Several people have died and hospitalizations have significantly increased over the last two months in Arizona due to people ingesting hand sanitizer containing methanol, according to officials.

Since May, four people have died and 26 people were hospitalized after ingesting hand sanitizer with methanol, according to the director of the Arizona Poison and Drug Information Center Dr. Steve Dudley.  

People hospitalized for methanol exposure in Arizona were mostly 30 to 40 years old and some admitted to drinking hand sanitizer as an alcohol substitute, said Dudley. Some people experienced symptoms such as visual disturbances, vision loss and severely altered mental status.

“That triggered an alarm because hand sanitizer is normally primarily ethanol, which is what we generally see in alcohol,” Dudley said. “And while people definitely can get sick off alcohol, this was not at all the same picture. When you have hand sanitizer ingestions, normally they don’t need to be hospitalized, they certainly don’t end up in the ICU.” 

By comparison, only 33 people in Arizona were hospitalized in 2019 for ingesting hand sanitizer. In June, a total of 22 people were hospitalized for ingesting hand sanitizer with methanol, Dudley said. 

Hand sanitizers found in grocery stores in Navajo Nation

Two incidents involving methanol exposure occurred in Pima County, but the majority of cases occurred in Arizona within Navajo Nation, Dudley said. 

Dr. Jill Jim, executive director for the Navajo Nation Department of Health, said people ingesting hand sanitizer with methanol is a national issue. 

“A lot of those are in relation to how the hand sanitizer products are being sold out, sold into the public markets, so I think a lot of those products were in the grocery stores,” Jim said.

Once the department was notified about the products, Jim said they worked with Apache County to identify some of the products and removed them from stores in areas where incidents were occurring. 

Jim said the department also issued messages to the public and assessed their stockpiles, which did not contain any hand sanitizers with potential methanol.

“Our cases are not ongoing, so I think the messages out in the community are working,” Jim said. 

FDA recalls dozens of hand sanitizers

Methanol, which is also known as methyl alcohol or wood alcohol, can be toxic when ingested or absorbed through the skin, according to a U.S. Food and Drug Administration warning, which notified the public on June 19 about nine sanitizers with potential methanol. 

“The agency is aware of adults and children ingesting hand sanitizer products contaminated with methanol that has led to recent adverse events, including blindness, hospitalizations and death,” an FDA statement said on July 2. 

Exposure to methanol can cause nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death, according to the FDA. 

Dudley said, in a recent case, a person who rubbed hand sanitizer with methanol on their hands multiple times per day over the course of several days experienced temporary vision loss.  

Arizona heat: You probably shouldn’t leave hand sanitizer in the car. Here’s why

The FDA has continued to announce recalls for 67 products, most of which were imported from Mexico, according to the online list. Many of the sanitizers were recalled because they were produced by the same company but sold under a different product name.

Dudley said after two patients in Arizona were affected by Bersih Hand Sanitizer Gel Fragrance Free, the FDA added the product to its recall list on July 2. 

After the pandemic started, some businesses started producing alcohol-based hand sanitizers to help alleviate the low supply in hospitals and stores in Arizona. 

“With COVID-19, you have this increased demand for hand sanitizer and cleaning products — Everyone’s trying to do their part, right? But the flip side is that supplies can’t keep up with demand, so what we think is happening is we have all these other manufacturers who are coming in and saying, ‘Oh there’s money to be made here, we can produce hand sanitizer.’ And they’re not properly distilling it or properly producing it and … they’re getting methanol in the byproducts,” Dudley said. 

Following the guidelines

In Arizona, several distilleries started producing hand sanitizer that was then donated to hospitals in need during the pandemic, according to Stephen Paul, co-founder of Whiskey Del Bac in Tucson. 

Paul said distilleries with the Arizona Craft Distillers Guild teamed up to safely create hand sanitizer to donate and also sell in their stores. 

“When the hand sanitizer possibility came up … no one had done it, so we were looking at the FDA guidelines and American Craft (Spirits) Association was helping us a lot,” Paul said. “We were talking to each other a lot and helping each other’s stores.”    

Dudley said he is not aware of distilleries or breweries producing hand sanitizers containing methanol, but said it can happen if they don’t follow FDA guidelines for creating hand sanitizer. 

According to the guidelines, hand sanitizer should be manufactured using only alcohol that contains more than 94.9% ethanol, United States Pharmacopeia Isopropyl Alcohol, Glycerin USP or Food Chemical Codex, hydrogen peroxide or sterile water by boiling or distillation. 

The alcohol should also be denatured to discourage people from ingesting the hand sanitizer, according to the FDA guidelines. 

The two main types of ingestion that can occur are accidental, such as cases of children ingesting hand sanitizer, and intentional abuse, including teenagers who may be experimenting or adults who are alcoholics, said Dudley. 

When someone ingests methanol, the person may not feel any effects until one or two days later, he said. 

Because hand sanitizer with ethanol or methanol look similar, Dudley said people should refer to the FDA recall list to learn which hand sanitizers are safe to use. 

Right now, most recalled hand sanitizers are from smaller, lesser-known brands, Dudley said. 

For anyone who is concerned they have been exposed to methanol in hand sanitizer or want to learn more, they can contact the Arizona poison center 24/7 at 1-800-222-1222. 

People can also report adverse events or quality issues with hand sanitizers to the FDA’s MedWatch Adverse Event Reporting program online. 

FDA said in a statement it is most concerned with:

• Dangers of drinking any hand sanitizer under any conditions.
• Hand sanitizers that do not have a sufficient amount of ethyl alcohol or isopropyl alcohol.
• Products that are sold with false and misleading, unproven claims that they can prevent the spread of viruses such as COVID-19.
• Products fraudulently marketed as “FDA-approved.”
• Products packaged to appear as drinks, candy or liquor bottles or products marketed as drinks or cocktails

Reach the reporter at [email protected] or on Twitter at @Audreyj101.

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