Hand sanitizer can be harmful to children, but experts say benefits outweigh risks in COVID-19 fight

One of many ways of trying to keep children safe from the COVID-19 illness has also meant increasing their exposure to products that can be toxic and have harmful side effects when misused or mislabelled.

Hand sanitizer has become ubiquitous during the pandemic as a proven way to fight the coronavirus that causes COVID-19. But as the virus-killing liquids, gels and sprays proliferate in our daily lives, so do their inherent risks, especially for young children.

The number of accidental poisonings involving hand sanitizer and children has sharply increased since the pandemic began when compared with previous years, according to the Ontario Poison Centre.

In Ontario, Manitoba and Nunavut (the data provided includes all three jurisdictions), there were 536 cases of accidental poisonings between January and September, compared to 318 cases in the same period last year.

August saw the sharpest one-month increase, with 101 reported poisonings. That compared with 29 in August 2019.

The majority of cases involved children five and younger, according to the poison centre.

The amount of harm consuming hand sanitizer would have on a child would depend on the amount consumed and the ingredients, according to Dr. Anna Banerji, pediatric infectious disease specialist at the University of Toronto's Dalla Lana School of Public Health.

Banerji said ingesting hand sanitizers could have less severe effects such as drowsiness, to more serious effects, including trouble breathing.

"It could even kill them," she said in an interview.

Hand sanitizers containing methanol are of particular concern. They are not approved by Health Canada. Yet, a product has recently found its way onto store shelves in Canada. Earlier this week, discount retailer Dollarama recalled a brand of hand sanitizer containing the chemical.

Ingesting a methanol-based hand sanitizer could cause severe toxicity, blindness, kidney failure and could also be fatal, Banerji said.

Hand sanitizers have been growing in popularity for years, with big brands such as Purell becoming household names. Some even come in kid-friendly packaging, colours and scents. At least one product is marketed as "fruit flavour."

Skin irritation

Along with the risk of young children accidentally consuming hand sanitizers, there's also concern about what every day use can do to the skin.

Alcohol-based hand sanitizers are "drying agents" and when heavily used could be irritating to children with eczema or sensitive skin, according to Banerji. In more severe cases, hand sanitizers could dry skin to the point of cracking, which could be a risk for infection, she said.

There's also the risk of over-sanitizing hands.

"It kills bad and good bacteria," Banerji said. "It may change the flora of bacteria on your skin and allow aggressive drug-resistant bacteria to grow."

The Ontario Poison Centre recommends using just one squirt when sanitizing the hands of young children and making sure to allow it to completely dry.

WATCH | How to determine a hand sanitizer is safe to use:

Liane Fransblow, co-ordinator of injury prevention at Montreal Children's Hospital, said prior to the pandemic, hand sanitizer was not recommended for use with young children. Now it is, she said, but children under the age of six should be supervised by an adult when sanitizing.

Hand sanitizer should be kept out of reach and out of sight of young children, Fransblow said.

"We should keep hand sanitizer the way we would keep any other poison."

At the Toronto District School Board (TDSB) and the Toronto Catholic District School Board, hand sanitizer is available at screening stations located at building entrances. Many classrooms have sinks, and handwashing is encouraged. In classrooms without sinks, hand sanitizer is provided.

Hand sanitizer is only accessible in staff-supervised areas, a TDSB spokesperson said.

Benefits outweigh risks

Experts say parents should be cautious about choosing and using hand sanitizer on their children, and continue to use it in the absence of soap and water.

Kelly Grindrod, an associate professor at the University of Waterloo's School of Pharmacy, said hand sanitizer is helping to stop COVID-19 from spreading.

"Especially in this particular time, with cold and flu season and COVID, there's probably a lot of benefit to using hand sanitizer throughout the day to avoid getting viruses into your eyes, nose, your mouth," Grindrod said.

Most of all, parents should be watching for methanol-based products and hand sanitizers not recommended for children or pregnant women. Grindrod said they have the most risk of causing skin irritation or other side effects and could cause the most harm if ingested.

"The solution is to have better hand sanitizer," she said.

Grindrod said you should always look for a hand sanitizer's Natural Product Number (NPN) or Drug Identification Number (DIN), which means it has been registered with Health Canada.

According to Banerji, the risks associated with hand sanitizer are something that can be managed through proper labelling and public awareness.

"Hand sanitizers used wisely and kept in safe place is something we need to continue to do," she said.