Introduction

Methanol is a toxic alcohol that may be ingested intentionally or unintentionally through a number of products readily available to consumers.1 Methanol poisoning carries unique considerations from an ophthalmologic perspective due to its metabolism to formic acid, which can lead to severe visual impairment and even permanent blindness.2 Trends in methanol poisoning have fluctuated over the years, influenced by product availability, public health interventions,3 and most recently, the COVID-19 pandemic, where public health surveillance programs detected a surge in poisoning cases associated with methanol-contaminated hand sanitizers.4

Methods

We examined the Centers for Disease Control WONDER multiple cause of death database for the years 1999-2022, examining ICD code T51.1, corresponding to deaths involving Methanol poisoning.5 Trends were characterized using Joinpoint Regression Program Version 5.0.2 (National Cancer Institute). The Johns Hopkins Medicine Institutional Review Board determined that this study did not constitute human subjects research.

Results

Mortality due to methanol poisoning increased over the study period from 23 deaths in 1999 (0.008 deaths per 100,000 [95% CI 0.005-0.012]) to 60 deaths in 2022 (0.018 deaths per 100,000 [95% CI 0.014-0.023]). Joinpoint analysis demonstrated an annual percent change of 5.4% (95% CI 4.3-6.6%) across the study period (P<.001). The year with the highest mortality was 2020 (109 deaths and 0.033 deaths per 100,000 [95% CI 0.027-0.039]) (Figure 1).

Conclusions

Mortality due to methanol poisoning increased from 1999 to 2022. Increased deaths in 2020 and subsequent years may be attributed in part to the COVID-19 pandemic, but the overall trend is likely due to multifactorial causes warranting further investigation. Additional research will be valuable to understand the epidemiologic and toxicologic factors associated with the observed mortality increase, and to inform prevention efforts. The chief limitation of this study relates to the use of death certificates, which may be subject to misdiagnosis.

Tables and Figures

Figure 1

References

  1. Kraut JA, Mullins ME. Toxic Alcohols [published correction appears in N Engl J Med. 2019 Jan 10;380(2):202. doi: 10.1056/NEJMx180046]. N Engl J Med. 2018;378(3):270-280. doi:10.1056/NEJMra1615295

  2. Tristira, Urvina., Tristira, Rosyida., Erwanda, Fredy, Purliawan. (2022). Clinical Findings and Management of Methanol Induced Toxic Optic Neuropathy: Literature Review. Manuju, 4(12):3377-3384. doi: 10.33024/mnj.v4i12.7965

  3. Peter, Pressman., Roger, Clemens., Saura, C., Sahu., A., Wallace, Hayes. (2020). A review of methanol poisoning: a crisis beyond ocular toxicology.. Cutaneous and Ocular Toxicology, 39(3):173-179. doi: 10.1080/15569527.2020.1768402

  4. Yip L, Bixler D, Brooks DE, et al. Serious Adverse Health Events, Including Death, Associated with Ingesting Alcohol-Based Hand Sanitizers Containing Methanol - Arizona and New Mexico, May-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(32):1070-1073. Published 2020 Aug 14. doi:10.15585/mmwr.mm6932e1

  5. National Center for Health Statistics. Mortality data on CDC WONDER. Centers for Disease Control and Prevention. Accessed September 9, 2024. https://wonder.cdc.gov/mcd.html