Potential methanol toxicity and the importance of using a standardised alcohol-based hand rub formulation in the era of COVID-19

Table 1 Toxic effects of methanol, isopropyl alcohol and ethyl alcohol

Alcohol	Dermal absorption from use of ABHRs	Toxic metabolite	Toxic effects
Methanol	Can occur with toxic effects [15].	Formic acid	Nausea Vomiting Abdominal pain Central nervous system (CNS) depression Visual disturbance Increased osmolar gap with metabolic acidosis [19].
Isopropyl alcohol	Can occur but not to toxic levels [20,21,22].	Acetone	Inebriation Gastrointestinal mucosal irritation (abdominal pain, vomiting, diarrhoea, haematemesis) Profound CNS depression (headache, dizziness, stupor/coma) Increased osmolar gap but no metabolic acidosis [19].
Ethanol	Can occur but not to toxic levels [21,22,23,24].	Acetaldehyde	Inebriation Gastrointestinal mucosal irritation (vomiting, haematemesis, diarrhoea) Hypoglycaemia CNS depression [25].

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