Hand sanitizer causes ocular chemical burns in pediatric population

In response to the COVID-19 pandemic, alcohol-based hand sanitizers (ABHS) have become widely available in public places. ABHS dispensers are typically posted around small children’s eye level where they have been accidentally sprayed directly into young eyes or unwittingly rubbed into eyes after being applied to hands.¹

The chemical makeup of hand sanitizer can be seriously damaging to the ocular surface because it contains high concentrations of alcohol, typically ethanol, which causes serious pain and can kill corneal cells, which may require a corneal transplant.¹

Findings

A team of researchers, working with data from the French Poison Control Center (PCC), discovered that from April 1 to August 24, 2020, there was a sevenfold increase in French reports of ocular hand sanitizer accidents in children compared to data from the same timeframe in 2019.¹

The number of ABHS eye exposures occurring in public places increased from 16.4% in May 2020 to 52.4% in August 2020, and hospital admissions for ABHS eye exposure increased during the same period.¹ A total of 16 children were admitted for ABHS in 2020, including 10 boys (mean age of 3.5 years) vs 1 boy (aged 16 months) in 2019.¹

By the numbers

In 2020:

· 16 children were admitted to the hospital for injuries caused by ABHS eye exposure

· 8 presented with a corneal and/or conjunctival ulcer

· 6 patients’ corneal ulcers involved more than 50% of the corneal surface

· 2 cases required amniotic membrane transplants

While compliance with hand disinfection is important to public health, these findings suggest ODs and other health authorities should ensure ABHS dispensers are being used properly and safely and warn the parents and caregivers of young children about potential dangers.

References

1. Martin GC, Le Roux G, Guindolet D, et al. Pediatric eye injuries by hydroalcoholic gel in the context of the coronavirus disease 2019 pandemic. JAMA Ophthalmol. 2021;139(3):348-351. doi:10.1001/jamaophthalmol.2020.6346