COVID-19: beware of poisoning linked to disinfection and other risk situations

In the context of the COVID-19 health crisis, ANSES and the network of French poison control centres are closely monitoring calls made to the centres for reasons related to COVID-19. The purpose is to identify specific risk situations in order to issue recommendations and alert the public authorities.

Between 1 and 24 March 2020, 337 calls concerning cases of exposure (with or without symptoms) or requests for information were identified as being potentially associated with the COVID-19 context. Symptoms were mentioned in 144 of the 245 cases of exposure, while the remaining 101 cases were asymptomatic.

The poison control centres identified several different origins for the risk situations, including cleaning products/disinfectants, alcohol-based solutions, essential oils and anti-inflammatory drugs.

To prevent cases of poisoning and accidents, ANSES and the poison control centres are issuing some recommendations.

Cleaning products and disinfectants

Several specific risk situations were identified, such as inhalation of toxic vapours, accidental poisoning of young children following transfers of household products to bottles, water glasses, etc., and using bleach to clean food.

To avoid accidents:

• strictly comply with the conditions of use of cleaning or disinfecting products (for floors, surfaces in the home or workplace);
• never mix cleaning or disinfecting products with each other, especially bleach and descaler;
• if products are not in their original packaging, label them very clearly with the type of contents (name of the product written in marker pen, coloured label, etc.) and keep them out of the reach of children;
• keep all household products out of the reach of children;
• do not use floor and surface cleaners or disinfectants for personal hygiene purposes;
• do not clean food with bleach or any other cleaning or disinfecting product not intended to come into contact with food.

Alcohol-based solutions

Some specific risk situations concern accidental exposure of children to alcohol-based solutions (hand sanitiser) or products used for preparing DIY solutions, left within their reach.

To avoid accidents:

• keep alcohol-based solutions out of the reach of children;
• if products are not in their original packaging, label them very clearly with the type of contents (name of the product written in marker pen, coloured label, etc.) and keep them out of the reach of children;
• for DIY solutions, strictly follow the official manufacturing instructions (WHO website) and keep the resulting products out of the reach of children.

Essential oils

Several specific risk circumstances have been identified: oral self-medication with essential oils to "strengthen natural defences" and "fight against coronavirus", spraying of essential oils to "sanitise an enclosed space" by an at-risk person (asthma sufferer), or inappropriate use to disinfect a surgical mask, for example.

ANSES reiterates that essential oils cannot be used to combat coronavirus. It is important to comply with the conditions of use of these oils (route of administration, dose, area of application, etc.). People suffering from respiratory conditions (especially asthmatics) and pregnant or breastfeeding women should not use essential oils. Before using them at all, and if you have any questions about the use of essential oils, seek advice from a pharmacist.

Anti-inflammatory drugs

There is a clear need for guidance on the use of non-steroidal anti-inflammatory drugs, corticosteroids, bronchodilators and associated anti-inflammatory drugs, following information from the Ministry of Health that anti-inflammatory drugs could worsen the signs of infection associated with COVID-19.

The right behaviour:

• do not stop taking any anti-inflammatory treatment prescribed for a chronic condition, and seek advice from your general practitioner. Any sudden discontinuation of anti-inflammatory therapy could result in a resurgence of symptoms of the chronic condition;
• besides any chronic treatment, do not take non-steroidal anti-inflammatory drugs in the event of fever and opt instead for paracetamol, as recommended by the Ministry of Health.