Hand Sanitizer: What's the Real Story?
The Bottom Line
Hand sanitizers usually contain alcohols that have been FDA approved for topical use. These can be hazardous in larger quantities, but a taste amount usually does not cause serious symptoms. Even so, check here to make sure it is not a product contaminated with methanol. Methanol will not be listed on the label.
The Full Story
Hand sanitizers usually contain alcohols that have been FDA approved for topical use. Such products usually contain ethanol (ethyl alcohol), isopropanol (isopropyl alcohol), or benzalkonium chloride (a detergent). Most of the time, the risk of hand sanitizer exposure was not considered more dangerous than exposure to other sources of alcohol in a child's environment. All alcohol-containing products such as beer, wine, liquor, rubbing alcohol, mouthwash, facial toner, or hair tonics that contain alcohol should be stored out of sight and out of reach of children.
Recently, potentially dangerous contaminants have been discovered in some hand sanitizers. In June 2020, the FDA announced that some popular hand sanitizers are contaminated with methanol (methyl alcohol). This news has prompted health care providers to be more cautious. Methanol has a much narrower range of safety compared to ethanol and isopropanol. Too much methanol can cause permanent blindness and death secondary to severe changes in body chemistry that happen as our bodies metabolize it.
In March 2021, a contaminant called benzene was detected in several hand sanitizer brands across multiple production batches. Benzene is a chemical known to cause leukemia.
Even if your hand sanitizer label says it contains alcohol, ethanol, isopropyl alcohol, or benzalkonium chloride, it is important to check here to make sure it is not one of the contaminated products. Methanol or benzene will not be listed on the label. It is best to throw away these recalled products to make sure no one accidentally uses them or ingests them.
Children will most commonly access hand sanitizer by putting their mouths on the pump, or by licking what was pumped out on their hands by parents. Serious toxicity would not be expected in either of these situations, even if it was a methanol- or benzene-containing product.
Even alcohol-based hand sanitizers that are made properly and do not contain contaminants can cause serious effects in children if ingested. If swallowed, it can lower blood sugar. In extreme, untreated situations, that can lead to coma and seizures. That's why the first treatment instruction after a child drinks alcohol, from any source, is to give something sweet to drink. Alcohol-based hand sanitizers can also make kids drunk. That doesn't just mean woozy; it means slow heart rate and slow breathing. Another issue with all hand sanitizers is that they can be irritating to the stomach, causing nausea or vomiting if swallowed. BUT, a lick of hand sanitizer should not do this. If a person swallows hand sanitizer, call Poison Control (1-800-222-1222) or go online to get help with webPOISONCONTROL® to see if they need medical attention or if it is safe to watch them at home.
The contaminated hand sanitizers are a different story. Just a sip of methanol-tainted hand sanitizer can cause poisoning in a small child. Long-term chronic use on the skin could also be a problem for both adults and children. The likelihood of toxicity must be considered on a case by case basis. A taste of benzene-contaminated hand sanitizer would be unlikely to cause any immediate symptoms. There is no way to predict whether an individual person exposed to benzene this way would go on to develop long-term health effects. Prevention is best since benzene is known to be harmful.
Some people abuse hand sanitizer to try to become intoxicated or drunk. If someone you know is abusing hand sanitizer, get help. While it is never safe to intentionally drink hand sanitizer, if a person is abusing a contaminated hand sanitizer, this behavior could be deadly.
Remember, the products that are contaminated with methanol or benzene are much more dangerous than those made with approved hand sanitizer ingredients. Smaller quantities need to be ingested before they can cause serious, sometimes permanent health effects and even death. Methanol or benzene will not be listed as an ingredient. If someone ingests one of the recalled products (see this list) get help right away. Don’t wait until symptoms develop as they could become permanent! Get help online with webPOISONCONTROL® or call 1-800-222-1222.
Rose Ann Gould Soloway, RN, BSN, MSEd, DABAT emerita
Clinical Toxicologist
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Supervise young children when they use hand sanitizer.
- Between uses, keep it out of sight and reach of young children.
This Really Happened
Case 1: A 3-year-old girl had the 16-oz pump dispenser bottle of hand sanitizer containing 68% alcohol in her hands. She had squirted it on her hands, face, clothing and hair. Her mom called Poison Control, concerned that she may have swallowed some. The child didn't remove the pump attachment and had only about a minute to swallow anything. She appeared fine. Poison Control reviewed the concerns with alcohol ingestion in small children but reassured her mom that the small amount she may have swallowed would not poison her. A bath, sweet fluids and a snack were recommended. Two hours later in a follow-up call to the home by Poison Control, her mom reported that she had followed Poison Control's advice and the child was fine.
Case 2: A 2-year-old boy tasted what his mom estimated was a dime-size amount of hand sanitizer containing 62% alcohol one evening. He squeezed some on his hands and then licked them. His mom called Poison Control and was advised to keep him awake for an hour and give sweet fluids and a snack, and to watch for symptoms of inebriation (acting drunk), though no symptoms were expected with this amount. In a follow-up call from Poison Control to his mom an hour later, his mom reported he was a little sleepy, but it was past his bedtime. He had had some juice and appeared his normal self.
For More Information
References
Engel JS, Spiller HA. Acute ethanol poisoning in a 4-year-old as a result of ethanol-based hand-sanitizer ingestion. Pediatr Emer Care. 2010;26:508-509.Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Supervise young children when they use hand sanitizer.
- Between uses, keep it out of sight and reach of young children.
This Really Happened
Case 1: A 3-year-old girl had the 16-oz pump dispenser bottle of hand sanitizer containing 68% alcohol in her hands. She had squirted it on her hands, face, clothing and hair. Her mom called Poison Control, concerned that she may have swallowed some. The child didn't remove the pump attachment and had only about a minute to swallow anything. She appeared fine. Poison Control reviewed the concerns with alcohol ingestion in small children but reassured her mom that the small amount she may have swallowed would not poison her. A bath, sweet fluids and a snack were recommended. Two hours later in a follow-up call to the home by Poison Control, her mom reported that she had followed Poison Control's advice and the child was fine.
Case 2: A 2-year-old boy tasted what his mom estimated was a dime-size amount of hand sanitizer containing 62% alcohol one evening. He squeezed some on his hands and then licked them. His mom called Poison Control and was advised to keep him awake for an hour and give sweet fluids and a snack, and to watch for symptoms of inebriation (acting drunk), though no symptoms were expected with this amount. In a follow-up call from Poison Control to his mom an hour later, his mom reported he was a little sleepy, but it was past his bedtime. He had had some juice and appeared his normal self.