Medical associations and expert committees urge that ethanol be approved as a virucidal active substance for use in hand antiseptics under the European Biocidal Products Regulation, without a CMR classification.

Introduction: Since 2007, the classification of ethanol under the Biocidal Products Regulation has paradoxically remained unresolved due to conflicting views among experts and authorities. Initially, there was a discussion about classifying ethanol as carcinogenic. The current proposal to extend its harmonized classification includes, among other things, categorizing it as reproductive toxicity category 2 ("suspected to have CMR potential for humans"; carcinogenic, mutagenic, reprotoxic). If ethanol were classified under reproductive toxicity category 2, it would mean that the only active ingredient in hand antiseptics effective against non-enveloped viruses would no longer be available. Scientific assessment of the safety of ethanol-based hand rubs EBHR: Available epidemiological studies do not confirm an increased risk for cancer from EBHR in exposed individuals, except under uncommon or unlikely routes or levels of exposure.The evidence for ethanol's reprotoxic effect originates from the consumption of alcoholic beverages by pregnant women, where ethanol uptake is incomparably higher. The amount of transdermal ethanol absorption during hand antisepsis is up to ten times lower than the oral intake of beverages containing hidden ethanol, such as apple juice, kefir, or non-alcoholic beer. Blood alcohol levels after using EBHR remain within the physiological range associated with food intake. Conclusion: There is no epidemiological evidence of toxicity for workers handling ethanol-containing products in industry or using EBHR in healthcare settings. Given that the classification of EBHR as reproductive toxicity category 2 is not supported by current scientific research and that no alternative biocidal active substance in hand rubs is effective against non-enveloped viruses, medical associations and expert committees from Europe, the USA, Canada, the Asia-Pacific region, and the World Society for Virology unequivocally recommend, with the highest priority, that EBHR be approved as an active substance for PT1 biocides and not be classified as a reproductive toxicant in category 2.