Case Report - A disturbing emerging trend of alcohol-based hand sanitizer burns in northern Ghana: a case series

Abstract

Introduction: During the COVID-19 pandemic and in the aftermath of it, there was a surge in the use of alcohol-based hand sanitizer (ABHS). This was because the Center for Disease Control and Prevention and the World Health Organization recommended it as an essential commodity for hand hygiene and the reduction of infection transmission. However, alcohol is flammable and has the potential to cause burns if ignited. There are few reports of ABHS-related burns in literature. We aim to report 8 cases of ABHS burns in Northern Ghana and sound a clarion call to stakeholders on a disturbing emerging trend.
Case Presentation: About 62.5% of the victims were children and 75% were female with a male-to-female ratio of 1:3. The mean age of victims was 13.25 years while the mean total burn surface area was 29.8%. All victims in this study sustained their injuries because of an attempt by either them or their collaborators to use ABHS as fuel to light a fire for domestic purposes. Most of the burns sustained were second-degree (75%). The case fatality rate of ABHS burns was 25%.
Conclusion: Alcohol-based hand sanitizer, though effective for hand hygiene, is flammable and can cause burns when used injudiciously. ABHS burn is an emerging public health problem. There is a need for public education to curb this emerging trend and forestall future incidents. The Food and Drugs Authority (FDA) should consider the addition of warning labels for flammability on the containers and instruction manuals of sanitizers.