain 
    fluoride. Two of these were accidental ingestions by children under 5 
    years old. Most other injuries involved chemical burns of the hands.[2]
        The INDP files contain numerous injury reports. For example, a 50-
    year-old woman was using a water stain remover with 6 percent HF when 
    it leaked through her rubber gloves and to her skin. She developed 
    intense pain 4 hours later when the fluoride ion penetrated through to 
    the bones of her forearm. Four months after the incident she had only 
    partial use of her arm and hand. In another case, an 18-year-old man 
    developed second and third degree burns on his hands after exposure to 
    an automobile water spot remover with HF. His fingers became 
    permanently flexed from damage to the muscle and connective tissue. A 
    20-year-old male died of cardiac arrest after ingesting one to two 
    ounces of a wheel cleaner with fluoride.[2]
        Three reports in the INDP files involve children under 5 years old 
    who died after ingesting fluoride-containing products. A three-year-old 
    child ingested an unknown product with HF. The second case involved a 
    2-year-old child who ingested a toilet bowl stain remover that 
    contained 15.9 percent ammonium bifluoride. The most recent case was an 
    18-month-old child who ingested an unknown amount of air conditioner 
    coil cleaner with 8 percent HF and 8 percent phosphoric acid.[2]
        Since 1995, there have been six additional reports of fluoride 
    poisoning in children under 5 years of age from the wheel cleaning 
    product involved in the death of the 20-year-old man described above. 
    The product contains ammonium bifluoride and ammonium fluoride salts, 
    reportedly containing at least 15 percent fluoride. Before December, 
    1996, it was marketed for household use in non-CR packaging. Since that 
    date it has been packaged in CR packaging, and in September 1997 it was 
    recalled by the manufacturer.[2]
    
    AAPCC Data
    
        The staff reviewed AAPCC ingestion data involving children under 5 
    years old and products known to, or that may, contain fluoride. (The 
    actual number of fluoride exposures cannot be determined because some 
    products that contain fluoride are not identified as such and therefore 
    may be coded to generic categories such as acidic cleaning products or 
    other unknown cleaning products.) From 1993 to 1995, there were no 
    reported fatalities in this age group. Out of a total of 499 exposures 
    to products known to contain HF, there were 2 major 3 
    outcomes and 24 moderate 4 outcomes. The AAPCC data also 
    show 23 major outcomes and 188 moderate outcomes for other acid 
    household products. Some of these may have contained fluoride. The 
    frequency of injury for dental treatments was much lower than that for 
    household products containing HF. Of approximately 23,000 exposures to 
    such dental products, there were 34 moderate outcomes, and the only 
    documented major outcome was a miscoded incident where the child 
    experienced an allergic reaction to the product rather than systemic 
    toxicity from an overdose.[2]
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        \3\ Major outcome--The patient exhibited signs or symptoms which 
    were life-threatening or resulted in significant residual disability 
    or disfigurement.
        \4\ Moderate outcome--The patient exhibited signs and symptoms 
    that were more pronounced, more prolonged, or more of a systemic 
    nature. Usually some form of treatment was required. Symptoms were 
    not life-threatening and the patient had no residual disability or 
    disfigurement.
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        The staff also compiled data from AAPCC annual reports for all ages 
    and all routes of exposure for the years 1985 to 1995. During this time 
    period, there were about 25,000 exposures to products containing HF. Of 
    these, 2,881 resulted in moderate outcomes and 275 in major outcomes. 
    There were also injuries from dental products, fluoride mineral/
    electrolyte products, and vitamins with fluoride. A total of 18 deaths 
    were reported in the HF category. Two deaths involved children under 5 
    years old. One ingested an ammonium bifluoride toilet stain remover 
    (described above) and the other child died after ingesting a toilet 
    cleaner with HF. Generally, these AAPCC data suggest that household 
    products with HF pose a more serious risk of injury than other classes 
    of fluoride products. Moderate to serious outcomes developed in 12.8 
    percent of the exposures to HF compared to only 0.4 percent of the 
    exposures to anticaries products.[2]
    
    D. Level of Regulation for Household Products Containing Fluoride
    
        The Commission is proposing a rule that requires special packaging 
    for household products containing more than the equivalent of 50 mg of 
    elemental fluoride and more than the equivalent of 0.5 percent 
    elemental fluoride on a weight-to-volume (``w/v'') basis for liquids or 
    a weight-to-weight (``w/w'') basis for non-liquids.[1&2] The Commission 
    is especially interested in obtaining information and receiving
    
