Fatal Ethanol Intoxication from Household Products Not Intended for Ingestion

Abstract

Fatal acute ethanol intoxication is frequently encountered in medicolegal practice. Although the vast majority of acute ethanol toxicity deaths follow the ingestion of conventional alcoholic beverages, ethanol can be obtained from a variety of commercial products, which often contain high levels of ethyl alcohol but are not manufactured or designed for consumption. Such products may be easily purchased in locales where statutory limitations restrict liquor availability on Sundays or during the early morning hours. Several acute ethanol fatalities have been encountered in New Mexico that were directly related to consumption of non-beverage ethanol-containing products, all of them occurring during times when alcoholic beverage sales were restricted. Despite the fact that manufacturers deliberately include compounds in these products that discourage ingestion, this policy apparently does little to deter individuals who are searching for a source of ethanol when no conventional beverages are available. The products that were consumed in these fatalities also contained other compounds which would be toxic at much greater concentrations, but which were inconsequential in their effects in comparison with the direct toxic effect of ethanol. Investigation of the scene and awareness that alcohol-containing products can be fatally abused are essential to detecting these unconventional ethanol sources.

Reviewed evidence about the safety of the daily use of alcohol-based mouthrinses

“…It should be highlighted that little ingestion of ethanol, whether in the form of beverages or other alcohol-based liquids, can potentially induce death by hypoglycemia. 12,17,18 Alcohol-based mouthrinses whose packaging does not warn against its use by infants can be easily purchased in the market. 1 The American Dental Association (ADA) and the Food and Drug Administration (FDA) have recently required that industries that produce mouthrinses at a higher than 5% ethanol concentration bear in their packaging a safety seal device and labels that clearly inform caution procedures regarding the intake of such solutions by children.…”

“…Some reports discuss the case of alcohol addicts who are craving for alcohol and so resort to alcohol-based aftershave lotions, fuels or mouthrinses as a substitute for alcoholic beverages. 18,19 The dependence on such products has been recorded and is primarily related to easy access to such products rather than to social or financial factors.…”

A fatal case of pure ethanol ingestion

“…Fatal alcohol intoxications usually occur from ingesting these strong alcoholic beverages. However, severe or fatal intoxications sometimes occur from other products containing alcohol such as mouthwashes or solvents that are drunk as alternative to alcohol if availability is restricted [6]. Most of these nonliquor products contain denaturants to discourage drinking such as an added bitter taste, but intoxicating accidents still occur due to the relatively high amount of alcohol and other toxic chemicals contained in the products [7].…”

Daily biofilm control and oral health: consensus on the epidemiological challenge - Latin American Advisory Panel

“…Moreover, alcohol-containing mouthwashes are also contraindicated for patients who are addicted to alcohol or recovering from alcohol addiction. 76 There is evidence of a rise in the daily use of mouthwashes by the population in Latin America, as compared with populations in the United States and Europe, where this habit is more widespread. There is a great variety of formulations available today, but not all are backed up by scientific evidence to confirm their efficacy and safety.…”