ABSTRACT
Objective: During the COVID-19 pandemic, public health messaging emphasized the use of hand sanitizer products to reduce SARS-CoV-2 exposure, the agent responsible for COVID-19. Our aim was to analyse these exposures and compare to the same period in 2019. Methods: We used descriptive statistics to analyse Milan Poison Center exposures to alcohol-based hand sanitizers for the period 1 January 2019 to 30 September 2019 to the same period in 2020. Results: During the 2020 study period a total of 474 exposures were collected and in the same period in 2019 there were 211 exposures. During the COVID-19 pandemic in 2020 an increase in exposures of 124.6% compared to 2019 was observed. In relation to the year 2020, the age group distribution was: < 1 year 5.5% (n=26), ≥ 1<5 years 49.6% (n=235), ≥ 5<18 years 6.5% (n=31);≥ 18 years 50.4% (n=239) and age unknown 7% (n=33). The circumstance of exposure was unintentional for 77.2% (366 cases), intentional 2.1% (n=10), transfer from original container 5.9% (n=28), other 13.3% (n=63), and therapeutic error instead of medicament 1.5% (n=7). In one of the therapeutic error cases, the hand sanitizer was mistaken for vitamins and was administered to a baby of one week and in a second case a man of 78 years mistook the hand sanitizer for ophthalmic gel and presented pain and ocular inflammation. The oral route was involved in 79% of cases, ocular in 4.9%, skin in 3.8%, and multiple routes in 12.3%. Most exposures were managed at home (86.5%) and 13.5% in hospital. The most frequently reported clinical effects were nausea, vomiting, diarrhea, heartburn, pharyngodynia, ocular pain and inflammation. Overall, 377 patients (79.5%) had no effects, 79 had minor effects (16.7%) and 18 (3.8%) had moderate effects. Conclusion: The public health messaging advocating the use of these products was necessary to mitigate COVID-19 health effects. Messaging should also emphasize proper use of these products. The increased availability at home was temporally associated with an increase in exposures. The analysis of data reveals the role of poison control centers in the identification of risk factors for prevention and for reducing unnecessary emergency medical attention.