Proceedings of the Toxicology and Poisons Network Australasia (TAPNA) 2021 Scientific Meeting

Background: Covid-19 resulted in a sharp increase in the use of, demand and supply for alcohol-based hand sanitisers. A dramatic increase in calls to the NSW Poisons Information Centre (PIC) regarding hand sanitiser exposures prompted this investigation into increased risks of hand sanitisers. Methods: This prospective observational study aims to evaluate hand sanitiser products resulting in calls to the NSW PIC from April to July 2020. Photos and extra information of products including brand, alcohol type and percent, bottle size, formulation, country of manufacture, amount ingested and symptoms were obtained during normal NSWPIC operation. Follow-up phone calls were made following caller’s permission to determine outcome of exposures. Two specialists in poisons information critically reviewed all images for compliance. First step determined whether the products classify as therapeutic goods or cosmetic goods in accordance with therapeutic good regulations. Second determined appropriateness of labelling and packaging respectively against its category. Results: 309 images were received from callers for 124 separate hand sanitisers. Review of images revealed 105 products (84.7%) classified as cosmetic goods, 17 made claims that classify them as therapeutic goods, of which 14 did not comply with regulations. NSWPIC reported these 14 products to the TGA and prompted relevant regulatory bodies and industry representatives. Only 3 of 124 products had ARTG number on the packaging. 18 products had packaging similar to drink/ beverage containers or cosmetics. Community members reported concerns of inappropriate packaging for another 15 products. There was a 2.2-times increase in calls to NSWPIC regarding hand-sanitisers from January to July 2020 (1095 cases) when compared to the same period in 2019 (504 cases). Most patients were children under 5 years old and had minor illness. No death was observed in our patients. Discussion: A significant number of hand sanitiser products in this study were misclassified by the manufactures and had inappropriate containers and labelling. Safety measures must be critically taken in timely manner to achieve safe hand sanitiser use. Poisons Information Centre has played an important role enacting prompt data collections and public health interventions leading to modification of the regulations and recommendations.