Evidence map›Paper›PMID 37098641›Full record

ArticleAntimicrobial resistance and infection control2023

The danger of the toxicity and inefficacy of alcohol-based hand rubs in Iran during COVID-19: a cross-sectional study.

Ali Rafizadeh, Ali-Asghar Kolahi, Shahab Shariati, Nasim Zamani, Darren M Roberts, Hossein Hassanian-Moghaddam

Open access · goldAbstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Ali RafizadehFaculty of Nursing & Midwifery, Rasht Branch, Islamic Azad University, Rasht, Iran.
Ali-Asghar KolahiSocial Determinant of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shahab ShariatiDepartment of Chemistry, Rasht Branch, Islamic Azad University, Rasht, Iran.
Nasim ZamaniDepartment of Internal Medicine, St. Agnes Medical Center, Fresno, CA, USA.
Darren M RobertsEdith Collins Centre, Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Hossein Hassanian-MoghaddamSocial Determinant of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. hassanian@sbmu.ac.ir.
Islamic Azad University Rasht Branch · IRShahid Beheshti University of Medical Sciences · IRRoyal Prince Alfred Hospital · AUSaint Agnes Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of disinfectants and alcohol-based hand rubs (ABHR) to prevent COVID-19 transmission increased in the first wave of the infection. To meet the increased demand, the Iranian Ministry of Health issued an emergency use authorization allowing new manufacturers to enter the market, despite the limited capacity for surveillance of these products during COVID-19. Methanol poisoning outbreaks spread rapidly, and more people died from methanol poisoning than COVID-19 in some cities. The aim of this study was to analyze some ABHRs in the Iranian market to see if (a) ABHRs are standard and suitable for hand antisepsis and (b) contained potentially dangerous toxic alcohols.

methodBetween February and March 2020, 64 brands of ABHR were conveniently collected from pharmacies, supermarkets, and shops selling hygienic products and analyzed using Gas Chromatography. World Health Organization and Food and Drug Administration guidelines were used to define minimum requirements for ABHR. For estimating the risk for acute methanol poisoning, we assumed a serum methanol concentration of 200 mg/L following ABHR ingestion was sufficient to cause intoxication. This threshold concentration would be achieved in an average 75-kg adult after consuming 8000 mg (or eight grams) methanol in 1-2 h.

resultsThe median [IQR] (range) concentration of ethanol, isopropanol, and methanol were 59% v/v [32.2, 68] (0, 99), 0 mg/L [0, 0] (0, 197,961), and 0 mg/L [0, 0] (0, 680,100), respectively. There was a strong negative correlation between methanol and ethanol contents of hand rubbers (r= -0.617, p < 0.001). Almost 47% of ABHRs complied with minimum standards. In 12.5% of ABHRs, high concentrations of methanol were observed, which have no antiseptic properties but could cause acute methanol poisoning if ingested.

conclusionCOVID-19 initiated a policy for distribution and use of ABHR with little control. As ABHR and masks are still accepted preventive measures of the disease, non-standard ABHR compositions may increase the population's risk to both COVID-19 infection and methanol poisoning.

Indexed as

2-PropanolCOVID-19AdultCross-Sectional StudiesEthanolHand DisinfectionHumansIranMethanolUnited States2-PropanolEthanolMethanolCOVID-19Hand rubbersHand sanitizerMethanolMethanol detectionMethanol determinationMethanol intoxication

Identifiers

PMID37098641
PMCPMC10127170
OpenAlexW4366987582

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.