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, August 30, 2008

Winnipeg (Canada) largest school system bans alcohol-based hand sanitizers; as do Edmonton and Vancouver School Boards

Winnipeg's largest school division has banned alcohol-based antiseptic hand-washing stations from its schools over fears that they are flammable and toxic. The policy, reported this week, means the division's 77 schools will not be provided with, and cannot order, alcohol-based hand sanitizer.

"Alcohol-based hand cleaners are not to be used with students within our division, because they are highly flammable and potentially fatal if ingested," nurse educator Kerry Heather has told the Winnipeg School Division's 77 schools. The cleansers are typically about 60-per-cent alcohol. "You don't see that even in a liquor mart," Ms. Heather said.

Edmonton Public Schools is making a similar move in its schools, said spokeswoman Jane Farrell. "We are moving to the non-alcohol-based sanitizers." The Vancouver School Board does not allow alcohol-based cleansers, either.

Students who insert an electrical plug could set off a spark and cause a fire on their hands, she said. They could hurt themselves in a science lab or if they go outside for a cigarette, if they still had the alcohol-based material on their hands.

"Absolutely, any time you're going to add fuel, if it isn't used properly," she said, noting that burns have been suffered in health-care facilities.

Thursday, August 28, 2008

What The CDC Really Says about Hand Sanitizers

You’re reviewing this because you’ve either already implemented a hand hygiene program within your facility, or you are researching various hand sanitizer products and dispensing systems that would be appropriate for use by your employees and visitors.

You already know that the vast majority of hand sanitizer products, whether consumer-based or institutional, are alcohol-based; over the past 10-15 years, these products have become ubiquitous in a wide variety of settings and venues.

But here’s the rub: alcohol-based products have become equally notorious for (i) causing dry/irritated skin, (ii) destroying protective skin cells, (iii) having limited persistency, and of course, these products are (iv) both flammable and (iv) potentially toxic, creating significant facility implementation risks that are NOT covered by traditional insurance policies.

These “features” are barely-noticed “footnotes” in the US Centers For Disease Control hand hygiene white paper; the “bible for hand hygiene.” This white paper, exclusively intended for hospital workers (HCW’s), was originally prepared in 1996, and slightly modified in 2002 (with no significant changes). However, as recently as October 2007, Kathleen Stewart, a senior spokesperson for the CDC, stated unabashedly that “..the report is widely misinterpreted, as CDC does not in fact “recommend” the use of alcohol-based gels (we only recommend washing with soap and water), and contains numerous statements cautioning against the use of alcohol-based hand sanitizer rubs and gels..” Below extracts from the CDC publication illustrate Ms. Stewart’s observations.

 When evaluating hand hygiene products for potential use in health care facilities, administrators or product selection committees should consider the relative efficacy of antiseptic agents against various pathogens and the acceptability of hand hygiene products by personnel. Characteristics of a product that can affect acceptance and therefore usage include its smell, consistency, color and the effect of dryness on hands.

 Allergic contact dermatitis due to alcohol hand rubs is relatively uncommon. However, with increasing use of such products by health care personnel, it is likely that true allergic reactions to such products will occasionally be encountered.

 Alcohols are rapidly germicidal when applied to the skin, but they have no appreciable persistent (i.e., residual) activity.

 Depending on the alcohol concentration, the amount of time that hands are exposed to the alcohol, and viral variant, alcohol may not be effective against hepatitis A and other nonlipophilic viruses. The inactivation of nonenveloped viruses is influenced by temperature, disinfectant-virus volume ratio, and protein load
 Alcohols are not appropriate for use when hands are visibly dirty or contaminated with proteinaceous materials.

 Further studies are warranted to determine the relative efficacy of alcohol-based rinses and gels in reducing transmission of health-care--associated pathogens.

 Even well-tolerated alcohol hand rubs containing emollients may cause a transient stinging sensation at the site of any broken skin (e.g., cuts and abrasions). Alcohol-based hand-rub preparations with strong fragrances may be poorly tolerated by HCWs with respiratory allergies.

 Alcohols are flammable. Flash points of alcohol-based hand rubs range from 21ºC to 24ºC, depending on the type and concentration of alcohol present (169) One recent U.S. report described a flash fire that occurred as a result of an unusual series of events, which included an HCW applying an alcohol gel to her hands, immediately removing a polyester isolation gown, and then touching a metal door before the alcohol had evaporated

 In certain surveys, approximately 25% of nurses report symptoms or signs of dermatitis involving their hands, and as many as 85% give a history of having skin problems (249).

