In June 2020, the U.S. Food & Drug Administration (FDA) issued an important alert advising consumers not to use hand sanitizers that contained the hazardous substance methanol.1 Due to the increasing incidence of methanol contamination, the FDA issued a recall of hand sanitizer products that contained this substance, and encouraged manufacturers to remove those products from stores and online marketplaces.1 As of August 2020, the FDA expanded the recall to include hand sanitizers that also contain 1-propanol.2 To verify which hand sanitizers are safe for use, visit the FDA’s list of recalled hand sanitizers.
Methanol and 1-propanol: Two toxic ingredients in hand sanitizer
As the U.S. works to decrease the spread of the coronavirus, frequent and proper hand hygiene is essential in reducing transmission. As a result, there is an increased demand for hand sanitizer. As manufacturers work to produce hand sanitizer for the public, the FDA has taken a closer look at its chemical components.
According to the National Institute for Occupational Safety and Health (NIOSH), methanol is an alcohol routinely used as a solvent, pesticide and alternative fuel source. Also known as “wood alcohol,” this colorless liquid can be found in food and drinks that contain aspartame. Methanol can be harmful when absorbed through the skin or inhaled in high concentrations, and is also considered life-threatening when ingested. This substance is highly flammable and can be easily ignited by heat or sparks. Additional information about methanol and its characteristics can be found on the NIOSH’s Methanol: Systemic Agent webpage.
Signs and symptoms of methanol poisoning may not be observed for up to 72 hours due to the body’s metabolization process. Initial side effects include drowsiness, a reduced level of consciousness and decreased muscle movement. According to the FDA, methanol toxicity can also produce3:
- Blurred vision
- Permanent blindness
- Permanent damage to the nervous system
For additional information about the effects of methanol exposure, refer to the FDA’s updates on hand sanitizers consumers should not use.
Another toxic substance that may be found in certain hand sanitizers is 1-propanol. This solvent and chemical intermediate is not the same as 2-propanol or isopropyl alcohol. The National Center for Biotechnology Information states that 1-propanol can be used to make cosmetics, pharmaceuticals, antifreeze, rubbing alcohols and acetone. The FDA warns that ingesting 1-propanol can lead to death by depressing the central nervous system. Other symptoms may include decreased consciousness and slowed breathing. Skin or eye exposure to 1-propanol can lead to irritation, with rare cases of allergic skin reactions. Additional information on symptoms and proper disposal of products containing 1-propanol can be found on the FDA’s updates on hand sanitizers consumers should not use webpage.
Guidelines for purchasing hand sanitizer
Unfortunately, methanol and 1-propanol are sometimes omitted from the product labels of certain hand sanitizers; when the FDA tested their contents, methanol and 1-propanol were present although not indicated on the labels. The FDA recommends that consumers avoid purchasing a hand sanitizer product if it2:
- Has been tested by the FDA and is found to contain methanol or 1-propanol
- Is labeled to contain methanol
- Has been tested and is found to have microbial contamination
- Is being recalled by the manufacturer or distributor
- Has less than the required amount of ethyl alcohol, isopropyl alcohol or benzalkonium chloride
- Is purportedly made at the same facility as products that have been tested by the FDA and has been found to contain methanol or 1-propanol
The FDA recommends the immediate disposal of products containing methanol and 1-propanol due to their toxic nature; contaminated hand sanitizer should be placed in a hazardous waste container or follow your local waste and recycling center’s recommendations.4 Additional information about local waste programs can be found on the United States Environmental Protection Agency’s website.
Increased production of hand sanitizers
Manufacturers that regularly produce products in other industries are working to increase the supply of hand sanitizers to meet demand, although they must request permission to do so during the COVID-19 pandemic. This permission is granted by the FDA.
