COVID-19 - Hand and other sanitisers effectiveness

News articles in the USA this week state many brands of hand sanitiser containing Methanol are being withdrawn from sale. It is toxic if absorbed through the skin. I’m concerned that some product available in Australia may not be safe to use? Distilleries and other business have turned their hand to manufacturing this during recent months. Is the TGA is testing? Ones I’ve seen on Woolworth’s shelves don’t have clear labelling.

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Welcome to the community @Dee77

I moved your post here because you may find previous discussion here relevant and interesting.

The TGA does not register sanitisers per se. They have a consumer information page

and a manufacturer / importer page

Noting there are different classes of sanitisers, some registered and some classed as cosmetics.

It is not just those at Woolies. Many of the ‘sanitising’ products on shelves do not have active ingredient (eg alcohol content) labelling and as cosmetics are held to a different and lower standard than registered products.

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The amount of Methanol that would be adsorbed through the skin is minimal, the human body deals quite well with it in these small amounts, some fermented food products contain small amounts of alcohols of which methanol can be a small part of it. Of course alcoholic drinks have much larger concentrations of alcohol which hopefully is ethanol but some Apple Ciders that are made with straw can be high in methanol if not made properly (mostly home made brews). Methanol like it’s cousins is de-fatting to the skin and so will make the skin very dry so use on it’s own should be avoided but most sanitisers have about 70% alcohol content and also generally contains some moisturising compound eg glycerine. Another alcohol used frequently is iso propyl alcohol, and it is also poisonous if imbibed or adsorbed in large enough quantities but if applied topically to skin of the hands those amounts should not be reached.

The risks are so small in the case of hand sanitisers as to be negligible. You are at far greater risk of contracting pathogens if you don’t use them or by not washing your hands with soap and water.

EDIT: Based on the FDA notice that @PhilT provided the FDA is removing those products contaminated with Methanol. From my reading of the link it seems that the vast majority of the poisonings are occurring due to people drinking the product rather than application to hands.

I would be cautious and it would be prudent in the case of children that all alcohol exposure whether methanol (methyl alcohol), ethanol (ethyl alcohol), or propanol (propyl alcohol) should be avoided.

If used in large amounts for many applications of hand sanitising the level of methanol would be dangerous but in most cases of occasional domestic use it should not be of significant risk.

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I believe @Dee77’s reference may have been (2 July 2020 - got to love the ‘date problem’ with imported snippets)

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I would like to see this change. That, if anything, has been highlighted by the pandemic (at least for hand sanitisers).

If I’m putting it on me or in me, I have a right to know what ‘it’ is.

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Our elected officials (and most of them globally) respond that for cosmetics it is ‘your’ choice to buy and use or not, whereas ‘medical products’ are not always discretionary. Companies wanting to sell to the discerning would be expected to voluntary provide proper ingredients lists. Those who don’t? ‘You’ are not their target customer.

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Many of the recalls for cosmetics I have posted in the Recalls category were recalled for failing to list the ingredients or had excessive levels listed for some ingredients so there must be some requirement in Australia to do so.

That is 5 in the past 12 months alone.

Yet still no warnings that ethanol can be absorbed by the skin and enter the blood stream when topically applied.

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Cosmetics are ‘regulated’ by product safety.

As stated, the requirement is that

  • When listing ingredients, the ingredients need to appear in descending order calculated by either mass or volume.

and

  • The mandatory information standard does not require the listing of the quantity or percentage of each ingredient.

which is a germane requirement re sanitiser efficacy.

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@AndyKollmorgen

The discussion is dividing onto different but important topics, ie, labeling and the suitability of the ingredients.

Rather than ill informed opinion I think we need Choice staff to take these two aspects up, and provided some definitive info.

IMO hand sanitiser is essential when out in the community. When I enter a service provider/retailer, I need to sanitise my hands so I don’t infect others when I touch products and produce (particularly the latter). NOTE I AM PROTECTING OTHERS, FROM ME, not FOR ME!! Hand washing in this situation isn’t viable.
So, that sanitiser needs to be effective in its protection role, but also not harmful to me in its use.

The labeling needs to be suitable and accurate.

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Then to be not harmful means that no alcohol sanitiser is without effects as all the alcohols used pass into the bloodstream albeit in small amounts. So do other compounds that may be used as bactericides (not effective against viruses). The risk of infection is weighed against any ill effects that the agents may have. If children under 2 years old have hand sanitisers used on them then even if the sanitiser is based on ethanol there is no safe limit recommended. Alcohol also acts to make the skin more permeable to other things, it is used in Cosmetics to both keep the product sterile and also assist chemicals to get past the skin barrier.

Purely based on methanol is dangerous:

From https://www.methanol.org/wp-content/uploads/2020/04/Methanol-Safety-During-the-COVID-19-Pandemic-3.pdf

“Although methanol is an alcohol like ethanol and isopropanol, methanol cannot be used as they are because it breaks down and produces different chemicals in the body. Ethanol produces acetate in the body, isopropanol produces acetone in the body, and methanol produces formaldehyde or formic acid in the body, which is more toxic and harmful than those produced by the other alcohols.”

