One of the most effective method for decreasing the spreading rate of COVID-19 is to regularly wash hands with soap and water for 20 seconds. In conditions where there is no access to soap and water, Centers for Disease Control and Prevention (CDC) recommends using alcohol based hand sanitizers that contain at least 60% alcohol (ethanol or isopropyl alcohol)¹. Using hand sanitizers is a cheap and effective method against microorganisms on our skin but ingestion or inappropriate usage can be linked with various health risks².

Ingestion of alcohol based hand sanitizers can lead to alcohol poisoning. Especially products with fragrance, colorful and attractive packaging is more likely to be swallowed by children³. A research conducted in United States of America between 2011-2014 has shown 70,669 cases of poisoning in children due to alcohol based and non-alcohol based hand sanitizers and 91% of these cases are reported to be seen in 0-5 age group². American Association of Poison Control Centers (AAPCC) has reported that from January 1, 2020 through July 12, 2020 there is an increase of 51% in the number of cases related to hand sanitizer poisoning compared to the same period in 2019. Children in the 0-5 age group had the highest incidence of poisoning compared to other age groups by a wide margin⁴. To prevent poisoning in children due to hand sanitizers, these products must be kept away from children’s reach and should be used with the supervision of an adult³.

Ethanol and isopropyl alcohol used in hand sanitizers can cause irritation on skin and eyes when in contact with the skin and prolonged usage can lead to dryness, redness, itching and cracking of the skin. Ingestion of ethanol containing hand sanitizers can cause nausea, vomiting, stomachache and central nervous system depression in various stages. Ingestion of 360 ml of ethanol based hand sanitizer can be life threatening for adults. Ingestion of hand sanitizers prepared with isopropyl alcohol can lead to central nervous system depression, decrease in respiratory drive, hypotension, irritation on gastrointestinal system, gastritis, hypoglycaemia and respiratory depression. Ingestion of 100-200 ml of 70% isopropyl alcohol solution can cause death⁵.

Another important point about hand sanitizers is the potential hazards due to production of hand sanitizers at home. Food and Drug Administration (FDA) has stated that hand sanitizers must not be produced and used at home for any reason as these products can be ineffective or even harmful if prepared improperly by emphasizing cases of skin burns caused by improperly produced hand sanitizers at home during COVID-19 pandemic. In addition to that disinfectant sprays and wipes used for surface cleaning must not be used for personal cleaning as these products can cause severe irritation on skin and eyes¹.

REFERENCES

1. Food and Drug Administration, https://www.fda.gov/consumers/consumer-updates/safely-using-hand-sanitizer, access date:14.07.2020
2. Santos, C., Kieszak, S., Wang, A., Law, R., Schier, J., Wolkin, A. 2017. Reported adverse health effects in children from ingestion of alcohol-based hand sanitizers—United States, 2011–2014. MMWR. Morbidity and Mortality Weekly Report, 66(8), 223.
3. Centers For Disease Control and Prevention, https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html, access date:14.07.2020
4. American Association of Poison Control Centers, https://piper.filecamp.com/uniq/9xx1bIxRd7tbq0wc.pdf , access date:20.07.2020
5. Mahmood, A., Eqan, M., Pervez, S., Tabinda, A. B., Yasar, A., Brindhadevi, K., Pugazhendhi, A. 2020. COVID-19 and frequent use of hand sanitizers; human health and environmental hazards by exposure pathways. Science of The Total Environment, 140561.

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