Dozens Of Hand Sanitizers Contain A Toxic Ingredient

August 26, 2020

The U.S. Food and Drug Administration (FDA) has identified at least 77 hand sanitizers that contain dangerous levels of methanol, a toxic substance that can cause nausea, nerve damage and blindness when absorbed through the skin, and death if ingested.

In June, the U.S. Food and Drug Administration issued a warning about nine contaminated hand sanitizers made by a company called Eskbiochem, but since then, the agency has flagged dozens more products that contain dangerous levels of methanol, also known as wood alcohol, according to The Washington Post. The agency maintains a running list of these sanitizers on its website, noting that these products pose a particular risk to young children, who may ingest them by mistake, and to adults who knowingly consume them as a substitute for alcohol.

But how could so many products be contaminated with methanol in the first place? Most likely, the spike stems from crude manufacturing processes, where manufacturers may not have properly removed the methanol that occurs naturally during alcohol distillation, or they may have violated FDA guidelines by basing it on already distilled, high-methanol solvents, sources told Live Science. (Methanol distillates are a common ingredient in antifreeze and racing fuels).

And unfortunately, while experts can smell the difference between methanol and ethanol, most consumers can’t detect the difference. And “methanol” won’t be listed among the ingredients on the bottle. Instead, experts tell Live Science, people should check the FDA’s list of recalled sterilized products to make sure theirs isn’t on there and to avoid unknown brands.

Methanol can be deadly at fairly low doses. Ingesting 2 tablespoons (30 milliliters) of methanol is deadly for children, and 2 to 8 ounces (60 to 240 milliliters) is deadly for adults, Live Science has reported. Dr. William Banner, medical director of the Oklahoma Poison and Drug Information Center and past president of the American Association of Poison Control Centers, told Live Science that methanol can be absorbed even when just applied to the skin, causing serious illness and nerve damage.

Banner added that topical methanol is particularly dangerous for children, who have a greater ratio of skin surface area to body weight than adults. That said, consumers will likely need to apply the product repeatedly (as one would with hand sanitizer) to absorb a high enough dose to become poisoned, he said.

Lessons from the brewery
Methanol contamination is a problem that brewers appreciate – that’s why illegal bootleg and other homemade alcohol may be more risky to consume than spirits produced by legal distilleries.

Alcohol production begins with the fermentation of sugars to produce methanol and ethanol, an alcohol that is considered quite safe to drink and one of the best base ingredients for hand sanitizer, Live Science has reported. After fermentation, manufacturers boil the alcohol and collect its vapors, allowing them to condense into a concentrated “distillate.” But methanol boils at a lower temperature than ethanol, so it evaporates first in this distillation process.

When ethanol does start to boil, at 173.1 degrees Fahrenheit (78.37 degrees Celsius), the manufacturer must “cut off” the alcohol stream and replace it, Mike Blaum, co-owner and chief distiller at Blaum Bros. Distilling Co. in Galena, Illinois, told Live Science Collection vessel; this ensures that the final product contains primarily ethanol, while the excess methanol is thrown away. After the methanol is removed, the distillate that remains is primarily ethanol, a key component of spirits, along with other compounds that provide flavor.

According to a 2001 report in the journal Human and Experimental Toxicology, very small amounts of methanol do end up in the final beverage, but the dose must be kept below a certain threshold so that it does not pose a significant health risk. For example, the U.S. Food and Drug Administration has capped the maximum allowable amount of methyl alcohol in brandy at 0.35 percent.

While commercial alcohol producers are subjected to rigorous safety checks to prove they have done so correctly, unregulated moonshine makers are not.

“For us, we really know how to make sure there’s no risk of methanol or any other toxicity,” says Blaum. As a trained distiller, when the ratio of methanol to ethanol becomes too high, “you can smell it, you can taste the difference,” he says. In addition to these sensory cues, the distiller monitors the density of the distillate and the temperature of the various components in the equipment through which the alcohol flows.Blaum says the company also regularly sends samples of the distillate to a lab equipped with a gas chromatography-mass spectrometer (GCMS) – a technique used to analyze the proportion of chemicals present in a given batch.

As Live Science previously reported, manufacturers also make sure their fermenting vats aren’t taken over by bacteria that produce additional methanol.

