Chemical exposures reported to the National Poison Data System (NPDS) increased substantially in early March 2020, likely due to cleaning efforts related to coronavirus disease 2019 (COVID-19), according to a recent Morbidity and Mortality Weekly Report

To investigate the association between these exposures and COVID-19 cleaning recommendations, the Centers for Disease Control and Prevention (CDC) and the American Association of Poison Control Centers surveillance team compared the number of reported cases from January to March 2020 to the same 3-month period in 2018 and 2019. Between January and March of this year, the call centers received 45,550 exposure calls related to cleaners and disinfectants. This represented overall increases of 20.4% and 16.4% when compared with the same 3-month period in 2018 and 2019, respectively. 

Additional analysis of the calls showed an increase of total calls across all age groups, however a larger percentage of calls were related to children aged ≤5 years. Increases in poison control calls were largely attributed to bleaches, non-alcohol disinfectants, and hand sanitizers. Among exposure routes, inhalation accounted for the largest percentage increase from 2019 to 2020. 

To illustrate the potential dangers, the report also included 2 case vignettes. In one case, a woman used a mixture of 10% bleach solution, vinegar, and hot water to soak her produce. The noxious fumes produced by the mixture subsequently led to the development of mild hypoxemia and end-expiratory wheezing, which improved with oxygen and bronchodilators.

In the second case, a preschool-aged child had ingested an unknown amount of ethanol-based hand sanitizer, which caused her to become dizzy and hit her head, leaving her unresponsive. In the emergency department, her blood alcohol level was elevated at 273mg/mL. She was admitted to the pediatric intensive care unit and was discharged 48 hours later after her mental status improved. 

“Although a causal association cannot be demonstrated, the timing of these reported exposures corresponded to increased media coverage of the COVID-19 pandemic, reports of consumer shortages of cleaning and disinfection products, and the beginning of some local and state stay-at-home orders,” the authors concluded.

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