Methanol is added to ethanol to make methylated spirits (denatured alcohol) to about 10% of the alcohol content. If a rub is made with 100% methanol it would be concerning to a person but as pure methanol it is not generally available to normal consumers the problem seems to be that some manufacturers have used it.

From Methylated Spirits - Denatured Alcohol, Features, Uses and Rubbing Alcohol

" Methylated Spirits Rubbing Alcohol

“Methylated spirits can be used as rubbing alcohol when diluted down to about 65-70%. The reason it needs to be diluted down to this is so it is not as harsh on the skin and so it evaporates off slower in order to kill the bacteria. The higher the strength the more it will flash off but in the circumstance when you need to kill bacteria, sometimes the 70% works better as it has longer surface time, therefore, more time to kill the germs.”

Sanitising for most people is not just to protect others but also to protect the user. If COVID gets on the hands it is unlikely to infect the person unless they then touch their face with contaminated hands. Hence cleaning the hands regularly is to protect the user themselves as well as the greater population.

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Your opinion is interesting, but, I’m a member of Choice to get more definitive info from them.

I think the current global pandemic suggests that hand sanitiser is not a cosmetic. Use is not really a choice. Use is the responsible option, for yourself and for everyone else in the community.

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One can be pedantic, accept the reality of regulation as it is, or try to change the regulation so all are in the same ‘bin’ of medical products.

Whether right or wrong reality is today some sanitisers are sold and regulated as cosmetics, and others as medical products, and some cosmetic products do have proper labelling even though not required.

It is in the labelling

My preference is that they all should be required to show their active ingredients in full detail, be efficacious, or stop calling themselves sanitisers.

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Maybe it is a bit of opinion but also backed a bit by science and research.

https://www.cdc.gov/mmwr/preview/mmwrhtml/00001109.htm

In the following there is discussion/research about when favourable alcohol and ethanol outcomes were found without side effects the studies were often funded or had influence from Alcohol business. Negative outcomes were often reported by independent research.

" Industry participation in studies about the safety of topically applied ethanol

Warnings can be found in the recent literature about systematic bias in scientific studies favouring products that are made by the company funding the research [178-180]. It became evident that a number of studies dealing with the safety of topically applied ethanol reviewed in this article (especially those about mouthwashes and hand disinfectants) were supported by industry, or at least one of the researchers was a paid employee of a manufacturer of the discussed product. The relevant studies are summarized in Table ​Table11 according to the outcome and industry participation. It can be generally seen that the studies with industry participation judged ethanol to be safe per se , whereas independent studies were more cautious."

From https://info.debgroup.com/blog/bid/337803/is-it-safe-for-children-to-use-hand-sanitizers there is the following from Barry Michaels, a regular blog contributor, microbiologist and expert in infectious disease who provided the following response.

"For adults and children > 2 years old (under adult supervision) and not suffering from ALDH it is relatively [safe] as per caveats above. For children <2 years, it is clearly not appropriate due to their under developed skin barrier function. At the border line (<2 and >2) there is a gray area, where adults supervising children need to be aware of the risks and take into account skin science presented here to manage risks not just due to skin issues but also potential pathogen exposures (e.g. petting zoos etc.).

Indications are that for healthy adults there are no safety issues with these products with normal and even exaggerated use. All bets are off if skin is damaged for adults or children. Toxicology is not an exact science with a great deal of individual variability having been identified in how we respond to various types of toxic exposure (e.g. even water can be toxic). Therefore in this borderline region individual child health constitution must be weighed with respect to skin barrier function, type and extent of potential pathogen exposure and if there is time to get to a water source to wash hands before that little hand makes it into the child’s mouth," concludes Michaels".

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The side effects of putting people off using anything that might seem alcoholic in the entrance to a retailer, etc, is potential death to other people, because I didn’t know I had coronavirus and I infected others!!

That’s the bottom line!

Ahh that’s why I feel masks and gloves should be mandatory, the sanitising is about protecting me as well as the public. The masks have a similar effect in that they reduce the spread of the virus, gloves can help as long as a person doesn’t then touch their face with the gloves. Just having clean hands is not enough, there is the airbourne vector which WHO are now acknowledging.

So the other thing is to get tested, wait to get a result that shows that a person is clear and then continue using safe practices to avoid getting the virus, not perfect but at the moment seems the best we have. If tested positive obviously they are then quarantined and contact tracing begins. The person who is infected then should be making sure they keep their surroundings and themselves clean and out of contact with all others unless others are necessary eg nursing/medical staff and these contacts should be using all necessary precautions to avoid themselves getting infected…this goes back to protecting oneself so that they and then others are not casualties.

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That’s a topic for a different thread

I wear gloves in the supermarket, I have no way of knowing what is in the sanitizer they offer at the entrance, could be giving us a false sense of security. I can better protect myself and others when I use the trolley and the self-service screen.
Also I’m less likely to touch my face while wearing gloves.

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Completely correct. Rockmans sent another email spruiking hand sanitisier that with an earlier delivery date than the delivery date for the stuff already ordered from Rockmans.
figure that one out.

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