Alcohol-based hand sanitizers became a must have during the pandemic. But as sales rose and families stocked up, poison centers received more and more calls about small children they’d accidentally picked up.

Even now, roughly a year after the frenzy of stocking up on disinfectants began, hand sanitizer is still easy to get hold of in many households, and calls to the country’s poison control centers are at a faster pace than before the pandemic.

In the past year, there were more than 20,000 exposures to hand sanitizer in children under 6, an increase of 40 percent over 2019. This is based on data from the American Association of Poison Control Centers obtained from the New York Times.

Most of these exposures involved children up to 2 years of age who had ingested the disinfectant. In many cases, no symptoms were noted, which means the child may have just taken or licked a brief taste, which usually doesn’t have significant health effects, said Dr. Justin Arnold, the Medical Director of the Florida Poison Information Center Tampa. In other cases, vomiting, coughing and mouth irritation occurred in children.

While most cases are mild, by properly storing the disinfectant and monitoring young children while using it, parents can avoid the stress of calling poison control or taking an unnecessary trip to the emergency room.

The increase in exposures has continued over the past few months. In January, for example, almost 34 percent more exposure to hand sanitizer was reported in children under 6 than in the previous year.

Exposure to household cleaners such as liquid laundry detergent packs, bleach, all-purpose cleaners, drain cleaners, and oven cleaners also increased, increasing 10 percent in children under 6 years of age in the first few months of the pandemic. This comes from a report published in August by the American Association of Poison Control Centers.

But when it comes to hand sanitizer that we regularly reach for when we’re outside and all our hands frothed up, it’s easy to let go of your guard, experts said. Mainly because hand sanitizer does not come with a child-resistant closure.

“People don’t realize how toxic it is when ingested, what effects it has, and what to do to store it safely,” said William Eggleston, clinical toxicologist at the Upstate New York Poison Center in Syracuse, NY. and an assistant professor at Binghamton University School of Pharmacy.

It depends on how much is swallowed.

If children take enough alcohol-based hand sanitizer, they can get “dangerously drunk,” said Dr. Diane Calello, a pediatric toxicologist and executive and medical director of the New Jersey Poison Center.

Last spring, Dr. Calello co-authored a report by the Centers for Disease Control and Prevention on the rise in calls to poison centers warning parents to keep hand sanitisers, detergents and disinfectants away from children. The report highlighted the case of a preschooler who became unresponsive in her home near a 64-ounce bottle of ethanol-based hand sanitizer. Her blood alcohol level was 0.27 percent, more than three times the legal limit above which an adult is not allowed to drive.

Updated

Apr. 25, 2021 at 12:46 AM ET

Hand sanitizer is 60 to 95 percent alcohol, a much higher concentration than beer, wine, or most liquor. A child weighing 20 pounds who drank a tablespoon or two could get high, said Dr. Calello and “a little drunk” appear.

“If a dose goes higher, they can become very sleepy and have difficulty breathing, just like we see with severe alcohol intoxication in adults,” she added.

After drinking a small amount of alcohol, children are more likely than adults to experience dangerous blood sugar drops, which can make them sluggish from about six to ten hours after consumption, said Dr. Calello.

Ingesting disinfectants can also be irritating to the throat or stomach, especially if they’re formulated with isopropyl alcohol, an ingredient often found in alcohol, the experts say.

Keep all hand sanitizer out of the reach of children – and out of sight, even if you only have a small bottle tucked in a purse or backpack.

“It is important for parents to treat it like household drugs,” said Dr. Eggleston.

You may be wondering if your family should avoid hand sanitizer entirely. While hand washing is the most effective way to get rid of germs, the CDC nonetheless recommends using a hand sanitizer with at least 60 percent alcohol to help prevent the spread of the coronavirus when soap and water are not readily available.

If you have children under 6 at home, supervise them while they use it, said Dr. Arnold.

“You don’t want the kid to pump their own and start trying,” he added.

There was a surge in calls to U.S. poison centers in July and August after the Food and Drug Administration warned about hand sanitizer, which may contain methanol, which can be toxic if ingested. Hand sanitisers should never contain methanol.

“You can die if you drink methanol – and people do,” said Dr. Calello.

However, the absorption of methanol into the skin is “quite low,” she added.

You can visit the FDA website for a list of disinfectants that should not be used (including several brands imported from Mexico that contain methanol). If you find you have any of these products at home, the FDA recommends placing the hand sanitizer bottle in a hazardous waste container, if available, and contacting your local waste disposal center for advice on the safest disposal. Do not flush, pour it down the drain, or mix it with other liquids.

If your child has swallowed hand sanitizer, don’t try to induce vomiting, the experts said. Call Poison Control at 1-800-222-1222 for quick instructions on best course of action.

If your child is passed out, behaves abnormally, has difficulty waking up, or has difficulty breathing, call 911.

“Fortunately, the milder cases are much more common,” said Dr. Calello. “More likely we’ll say, ‘Stay home, watch him, I’ll call you back in an hour or half an hour.’ In this way we keep a lot of people away from the hospital by giving them real-time telephone instructions. “

You should also call poison control if your child has hand sanitizer in their eyes. In the United States, there were about 900 reports of eye exposure in children under 6 years of age in 2020, up 54 percent from 2019. A recent JAMA Ophthalmology study in France, reviewing data from poison centers, found this hand to be related to the eye Disinfectant exposure in children increased seven-fold in 2020 compared to 2019, and the number of surgeries performed to Addressing the resulting chemical injuries required has increased.

“In an emergency, any clean liquid can be used to rinse the eye after chemical exposure,” wrote Dr. Kathryn Colby, an ophthalmologist at New York University’s Grossman School of Medicine, in a comment published in JAMA Ophthalmology last month. “Finally,” she added, “parents need to understand the importance of an eye exam when exposure occurs in children,” as early diagnosis and treatment is critical.