Pediatric ingestions of hand sanitizers: debunking the myth

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.

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.

Six hundred forty-seven cases were identified including 324 females and 323 males. Ages ranged from 1 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 Y 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.

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.