The FDA regulates hand sanitizer as a nonprescription or over-the-counter drug. As stated in its Temporary Policy for Manufacture of Alcohol, for the duration of the pandemic the FDA will not take action against manufacturers of alcohol or alcohol-based hand sanitizer products that use ethanol as their active ingredient. Manufacturers are encouraged to review the following FDA policies for additional information:
- Temporary Policy for Preparation of Certain Alcohol-Based Hand Sanitizer Products During the Public Health Emergency (COVID-19) Guidance for Industry
- Policy for Temporary Compounding of Certain Alcohol-Based Hand Sanitizer Products During the Public Health Emergency
- Temporary Policy During the Public Health Emergency (COVID- 19)
Homemade hand sanitizer
Due to potential harmful risks, the FDA recommends that consumers avoid making their own hand sanitizers.5 Homemade sanitizers may not contain effective levels of ethyl or isopropyl alcohol, and there have been reported injuries such as skin burns. The FDA also encourages health care professionals and consumers to report adverse reactions to hand sanitizers to the MedWatch Program to ensure adequate tracking and documentation.
Hand-washing and hand sanitizer recommendations
The Centers for Disease Control and Prevention (CDC) states that coronavirus disease 2019 is spread from respiratory droplets, mainly from person to person. Transmission occurs when an infected person sneezes, coughs or talks. People infected with COVID-19 can also spread the disease even if they do not exhibit symptoms such as a fever, cough, or loss of taste and smell.
The CDC recommends hand-washing as the best way to prevent the spread of infection, including COVID-19.6 Individuals should wash their hands with soap and water for a minimum of 20 seconds.6 If soap and water are not available, an alcohol-based rub with at least 60% alcohol can be used.6 This method of infection prevention should be used after blowing the nose, coughing, sneezing or being in a public place.6
The World Health Organization (WHO) states that wearing gloves is not a substitute for proper hand hygiene. Pathogens can be transferred from gloved hands to surfaces, including the mouth and eyes. The use of gloves in public spaces is not recommended nor proven as a prevention measure. For additional hand hygiene resources visit the CDC’s handwashing webpage or the WHO’s Q&A on cleaning and disinfecting environmental surfaces webpage.
- Topical Antiseptic Products: Hand Sanitizers and Antibacterial Soaps
- Vizient: COVID-19 Clinical Resource Guide
- Vizient: Hand Hygiene Clinical Resource Guide
- Vizient: Emerging Practices to Combat Coronavirus Disease (COVID-19): Managing critical supplies
- FDA advises consumers not to use hand sanitizer products manufactured by Eskbiochem. U.S. Food & Drug Administration. June 19, 2020. Updated June 29, 2020. Accessed August 31, 2020.
- FDA updates on hand sanitizers consumers should not use. U.S. Food & Drug Administration. August 12, 2020. Accessed August 31, 2020.
- Coronavirus (COVID-19) update: FDA takes action to warn, protect consumers from dangerous alcohol-based hand sanitizers containing methanol. U.S. Food & Drug Administration. July 2, 2020. Accessed August 31, 2020.
- Q&A for consumers: Hand sanitizers and COVID-19. U.S. Food & Drug Administration. Updated July 29, 2020. Accessed August 31, 2020.
- Safely using hand sanitizer. U.S. Food & Drug Administration. Updated July 8, 2020. Accessed August 31, 2020.
- Handwashing. Centers for Disease Control and Prevention. Updated July 11, 2020. Accessed August 31, 2020.
Visit the COVID-19 Resources for more information.
- COVID-19 Clinical Resource Guide
- COVID-19 guide to face masks and filtering facepiece respirators
- Guide to decontamination methods for filtering facepiece respirators
- FDA N95 Decontamination Systems Emergency Use Authorization Updates Guide
- FDA Personal Protective Equipment EUA Update Guide
- Guide to isolation and surgical gown selection
- Nonwoven Fabric PPE Guide
- FDA recall of hand sanitizers containing methanol and 1-propanol
- Conservation of exam gloves