Presence of unsafe chemical impurities, accelerated evaporation of alcohol, and lack of key labeling requirements are risks and concerns for some alcohol-based hand sanitizers and dispenser practices during the COVID-19 pandemic

PLoS One. 2022 Mar 18;17(3):e0265519. doi: 10.1371/journal.pone.0265519. eCollection 2022.

Abstract

Alcohol-based hand sanitizers (ABHS) have been an important hand hygiene tool during the COVID-19 pandemic. Recently, ABHS from non-traditional drug manufacturers have entered the market, triggered by a lack of ABHS availability. Some of these ABHS contain high levels of chemical impurities that may be harmful with frequent exposure. Additionally, the use of refillable dispensers designed to accept ABHS from bulk containers allows for mixing and evaporation that may compromise ABHS integrity. To understand the risks associated with low quality ABHS and bulk refilling practices, we collected 77 ABHS samples sourced from community settings (restaurants, grocery stores, etc.) and 40 samples from a single school district. All samples were obtained from bulk refillable dispensers that were in use. Samples were analyzed for alcohol content, chemical impurities, aesthetic qualities, and presence of drug labeling information. Additionally, we performed laboratory-based experiments to determine the impact of dispenser design on alcohol evaporation rates. Over 70% of samples for which photos were available showed lack of essential labeling information, including missing "Drug Facts Labels". For ABHS samples acquired from community settings, nearly 14% of samples had visible impurities, and over 30% of samples had concentrations of acetal and acetaldehyde in excess of FDA interim limits. Subpotent ethanol concentrations were observed in 9.09% and 82.05% of samples from community settings and the school district, respectively, with the school district sample results being associated with dispenser misuse. Laboratory-based experiments show dispenser design significantly impacts the rate of ethanol evaporation of ABHS products, especially if stored in open refillable dispensers without an internal reservoir. This study demonstrates risks associated with use of inferior ABHS and bulk refilling practices. Regulatory agencies should issue guidance on best practices in community settings to ensure the integrity of ABHS as an essential public health tool to prevent the spread of COVID-19 and other transmissible diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 / prevention & control*
  • Drug Contamination / statistics & numerical data
  • Drug Storage
  • Ethanol / analysis*
  • Hand Sanitizers / analysis*
  • Hand Sanitizers / standards
  • Humans
  • Product Labeling / standards
  • Product Labeling / statistics & numerical data
  • Quality Control

Substances

  • Hand Sanitizers
  • Ethanol

Grants and funding

GOJO Industries and Valisure LLC provided funding and resources to execute the work for this study. GOJO Industries compensated Valisure LLC for material consumables and labor associated with analytical testing for chemical impurities. Valisure LLC also provided support in the form of salaries for KK and DL. GOJO Industries also provided support in the form of salaries for CM, DY, JW, CF, and JA. The specific roles of these authors are articulated in the ‘author contributions’ section. The funders had no additional role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.