Make Sure Methanol-Based Hand Sanitizers Aren’t Being Sold, Ingested

Ingestion of alcohol-based sanitizers isn’t safe in general, but it is especially dangerous when products made from methanol are improperly on the market, public health officials say. With cases of methanol poisoning reported in some Western states, the CDC is urging healthcare professionals to make sure methanol-based hand sanitizers aren’t being used and to make sure they can recognize the signs of poisoning from those types of products.

ATLANTA – Pharmacists might want to check their stock of alcohol-based hand sanitizers to make sure the products only contain ethanol or isopropanol. Public health officials are warning that some products imported into the United States have been found to contain methanol.

An article in the Morbidity & Mortality Weekly Report reveals that, from May 1 through June 30, 2020, 15 cases of methanol poisoning were reported in Arizona and New Mexico, associated with swallowing alcohol-based hand sanitizers. In those cases, four patients died, and three were discharged with visual impairment, write national Centers for Disease Control and Prevention-led authors.

“Alcohol-based hand sanitizer products should never be ingested,” the CDC emphasizes. “In patients with compatible signs and symptoms or after having swallowed hand sanitizer, prompt evaluation for methanol poisoning is required. Health departments in all states should coordinate with poison centers to identify cases of methanol poisoning.”

Because severe methanol poisoning resulting in permanent disability or death can occur after swallowing alcohol-based hand sanitizer containing methanol, the report urges that products be checked against the FDA Updates on Hand Sanitizers Consumers Should Not Use website.

“In addition to social distancing and consistent use of face masks, hand hygiene is an integral component of the response to the emergence of SARS-CoV-2 in the United States,” according to the authors. “Practicing hand hygiene, for example, by washing hands with soap and water for at least 20 seconds, is a simple and effective way to decrease the spread of pathogens and infections. If soap and water are not readily available, CDC recommends the use of alcohol-based hand sanitizer products that contain at least 60% alcohol (ethanol or isopropanol) in community settings.”

Alcohol-based hand sanitizers used in healthcare settings should contain 60%–95% alcohol -- ≥60% ethanol or ≥70% isopropanol, the report notes.

On the other hand, the CDC  investigation highlights the serious adverse health events, including death, that can occur after ingesting alcohol-based hand sanitizer products containing methanol.

“Swallowing alcohol-based hand sanitizer products containing methanol can cause life-threatening methanol poisoning,” public health officials advise. “Young children might unintentionally swallow these products, whereas adolescents or adults with history of alcohol use disorder might intentionally swallow these products as an alcohol (ethanol) substitute.”

The article notes that, while methanol can be absorbed through the skin, transcutaneous methanol poisoning remains rare and has been reported under very specific circumstances, so the public health messaging is primary focused on ingestion.

Any product on the FDA’s “Do Not Use” list should be disposed of in hazardous waste containers, not flushed down a toilet or poured down a drain, according to the report.

The CDC also is issuing a more generally warning about ingestion of alcohol-based hand sanitizers, even if they don’t contain methanol. “All alcohol-based hand sanitizers should only be used to disinfect hands and should never be swallowed,” the authors caution. “Children using hand sanitizers should be supervised, and these products should be kept out of reach of children when not in use. Swallowing alcohol-based hand sanitizer products, including those that do not contain methanol, might also lead to serious illness and

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