Recently, an email has circulated warning parents not to use hand sanitizers due to the danger they pose to children. And while hand sanitizers can be dangerous if swallowed, actual symptoms from their misuse are extremely rare. Hand sanitizer taste bad and can result in a burning sensation, so most children will not swallow an amount large enough to produce symptoms.
However, there are children who will drink anything, no matter how bad it tastes — and in those cases alcohol poisoning can result. The same thing can occur if mouthwash or perfume is swallowed.
The bottom line is — hand sanitizers are beneficial for killing germs on hands and like all potentially poisonous items, they should be stored out of the reach of children and should be used according to the label. Adults should monitor use of hand sanitizer by children to ensure that the proper amount is used and that hands wet with sanitizer are not put in the mouth.
To reduce the risk of injury from children drinking hand sanitizers, producers should add ingredients to make them taste bitter. This important step helps prevent children from eating the product. At the start of the pandemic, the FDA began letting distilleries and other companies that do not normally produce hand sanitizer make and sell it to help meet demand.
At the same time, the FDA received alerts that some young people have tried drinking hand sanitizers from distilleries that have not taken the step to make them taste bad. It has since ended this temporary policy and now expects careful production standards. You can check for bitter ingredients such as denatonium benzoate Bitrex ; sucrose octaacetate; or butanol also called tert-butyl alcohol.
Current denatured hand sanitizers are made to taste bitter, but you should dispose of any old bottles of "denatured alcohol," which may have toxic methanol added. Be especially careful with hand sanitizers made with isopropyl alcohol isopropanol around children. These can be more toxic than those made with ethanol or ethyl alcohol. Make-your-own hand sanitizer recipes, widely available on the internet, may not be the best option for families.
The FDA warns that if made incorrectly, hand sanitizer may not work. There have also been reports of skin burns from homemade hand sanitizer. Do not flush or pour recalled hand sanitizers down the drain. These products should be disposed of in hazardous waste containers, if possible.
If unsure, check with your local waste management and recycling center. Call right away if your child has collapsed, is having a seizure, is having a hard time breathing, or if they can't wake up after using or swallowing hand sanitizer products.
Otherwise, you can reach your regional poison control center by calling If you have questions about hand sanitizers, talk with your pediatrician. You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Turn on more accessible mode. Turn off more accessible mode. Skip Ribbon Commands. Skip to main content.
Six patients developed seizures during their hospitalization. All patients were treated with fomepizole a competitive inhibitor of alcohol dehydrogenase, the enzyme that catalyzes the initial step in the metabolism of methanol to its toxic metabolites , and nine received hemodialysis or continuous renal replacement therapy.
As of July 8, four patients remain hospitalized. Among seven patients discharged from the hospital, four had no sequelae, and three were discharged with new visual impairment.
Among the four patients who died, three had seizures at the time of admission; initial signs and symptoms were not reported for the fourth patient. A man aged 44 years was evaluated at a health care facility for recent onset of visual impairment. The patient reported drinking an unknown quantity of alcohol-based hand sanitizer during the few days before seeking medical care. His clinical course was complicated by seizures. The patient was treated with fomepizole and underwent hemodialysis.
He recovered after a 6-day hospitalization for acute methanol poisoning and was discharged with near-total vision loss. In addition to social distancing and consistent use of face masks, hand hygiene is an integral component of the response to the emergence of SARS-CoV-2 in the United States.
This investigation highlights the serious adverse health events, including death, that can occur after ingesting alcohol-based hand sanitizer products containing methanol.
Safety messaging to avoid ingestion of any alcohol-based hand sanitizer product should continue. Swallowing alcohol-based hand sanitizer products containing methanol can cause life-threatening methanol poisoning.
Young children might unintentionally swallow these products, whereas adolescents or adults with history of alcohol use disorder might intentionally swallow these products as an alcohol ethanol substitute 3 , 4.
Although methanol can be absorbed through the skin 8 , transcutaneous methanol poisoning is rare and has been reported under unusual circumstances 9. The extent and rate of transcutaneous methanol absorption depends on variables such as its form e. The findings in this report are subject to at least two limitations. First, the clinical diagnosis of methanol poisoning can be challenging because eliciting an exposure history can be challenging for patients with altered mental status, and some hospitals might be unable to test for a blood methanol level.
Cases of methanol poisoning might not have been recognized or reported to poison centers or state health departments. Second, the extent of potential exposure to alcohol-based hand sanitizer products containing methanol is uncertain; additional cases might be identified. As of July 15, , FDA had tested and identified 67 alcohol-based hand sanitizer products that contain methanol 7. These products are being recalled by the manufacturer or distributor in the United States.
An FDA investigation is ongoing. Severe methanol poisoning resulting in permanent disability or death can occur after swallowing alcohol-based hand sanitizer containing methanol. If the product is on this list, its use should be discontinued immediately, and the product should be disposed of in hazardous waste containers; these products should not be flushed down a toilet or poured down a drain.
Children using hand sanitizers should be supervised, and these products should be kept out of reach of children when not in use. Swallowing alcohol-based hand sanitizer products, including those that do not contain methanol, might also lead to serious illness and outcomes, including death 3 , 4.
Consumers who have been exposed to alcohol-based hand sanitizers containing methanol should stop using them immediately and seek immediate medical attention if they experience any concerning symptoms. Clinicians should have a high index of suspicion for methanol poisoning when evaluating patients with either a history of swallowing an alcohol-based hand sanitizer or compatible signs and symptoms and, if needed, obtain medical management advice from their regional poison center All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest.
No other potential conflicts of interest were disclosed. Laboratory data were earliest recorded results. Department of Health and Human Services. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.
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