Wayne State University School of Medicine, Detroit, MI, USA.
Children's Hospital of Michigan, Detroit, MI, USA.
Clin Toxicol (Phila). 2023 Jun;61(6):463-469. doi: 10.1080/15563650.2023.2221816.
The COVID-19 pandemic increased demand for alcohol-based hand sanitizers. We aimed to describe the epidemiological trends in pediatric alcohol-based hand sanitizer cases reported to United States poison centers. We characterized clinically significant pediatric reports involving alcohol-based hand sanitizer products before and during the pandemic and methanol-containing hand sanitizers during the pandemic.
We included all single-substance cases involving alcohol-based hand sanitizers reported to the National Poison Data System among children ≤ 19 years from 1 January 2017 to 31 December 2021, and methanol-containing hand sanitizers from 23 June 2020 to 31 December 2021. Multiple product exposures and non-human exposures were excluded. Clinically significant outcomes included moderate or major effects or death.
There were 95,718 alcohol-based hand sanitizer pediatric cases during the study period. Most ( = 89,521; 94%) were unintentional, occurred by ingestion ( = 89,879; 93.9%), occurred at home, and were managed at the exposure site ( = 89,774; 93.8%). Common symptoms were vomiting ( = 2,969; 3.1%), coughing ( = 1,102; 1.2%), ocular irritation ( = 1,244; 1.3%), and drowsiness ( = 981; 1.0%). Most children ( = 3,937; 66.2%) managed at a health care facility were treated and released; a minority were admitted ( = 527; 9.0%). Few children ( = 81; 1.4%) were admitted to the intensive care unit. The prevalence of clinically significant cases increased in 2020 and 2021, compared to 2017. Population-adjusted rates, by state, of alcohol-based hand sanitizer cases ranged from 280 to 2,700 per million children. Of the 540 reported cases involving methanol-containing hand sanitizers, the majority ( = 255) occurred in July 2020. Thirteen cases (2.4%) had clinically significant outcomes. The prevalence of clinically significant cases remained similar in 2020 and 2021 and exhibited lower prevalence compared to alcohol-based products. Population-adjusted rates, by state, ranged from fewer than 0.9 to 40 per million children.
Clinically significant pediatric cases involving alcohol-based hand sanitizers increased during the pandemic and remained elevated in 2021. Cases involving methanol-containing products were less frequent. Our findings may inform heightened product quality control and regulatory oversight.
COVID-19 大流行增加了对含酒精的洗手液的需求。我们旨在描述向美国中毒中心报告的儿科含酒精的洗手液病例的流行病学趋势。我们描述了大流行前和大流行期间与含酒精的洗手液产品有关的临床显著儿科报告，以及大流行期间含有甲醇的洗手液产品的报告。
我们纳入了 2017 年 1 月 1 日至 2021 年 12 月 31 日期间向国家毒物数据系统报告的所有 19 岁以下儿童的单一物质病例，涉及酒精基洗手液，2020 年 6 月 23 日至 2021 年 12 月 31 日期间涉及含甲醇的洗手液。排除了多种产品暴露和非人类暴露的情况。临床显著的结果包括中度或重度影响或死亡。
研究期间共有 95718 例儿科酒精基洗手液病例。大多数（=89521；94%）为非故意的，通过摄入（=89879；93.9%）发生，发生在家中，在暴露地点得到处理（=89774；93.8%）。常见症状为呕吐（=2969；3.1%）、咳嗽（=1102；1.2%）、眼部刺激（=1244；1.3%）和嗜睡（=981；1.0%）。大多数在医疗机构接受治疗的儿童（=3937；66.2%）接受治疗并出院；少数（=527；9.0%）住院。少数儿童（=81；1.4%）入住重症监护病房。与 2017 年相比，2020 年和 2021 年临床显著病例的患病率增加。按州划分的酒精基洗手液病例的人口调整率在每百万儿童 280 至 2700 例之间。在报告的 540 例含甲醇的洗手液病例中，大多数（=255）发生在 2020 年 7 月。13 例（2.4%）有临床显著的结果。2020 年和 2021 年临床显著病例的患病率相似，且低于酒精基产品。按州划分的人口调整率在每百万儿童中不到 0.9 至 40 例之间。
大流行期间儿科与酒精基洗手液有关的临床显著病例增加，2021 年仍居高不下。涉及含甲醇产品的病例较少。我们的研究结果可能会为提高产品质量控制和监管监督提供信息。