    [[Page 61931]]
    
    comments on the uses and marketing patterns of glass etching creams.
        There is no well defined lethal dose for fluoride. In the medical 
    literature, one source cites a minimum lethal dose in humans of 71 mg/
    kg and another specifies a lethal oral dose in the range of 70 to 140 
    mg/kg. The staff considers these values too high based on documented 
    cases of fluoride toxicity. There is one documented death from 
    ingestion of 16 mg/kg fluoride, but as discussed above, other medical 
    factors may have contributed to that death. Most evidence suggests that 
    the lower limit of the calculated certainly lethal dose (CLD) of 32 mg/
    kg is a reasonable estimate for a minimum lethal dose.[2]
        Similarly, there is no established toxic dose for fluoride. 
    Generally, greater than 6 percent HF can cause dermal burns and more 
    than 0.5 percent can lead to serious eye injury. Several reports 
    suggest ingestion of 3 to 5 mg/kg produces symptoms and that more than 
    5 mg/kg (50 mg in a 10 kg child) can produce systemic toxicity. 
    Additionally, some medical professionals advise medical observation 
    following ingestions of more than 5 to 8 mg/kg. Based on this 
    information, the Commission proposes a level for regulation that would 
    include all household products with more than 50 mg of elemental 
    fluoride and more than 0.5 percent elemental fluoride on a w/v basis 
    for liquids or a w/w basis for non-liquids. There is no evidence that 
    50 mg or less of elemental fluoride or concentrations less than 0.5 
    percent cause serious systemic toxicity or serious burns. [1&2]
    
    E. Level of Regulation for Oral Prescription Drugs Containing 
    Sodium Fluoride
    
        Based on the toxicity information discussed above, the Commission 
    believes that the current exemption for oral prescription drugs with no 
    more than 264 mg of sodium fluoride should be modified. To be 
    consistent with the proposed level for household products containing 
    fluoride, the Commission is proposing that the level for the oral 
    prescription drug exemption be changed to allow no more than the 
    equivalent of 50 mg of elemental fluoride (110 mg sodium fluoride) per 
    package and no more than a concentration of 0.5 percent elemental 
    fluoride on a w/v basis for liquids or a w/w basis for non-liquids. The 
    proposed level provides a safety factor to protect sensitive 
    individuals.[1&2]
        The Commission does not believe that changing the level of 
    exemption for prescription drugs containing sodium fluoride will impact 
    any of the currently exempted dental products with more than 50 mg of 
    fluoride because these products have 0.5 percent or less fluoride. 
    There is no evidence that any of these products have caused serious 
    injury. The Commission proposes modifying the exemption level so that 
    it is consistent with the regulated level proposed for household 
    products containing fluoride.[1]
    
    F. Statutory Considerations
    
    1. Hazard to Children
    
        As noted above, the toxicity data concerning children's ingestion 
    of fluoride demonstrate that fluoride can cause serious illness and 
    injury to children. Moreover, it is available to children in common 
    household products. Although some products currently use CR packaging, 
    others do not. The Commission preliminarily concludes that a regulation 
    is needed to ensure that products subject to the regulation will be 
    placed in CR packaging by any current as well as new 
    manufacturers.[1&2]
        The same hazard posed to children by toxic amounts of fluoride in 
    household products also exists from such levels of fluoride in oral 
    prescription drugs. Therefore, the Commission is proposing to modify 
    the existing exemption for such drugs with sodium fluoride to reflect 
    current toxicity data and be consistent with the proposed level for 
    fluoride-containing household products.[1&2]
        Pursuant to section 3(a) of the PPPA, 15 U.S.C. 1472(a), the 
    Commission preliminarily finds that the degree and nature of the hazard 
    to children from handling or ingesting fluoride is such that special 
    packaging is required to protect children from serious illness. The 
    Commission bases this finding on the toxic nature of these products, 
    described above, and their accessibility to children in the home.
    
