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Interesting article about hand sanitizers I found on another board


Rebecca
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Hand Sanitizers, Good or Bad?

By DEBORAH FRANKLIN

Published: March 21, 2006

What started out as an informal classroom experiment at East Tennessee State University has turned up disturbing evidence about some alcohol-based instant hand sanitizers — the antiseptic gels and foams that have become popular as a quick way to disinfect hands when soap and water aren't available.

Many such sanitizers — whether a brand name or a generic version — work well, and are increasingly found in hallway dispensers in hospitals, schools, day care centers and even atop the gangways of cruise ships as one more safeguard against the hand-to-mouth spread of disease. Several studies from such settings have shown that use of the alcohol-based rubs on hands that aren't visibly soiled seems particularly helpful in curbing the spread of bad stomach and intestinal bugs.

But a study published in this month's issue of the journal Emerging Infectious Diseases found that at least one brand of sanitizer found on store shelves, as well as some recipes for homemade versions circulating on Web sites about crafts or directed at parents, contain significantly less than the 60 percent minimum alcohol concentration that health officials deem necessary to kill most harmful bacteria and viruses.

"What this should say to the consumer is that they need to look carefully at the label before they buy any of these products," said Elaine Larson, professor of pharmaceutical and therapeutic research at Columbia's nursing school. "Check the bottle for active ingredients. It might say ethyl alcohol, ethanol, isopropanol or some other variation, and those are all fine. But make sure that whichever of those alcohols is listed, its concentration is between 60 and 95 percent. Less than that isn't enough."

Scott Reynolds, a specialist in infection control at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tenn., discovered the problem inadvertently, in the course of giving a simple demonstration on the merits of hand washing to a friend's class of biology students at nearby East Tennessee State.

Mr. Reynolds had the students place their hands on agar plates of growth medium before and after one of several experimental conditions: rubbing their hands briskly under tap water; sudsing with hospital-grade soap and then rinsing with water; or rubbing their hands with a dollop of one of two types of alcohol-based hand sanitizer. The sanitizers used were a foam version from the hospital that contained 62 percent ethanol, and a gel version Mr. Reynolds's wife bought at a local discount store.

The next day, much to Mr. Reynolds's surprise, the culture plates from hands doused and rubbed with the store-bought gel were covered with clumps of bacteria that had, in some cases, formed a visible outline of the student's handprint on the plate.

Only when he flipped the bottle around to read the label on the back did Mr. Reynolds see that the gel's active ingredient was "40 percent ethyl alcohol."

"Otherwise, it looked like all the rest you see in the store," he said. "Same price. Same claims. Same pump bottle."

In a more formal follow-up study, Mr. Reynolds and two colleagues replicated the results, and confirmed that the lack of sufficient alcohol was to blame. If anything, he said, the faulty gel seemed to mobilize the bacteria, spreading them around the hand instead of killing them.

Allison Aiello, an epidemiologist at the University of Michigan who has studied the use and relative effectiveness of alcohol-based gels and antibacterial soaps by consumers as well as hospital workers, said she wasn't surprised by Mr. Reynolds's results from the low-alcohol sanitizer, but she was concerned to read that such a product was on the market.

"I used to work in a virology lab," Dr. Aiello said, "and we knew — it has been known for decades — that an alcohol concentration under 60 percent won't kill the microbes. It's really frightening to think that there are products out there that contain levels lower than that."

Sometimes much lower. One recipe Mr. Reynolds and his colleagues discovered on the Internet for a bubble gum-scented sanitizer aimed at children called for half a -cup of aloe vera gel and a quarter cup of 99 percent rubbing alcohol, with a bit of fragrance. That translates to a concentration of roughly 33 percent alcohol, Dr. Aiello said.

Since 2002, officials at the Centers for Disease Control and Prevention have recommended that health care workers routinely use high quality alcohol-based gels instead of soap and water on their hands when moving from patient to patient — as long the worker's hands aren't visibly soiled.

Alcohol doesn't cut through grime well, so dirt, blood, feces or other body fluids or soil must be wiped or washed away first, if the alcohol in the sanitizer is to be effective. In such cases, hand washing with soap and water is advised.

In October 2005, a committee appointed by the Food and Drug Administration met to discuss, among other things, whether consumers should also be encouraged to use the alcohol-based hand sanitizers.

Dr. Tammy Lundstrom, representing the nonprofit Association for Professionals in Infection Control and Epidemiology, argued that they should. The committee's decision is expected this month.

"About 60 percent of surgery these days is outpatient," Dr. Lundstrom said last week in a phone interview. "We have so many people caring for ill family members at home. Maybe you're without running water because of a hurricane or blackout, or you've got a bad hip and can't move easily to get to the sink as often as you should to wash your hands. What about after you sneeze in the car, or stop to put in contact lenses?"

In all those cases, she said, alcohol-based hand sanitizers — of the correct formulation — could be a godsend, not to replace soap and water, but as an important supplement.

Dr. Aiello sees even more potential uses in the office. "Studies show that the computer keyboard, the phone receiver, and the desk are worse than the bathroom in terms of micro-organisms," she said. "Washing with plain old soap and water should be your first choice. But if you're stuck between meetings and about to grab lunch at your desk, or just use somebody else's keyboard, using a hand sanitizer before and after could be a really good idea."

How much goop should you use? Vigorously rub all sides of your hands with enough gel or foam to get them wet, and rub them together until they are dry. If your hands are dry within 10 or 15 seconds, according to the C.D.C. guidelines for health care workers, you haven't used enough.

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Yeah, I read that somewhere before... scary stuff. Wouldn't 60-95% alcohol dry your skin out something fierce though?