 Affected persons often complain of a feeling of dryness or burning; skin that feels "rough;" and erythema, scaling, or fissures. Detergents damage the skin by causing denaturation of stratum corneum proteins, changes in intercellular lipids (either depletion or reorganization of lipid moieties), decreased corneocyte cohesion, and decreased stratum corneum water-binding capacity (250,251). Damage to the skin also changes skin flora, resulting in more frequent colonization by staphylococci and gram-negative bacilli (17,90). Although alcohols are among the safest antiseptics available, they can cause dryness and irritation of the skin (1,252)

 Skin that is damaged by repeated exposure to detergents may be more susceptible to irritation by alcohol-based preparations (253)

 Allergic reactions to products applied to the skin (i.e., contact allergies) may present as delayed type reactions (i.e., allergic contact dermatitis) or less commonly as immediate reactions (i.e., contact urticaria). The most common causes of contact allergies are fragrances and preservatives; emulsifiers are less common causes (256--259). Liquid soaps, hand lotions or creams, and "udder ointments" may contain ingredients that cause contact allergies among HCWs (257,258).

 Allergic reactions to alcohol-based products may represent true allergy to alcohol, allergy to an impurity or aldehyde metabolite, or allergy to another constituent of the product (167). Allergic contact dermatitis or immediate contact urticarial reactions may be caused by ethanol or isopropanol (167).

Which is exactly why alcohol-based products are being systematically banned from corporate, government, correctional, and educational venues, and why a continuously growing number of infection control experts are embracing the use of non-alcohol, rinse free products, and specifically those that incorporate the organic compound Benzalkonium Chloride (BAC)

Monday, August 25, 2008

Indiana Dept of Education: Out of Touch when it comes to hand sanitizers?

Very disheartening to notice a recent posting in a national listserve for school nurses, and that as the school year begins, some school adminstrators are actually facilitating the promotion of alcohol-based hand sanitizers--and pointing influencers to marketing collateral such as "Scrub Club", which incorporates subliminal product marketing 'sponsored' by manufacturers of alcohol-based hand sanitizers (i.e. Purell), despite the fact that health care experts are repeatedly warning about the dangers of alcohol-based hand sanitizer products, especially within school settings.

Last year, in the midst of the MRSA outbreak taking place in schools across the country, the news media repeatedly focused on the dangers of alcohol-based products and the misconceptions about their appropriateness within school settings. Contrary to popular belief, the CDC only recommends washing with soap (non-antimicrobial) and water, and actually cautions against the use of alcohol-based rubs and gels within specific settings and circumstances, and a senior spokesperson from CDC (Kathleen Stewart) has repeatedly stated that "too many people are mis-reading, or not completely reading the CDC hand hygiene recommendation (which is now more than 12 years old and was intended exclusively for hospital environments)..."

By now, everyone knows that alcohol-based sanitizers have virtually no effectiveness when applied to dirty hands, they certainly can't be applied to scrapes/abrasions, and prolonged use cause dry/irritated skin--and actually destroys protective skin cells.

And, we've all read stories about little kids inadvertently licking this products off of their hands (perhaps because of the interesting fragrances that are imbedded in the products), and subsequently getting sick from ingesting the alcohol. A search on using the key words "hand sanitizer" will also illustrate how inventive our teens can be when seeing how they are re-purposing alcohol-based sanitizers. For those that can't log on to YouTube from school computers, think "libation" and "accellerant" and you can easily envision how easily these products can be abused.

And by now, many have become aware that there are more than several alcohol-free, rinse free hand sanitizer products that use benzalkonium chloride as the active ingredient--which is the same active used in a variety of antiseptics (Bactine, BandAid foaming antiseptic, etc.), and are otherwise proven to be equally, if not more effective with respect to killing the variety of commonly-transmitted germs, bacteria and viruses, including MRSA, and other forms of staph. These products can be applied to cuts/abrasions, BAC has extended persistency, and the better products contain no fragrances or dyes.

From the perspective of health care product safety, wisdom suggests that too much of anything is no good, but if a choice is to be made insofar as hand sanitizer products, why would anyone recommend applying a flammable and toxic product to our kids hands, when there are products that can kill germs without killing the skin cells that are intended to protect against germs and bacteria?

Lets get smart and keep everyone safe and healthy.

Thursday, August 14, 2008

Drinkers are dying after downing high-alcohol hospital hand gel used to fight superbugs such as MRSA.