    2. Technical Feasibility, Practicability, and Appropriateness
    
        In issuing a standard for special packaging under the PPPA, the 
    Commission is required to find that the special packaging is 
    ``technically feasible, practicable, and appropriate.'' 15 U.S.C. 
    1472(a)(2). Technical feasibility may be found when technology exists 
    or can be readily developed and implemented by the effective date to 
    produce packaging that conforms to the standards. Practicability means 
    that special packaging complying with the standards can utilize modern 
    mass production and assembly line techniques. Packaging is appropriate 
    when complying packaging will adequately protect the integrity of the 
    substance and not interfere with its intended storage or use.[4]
        Some OTC fluoride-containing household products are packaged in 
    containers with non-CR continuous threaded closures. The Commission 
    also is aware of such products packaged in aerosols and mechanical 
    pumps. Various types and designs of senior friendly CR packaging can be 
    readily obtained that would be suitable for fluoride-containing 
    products.[3&4]
        Two manufacturers currently use senior-friendly continuous threaded 
    CR packaging for their fluoride-containing household products. Another 
    manufacturer uses a senior-friendly trigger mechanical pump mechanism 
    for its product. This shows that these types of CR packages are 
    technically feasible, practicable and appropriate for fluoride-
    containing products. The Commission knows of at least one fluoride 
    product that uses a non-CR aerosol package. The manufacturer of another 
    regulated product is currently using a senior-friendly CR aerosol 
    overcap. Thus, this kind of CR packaging could be used for fluoride-
    containing products. Finally, various designs of senior-friendly snap 
    type reclosable CR packaging that would be appropriate for non-liquid 
    fluoride-containing products are available. Thus, appropriate senior-
    friendly CR packaging is available for products marketed in continuous 
    threaded, snap, aerosols, and trigger spray packaging.[4] Therefore, 
    the Commission concludes that CR packaging for fluoride-containing 
    products is technically feasible, practicable, and appropriate.
    
    3. Other Considerations
    
        In establishing a special packaging standard under the PPPA, the 
    Commission must consider the following:
        a. The reasonableness of the standard;
        b. Available scientific, medical, and engineering data concerning 
    special packaging and concerning childhood accidental ingestions, 
    illness, and injury caused by household substances;
        c. The manufacturing practices of industries affected by the PPPA; 
    and
        d. The nature and use of the household substance. 15 U.S.C. 
    1472(b).
        The Commission has considered these factors with respect to the 
    various determinations made in this notice, and preliminarily finds no 
    reason to conclude that the rule is unreasonable or otherwise 
    inappropriate.
    
    G. Effective Date
    
        The PPPA provides that no regulation shall take effect sooner than 
    180 days or later than one year from the date such
    
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    final regulation is issued, except that, for good cause, the Commission 
    may establish an earlier effective date if it determines an earlier 
    date to be in the public interest. 15 U.S.C. 1471n.
        Senior-friendly special packaging is currently commercially 
    available for most types of CR packaging. Aerosol and mechanical pump 
    packages should be commercially available in senior-friendly CR designs 
    within nine months of a final rule.[1,4 & 5] Thus, the Commission 
    proposes that a final rule would take effect nine months after 
    publication of the final rule.
        Currently available information indicates that full commercial 
    availability for senior-friendly mechanical pump packages and aerosol 
    overcap packages could take from 9 to 12 months from the date a final 
    rule is issued. If comments on this proposal indicate that 
    manufacturers using mechanical pump packages and aerosol overcap 
    packages need more than 9 months to comply with the rule, the 
    Commission may (1) specify a 1-year effective date for these types of 
    packages only, or (2) provide that manufacturers may request a stay of 
    enforcement so they can market their products in conventional packaging 
    for the minimum period needed to obtain an adequate supply of senior-
    friendly packaging.
        A final rule would apply to products that are packaged on or after 
    the effective date.
    
