Pretty much everywhere we turn in Hong Kong, there’s a little dispenser for disinfecting your hands. During the years of the pandemic, the number of these things skyrocketed, and while some have disappeared, quite a few are still hanging around.
So, what’s the problem? Published research and an OT&P doctor weigh in on this question.
What are the risks of disinfectants?
Recently published research has pointed out some glaring concerns over the chemicals contained in these disinfectants. Whether we are talking about the alcohol-based products or those containing quaternary ammonium compounds (known as QACs), the possibility for extremely harmful effects exists.
QACs are a class of hundreds of chemicals used in disinfectants, hand sanitisers, paints, pesticides, and personal care products, among other things. Alongside other health issues, recent research has linked these chemicals to infertility, birth defects, metabolic disruption, asthma, skin disorders and other diseases.
In one recent peer-reviewed paper, the conclusions show QACs are linked to serious health problems. They also pollute the environment and are not particularly effective. A co-author on the research article shares that these chemicals, “might not be efficacious, but also might be harmful” at the same time. The group of toxics researchers from academia, government agencies and non-governmental organizations who developed the research paper, highlight the risks of QACs (the common components in most disinfectant wipes and sprays, especially those that claim to “kill 99.9 per cent of germs”) and calls on regulators to “eliminate the chemicals for non-essential uses.”
It’s also important to point out QACs’ role in antimicrobial resistance. This is likely due to overuse.
Who is most at risk?
Young children tend to be most at risk since disinfectant wipes are frequently used in day care, pre-schools, and primary schools. Children or adults in any supervised care environment, healthcare workers, cleaning professionals and others who frequently use disinfectants are also at risk.
Since these harsh chemicals are thought to be bioaccumulative, meaning they accumulate in our bodies and the environment, the more they are used, the more exposure we have and the more the chemicals build up. The use of common mixtures of QACs (contained in many cleaning and personal care products like eye drops, mouthwashes, nasal sprays, detergents and shampoos, conditioners, dryer sheets and fabric softeners) and from multiple sources has not been researched. Restrictions on the use of QACs have been implemented in the US and elsewhere, primarily focused on personal care products. This should tell us all something!
What about alcohol-based hand sanitisers?
They are effective against viruses but are not much better in terms of safety, especially for children. According to the 2021 published article Raising awareness about the unintended consequences of hand sanitiser in children, the inadvertent exposure of hand sanitiser to children poses a high risk of potentially life-threatening complications.
As we know, the usage of all disinfectants and hand sanitisers shot up sharply over the past few years. Naturally, increased misuse and unsupervised availability of alcohol- based hand sanitisers created avoidable adverse events in children.
Accidental or intentional ingestion of these hand sanitisers likely happens in children (typically under the age of 12 years) due to the appealing colours and smells added to them. Remember those sparkly little bottles of hand sanitiser you could attach to your handbag or to your child’s backpack? I know my kids (especially my daughter) thought they were a must have accessory. Unfortunately for younger children these can create a dangerous temptation.
“Using a hand sanitiser that contains methanol (wood alcohol) can be dangerous as it can cause side effects like vomiting, headache and blindness, among others” – Dr. Namrata Arora, OT&P
The danger lies in the level of ethanol in the particular product and how much a child consumes or ingests. Mouthwash, cosmetics and hand sanitisers can become hazardous at certain concentration levels. For example, if a child consumes a certain amount of mouthwash resulting in a concentration above 400 mL/dL (80% ethanol), this may be toxic or fatal. Concentrations above 300 mL/dL can lead to serious respiratory and cardiac complications. “Consumption of alcohol in children may result in hypoglycaemia, apnoea, acidosis and possibly coma”.
Even contact with the skin can cause trouble like allergic reactions, skin irritation and eye infections/injury (due to children touching/rubbing their eyes frequently). Irritated skin may allow the invasion of bacterial and viral infections due to the integrity of the skin being compromised. It’s clear the use of hand sanitisers, in general, needs to be limited in both children and adults.
Alternatives to hand sanitiser
To avoid health complications associated with the misuse of hand sanitiser, it’s important to find alternatives. One easy way to decrease risks whilst keeping safe from germs is simply washing hands with soap and water rather than using sanitisers.
“It’s important to know when to use hand sanitisers in the community. Sanitisers do not eliminate all germs or harmful chemicals (like pesticides or heavy metals), and are not as efficacious when hands are visibly dirty or greasy. In these cases, washing hands with soap is recommended instead since it s more effective,” advises Dr. Namrata Arora, OT&P.
Another tip is to oversee children when they use hand sanitising products and train them how to use them carefully, avoid using too much and not get any near their eyes. Creating awareness of the dangers of these products (if ingested or coming in contact with the eyes) is also key. Ultimately, hand washing with regular soap and water should be encouraged as common practice over using chemicals. There’s even a Global Handwashing Day established to promote it.
“If soap and water are not available, a hand sanitser with at least 60 per cent alcohol can be used. Swallowing more than a couple of mouthfuls of alcohol hand sanitiser can cause alcohol poisoning, especially among children. Hence, hand sanitisers should be stored out of reach of young children and should only be used under adult supervision.” – Dr. Namrata Arora, OT&P
Of course, there may be times when you need a disinfectant, like when the stomach flu strikes. In those cases, try to find safer products and use them sparingly.
Where to find safe cleaning products
If you’re concerned about using chemical laden products, you can look up many cleaning products on the Environmental Working Group website. They have a guide to cleaning products and a database to consult too www.ewg.org/guides/cleaners.
References:
www.ncbi.nlm.nih.gov/pmc/articles/PMC8378183
pubs.acs.org/doi/10.1021/acs.est.2c08244
pubmed.ncbi.nlm.nih.gov/9348605
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