Cornea & Ocular Surface

Pediatric Eye Exposure to Hand Sanitizer Soars Amidst Pandemic

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BOSTON, MA – SEPTEMBER 9: A first grade student checks to see if it’s his turn into the boys room as others wait their turn next to hand sanitizer at South Boston Catholic Academy in South Boston on Sept. 10, 2020. Limited students are allowed in each classroom and students must social distance and wear masks. Schools in the Boston Archdiocese have opened for in-person learning after registration spiked this summer amid the pandemic. Thomas W. Carroll, superintendent of schools for the archdiocese, said they wanted to offer families both a return to in-person learning and a remote option. Like in public school districts, all families can opt out of in-person learning in Boston Archdiocese schools. (Photo by David L. Ryan/The Boston Globe via Getty Images)
The COVID-19 pandemic is associated with an increase in ocular exposure to alcohol-based hand sanitizer in pediatric patients.

Children experienced 7 times more cases of alcohol-based hand sanitizer (ABHS) exposure in 2020 than in 2019, according to findings published in JAMA Ophthalmology. 

Researchers conducted a retrospective case series in which they analyzed data recorded in 2019 and 2020 from the national database of the French Poison Control Centers (PCC) and a pediatric ophthalmology referral hospital in Paris. The main outcome measure was a comparison of cases of ocular exposure to ABHS from April 2020 to August 2020 to cases during the same period in 2019. The data recorded was from cases concerning children and adolescents who were younger than 18 years during the study period.

The analysis found that, in 2020, 232 cases of ABHS eye exposures were recorded of the 2336 calls made to PCCs associated with chemical eye splatter (9.9%), while in 2019, there were only 33 cases of exposure to ABHS of the 2553 calls made (1.3%). Similarly, in 2020, the researchers identified an increase in admissions to the eye hospital for ABHS exposure. Of the admissions, there were 8 presentations of ulcer and 2 requiring amniotic membrane transplant. The data collected also included age, sex, and symptoms experienced.

The researchers explain that the increase in exposures reported corresponded with the end of the coronavirus disease 2019 (COVID-19) lockdown in France, which saw children with more access to freely-available ABHS devices installed in public places.

“The pediatric specificity of this outbreak is most likely owing to the emplacement of the gel dispenser in the proximity of children’s faces,” the study explains. “Dispensers, often pressure-operated via a pedal, allow the delivery of unit doses of ABHS. However, these devices are usually around 1 m in height, delivering ABHS at the level of small children’s eyes.”

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The researchers conclude that health authorities should make caregivers aware of the potential danger of ABHS devices, as well as ensuring the safe use of the devices. As the epidemiology of other countries may differ, this study is limited to conditions in France during the study period.

Reference

Martin G, Le Roux G, Guindolet D, et al. Pediatric eye injuries by hydroalcoholic gel in the context of the coronavirus disease 2019 pandemic. JAMA Ophthalmol. Published online January 21, 2021. doi:10.1001/jamaophthalmol.2020.6346.

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