The same quality control measures should be applied when producing alcohol for hand sanitizer, which Blaum Bros. and other U.S. distilleries began producing at the end of March under the guidance of the FDA and the Alcohol and Tobacco Tax and Trade Bureau. These breweries were instructed to follow hand sanitizer formulas provided by the World Health Organization (WHO) and the FDA. These formulas call for a blend of 96% ethanol by volume (ABV), hydrogen peroxide diluted to a maximum concentration of 3%, and glycerin diluted to 98%. (Formulas for other alcohol-based sanitizers, such as isopropyl alcohol, use slightly different ratios.)

“If you do your due diligence, it’s hard to do it wrong,” says Blaum.

While the distillery originally brewed its own ethanol for sanitizers, Blaum Bros. now buys distilled ethanol in bulk at the beginning of production. As hand sanitizer sales skyrocketed at the start of the outbreak, Blaum says pure ethanol distillates were in short supply. He noted that manufacturers of contaminated sanitizers labeled by the FDA may have been using high-methanol distillates from the start, given that ethanol became difficult to procure. But that’s just speculation, he said.

Buying the right disinfectant
In its warning about contaminated hand sanitizers, the FDA noted that the products were mislabeled as containing ethanol, but then “tested positive for methanol contamination.” Unfortunately, if consumers do buy mislabeled products, they may not have a sure way to check if their sanitizer is contaminated, Banner said.

“I wouldn’t expect the general public to know the smell of methanol,” Blaum noted. While other toxins removed in the distillation process have distinctive odors – for example, ethyl acetate smells like nail polish remover – methanol smells similar to ethanol, but with slightly more synthetic or “chemical” odors, he said. Someone outside the distillation business might not be able to sniff out the difference, and more importantly, the humble disinfectant manufacturer “will likely add fragrance” to hand sanitizer to mask any noticeable odor, Blaum adds.

“I just follow the FDA’s warnings” to keep up with which sanitizers are safe and call poison control centers with any questions about unfamiliar products, Banner says. He said, “Be aware that sometimes ‘cheap’ may not always be so good.” An unknown product made by a small company “just jumping into the market” may not be as trustworthy as an established brand, he added. In any case, the best practice is to check the FDA list before using a new product.

In addition, the FDA warns consumers to be wary of products on the market with misleading claims, such as being able to “protect for the long term” with COVID-19. any hand sanitizer is not approved by the FDA before entering the market, so products labeled “FDA approved” should also be wary. Products packaged to look like drinks, candy, or wine bottles, as well as products marketed as drinks or cocktails, may put children at particular risk because their appearance may tempt them to drink them.

Signs of exposure to methanol
As more rudimentary disinfectants may be on the horizon as the epidemic continues, here’s what you should know about methanol exposure and its effects on your body.

“Methanol is no more toxic than ethanol,” at least when first ingested, notes Banner. The trouble, he says, occurs in the liver, where an enzyme called alcohol dehydrogenase metabolizes both types of alcohol. Unlike ethanol, methanol is converted to formaldehyde as it breaks down, the other metabolite; formaldehyde then gets passed on to a second enzyme that converts the compound to formic acid. According to a 2011 report in the Indian Journal of Ophthalmology, the accumulation of formic acid causes the pH of the blood to drop, making it dangerously acidic; this disrupts the metabolic processes needed for cells to produce energy; and leads to the accumulation of waste products such as lactic acid.

This harmful combination of acidity and metabolic disruption hits nerve cells the hardest, especially those in the retina and optic nerve, which begin to “swell” and may be permanently damaged by exposure to formic acid, Banner said. But because the body takes time to metabolize methanol, he said, it can take about four to six hours for symptoms to appear.

People who experience vision loss after methanol exposure describe their vision first becoming blurry, and then everything looks like they’re “walking in a blizzard,” Banner said. If these people don’t receive kidney dialysis quickly, “they will be permanently blind,” he said. In addition to dialysis, people suffering from methanol poisoning can be treated with a drug called Formizole, which inhibits alcohol dehydrogenase, which prevents the liver from producing formic acid. More rarely, patients may be treated with doses of ethanol because the two alcohols compete for alcohol dehydrogenase, and the presence of one alcohol slows the metabolism of the other.

In addition to vision loss, people exposed to methanol may experience nausea, vomiting, headache, seizures or coma, according to the U.S. Food and Drug Administration. The earliest signs of exposure often include feeling a bit intoxicated and beginning to hyperventilate as the body responds to increased acid in the blood, Banner added.