Drinkers are dying after downing high-alcohol hospital hand gel used to fight superbugs such as MRSA.

A string of deaths have been caused by the colourless gel, which contains 70 per cent alcohol.

Hospitals are being forced to remove the gel from public areas and instead have it only on wards under the watchful eyes of nurses.

At least two people have died this year after drinking the gel and Lewisham hospital in South East London confirmed 10 cases where people had stolen the gel from its building.

Thomas Sajdak, 29, was found dead in Streatham, South London, in February, while his friend Oleh Wowczyshyn, 29, collapsed and died four days later after complaining of severe stomach pains.

Detective Constable Nainesh Desai confirmed at their inquest that the deaths were caused by drinking "hospital fluids".

Petra Salva, spokesman for homeless charity Thamesreach, said: "It's a horrible way to die.

"We've started to get reports of this from speaking to people sleeping rough and police who have met people with bottles (of the gel).

"A lot of it has been anecdotal so far but it's something that's come onto our radar and we have been looking into it ourselves over the past three months."

The colourless gel, called Spirigel, has been introduced into hospitals as an effective way of trying to prevent superbugs, including MRSA, being passed from visitors to patients.

A NHS source said: "This handwash is a vital tool in combating the spread of bugs, and we encourage everyone on wards to use it regularly.

"Having to remove it from public areas because of abuse is obviously causing hygiene problems."

Saturday, August 9, 2008

Massachussets requires CVS to maintain hand sanitizer dispensers at Walk-In Clinics

The big question is whether CVS will be implementing alcohol-free hand sanitizers, or the alcohol-gel products--and of course, if CVS opts for the legacy products, whether their implementation will conform to local fire marshall regulations. Yes, alcohol-based hand sanitizer dispensers are increasingly found to violate local fire code ordinances.

Benzalkonium Chloride-based hand sanitizers great for dog's (and other pet) skin problems too!

Alkyl dimethyl benzyl ammonium chloride (benzalkonium chloride) is a mixture of alkylbenzyl dimethylammonium chlorides of a range of alkyl chain lengths. This creation has three chief categories of exercise plus is a nitrogenous cationic surface-acting agent belonging to the quaternary ammonium group. It acts as a biocide, a cationic surfactant plus phase transfer agent in the chemical industry.

In treatment for dog skin problems, this ingredient is here in antimicrobial solutions which causes healing to be accelerated as a result of keeping the wound bacteria plus infection free. This means the body does not exercise wasted energy fighting off infection, but instead uses the alike energy to replace damaged tissue. Dissimilar iodine plus alcohol products which will dry the skin by extended use, conditioners by benzalkonium chloride maintain exact skin moisture through a healthy PH balance.

Although currently used in human pharmaceuticals such as skin antiseptics plus wet wipes, it has been proven to be a fantastically effectual ingredient in the animal or else pet industry, particularly in the treatment of dog skin problems. These sort solutions are used prior to withdrawing blood for Blood Alcohol Content tests plus along as a preservative for general safety.

Vanessa Fisher is an expert when it comes to the treatment of dog skin problems. Her Antimicrobial Solutions which seize the ingredient, Benzalkonium Chloride, proves to be of the highest normal in not simply treatment for dogs, but along in the equine industry for horse diseases such as white column disease.

Friday, August 8, 2008

Arizona Schools Banning Alcohol Hand Santizers-Back To School Shopping Quandry

Actually, not much of a quandry for the teachers and moms that are receiving memo's re: back to school supplies, "but don't provide your kids with alcohol-based hand sanitizers (you know the brands, Purell, GermX, etc)

In the past four days, we've received calls from 4 different elementary school systems in Arizona asking for guidance on where/how to procure non-alcohol based hand sanitizers...The pat on hand answer is : go to and type in "hand sanitizer"'ll find only one product--and its alcohol free...or go to your Wal-Mart supercenter--they carry "Soapopular", or go to, they carry this product also... Others are out there, but most have fragrances or some type of coloration...that's not popular with those concerned about allergic reactions.

Monday, August 4, 2008

Benzalkonium Chloride- Hand Sanitizers & Herpes

For those that are just now noticing claims i.e. effectiveness against HIV and Herpes from manufacturers of benzalkonium chloride-based hand sanitizer products ---the following links should help to document the research... which otherwise is finding that Yes, Matilda, benzalkonium chloride is a widely-accepted organic compound that has proven to successfully mitigate STD's.