Citation

Gormley NJ, Bronstein AC, Rasimas JJ, Pao M, Wratney AT, Sun J, Austin HA, Suffredini AF. Crit. Care Med. 2012; 40(1): 290-294.

Affiliation

Critical Care Medicine Department (NJG, JS, AFS), Clinical Center, Bethesda, MD; the Rocky Mountain Poison Center (ACB), Denver Health, University of Colorado School of Medicine, Denver, CO; the National Institute of Mental Health (JJR, MP), Bethesda, MD; Children's National Medical Center (ATW), Washington, DC; and the National Institute of Diabetes and Digestive and Kidney Diseases (HAA), Bethesda, MD.

Copyright

(Copyright © 2012, Society of Critical Care Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/CCM.0b013e31822f09c0

PMID

21926580

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. 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 1894 (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 complications 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.

Language: en