Hand Sanitizer Intoxication in the Emergency Department

Pourmand, Ali; Ghassemi, Mateen; Frasure, Sarah E.; Kreisman, Alexandrer; Shesser, Robert

doi:10.7759/cureus.17906

Cited by 4 publications

(10 citation statements)

References 18 publications

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“…It is important to recognize that despite the focus on dermal or pulmonary absorption from ABHS, there is a huge risk of toxicity from oral exposure or accidental ingestion of ABHS, especially, in the younger people. For example, Pourmand et al (2021) reported a case where a patient ingested hand sanitizer while staying in the emergency department [87]. Moreover, a recent study by Hohl et al (2021) reported a greater incidence of ethanol-mediated burns during the pandemic [88].…”

Section: Oral Dermal and Pulmonary Absorption Of Alcohols And Their Related Toxicitiesmentioning

confidence: 99%

Sensitivity of SARS-CoV-2 towards Alcohols: Potential for Alcohol-Related Toxicity in Humans

Deb

2021

Life

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative organism that is highly contagious and has been responsible for more than 240 million cases and 5 million deaths worldwide. Using masks, soap-based hand washing, and maintaining social distancing are some of the common methods to prevent the spread of the virus. In the absence of any preventive medications, from the outset of pandemic, alcohol-based hand sanitizers (ABHS) have been one of the first-line measures to control transmission of Coronavirus Disease 2019 (COVID-19). The purpose of this narrative review is to evaluate the sensitivity of SARS-CoV-2 towards ABHS and understand their potential adverse effects on humans. Ethanol and isopropanol have been the most commonly used alcohols in ABHS (e.g., gel, solution, spray, wipes, or foam) with alcohol in the range of 70–85% v/v in World Health Organization or Food and Drug Administration-approved ABHS. The denaturation of proteins around the envelope of SARS-CoV-2 positive sense single-stranded RNA virus is the major mechanism of action of ABHS. Due to frequent use of high-percentage alcohol-containing ABHS over an extended period of time, the oral, dermal, or pulmonary absorption is a possibility. In addition to the systemic toxicity, topical adverse effects such as contact dermatitis and atopic dermatitis are plausible and have been reported during COVID-19. ABHS appear to be effective in controlling the transmission of SARS-CoV-2 with the concern of oral, dermal, or pulmonary absorption.

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Section: Oral Dermal and Pulmonary Absorption Of Alcohols And Their Related Toxicitiesmentioning

confidence: 99%

Sensitivity of SARS-CoV-2 towards Alcohols: Potential for Alcohol-Related Toxicity in Humans

Deb

2021

Life

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“…However serious outcomes were not reported and cases were managed favorably [4]. In 2019 a case was reported in the New England Journal of Medicine, in which a 54-year-old man undergoing alcohol withdrawal ingested hand sanitizer (which contained 63% isopropanol) had access to hand sanitizer at his bedside which is commonly provided in health care settings for hygiene purposes [5].…”

Section: Editorialmentioning

confidence: 99%

Hand Sanitizer: A Savoir or Poison

Kumar

2021

BJSTR

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Hand sanitizer also called antiseptic is a liquid or Gel type substance needed to kill various different germs including bacteria and viruses present on our external body surfaces. Hand hygiene is the single most important factor needed to control the spread of many contagious diseases. Routine hand hygiene with hand sanitizers is the single most effective way to prevent infections, especially in health care settings. Despite a lot of beneficial effects in daily life, it is not completely free of shortcomings. It is known to cause antibiotic resistance, dry skin, unsafe if ingested, and potential alternatives for alcohol abusers.

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“…Research in animal models concluded that previous exposure to alcohol and stress can lead to alcohol-seeking behavior by activating specific areas in the brain [4]. Therefore, when alcoholic beverages are not accessible, alcohol users in the late and end stages of addiction shift to any available alternative, such as paint, perfumes, hairsprays, gasoline, sanitizers, and cooking extracts, as these can contain large amounts of alcohol [5].…”

Section: Introductionmentioning

confidence: 99%

“…World health Organization and Centers for Disease control guidelines for hand hygiene require alcohol-based hand sanitizers to be available in all healthcare facilities [5,6]. Furthermore, the use of hand liquid antiseptics has increased drastically after the emergence of the corona virus pandemic, and hand cleaners are used in medical settings and in homes [7].…”

Section: Introductionmentioning

confidence: 99%

“…Symptoms of ethanol ingestion intoxication include hypoglycemia, disequilibrium, seizures, confusion, coma, respiratory arrest, and death [8]. Several published articles have addressed the issue of hand sanitizers being widely available with easy access in EDs [5,6]. Patients therefore can easily ingest, steal, and hide these hand sanitizers without being noticed by medical staff.…”

Section: Introductionmentioning

confidence: 99%

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The Rising Concern of Ethanol Intoxication from Easy Access to Hand Sanitizers: A Case Report

El-Hussein,

Hamieh,

Nasrallah

et al. 2024

Am J Case Rep

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Unusual clinical course Background:Ethanol intoxication is very common, and several forms of alcohol intoxication can lead to emergency department visits. Excessive alcohol users, when in withdrawal, might seek replacement alcoholic beverages; one of the common sources of ethanol is hand sanitizer, which contains 45-95% alcohol. It becomes even more challenging to deal with alcohol use disorder patients when they seek these replacement products inside hospital premises, and medical clinics and hospitals have increased their use of ethanol-based hand sanitizer since the start of the COVID-19 pandemic. Case Report:We report the case of a 26-year-old man with alcohol dependence presenting with a fictitious illness leading to hospital admission and consumption of ethanol-based hand sanitizer in the emergency department (ED).The patient initially presented reporting severe abdominal pain that persisted despite medications. The initial laboratory tests and imaging were non-significant. The patient was later caught stealing hand sanitizer bottles, consuming them within 4-6 h. The COVID-19 pandemic has increased alcohol intoxication, especially in EDs. Hand sanitizers, including ethanol, are toxic and hazardous when misused, mostly by adolescents and young adults. Treatments include glucose determination, dextrose infusion, and thiamine perfusion. Strategies to reduce ethanol intoxication include eliminating hand sanitizers, using wall-fixed sanitizers, and using sanitizer wipes. Conclusions:Patients with alcohol use disorder are known to develop alcohol-seeking behaviors. This report has highlighted that healthcare professionals should be aware that the increased availability of ethanol-based hand sanitizers, some of which contain toxic antiviral chemical agents, may be targeted by individuals with alcohol dependency.

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Hand Sanitizer Intoxication in the Emergency Department

Cited by 4 publications

References 18 publications

Sensitivity of SARS-CoV-2 towards Alcohols: Potential for Alcohol-Related Toxicity in Humans

Sensitivity of SARS-CoV-2 towards Alcohols: Potential for Alcohol-Related Toxicity in Humans

Hand Sanitizer: A Savoir or Poison

The Rising Concern of Ethanol Intoxication from Easy Access to Hand Sanitizers: A Case Report

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