title: The rising incidence of intentional ingestion of ethanol-containing hand sanitizers.
abstract: OBJECTIVE
  To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers' National Poison Data System.
  
  
  METHODS
  A case report, a literature review of published cases, and a query of the National Poison Data System.
  
  
  METHODS
  Medical intensive care unit.
  
  
  METHODS
  Seventeen-yr-old male 37-kg with an intentional ingestion of a hand sanitizer product into his gastrostomy tube.
  
  
  METHODS
  Intubation, ventilation, and hemodialysis.
  
  
  RESULTS
  Incidence and outcome of reported cases of unintentional and intentional ethanol containing-hand sanitizer ingestion in the United States from 2005 through 2009. A literature search found 14 detailed case reports of intentional alcohol-based hand sanitizer ingestions with one death. From 2005 to 2009, the National Poison Data System received reports of 68,712 exposures to 96 ethanol-based hand sanitizers. The number of new cases increased by an average of 1,894 (95% confidence interval [CI] 1266-2521) cases per year (p =.002). In 2005, the rate of exposures, per year, per million U.S. residents was 33.7 (95% CI 28.4-39.1); from 2005 to 2009, this rate increased on average by 5.87 per year (95% CI 3.70-8.04; p = .003). In 2005, the rate of intentional exposures, per year, per million U.S. residents, was 0.68 (95% CI 0.17-1.20); from 2005 to 2009, this rate increased on average by 0.32 per year (95% CI 0.11-0.53; p = .02).
  
  
  CONCLUSIONS
  The number of new cases per year of intentional hand sanitizer ingestion significantly increased during this 5-yr period. Although the majority of cases of hand sanitizer ingestion have a favorable outcome, 288 moderate and 12 major medical outcomes were reported in this National Poison Data System cohort. Increased awareness of the risks associated with intentional ingestion is warranted, particularly among healthcare providers caring for persons with a history of substance abuse, risk-taking behavior, or suicidal ideation.
authors.affiliation: Critical Care Medicine Department, Clinical Center, Bethesda, MD, USA.
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Gormley
authors.forename: Alvin C
authors.initials: AC
authors.lastname: Bronstein
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Rasimas
authors.forename: Maryland
authors.initials: M
authors.lastname: Pao
authors.forename: Angela T
authors.initials: AT
authors.lastname: Wratney
authors.forename: Junfeng
authors.initials: J
authors.lastname: Sun
authors.forename: Howard A
authors.initials: HA
authors.lastname: Austin
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Suffredini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004202:Disinfectants / Q000009:adverse effects*; D004750:Enteral Nutrition; D000431:Ethanol / Q000097:blood / Q000506:poisoning*; D005260:Female; D006235:Hand Disinfection; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged
chemical_list: D004202:Disinfectants; D000431:Ethanol