Alcohol-based hand sanitiser in healthcare facilities

Background

Alcohol-based hand sanitiser is commonly used for infection control in healthcare facilities, usually in the form of liquid or gel. Containers are typically located in many different areas of facilities and their contents are commonly accessible by members of the public and patients.

Recent incidents have involved liquid alcohol-based hand sanitisers.

A patient was admitted to intensive care after consuming alcohol-based hand sanitiser in an emergency department.

The patient, who had a known history of alcohol intoxication, consumed about 300 millilitres of liquid sanitiser containing more than 70% alcohol. The 600mL bottle was located in the emergency department where members of the public could easily pick up the bottle and remove the lid.

A second incident occurred where a patient set fire to their bed and blanket in a four bed room. The alcohol-based sanitiser was used as an accelerant. The patient also threw the sanitiser at an employee’s face causing an eye injury and contaminating their clothing.

Safety issues

Alcohol-based hand sanitiser contains high amounts of ethanol or ethyl alcohol (generally between 60%-95%).

The easy accessibility of alcohol-based hand sanitiser can pose risks where vulnerable people are present, for example patients with clinical conditions such as alcohol dependence or other behaviours of concern. Conducting a risk assessment of accessible areas to consider where vulnerable patients may be present can assist in identifying areas of increased risk.

Accidental or deliberate misuse of alcohol-based hand sanitiser by members of the public can cause health risks to members of the public and employees such as:

• alcohol poisoning from the ingestion of alcohol-based sanitiser
• fire, if used as a fire accelerant
• eye injury.

Recommended ways to control risks

The following measures may help to reduce the risk of harm from the misuse of alcohol-based hand sanitiser in areas of healthcare facilities where vulnerable people may be present:

• restrict access to sanitiser by removing containers from areas
• make sanitiser containers more difficult to open by using brackets, dispensers or tamper-proof lids
• reduce the volume of sanitiser that can be obtained from a container, for example by using smaller containers or single use containers
• use a different form of hand sanitiser that is harder to ingest or ignite, for example gels (which are thicker/more viscous) or wipes
• follow manufacturer’s recommended risk controls (if any) specified in safety data sheets
• ensure emergency responses are available, for example eye wash facilities, fire extinguishers.

Legal duties

Employers have duties under the Occupational Health and Safety Act 2004. These include:

• providing and maintaining for employees of the employer a working environment that is safe and without risks to health, so far as is reasonably practicable
• ensuring persons other than employees are not exposed to risks to their health and safety from the employer’s conduct, so far as is reasonably practicable
• consulting with employees, so far as is reasonably practicable, and any HSRs when:
  • identifying or assessing hazards or risks at the workplace
  • making decisions about risk control measures at the workplace
  • proposing changes to the workplace, plant or work processes that may affect health and safety.