Hand sanitizer is a commonplace product intended for external use to eliminate germs on the skin, but it is not harmless. These products contain a high concentration of alcohol, often ranging from 60% to 95%, making them significantly more potent than most distilled spirits. Swallowing even a small amount can lead to rapid and serious intoxication, particularly in children due to their smaller body mass and reduced ability to process alcohol. Ingestion of hand sanitizer is considered a medical emergency that can quickly result in life-threatening complications, demanding immediate intervention.
The Primary Toxic Ingredients
The danger in hand sanitizer stems primarily from its high alcohol content, which exists in a few different chemical forms. Most legitimate products contain either ethanol, also known as ethyl alcohol, or isopropanol, which is isopropyl alcohol or rubbing alcohol. Ethanol is the same alcohol found in alcoholic beverages, but the high concentration in sanitizer can quickly overwhelm the body’s ability to process it.
Isopropanol is more toxic than ethanol, as the body metabolizes it into acetone, a compound that acts as a central nervous system depressant and can lead to ketosis without acidosis. A greater concern is the inclusion of methanol, or wood alcohol, an unacceptable ingredient that has contaminated certain brands. Methanol is extremely toxic because the body converts it into formaldehyde and then into formic acid, which are highly destructive compounds.
Immediate Physical Effects of Ingestion
Ingesting hand sanitizer leads to a rapid onset of symptoms closely resembling severe alcohol poisoning. An individual may quickly experience gastrointestinal distress, including nausea, vomiting, and abdominal pain, as the substance irritates the stomach lining. The central nervous system quickly becomes affected, leading to confusion, slurred speech, and a loss of coordination.
Children are particularly vulnerable to a swift drop in blood sugar (hypoglycemia), which can quickly result in seizures. Symptoms of intoxication range from mild drowsiness to a decreased level of consciousness, indicating central nervous system depression. Even small amounts pose a risk, and any noticeable symptoms require immediate medical attention.
Severe Systemic Damage and Risks
Beyond the initial intoxication, the high concentration of alcohol and its metabolites pose risks of severe, life-threatening systemic damage. A major complication is respiratory depression, where central nervous system suppression slows breathing to a dangerously low rate, potentially leading to respiratory failure. Ingestion can also cause severe metabolic acidosis, a condition where the body accumulates too much acid, severely disrupting cellular function.
The most severe systemic damage is often linked to methanol, which creates formic acid that targets the optic nerve, causing permanent visual impairment, including blindness. Untreated methanol poisoning can also result in extensive damage to the kidneys and liver, leading to organ failure. In cases of significant ingestion, the toxic load can progress to seizures, prolonged coma, and death.
Critical Emergency Steps
If hand sanitizer is ingested, the first step is to immediately call the national Poison Help hotline at 1-800-222-1222, or local emergency services. Do not wait for symptoms to develop before seeking help. Be prepared to provide the operator with information about the person, including their age and weight, the specific product name, and the estimated amount consumed.
Medical management involves supportive care, including monitoring breathing and heart rate, and correcting severe metabolic imbalances. For methanol poisoning, a specific antidote like fomepizole may be administered. Fomepizole works by blocking the enzyme that converts methanol into its toxic metabolites. In some cases, ethanol itself is used as a temporary antidote because the body preferentially processes it first, allowing the unmetabolized methanol to be cleared.
Keeping Hand Sanitizer Out of Reach
Hand sanitizer should always be treated as a household poison and stored securely out of the sight and reach of children. The high alcohol content, often disguised by attractive packaging and sweet fragrances, makes it a serious ingestion hazard. Acknowledging the toxicity of this product is necessary to prevent accidental exposure and resulting complications.