The rising incidence of intentional ingestion of ethanol-containing hand sanitizers

Nicole J. Gormley, Alvin C. Bronstein, Joseph J. Rasimas, Maryland Pao, Angela T. Wratney, Junfeng Sun, Howard A. Austin, Anthony F. Suffredini

Research output: Contribution to journalArticle

Abstract

Objective: To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers' National Poison Data System. Design: A case report, a literature review of published cases, and a query of the National Poison Data System. Setting: Medical intensive care unit. Patient: Seventeen-yr-old male 37-kg with an intentional ingestion of a hand sanitizer product into his gastrostomy tube. Interventions: Intubation, ventilation, and hemodialysis. Measurements and Main Results: Incidence and outcome of reported cases of unintentional and intentional ethanol containing-hand sanitizer ingestion in the United States from 2005 through 2009. A literature search found 14 detailed case reports of intentional alcohol-based hand sanitizer ingestions with one death. From 2005 to 2009, the National Poison Data System received reports of 68,712 exposures to 96 ethanol-based hand sanitizers. The number of new cases increased by an average of 1,894 (95% confidence interval [CI] 1266-2521) cases per year (p =.002). In 2005, the rate of exposures, per year, per million U.S. residents was 33.7 (95% CI 28.4-39.1); from 2005 to 2009, this rate increased on average by 5.87 per year (95% CI 3.70-8.04; p = .003). In 2005, the rate of intentional exposures, per year, per million U.S. residents, was 0.68 (95% CI 0.17-1.20); from 2005 to 2009, this rate increased on average by 0.32 per year (95% CI 0.11-0.53; p = .02). Conclusions: The number of new cases per year of intentional hand sanitizer ingestion significantly increased during this 5-yr period. Although the majority of cases of hand sanitizer ingestion have a favorable outcome, 288 moderate and 12 major medical outcomes were reported in this National Poison Data System cohort. Increased awareness of the risks associated with intentional ingestion is warranted, particularly among healthcare providers caring for persons with a history of substance abuse, risk-taking behavior, or suicidal ideation.

Original languageEnglish (US)
Pages (from-to)290-294
Number of pages5
JournalCritical Care Medicine
Volume40
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Hand Sanitizers
Ethanol
Eating
Poisons
Incidence
Information Systems
Confidence Intervals
Poison Control Centers
Suicidal Ideation
Gastrostomy
Risk-Taking
Intubation
Health Personnel
Substance-Related Disorders
Intensive Care Units
Ventilation
Renal Dialysis
Alcohols

Keywords

  • Alcohol poisoning
  • Ethanol hand sanitizer
  • Hand sanitizer ingestion
  • NPDS

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Gormley, N. J., Bronstein, A. C., Rasimas, J. J., Pao, M., Wratney, A. T., Sun, J., ... Suffredini, A. F. (2012). The rising incidence of intentional ingestion of ethanol-containing hand sanitizers. Critical Care Medicine, 40(1), 290-294. https://doi.org/10.1097/CCM.0b013e31822f09c0

The rising incidence of intentional ingestion of ethanol-containing hand sanitizers. / Gormley, Nicole J.; Bronstein, Alvin C.; Rasimas, Joseph J.; Pao, Maryland; Wratney, Angela T.; Sun, Junfeng; Austin, Howard A.; Suffredini, Anthony F.

In: Critical Care Medicine, Vol. 40, No. 1, 01.2012, p. 290-294.

Research output: Contribution to journalArticle

Gormley, NJ, Bronstein, AC, Rasimas, JJ, Pao, M, Wratney, AT, Sun, J, Austin, HA & Suffredini, AF 2012, 'The rising incidence of intentional ingestion of ethanol-containing hand sanitizers', Critical Care Medicine, vol. 40, no. 1, pp. 290-294. https://doi.org/10.1097/CCM.0b013e31822f09c0
Gormley, Nicole J. ; Bronstein, Alvin C. ; Rasimas, Joseph J. ; Pao, Maryland ; Wratney, Angela T. ; Sun, Junfeng ; Austin, Howard A. ; Suffredini, Anthony F. / The rising incidence of intentional ingestion of ethanol-containing hand sanitizers. In: Critical Care Medicine. 2012 ; Vol. 40, No. 1. pp. 290-294.
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N2 - Objective: To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers' National Poison Data System. Design: A case report, a literature review of published cases, and a query of the National Poison Data System. Setting: Medical intensive care unit. Patient: Seventeen-yr-old male 37-kg with an intentional ingestion of a hand sanitizer product into his gastrostomy tube. Interventions: Intubation, ventilation, and hemodialysis. Measurements and Main Results: Incidence and outcome of reported cases of unintentional and intentional ethanol containing-hand sanitizer ingestion in the United States from 2005 through 2009. A literature search found 14 detailed case reports of intentional alcohol-based hand sanitizer ingestions with one death. From 2005 to 2009, the National Poison Data System received reports of 68,712 exposures to 96 ethanol-based hand sanitizers. The number of new cases increased by an average of 1,894 (95% confidence interval [CI] 1266-2521) cases per year (p =.002). In 2005, the rate of exposures, per year, per million U.S. residents was 33.7 (95% CI 28.4-39.1); from 2005 to 2009, this rate increased on average by 5.87 per year (95% CI 3.70-8.04; p = .003). In 2005, the rate of intentional exposures, per year, per million U.S. residents, was 0.68 (95% CI 0.17-1.20); from 2005 to 2009, this rate increased on average by 0.32 per year (95% CI 0.11-0.53; p = .02). Conclusions: The number of new cases per year of intentional hand sanitizer ingestion significantly increased during this 5-yr period. Although the majority of cases of hand sanitizer ingestion have a favorable outcome, 288 moderate and 12 major medical outcomes were reported in this National Poison Data System cohort. Increased awareness of the risks associated with intentional ingestion is warranted, particularly among healthcare providers caring for persons with a history of substance abuse, risk-taking behavior, or suicidal ideation.

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