The public must be warned that hand sanitiser can kill if it is swallowed, an expert has said, as cases of accidental poisoning continue to rise.
More needs to be done to protect people against the dangers of ingesting sanitiser with a high alcohol content, but particularly children, the elderly and those with mental health issues, according to researcher Georgia Richards from the University of Oxford.
Her analysis of two deaths identified in coroners’ reports, and published in the journal BMJ Evidence Based Medicine, says the public is largely unaware of the hazards posed by sanitiser.
The volume of these products now to be found around homes, hospitals, schools, workplaces and elsewhere may be a cause for concernGeorgia Richards
She points to a 61% increase in poisonings from alcohol-based hand sanitisers reported to the National Poisons Information Service (NPIS) in the UK, from 155 between January and September 2019 to 398 between January and September 2020.
Two children in Australia and the US have also suffered accidental poisoning from sanitiser at home during the pandemic, she writes.
“The volume of these products now to be found around homes, hospitals, schools, workplaces and elsewhere may be a cause for concern,” she said.
“Warnings about the toxicity and lethality of intentionally or unintentionally ingesting alcohol-based hand sanitisers have not been widely disseminated.”
Ms Richards describes two pre-pandemic deaths in NHS hospital trusts from ingestion, with the first being a young woman who was detained in a psychiatric unit and given an antidepressant.
She was found dead in her hospital bed three days later with a container of hand sanitising gel beside her.
The gel was readily accessible to patients on the ward from a communal dispenser, and patients were allowed to fill cups or other containers with it to keep in their rooms.
A high level of alcohol was found in her blood, and her death was attributed to “ingestion of alcohol and (antidepressant) venlafaxine” by the coroner, who said the combination had suppressed her breathing.
The Department of Health responded to the coroner’s report describing national guidelines and strategies to prevent suicides.
But no specific actions were undertaken or proposed by the Department of Health, Ms Richards said, and it is difficult to ascertain what steps were taken by the trust.
The second case involved a 76-year-old man who unintentionally swallowed alcohol-based hand sanitiser foam, which had been attached to the foot of his hospital bed.
John Haughey, 76, is known to have drunk more than half a litre of the gel while in a confused state at Hull Royal Infirmary in 2015.
The substance contained 75% alcohol, which is equivalent to consuming a litre of gin.
Hull and East Yorkshire Hospitals NHS Trust admitted in 2017 that it had failed to reach the standard of care it wanted but had since taken “robust action”.
It agreed to pay an undisclosed, five-figure sum in damages to Mr Haughey’s family.
Following an inquest, Hull coroner Professor Paul Marks wrote to the chief executive of NHS England to warn that similar deaths could occur if changes were not introduced.
In his response to the coroner in 2017, former NHS England medical director Professor Sir Bruce Keogh said organisations had already been issued with “significant guidance” underlining the need for risk assessments when gels were used near vulnerable patients.
However, he said “the continued persistence of these problems” meant regulators were considering further action, including the introduction of dispensers limiting the amount of gel released in NHS settings.