I work on other people's computers for a living-touching keyboards other than my own a lot. (yuk) Although I wash my hands frequently during the day, several times a day and after every keyboard, I bathe my hands in straight 70% isopropyl alcohol. Been doing this for years and have not found it to have a drying effect on the skin. Don't know about the skin sanitizers though.

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Only one that I have heard that can be drying is the isopropyl alcohol. I think the Purell brand is 62% alcohol.

Just thought it was interesting cause there are those homemade recipes out there and looks like they are ineffective.

Also don't use anything that has triclosan as the antibacterial. It's a ingredient that has actually been banned in many countries because it causes cancer. It's in the pesticide group. So it's effective against germs but also highly toxic and I know some supplier that people use here use the antibacterial bases and that's the main ingredient.

HTH

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Another thing people tend to forget is you still have to practice good regular handwashing. Many just want to use this stuff and it really is just not good enough alone.

Being a nurse, we are only allowed to use the hand sanitizer between patients 3 times then we HAVE to wash our hands. And that is just between patients that you are just handing pills to. We can NOT use it if doing procedures such as feeding tubes, invasive procedures, wound treatments, etc.

I am all for these at times but I simply stick with handwashing instead of these when I am able to get to a sink with some good ole soap :) So if you are using it constantly I can see it becoming drying but I strongly suggest that inbetween a couple of uses get to a sink and wash with some soap.

Angi

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Now I got to thinking how many people don't wash and don't even use the sanitizer UGH! LOL! I went to Walmart yesterday and was waiting in line to use the bathroom and only 1 person out of the line before me washed their hands when they left, omg! After I washed mine people looked at me funny when I wrapped my hand in the bottom of my shirt to open the bathroom door to leave :laugh2:

Angi

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Only one that I have heard that can be drying is the isopropyl alcohol. I think the Purell brand is 62% alcohol.

Just thought it was interesting cause there are those homemade recipes out there and looks like they are ineffective.

Also don't use anything that has triclosan as the antibacterial. It's a ingredient that has actually been banned in many countries because it causes cancer. It's in the pesticide group. So it's effective against germs but also highly toxic and I know some supplier that people use here use the antibacterial bases and that's the main ingredient.

HTH

I use the walmart brand and that's 62% also.

I remember reading several years ago that triclosan gets rid of the good bacteria too so I quit using it.

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I always have the sanitizer if I have to use a public bathroom cause if I have to touch a door after I washed my hands I need it to get out...lol

Those antibacterial wipes are good too in case the bathroom only has the air hand dryers...I use them to open the doors to get out and have become very good at opening and closing the stall doors with my foot...lol

Course I never understood why they make the stalls so small....:lipsrseal

Ugh! the aiming issues going through that too. I have 2 boys 6 and 8 never imagined I'd have to wash the friggin walls.:lipsrseal :lipsrseal ..lol

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Ugh! the aiming issues going through that too. I have 2 boys 6 and 8 never imagined I'd have to wash the friggin walls.:lipsrseal :lipsrseal ..lol

Oh it only gets better as they get older, they become craftier in their aiming rofl! It gets even worse when they go to the bathroom in the dark, don't turn on the lights and use the toilet. Now, they can't seem to aim properly when light is on so what on God's green earth tells them they can aim better in the dark! (this is a husband issue as well, omg and he is 34!):laugh2:

Angi

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AIM? What is that?

I keep telling my 26 year old son and ?? (lol, I think 12) year old husband to do me a favor and sit instead of stand. Seems when they are taller, they mis-aim and splash more. I swear it is like a game they play in the toilet.

Can I aim and hit this water bubble, hmmm, there is a spec of dirt on the side, can I clean it off the edge with my aim. Or whatever it is that they do but it is sooo wrong. I keep telling my husband I am going to put a long neck funnel onto the toilet some how and make them go in the funnel.

Actually, I wish I could afford to have a urinal installed, like in an empty closet so I never have to go near it, I can just open the door quickly and spray some scented spray in there! :laugh2:

The one thing I do seem to have control on in this house is putting the seat down after they are done. I threaten to wack someone where it hurts if the seat is left up, has worked for all the years I am married, thank goodness!

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I'm having the bathrooms re-done in the house and getting pedestal sinks cause the cabinets that were next to the toilet got ruined between them missing and me having to disinfects them everyday....amazing how much 2 little kids can pee...geeeeeeessssseeeee....LOL:rolleyes2

Who would have ever thought you'd be asking for "strength" to clean a bathroom...lol

BCN hand sanitizer is ok...it's their antibacterial soap I would never buy cause of the ingerdients.....

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Angi, your story reminded me of a lady I used to work with in a retail store. She was very well kept and very kind of 'uppity'. Whenever I was in the rest room the same time as her you could always hear her using those paper seat covers. She seemed like the most fastidious of all of us. Until one day I came out of my stall at the same time she did and she did not even stop to wash her hands. I could not beleive it!:shocked2: :shocked2: She left that job to be a nail tech. Can you imgine? Blech.

( Dontchya hate it when the restrooms dont have their papertowels and garbage anywhere Near the door so that you can use one to get out? Lol)

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I have a German guy friend who's quite neat, clean and well-mannered... once we went for dinner at a Chinese restaurant with my mom and aunt, and after looking at the fish in the aquariums, we parted to go to the loo. I came out pretty fast, then I stood and waited... and waited... and waited... after about 10 minutes, he came out and apologized. Turns out he couldn't bring himself to touch the doorknob after seeing a bunch of guys who didn't wash their hands after using the urinals and they were out of paper towels, so he was waiting for someone to open the door so he could slip out :laugh2:

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