Pediatric Ingestions of Hand Sanitizers Debunking the Myth

Objective: Poison centers frequently receive calls concerning children who are exposed to hand sanitizers. These exposures can occur while the product is being used correctly or when a child has unsupervised access to the container. In 2007, the use of ethanol-containing hand sanitizers in the pediatric population came under media scrutiny owing to an Internet urban legend that resulted in a greater awareness of the potential toxicity of these sanitizers based on their high ethanol content. Methods: A retrospective review of all exposures to hand sanitizers in children younger than 6 years reported to a regional poison information center from January 1, 2000 to March 30, 2007 was performed. Data reviewed included substance, age, sex, and outcome. Data were analyzed using descriptive statistics. Results: Six hundred forty-seven cases were identified including 324 females and 323 males. Ages ranged from I month to 5 years with a mean of 1.89 years and a median of 2 years. Outcome data included 31 patients (4.8%) with no effect, 26 (4%) with a minor effect, 372 cases (57.5%) coded as nontoxic - expect no effect, 208 cases (32.1%) with minimal clinical effects possible, and 10 cases (1.6%) where the symptoms were judged to be unrelated to the exposure. There were no moderate or major outcomes and no fatalities. Conclusions: Children in this age group have frequent hand-to-mouth activity and environmental curiosity making the application or availability of a hand sanitizer the perfect situation for an exposure to occur. Although ethanol-based hand sanitizers have the potential to cause toxicity, the benefits of prevention of illness outweigh the hazards when used in a supervised situation.