    H. Regulatory Flexibility Act Certification
    
        When an agency undertakes a rulemaking proceeding, the Regulatory 
    Flexibility Act, 5 U.S.C. 601 et seq., generally requires the agency to 
    prepare proposed and final regulatory flexibility analyses describing 
    the impact of the rule on small businesses and other small entities. 
    Section 605 of the Act provides that an agency is not required to 
    prepare a regulatory flexibility analysis if the head of an agency 
    certifies that the rule will not have a significant economic impact on 
    a substantial number of small entities.
        The Commission's Directorate for Economic Analysis prepared a 
    preliminary assessment of the impact of a rule to require special 
    packaging for household products containing fluoride with more than 50 
    mg elemental fluoride and more than 0.5 percent elemental fluoride (w/v 
    or w/w). The staff also considered the impact of a rule modifying the 
    current exemption for oral prescription drugs containing sodium 
    fluoride so that it would be consistent with the level proposed for 
    household products.[3]
        This assessment reports that the staff is aware of 25 suppliers of 
    products that are in categories of products that may contain fluorides. 
    Fourteen of these companies may be small businesses. It is unclear 
    which of these products actually contain fluorides and are marketed 
    directly to consumers rather than commercial markets. The staff is also 
    aware of 40 suppliers of automotive and household cleaning chemicals 
    and products. Some of these products may contain fluoride.[3] The 
    Commission requests comments from companies that supply fluoride-
    containing household products. The Commission is particularly 
    interested in comments and information on the likely effect of this 
    proposed rule on small businesses.
        Several consumer products containing fluoride are already in CR 
    packaging. For example, senior friendly packaging is used by a small 
    business marketer of a fluoride-containing rust remover packaged in a 
    plastic container with a continuous turn closure. Another small 
    business, marketing a fluoride-containing glass etching cream, also 
    uses senior-friendly CR packaging. However, the small business marketer 
    of another glass etching product is not currently using CR packaging. A 
    variety of types of senior friendly CR packaging that would be suitable 
    for such products are readily available at prices competitive with non-
    CR packaging. Similarly, of the three known marketers of fluoride-
    containing wheel cleaners, one (a large manufacturer) is using CR 
    packaging, while another (a small business) is not. Senior-friendly 
    trigger sprays like those used for this product are available. The 
    incremental cost of a CR trigger is not likely to be large relative to 
    the retail cost of the product.[3]
        Based on this assessment, the Commission concludes that the 
    proposed requirement for fluoride-containing household products would 
    not have a significant impact on a substantial number of small 
    businesses or other small entities.
        Furthermore, the proposed modification in the level for exemption 
    of oral prescription drugs containing sodium fluoride is not likely to 
    affect any currently available prescription drugs, and if such drugs 
    should become available in the future appropriate CR packaging is 
    readily available at prices competitive with non-CR packaging. 
    Therefore, the Commission concludes that the proposed modification to 
    the exemption for oral prescription drugs containing sodium fluoride 
    would not have a significant impact on a substantial number of small 
    businesses or other small entities.
    
    I. Environmental Considerations
    
        Pursuant to the National Environmental Policy Act, and in 
    accordance with the Council on Environmental Quality regulations and 
    CPSC procedures for environmental review, the Commission has assessed 
    the possible environmental effects associated with the proposed PPPA 
    requirements for fluoride-containing products.
        The Commission's regulations state that rules requiring special 
    packaging for consumer products normally have little or no potential 
    for affecting the human environment. 16 CFR 1021.5(c)(3). Nothing in 
    this proposed rule alters that expectation. Therefore, because the rule 
    would have no adverse effect on the environment, neither an 
    environmental assessment nor an environmental impact statement is 
    required.
    
    J. Executive Orders
    
        According to Executive Order 12988 (February 5, 1996), agencies 
    must state in clear language the preemptive effect, if any, of new 
    regulations.
        The PPPA provides that, generally, when a special packaging 
    standard issued under the PPPA is in effect, ``no State or political 
    subdivision thereof shall have any authority either to establish or 
    continue in effect, with respect to such household substance, any 
    standard for special packaging (and any exemption therefrom and 
    requirement related thereto) which is not identical to the [PPPA] 
    standard.'' 15 U.S.C. 1476(a). A State or local standard may be 
    excepted from this preemptive effect if (1) the State or local standard 
    provides a higher degree of protection from the risk of injury or 
    illness than the PPPA standard; and (2) the State or political 
    subdivision applies to the Commission for an exemption from the PPPA's 
    preemption clause and the Commission grants the exemption through a 
    process specified at 16 CFR Part 1061. 15 U.S.C. 1476(c)(1). In 
    addition, the Federal government, or a State or local government, may 
    establish and continue in effect a non-identical special packaging 
    requirement that provides a higher degree of protection than the PPPA 
    requirement for a household substance for the Federal, State or local 
    government's own use. 15 U.S.C. 1476(b).
        Thus, with the exceptions noted above, the proposed rule requiring 
    CR packaging for household products containing fluoride above the 
    regulated level and modifying the exemption level for oral prescription 
    drugs with sodium fluoride would preempt non-identical
    
    [[Page 61933]]
    
    state or local special packaging standards for such fluoride containing 
    products.
        In accordance with Executive Order 12612 (October 26, 1987), the 
    Commission certifies that the proposed rule does not have sufficient 
    implications for federalism to warrant a Federalism Assessment.
    
