By Frank Long, MS, Editorial Director
Hand sanitizers are sold in sizes small enough to be carried in a pocket and used instantly without running water. Compared to clunky bar soaps today’s hand sanitizers win the convenience argument hands down. However, something alarming was recently found in certain hand sanitizers: poisonous, colorless, flammable methanol.
Danger is Skin Deep
According to the Centers for Disease Control and Prevention (CDC) in a health advisory issued July 5, methanol is a type of toxic alcohol that can be lethal if absorbed through the skin. The CDC made this warning after it identified the first of several hand sanitizer products sold commercially in the United States:
“…the U.S. Food and Drug Administration (FDA) advised consumers not to use any hand sanitizer manufactured by “Eskbiochem SA de CV” in Mexico, due to the potential presence of methanol, a “toxic alcohol”, as an active ingredient, which can cause blindness and/or death when absorbed through the skin or when swallowed.
—U.S. Food and Drug Administration
Beware of These Products
As of July 8 the FDA has identified several hand sanitizer products that have dangerous levels of methanol and are working with manufacturers to facilitate recalls. The following products, also known as alcohol-based hand sanitizers or rubs (ABHSR), have been tested by the FDA and found to contain methanol:
- Andy’s Best
- Antiseptic Alcohol 70% Topical Solution (Hand Sanitizer, manufactured by Soluciones Cosmeticas SA de CV, Mexico)
- Berish Hand Sanitizer Gel (Fragrance Free)
- bio aaa Advance Hand Sanitizer
- Blumen Clear Advanced Hand Sanitizer
- Blumen Advanced Instant Hand Sanitizer
- Britz Hand Sanitizer
- Earths Amenities Instant Unscented Hand Sanitizer with Aloe Vera Advanced
- Hand Sanitizer Gel Unscented (manufactured by Grupo Insoma, Mexico)
- KLAR AND DANVER Instant Hand Sanitizer (labeled with Greenbrier Internationsl, Inc.)
- Lavar 70 Gel Hand Sanitizer
- Optimus Lubricants Instant Hand Sanitizer
Several other products have been voluntarily recalled by manufacturers, and others have been added to an import alert list to stop them from entering the United States. Clinicians may check the FDA site periodically for additions to this list.
Definitely Don’t Drink It
While alcohol-based hand sanitizers have a legitimate role in infection control, they become problematic when methanol is introduced in the formula, making them dangerous for external or internal use. For example, brightly colored or scented hand sanitizers may pique a young child’s curiosity, leading the child to swallow it.
Likewise, some older children and adults may intentionally swallow hand sanitizer for the purpose of becoming drunk.
Individuals affected by substance abuse issues are known to use sanitizer products as a substitute for alcohol and liquor, and the presence of methanol in these products becomes especially problematic for some members of this population.
In May when seven individuals in New Mexico drank hand sanitizer in what was described as an alcoholism-related manner the results were devastating. Among the group three individuals died, one became permanently blind, and three others were found in critical condition according to the Las Cruces Sun News.
What Can Therapists Do?
Healthcare workers have a role in preventing the misuse of hand sanitizer. One thing that clinicians are advised to do by the CDC is to educate patients about the adverse risks of ingesting ABSHRs and that some of these products may contain dangerous amounts of methanol. The center also suggests that clinicians should have a high suspicion of methanol poisoning for patients who use ABHSRs on the skin repeatedly, and should stress that these products are for hand hygiene only.
Methanol poisoning has specific steps for medical management. Symptoms of methanol poisoning include headache, blurred vision, blindness, nausea, vomiting, abdominal pain and diminished coordination. The CDC advises clinicians to contact the local poison control center at (800) 222-1222) to report cases.