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Booze Ooze

Claim:   Ingestion of hand sanitizer by children can result in alcohol poisoning.

MIXTURE

Examples:

[Collected via e-mail, January 2007]

Hi All-

Just wanted to send you a quick email and warn you about using hand sanitizers wtih your young kids. We have been using that with Sydney in place of hand washing for convience sake. Today she told me she was going up to her room to get a toy, while I was downstairs feeding Griffin, and after taking longer then it should I called for her. When she didn't answer I knew she was up to something and the bathroom door was closed. She got into the hand sanitizer and had ingested some of it. There wasn't a large amount missing from the bottle but I could smell it on her breath.

Within approx. 10 min. she was all glassy eyed and wobbly in her feet. As the minutes passed, she continued to get worse and got to the point where she couldn't even stand up or walk, it was awful!!

I called poison control immediately and they told me to take her to the ER right away due to the alcohol level in hand sanitizers. As we were driving there her speech became slurred and harder to understand and her eyes looked awful. They admitted her and did urine and blood tests and it turns out that her blood alcohol level was .10 — which is legally drunk. It turns out that the hand sanitizers (Purell) have 62% alcohol in them and the dr. compared it to her drinking something that is 120 proof.

We had a VERY scary afternoon but thankfully she is ok. We were in the ER until this evening, after spending the whole afternoon there, so they could monitor her and make sure her blood sugars were stable. They said that someone her size would only need to have 3 squirts of it to get to the point of being .10 blood level.

She has always wanted to lick her hands after we use it and we have warned her that it is dangerous and something that kids can't do or they will end up in the hospital. Needless to say, we are going to go back to washing hands with soap and water because it is way to risky and scary to use this stuff seeing how little a child needs to be affected by it. We asked about long term affected with the liver, brain, etc and the dr. said we have nothing to worry about but we need to get rid of all the hand sanitizer in the house.

Just wanted to let you all know so you can learn from our lesson and not have to go through something as scary as this...
 

[Collected via e-mail, May 2007]

Ok. I don't know where to begin because the last 2 days of my life have been such a blur. Yesterday, My youngest daughter Halle who is 4, was rushed to the emergancy room by her father for being severely lethargic and incoherent. He was called to her school by the school secretary for being "very VERY sick." He told me that when he arrived that Halle was barely sitting in the chair. She couldn't hold her own head up and when he looked into her eyes, she couldn't focus them.

He immediately called me after he scooped her up and rushed her to the ER. When we got there, they ran blood test after blood test and did x-rays, every test imaginable. Her white blood cell count was normal, nothing was out of the ordinary. The ER doctor told us that he had done everything that he could do so he was sending her to Saint Francis for further test. Right when we were leaving in the ambulance, her teacher had come to the ER and after questioning Halle's classmates, we found out that she had licked hand sanitizer off her hand. Hand sanitizer, of all things.

But it makes sense. These days they have all kinds of differents scents and when you have a curious child, they are going to put all kinds of things in their mouths. When we arrived at Saint Francis, we told the ER doctor there to check her blood alcohol level, which, yes we did get weird looks from it but they did it. The results were her blood alcohol level was 85% and this was 6 hours after we first took her. Theres no telling what it would have been if we would have tested it at the first ER. Since then, her school and a few surrounding schools have taken this out of the classrooms of all the lower grade classes but whats to stop middle and high schoolers too? After doing research off the internet, we have found out that it only takes 3 squirts of the stuff to be fatal in a toddler. For her blood alcohol level to be so high was to compare someone her size to drinking something 120 proof. So please PLEASE don't disregard this because I don't ever want anyone to go thru what my family and I have gone thru. Today was a little better but not much. Please send this to everyone you know that has children or are having children. It doesn't matter what age. I just want people to know the dangers of this.

Thank you Lacey Butler and family
 

Origins:   The first alert quoted above (which began circulating via e-mail in mid-January 2007) Hand sanitizer was written by Jennifer Moe, the mother of a 2-year-old girl who had ingested some hand sanitizer. The second example (May 2007) was written by Lacey Butler, the mother of a 4-year-old girl who had done the same; although it contains some errors of fact or transcription (e.g., a "blood alcohol level [measured at] 85%"), it is a true tale in the sense that 4-year-old Halle Butler, a pre-kindergarten student at Okmulgee Primary School in Okmulgee, Oklahoma, was treated at an area hospital after eating a small amount of hand sanitizer squirted into her palm by a teacher.

