National center for infection control professionals, healthcare experts, manufacturers, distributors, suppliers and consumers focused on best practices in hand hygiene and hand sanitizer products

Saturday, September 29, 2007

We've known this for 10 years??? Yep.

Excerpted from a 1998 research study!!!

Although alcohol-based formulas that comply with federal composition standards generally are considered effective, alcohol-based antiseptic handwash preparations are flammable and do not demonstrate persistent antimicrobial activity. Also, repeated use often can cause drying and irritation of the skin.(8) Alcohol strips the skin of essential oils and sebum, which act as a natural protective barrier against bacterial infection and precipitate protein.(9) When applied to wounds or raw surfaces, therefore, it not only increases the risk of injury, but also forms a coagulum under which bacteria may subsequently thrive.(10) It is, therefore, not useful for the disinfection of open lesions or abraded, inflamed skin. Together, these and other adverse properties greatly limit the alcohol-based antimicrobial product's immediate effectiveness and increase the chances for the spread of infection.

The Centers for Disease Control and Prevention (CDC) has stated that hand washing is the single most important factor in the prevention of disease and the spread of infections. Officials at the CDC estimate that one-third of all hospital-acquired infections are avoidable and are caused by a lack of adherence to established infection control practices such as hand washing.(16)

This insufficient hand washing has led to a great increase in the use of waterless hand sanitizers by health care personnel. This study evaluated the effectiveness of two ethanol-containing hand sanitizers and a novel, ethanol-free hand sanitizer using an FDA-approved protocol.

After a single application, the alcohol-free sanitizer and both alcohol-based formulas reduced bacteria more than a control nonantimicrobial handwash formula. When the protocol was repeated omitting the water rinse, similar results were achieved. This illustrated that the first time either of these types of products is used on any given day, degerming activity results that exceeds the federal requirements for antiseptic hand washes.

To be of any value in a health care setting, however, a hand antiseptic should give persistent antimicrobial activity with repeated use. Accordingly, the alcohol-free sanitizer, with or without the water rinse, produced increased antimicrobial effectiveness over time with no adverse effects. In contrast to this, repeated use of the alcohol-based sanitizers produced a decrease in antimicrobial effectiveness over time and was accompanied by swelling, erythema, and discomfort of the palmar surface of subjects' hands. Importantly, by the completion of both the rinsing and nonrinsing protocols, antimicrobial persistence of the alcohol-free formula was so pronounced that its performance exceeded federal requirements for antiseptic hand washes by at least 50%. The tested alcohol-based hand sanitizers, however, failed to meet this federal standard in both the rinse and nonrinse protocols.

In summary, the study showed

* the alcohol free hand sanitizer formula had a greater sustained degerming activity than the alcohol-containing hand sanitizer formula,

* the alcohol-containing hand sanitizer became less effective with repeated use and irritated the hands of subjects, and

* the alcohol-free hand sanitizer formula became more effective without irritation after repeated use.

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