PPB October 2020

• Stomachache • Nausea • Vomiting Rare Health Effects • Coma • Seizures • Hypoglycemia • Metabolic Acidosis • Respiratory depression Many manufacturers of hand sanitizers add a bitterant such as Bitrex tomitigate the unintentional or intentional risk of a consumer self-poisoning. Burn Hazard The active ingredient in the hand sanitizer manufacture and distribution exempted under the FDA’s EUA is ethyl alcohol, a flammable liquid. While alcohol is quick to evaporate, the user is directed to “rub hands until dry” and warned against exposure to a flame. Yet chemical burns remain one of the common injuries associated with hand sanitizers as reported in the National Electronic Injury Surveillance System (NEISS). Ethyl alcohol, when ignited, produces a blue flame. A 2017 YouTube sensation involved dipping the user’s fingers in hand sanitizer then lighting the hand sanitizer-coated fingertips. The quick-burning fuel, supposedly, burns out before singeing the skin. As withmany YouTube stunts, a warning should have accompanied the videos. The resulting injuries can range from first-degree burns to deeper second-degree or even third- degree burns. Recalled Hand Sanitizers Contaminated with Methyl Alcohol Hand hygiene is an important component of the U.S.’s response to the COVID-19 pandemic. At this writing, the FDA has recalledmore than 150 hand sanitizer products contaminated with or containing the chief ingredient methyl alcohol, also known as methanol. (Some recalled hand sanitizers’ contents have tested up to 81-percent (v/v) methanol.) Methyl alcohol smells and appears similarly to ethyl alcohol. In contrast to ethyl alcohol, methyl alcohol is highly toxic and burns a white flame. Common usages of methyl alcohol are as a precursor chemical for the production of formaldehyde and other specialized chemicals. Methyl alcohol should never be used in a hand sanitizer. The toxins attack the central nervous system, depressing breathing and heart rate. Symptoms include nausea, vomiting, headaches, permanent blindness and seizures among other harmful effects, up to and including coma and death. Other Recalled Hand Sanitizers The FDA recalls hand sanitizers for reasons beyond contamination. Recent hand sanitizer recalls include: • Inadequate concentrations of ethyl alcohol º Theminimum concentration required for efficacy is 60 percent v/v • Insufficient benzalkonium chloride (alcohol-free sanitizer) º This antimicrobial is not approved for fighting COVID-19 • Hand sanitizers sold or offered for sale with false and misleading, unproven claims that the product can prevent the spread of viruses such as COVID-19, including claims the product can provide prolonged protection (e.g. for up to 24 hours) dom K / Shutterstock.com TheCDChas identified ethyl alcohol-basedhand sanitizers as themost effective hand sanitizer in the fight against coronavirus. 86 | OCTOBER 2020 | THINK

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