HEALTH ADVISORY: Hand Sanitizer and Disinfectant Chemical Exposure

Health Advisory
Health Advisory
April 30, 2020

April 27, 2020


TheTexas Department of State Health Services (DSHS) is warning the public of improperuse of hand sanitizers and disinfectant products during the COVID-19pandemic.


FromMarch to April, the Texas Poison Center Network (TPCN) has experienced a 64 percentincrease incalls compared to the previous year about healthconcerns from accidental ingestion of hand sanitizer. Mostof these calls (303, 69 percent) involved young children less than 5 years. The majority ofcalls reported accidental ingestion, but some reported hand sanitizercontacting skin and eyes.


Handsanitizers can be tempting to children because they may be packaged in colorfulbottles, with sweet smells. The most effective hand sanitizers contain ethylalcohol at concentrations ranging from 60 to 95 percent. Young children can getalcohol poisoning by swallowing just a few squirts of hand sanitizer.


Additionally,the TPCN received increased calls about accidental use of bleach (67 percentincrease) and other disinfectant products (149 percent increase calls). About 24percent (295) of these calls reported accidental ingestions involving youngchildren less than 5 years. Calls also reported exposures to skin andbreathing in fumes.


When used correctly, hand sanitizers anddisinfectant products, including bleach, are safe and effective. However, improperuse can have harmful health effects, and young children are more at risk forthese health effects. 

Clinical Presentation:

The risk of harmful effects depends on the route ofexposure, the amount of substance and the type of product. Common signs and symptomsassociated with exposure to hand sanitizer and disinfectant products include conjunctivitis,mild irritation or redness of the skin, nausea or vomiting, mouth or throatirritation, and cough and abdominal pain. Some signs of alcohol poisoninginclude confusion, vomiting, slow breathing, low body temperature and bluishskin color.

When bleach ismixed with other cleaners breathing in the fumes may cause coughing, chesttightness, burning and irritation of the eyes, nose and throat, headache,choking and in severe cases death. 

Recommendations for Public:

To reduce improper useand prevent unnecessary chemical exposures, users should:


  • Always read and follow directions on the label,
  • Only use water at room temperature for dilution (unlessstated otherwise on the label),
  • Wear eye and skin protection,
  • Ensure adequate ventilation,
  • Store chemicals out of the reach of children.
  • Avoid mixing chemical products. NEVER mix bleach with other household cleaners. Bleach can become a dangerous gasif mixed with other household cleaners such as ammonia.
  • Use hand sanitizer only when soap and waterare not available. Guidance on proper hand sanitizer use may be found at theCenters for Disease Control and Prevention at

Guidance for cleaning and disinfecting publicspaces, workplaces, businesses, schools and homes may be found at the Centersfor Disease Control and Prevention



For More Information: 


Individualswho believe they may have been exposed to hand sanitizers and disinfectantproducts and are concerned about their health should contact their healthcareprovider, or the Texas Poison Center Network at 1-800-222-1222.



DSHS Environmental Surveillance and Toxicology Branch