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Alcohol-based hand sanitizers: serious intoxication in children

Alcohol-based hand sanitizers are in widespread use but can provoke serious alcohol intoxication when accidentally swallowed by a child.

Hand washing with soap and water is important to prevent healthcare-associated infections and the transmission of many infectious agents. Alcohol-based hand sanitizers (gels or rubs) are an alternative in situations where no water supply is available. Over the past decade, the use of these products has become widespread, and they have been responsible for cases of alcohol intoxication in children.

French poison control centres identified 248 cases in 2009 in which exposure to alcohol-based hand sanitizers was followed by symptoms. More than half of them involved children under the age of 15 years. The age-group most commonly affected were children under the age of 4 years.

Usually the product was accidentally swallowed, and about three-quarters of cases were classified as an everyday accident, rather than an occupational accident or a deliberate act. The neuropsychological effects of alcohol occurred in 12 cases: inebriation (5 times), agitation (4 times), drowsiness (twice), confusion (once). In other cases, notably in the US, the alcohol intoxication resulted in coma.

Alcohol-based hand sanitizers must always be kept out of the reach of children and only used rarely, i.e. only when no water supply is available.

©Prescrire 1 July 2012

"Alcohol-based hand sanitizers: severe intoxication in children" Prescrire Int 2012; 21 (129): 184. (Pdf, subscribers only).
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