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'It’s actually quite astonishing': The most dangerous hand sanitizer mistakes

Months into the COVID-19 pandemic, trends are changing as Canadians continue to run into health risks relating to common household cleaners and disinfectants.

In June 2020, there were 1,060 calls reported to Canada’s five poison centres, which marks an 88 per cent increase compared to June 2019, involving exposures to hand sanitizers, disinfectants, bleaches, chlorine and chloramine gases.

According to data shared by Health Canada to Yahoo News Canada, calls related to disinfectants and bleaches have gone down in June compared to May and April of this year. While the total number of exposures for the two gasses combined has stayed below the record-high mark that was set in March.

But exposures to hand sanitizers are at an all-time high amid the pandemic, with 394 cases in June 2020, which is the most of any household cleaner or disinfectant. The trend also continues to gain pace, considering there were 329 hand sanitizer exposures in May 2020 and 208 in April 2020.

“I’m not surprised that we’re hearing about exposures...I’m surprised that we’re hearing about as many calls as we are,” said Heather Hudson, an inter-professional education specialist at the Ontario Poison Centre.

Health and public safety officials have attributed the rise in hand sanitizer exposures to the fact that it wasn’t as readily available at the start of the pandemic. Now, it’s in high demand as people start to make their way back into public spaces as physical distancing restrictions ease. With it being out in the open, it’s also led to accidental and intentional exposures, most commonly with children.

Mistaken identity

“One of the scenarios that always strikes us at the poison centres is the number of cases we get where the cleaning product is stored outside of its original container,” said Hudson. “It’s actually quite astonishing...it blows me away how many calls we get relating to mistaken identity.”

Mistaken identity occurs when people stock up on cleaning products, and decide to move some from their original container to smaller ones, such as water bottles. It leads to accidental ingestion, after someone mistakes the cleaning product for a drink.

To avoid it happening, Hudson reminds people to only buy the amount they need.

Sometimes it’s also not always one’s fault; over the course of the pandemic, Ontario’s poison centre has received reports of cleaning products being sold in reused beverage containers, such as two-litre pop bottles.

But even when they’re in the right packaging, it may still lead to problems with children.

What worries Jim Chan, a retired Toronto Public Health inspector known for the Health Inspector’s Notebook, are hand sanitizer products with appealing fragrances. A mango-scented hand sanitizer may be appealing to a kid, and if they’re thirty or curious, it can be what they choose to drink.

Along with not keeping hand sanitizer in the car, since it can pose a fire risk, Chan advises parents to treat it like any other hazardous product and not to leave it sitting around the house, such as at your front door.

“It’s a problem with a lot of products,” said Hudson. “They make their products appealing to young eyes that can’t read the labels.”

The Quebec poison control centre, the only one to provide age breakdowns for their statistics, have reported more cases related to hand sanitizers among children (those under 19) than adults for each month between January-May.

The opposite is true for disinfectants, bleaches, and chlorine and chloramine gasses.

The 60-90 per cent alcohol content in isopropyl and ethanol based hand sanitizers can lead to health problems for an adult, let alone a child, considering liquor is only 40 per cent. Alcohol poisoning can lower blood sugar, leading to a shortness of breath; worst case, even though unlikely, it can result in a coma and seizures.

Putting on too much

Chan has seen people drench their hands with sanitizer, with many stores asking shoppers to apply some before they enter as restrictions ease nationwide.

With kids, it can lead to accidental poisonings, because of how often they touch their mouth and face. If the hand sanitizer has an appealing smell, it may further the risk.

“If you over apply and it’s still wet, and if kids are licking it, it’s almost like drinking a small alcoholic drink,” said Chan.

If your kid is going out to play, he advises applying hand sanitizer once before activities begin, then once before entering the car or house, to not bring any potential viruses back into your personal space. Exemptions can take place if you notice your kid make contact with a heavily touched surface.

Using too much hand sanitizer also applies to adults, with some restaurants and bars going the extra step to place a bottle on each table. You want to let the hand sanitizer dry on your hands before you start touching your food, said Chan.

As a former health inspector, Chan said he would never allow kitchen staff to use hand sanitizer — instead he’d always enforce hand washing — because it can lead to food contamination.

“In a household environment it’s the same thing,” said Chan. “Using hand sanitizer in the kitchen, preparing food, touching food, it can contaminate the food… Washing your hands should always be the number one option.”

Read the labels

In June, Health Canada recalled at least 15 different hand sanitizers, mainly due to them containing industrial-grade ethanol.

In a time that many people are purchasing products online, Chan warns people to also not only limit your search to Health Canada, but also to the United States Food & Drug Administration (FDA). Recalls have been taking place around the U.S. because some hand sanitizer products include methanal (wood alcohol), which could lead to blindness, permanent damage to the nervous system or death if ingested. Similar warnings have been issued by the B.C. Centre for Disease Control.

It’s a reminder to always research your cleaning products on Health Canada and the FDA, but to also always read the label to understand what ingredients there are and how to properly apply the cleaning product or disinfectant.

The most common mistake, says Chan, is when people use bleach on surfaces. While cleaning wipes have been selling out quickly, bleach has been readily available. According to statistics from Health Canada, the only product exposure to outnumber hand sanitizer cases (329) in May was bleach (393), before hand sanitizer eventually took the top spot in June.

Mixing bleach with anything other than water can create dangerous fumes. In June 2020, Canada saw a 48 per cent increase in cases relating to chlorine and chloramine gas related incidents compared to June 2019. It comes from mixing bleach with a cleaner that contains either acid or ammonia, respectively.

“There will be a vapour, which can create irritation for your eyes...it can even be fatal,” said Chan.

If you or someone you know has accidentally come into contact with a dangerous amount of a cleaning product or disinfectant, call a poison centre, said Hudson and Chan. At any point of day or night, a nurse will provide you with next steps. In some cases you can avoid an unnecessary hospital trip, which would help ease the burden currently on frontline workers.