While the stories as related in the e-mailed accounts fortunately did not result in death or serious injury, they are cautionary tales worth heeding because they present a scenario that can all too easily be repeated in other households, schools, or daycare centers with small children. Hand sanitizer gels and wipes include a surprising amount of alcohol (e.g., Purell and Germ-X contain 62% Ethyl Alcohol), and a child who swallowed enough of such products could experience what 2-year-old Sydney and 4-year-old Halle went through: intoxication, possibly even alcohol poisoning.

However, although such poisonings are possible, they are still quite rare due to the relatively large amount of bad-tasting sanitizer that a toddler would typically have to ingest to experience such harmful results:
"Typical exposure by a small child involves a squirt or two from a pump of 70 percent alcohol [sometimes labeled as ethanol] hand sanitizer [and] really isn't usually a problem," [Dr. Edward] Krenzelok [director of the Pittsburgh Poison Control Center & Drug Information Center and a professor of pharmacy and pediatrics at the University of Pittsburgh] explains. "They cry because it tastes bad and maybe it irritates their tongue," he says. According to the American Association of Poison Control Centers, centers are receiving more of these calls as the use of hand sanitizers increases. Combined data from 2005 and 2006 found that poison-control centers reported more than 20,000 exposures to hand sanitizer, with more than 17,000 cases involving children under the age of 6. None of the calls resulted in death, with no major medical problems reported in the children. In fact, more than 9,500 cases resulted in little or no effect.
Bottles of topical anti-bacterials do carry explicit warnings about the danger they pose (e.g., bottles of Purell hand sanitizer caution: "Keep out of reach of children. If swallowed, get medical help or contact a Poison Control Center right away.") However, unlike cleaning supplies and numerous other products commonly used in the home,
hand sanitizer isn't generally thought of as something that presents a poisoning danger to children — folks unthinkingly tend to regard it the way they do hand lotion, as something that can be safely left on a counter or nightstand. Yet such products shouldn't be left within easy reach, not if one has a small child about. While one might think the taste of the product (which in Purell's case is akin to a slightly flowery version of vodka) would keep children from swallowing too much of it, kids can and do get into the darnest things.

Youngsters are especially at risk of ingesting poisons from ordinary household products due to four factors, notes a 1992 Clinical Pediatrics article:
  • Children are naturally curious about most everything, including the taste, smell, and texture of products.
  • Children learn about the world through smelling, touching, and tasting. Brightly colored liquids, spray containers, pills, and leafy or flowering plants are all attractive lures to children, who may attempt to learn more about them through spraying, smelling, or swallowing. The mechanics of spray containers are of particular interest to many curious children.
  • Children lack the experience and knowledge to distinguish poisons and other non-potables from harmless substances. Children can think that fuels, cough syrup, and shampoo are safe to drink because they resemble beverages such as fruit punch or soft drinks. Children may also find the appearance, taste, or odor of a dangerous substance similar to that of a consumable product: medicine tablets look and taste like candy, anti-freeze tastes sweet, red mouthwash looks like fruit punch, etc.
  • Children imitate the behavior of adults and frequently mimic what they see their parents or grandparents do, such as taking medication, drinking colored liquids, cleaning house, and spraying chemicals.
Although the warning's author argues for the outright ban of hand sanitizer from any home where small children reside, it needs be kept in mind that a 2005 study of 292 families by Children's Hospital Boston (in which one-half of the subjects got hand sanitizers, while the other half received literature advising them to wash their hands frequently) found that those who used hand sanitizer gels experienced a 59% reduction in gastrointestinal illnesses, and that increased use of sanitizers corresponded with a decreased spread of contagions (including those resulting in respiratory illnesses).

Barbara "germ warfare" Mikkelson

Last updated:   24 February 2009

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Sources:

    Brayden, R.M.   "Behavioral Antecedents of Pediatric Poisonings."
    Clinical Pediatrics.   January 1993   (pp. 30-35).

    Mulkins, Phil.   "Do Hand Sanitizers Beat Soap and Water?"
    Tulsa World.   2 November 2004   (p. A2).

    Nishikawa, Maya.   "Hand Sanitizer Hazards."
    WCCO-TV [Minneapolis].   20 January 2007.

    Smith, Amber.   "Is This Goo for You?"
    The [Syracuse] Post-Standard.   12 October 1998   (p. C1).

    Verhoeven, Jace.   "Hand Sanitizer Makes Girl Drunk."
    FOX 23 [Tulsa].   14 May 2007.