A new report released by federal health officials highlights the risk of hand sanitizer poisoning from methanol contained in many imported products, indicating that the wood alcohol has been linked to at least 15 reports of injury among adults in Arizona and New Mexico, including at least four deaths and three cases that resulted in vision impairment.
The U.S. Centers for Disease Control and Prevention (CDC) released the update this week in the agency’s Morbidity and Mortality Weekly Report, as a growing number of hand sanitizers continue to be issued nationwide after regulators identify products that contain methanol, which is not approved for use in topical sanitary products due to its potentially harmful side effects.
Methanol is often used to make fuel and antifreeze, but including it in hand sanitizer can cause side effects like headache, nausea, vomiting, blurred vision, seizures, blindness, coma, permanent damage to the nervous system and death.
According to the CDC’s latest report, the agency has received at least 62 alcohol-based hand sanitizer-associated methanol poisoning cases from May 1, 2020 through June 30, 2020 nationwide. Of those, it received 15 confirmed case reports from Arizona and New Mexico, involving adults who ingested the hand sanitizer products.
After reviewing medical records of the cases, the CDC determined four patients died and three were left with visual impairments.
All 15 patients were treated with fomepizole, which is a competitive inhibitor of alcohol dehydrogenase. Six patients developed seizures during their hospitalization and nine patients received hemodialysis or continuous renal replacement therapy. CDC researchers indicated that as of July 8, four of patients were still hospitalized and being evaluated.
Although methanol poisoning typically only last eight to 24 hours, the severity of the injuries that can arise from the accumulation of acid in the blood, called metabolic acidosis, and can set in fast and causing a serious risk of permanent blindness or death.
While no hand sanitizer products on the market are safe for consumption, the CDC and FDA have become aware of unfortunate misuses of hand sanitizers among some with alcohol problems, and continue to persistently receive thousands of calls per year to poison control centers for children accidentally ingesting the products due to their bright colors, with scents similar to food and candy, including some that contain glitter or fun characters in the bottles.
According to a recent hand sanitizer warning issued by the FDA, the influx of unapproved imported methanol-containing products circulating through U.S. retailers have increased the risk of methanol poisoning from hand sanitizers, putting customers scrambling for topical sanitary products to be at increased risks.
To date, the FDA has issued more than 100 hand sanitizer recalls in recent months due to the presence of methanol, which may not be listed in the ingredients of the products.
On August 7, 2020, the FDA announced a temporary hand sanitizer testing guidance which outlines a series or procedures for manufacturers to test for potentially harmful methanol ingredients
The new hand sanitizer testing guidelines require manufacturers to have each lot of the active ingredient tested in a laboratory compliant with the FDA’s good manufacturing practice, as well as instructing manufacturers to discard and report any lot of ethanol or isopropyl alcohol containing more than 630 parts per million (ppm) of methanol.