Recalls of hand sanitizers spark concern

Hand sanitizers have come under scrutiny lately with more than 50 brands now recalled by Health Canada, leading some to wonder about the safety of products they’re using daily.

Colin Furness, an epidemiologist with the University of Toronto who specializes in hand hygiene, said hand sanitizers are still safe and effective, when made and used properly.

While quality-grade ethanol is the ingredient that makes hand sanitizers effective, there are two impurities that experts say are dangerous substitutions: methanol and ethyl acetate.

The molecular distinction between methanol and ethanol is quite small, Furness says, so it’s easy to mess up during the production process if the manufacturer doesn’t know what they’re doing.

“Methanol and ethanol will look similar and behave similarly,” he said. “The difference is one is quite dangerous.”

Health Canada has a growing list of hand sanitizers that have been recalled recently. The most updated version, released on Wednesday, included 51 brands containing certain types of alcohol that are “not acceptable for use in hand sanitizers.”

Most of the products in this round of recall contain ethyl acetate, which can be used in manufacturing products such as glue or nail polish removers.

Others contain methanol, which makes fuel or antifreeze.

Kelly Grindrod, an associate professor at the University of Waterloo’s School of Pharmacy, said ethyl acetate and methanol can both cause skin irritations, but methanol can also lead to eye irritation and upper-respiratory irritation when it evaporates and is breathed in after being applied to the skin.

“You inhale it and it can cause irritation, headaches can also happen,” Grindrod said. “So that’s a problem.”

There’s also concern with the product being absorbed through the skin, though Grindrod said the amount would be minimal, and long-term toxicity is “more of a question mark than a known risk.”

These concerns do become more important for health-care workers using the products “well over 100 times per day,” rather than an average person working from home and sanitizing their hands once or twice while running errands, Grindrod said.

Dangers with hand sanitizers containing methanol or ethyl acetate can be severe if they’re ingested, and the U.S. Centers for Disease Control and Prevention released a report this week warning of serious adverse effects, including deaths, associated with swallowing methanol.

The CDC said 15 cases of methanol poisoning associated with ingesting alcohol-based hand sanitizers were reported in Arizona and New Mexico between May 1 and June 30. Four patients died.

Ethyl acetate is also toxic when ingested, Grindrod said.

Furness said it’s dangerous to have alcohol-based sanitizer, even ones made with ethanol, in reach of unattended children or other vulnerable populations like inmates and patients in psychiatric facilities.

While there are alcohol-free hand sanitizer alternatives, those can be risky in other ways.

“They’re not dangerous but they’re ineffective,” Furness said. “And that’s a different kind of risk, thinking that your hands are disinfected when they’re not.”

Furness and Grindrod both say to look for sanitizer with at least 60 per cent ethanol, and to stay away from homemade solutions that can be unintentionally diluted, and therefore less effective.