    List of Subjects in 16 CFR Part 1700
    
        Consumer protection, Drugs, Infants and children, Packaging and 
    containers, Poison prevention, Toxic substances.
        For the reasons given above, the Commission proposes to amend 16 
    CFR part 1700 as follows:
    
    PART 1700--[AMENDED]
    
        1. The authority citation for part 1700 continues to read as 
    follows:
    
        Authority: Pub. L. 91-601, secs. 1-9, 84 Stat. 1670-74, 15 
    U.S.C. 1471-76. Secs 1700.1 and 1700.14 also issued under Pub. L. 
    92-573, sec. 30(a), 88 Stat. 1231, 15 U.S.C. 2079(a).
    
        2. Section 1700.14 is amended to revise paragraph (a)(10)(vii) and 
    to add paragraph (a)(27) to read as follows (although unchanged, the 
    introductory text of paragraphs (a) and (10) are included below for 
    context):
    
    
    Sec. 1700.14  Substances requiring special packaging.
    
        (a) Substances. The Commission has determined that the degree or 
    nature of the hazard to children in the availability of the following 
    substances, by reason of their packaging, is such that special 
    packaging meeting the requirements of Sec. 1700.20(a) is required to 
    protect children from serious personal injury or serious illness 
    resulting from handling, using, or ingesting such substances, and the 
    special packaging herein required is technically feasible, practicable, 
    and appropriate for these substances:
    * * * * *
        (10) Prescription drugs. Any drug for human use that is in a dosage 
    form intended for oral administration and that is required by Federal 
    law to be dispensed only by or upon an oral or written prescription or 
    a practitioner licensed by law to administer such drug shall be 
    packaged in accordance with the provisions of Sec. 1700.15 (a), (b), 
    and (c), except for the following:
    * * * * *
        (vii) Sodium fluoride drug preparations including liquid and tablet 
    forms, containing not more than 110 milligrams of sodium fluoride (the 
    equivalent of 50 mg of elemental fluoride) per package and not more 
    than a concentration of 0.5 percent elemental fluoride on a weight-to-
    volume basis for liquids or a weight-to-weight basis for non-liquids 
    and containing no other substances subject to this Sec. 1700.14(a)(10).
    * * * * *
        (27) Fluoride. Household substances containing more than the 
    equivalent of 50 milligrams of elemental fluoride per package and more 
    than the equivalent of 0.5 percent elemental fluoride on a weight-to-
    volume basis for liquids or a weight-to-weight basis for non-liquids 
    shall be packaged in accordance with the provisions of Sec. 1700.15 
    (a), (b) and (c).
    
        Dated: November 17, 1997.
    Sadye E. Dunn,
    Secretary, Consumer Product Safety Commission.
    
    List of Relevant Documents
    
        1. Briefing memorandum from Jacqueline Ferrante, Ph.D., EH, to 
    the Commission, ``Proposed Rule to Require Child-Resistant Packaging 
    for Household Products with Fluoride,'' September 30, 1997.
        2. Memorandum from Susan C. Aitken, Ph.D., EH, to Jacqueline 
    Ferrante, Ph.D., EH, ``Toxicity of Household Products Containing 
    Fluoride,'' August 4, 1997.
        3. Memorandum from Marcia P. Robins, EC, to Jacqueline Ferrante, 
    Ph.D., EH, ``Market Data, Economic Considerations and Environmental 
    Effects of a Proposal to Require Child-Resistant Packaging for 
    Household Products Containing Fluoride,'' June 20, 1997.
        4. Memorandum from Charles Wilbur, EH, to Jacqueline Ferrante, 
    Ph.D., EH, ``Technical Feasibility, Practicability, and 
    Appropriateness Determination for the Proposed Rule to Require 
    Child-Resistant Packaging for OTC Products Containing Fluoride,'' 
    June 27, 1997.
    
    [FR Doc. 97-30555 Filed 11-19-97; 8:45 am]
    BILLING CODE 6355-01-P
    
    
    

Document Information

Published:
11/20/1997
Department:
Consumer Product Safety Commission
Entry Type:
Proposed Rule
Action:
Proposed rule.
Document Number:
97-30555
Dates:
Comments on the proposal should be submitted no later than February 3, 1998.
Pages:
61928-61933 (6 pages)
PDF File:
97-30555.pdf
CFR: (1)
16 CFR 1700.14