Hand Sanitizer and Eye Injuries in Children
JAMA Ophthalmology, March 2021
Alcohol-based hand sanitizer (ABHS), widely used to limit SARS-CoV-2 transmission, contains ingredients that can be toxic to the eye. In France, Martin et al. tracked accidental ocular exposures to ABHS in children. They found a 7-fold increase in pediatric cases of ABHS eye exposure from 2019-2020, with some cases requiring surgery.
For this retrospective case series, a team of ophthalmologists and toxicologists retrieved epidemiologic data from the French National Database of Poisonings and a pediatric ophthalmology referral hospital in Paris. They then tallied the number of eye exposures to ABHS that occurred in children from April to August for both 2019 and 2020.
The number of ABHS exposures in 2019 was 33 (1.3% of total poison-related pediatric eye injuries); this rose to 232 cases (9.9%) in 2020. Similarly, hospital admissions among these patients increased during the same time frame, from one child (age, 16 months) in 2019 to 16 children (mean age, 3.5 years) in 2020. Eight children had a corneal and/or conjunctival ulcer, and two of the eight required an amniotic membrane transplant.
Of note, 63 of the 232 cases of exposure in 2020 occurred in public places. This is a key detail, the authors said, as public gel dispensers are easy for children to access—and the gel typically is delivered right at the height of a small child’s eyes. The authors urged caution in positioning the dispensers in public places and added that parents and caregivers should be warned about the potential danger that hand sanitizers can pose to children. (Also see related commentary by Kathryn Colby, MD, PhD, in the same issue.)
The original article can be found here.