Recently, we have received a number of questions about hand sanitizers and potential toxicity in children who lick their hands after using hand sanitizer. The concern is based on information that the hand sanitizer contains ethanol. As you may suspect, a lick is not a problem. Ethanol toxicity could occur if a large quantity of the product was swallowed in a suicide attempt. The following is the information that the
CHILDREN AND ETHANOL-BASED HAND SANITIZERS
There have been many emails lately warning of the hazards of ethanol-based hand sanitizers. Many hand sanitizers contain 62% ethanol, and by comparison, most brands of hard liquor (whiskey, etc.) are 40-50% ethanol. Many perfumes have high ethanol concentrations, ranging from 60% to 90%.
The main poisoning concern regarding hand sanitizers is from people drinking these products. Ingestion of an ethanol-based hand sanitizer can lead to ethanol intoxication. These ingestions have the same signs and symptoms of ethanol intoxication that results from drinking beer, wine or mixed drinks.
Some hand sanitizers use isopropyl alcohol instead of ethanol. These isopropyl hand sanitizers pose the some danger to children as ethanol-based sanitizers.
How Much Is Too Much?
Dermal
A single lick of a hand sanitizer that has been spread on the hands is unlikely to cause intoxication or produce symptoms more than irritation of the mouth and tongue.
Ethanol intoxication by absorbing the ethanol through intact skin is highly unlikely.
Ingestion
The symptoms of ethanol intoxication in a child include irritability, dizziness, nausea, vomiting, unsteady gait, loss of muscle control, and sleepiness. Severe ethanol intoxications can lead to coma, respiratory arrest and death. Children who are intoxicated with ethanol are particularly susceptible to dropping their blood sugar and can suffer the effects of low blood sugar (irritability, clouded thinking, seizure, coma, death).
Soap and Water versus Hand Sanitizers
Washing hands with soap and water for 20 seconds is the best way to remove dirt and germs from the hands and is preferred to the use of hand sanitizers. However, hand sanitizers are an excellent choice when there is no access to soap and water (such as field trips, etc).
What Should I Do If My Child Drinks Hand Sanitizer?
Prevention should always be first. A parent would not let their child play with a bottle of vodka or whiskey – they should not let their child play with a bottle of hand sanitizer. Hand sanitizers should be kept out of reach of children in the same way that prescription drugs and other chemicals are.
If a child is exposed to a hand sanitizer, call
Our Poison Specialists will assess the situation and provide medical treatment advice.
I am interested in any questions you would like answered in the Question of the Week. Please email me with any suggestion at donna.seger@vanderbilt.edu.
Donna Seger, M.D.
Medical Director
Website: www.tnpoisoncenter.org