What Some Doctors-Including Pediatricians, Still Don't Know About Hand Sanitizers

We were obliged to share the following letter--sent to "MommyDocs.com"

After noticing recent posting at healthymoms.com re: extending your recommendation to use alcohol based hand sanitizers, I was compelled to reach out.

I'll preface by acknowledging that I'm not an MD.

My knowledge with regard to the topic of hand sanitizers (alcohol vs. non-alcohol alternatives) is merely limited to two years of intensive research, including discussions with the leading experts in the field of infection control, HCW's, and independent labs. That research led myself and several business associates to come to the conclusion that alcohol based hand sanitizers are the last thing that anyone should be putting into their kids' hands. Or into anyone else's hands.

We weren't influenced by the 2006 report published by the US Association of Poison Control Centers (the one that was profiled by no less than a dozen leading news media platforms) which disclosed alcohol-based hand sanitizers were the direct cause of upwards of 12,000 cases of alcohol poisoning in kids 6 and under.

Nor were we influenced when we discovered that tens of dozens of schools throughout the country have been systematically banning alcohol-based hand sanitizers due to concerns i.e. toxicity and flash point risk.

Our eyebrows were raised when we noticed a 2004 mandate issued by the New York State Department of Education that prohibited alcohol based hand sanitizers unless a physician or parent authorized it.

We became much more focused on the topic after three separate discussions with CDC spokesperson Kathleen Stewart--who told us that CDC does not actually recommend alcohol-based hand gels when washing with soap and water is not available. She pointed out that CDC certainly does not recommend the use of this product for children.

What intrigued us was discovering that [unlike legacy, alcohol based formulas], alternative, rinse free hand sanitizer formulas (e.g. BAC-based products, there are several including brands Soapopular, Hy5, and others) do not destroy protective skin cells, do no cause dry/irritated skin (leading to risk of infection), provide greater persistency, and are otherwise equally effective i.e. broad spectrum of commonly-transmitted pathogens. These newer products are also effective when applied to soiled/dirty skin, they are non-flammable, and otherwise non-toxic.

Yes. The research conducted over the past 40 years with regard to BAC within sanitizer/antiseptic products indicates that some pathogens might become resistant to excessive exposure to BAC. If this were as significant a finding as some would claim, one would think that Bactine would have been taken off of the market, that J&J would not spend tens of millions promoting its BandAid foaming antiseptic, and that the makers of various spermicidal foams would have opted for a different active ingredient decades ago.

We'd be more than happy to send you samples of our products, independent lab studies, and testimonials from amongst others, the President of the Infection Control Nurse Association of a major east coast state, and a senior civilian employee at the US Naval Dept of Surface Warfare--he's a Ph.D. on the topic of chemical formulations and contacted us unsolicited in effort to implement our BAC-based hand sanitizers throughout the HQ of that government facility.

Without appearing to endorse any single manufacturer, we defer to blog visitors to do what the CDC actually recommends i.e. 'perform your own research when it comes to hand sanitizer products.."

Hand Sanitizers Battle The Common Cold: Expert Says: Alcohol Hand Sanitizers PROMOTE transmission of Common Cold (Rhinovirus)

According to J. Owen Hendley, a professor of Pediatric Infectious Disease at UVA Med, alcohol-based hand sanitizers are no good for cold prevention.

Flu, yes, but rhinovirus (yer common cold bug) apparently kinda likes booze. Dr. Hendley’s put out a lot of interesting, if icky, stuff on rhinovirus, and is something of a go-to expert on the subject

From the study: " ..It should be noted that 62% ethanol, contained in many commercial hand sanitizers, is also ineffective for complete removal of rhinovirus from the hands and would be expected to be ineffective for the prevention of rhinovirus infection..."

Certain acids (such as malic and citric acids) can also be helpful. Either way, next time you’re Purell-ing up, don’t think it’s as good as washing with soap and hot water, despite what the NIH says.

Another extract:

TURNER RB, WATSON DD, KESWICK B, BIEDERMANN KA, ERTEL KD, LEVINE MJ, MORGAN JM, MARIC A, BARKER MF; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. H-660.

Medical University of South Carolina, Charleston, SC

Direct hand-to-hand contact is an important mechanism of transmission of rhinovirus infection. Two randomized double-blind studies of antiseptic hand cleansers for prevention of transmission of rhinovirus were done. In both studies, the hands of volunteers were contaminated with 100 TCID50 of RV at defined times after use of the hand cleanser. Ten minutes after application of the virus the volunteers made intentional contact between one contaminated hand and the conjunctiva and nasal mucosa and quantitative viral cultures were done on the other hand. Volunteers were monitored for development of infection by culture and serology. The first study (85 subjects) compared active preparations containing either 3.5% salicylic acid (SA) and 62% ethanol (EtOH) or 1% SA, 3.5% pyroglutamic acid (PGA) and 62% EtOH with a control of 62% EtOH. Hand challenge with virus was done 15 minutes after treatment with the cleanser. In the control group, 28/31 (90%) had positive hand cultures and 10/31 (32%) developed infection. In contrast, 4/27 (15%) and 0/27 had positive hand cultures in the 3.5% and 1% SA groups, respectively (p<0.05). Infection developed in 2/27 (7%) of volunteers in both treatment groups (p<0.05 compared with control).

The second study (122 subjects) evaluated a hand wipe containing 4% PGA + 0.1% benzalkonium chloride.

Hand challenge was done 15 minutes, 1 hour, and 3 hours after treatment. Significantly fewer volunteers had positive hand cultures at all time points compared with the control group. These results suggest the feasibility of prevention of RV transmission by hand treatments that are virucidal on contact and have activity that persists after application.

What's the answer?: Many of the studies have concluded that iodine-centric products are actually the most effective in terms of killing rhinovirus. Iodine is also effective i.e. norovirus.
That said, wiping your hands with iodine has obvious down-sides and side effects.

The conclusion? If opting for a hand sanitizer product; why would you use an alcohol-based gel vs. those that use benzalkonium chloride as the active ingredient??

Salmonella Outbreak Hits 42 States: 400+ Cases Reported

According to the US Centers for Disease Control, more than 400 people have been infected in connection with an outbreak of Salmonella typhimurium that has spread to at least 42 states.

This particular strain is relatively common, and officials have yet to determine what type of food product may be the root of the problem. As always, in the case of advising consumers how to protect themselves in connection with exposure to salmonella,

"Consumers should thoroughly cook meats, poultry and eggs. They should also avoid consuming raw or unpasteurized milk and other dairy products. Produce should be thoroughly washed as well.

Avoid cross-contamination of uncooked meats and produce to prevent spreading any potential salmonella. Frequent washing of hands during food preparation can also help reduce cross-contamination......For situations where hand washing is not readily convenient, most alcohol-free hand sanitizers have proven to be effective against this particular strain of salmonella. Products include Soapopular, Hy5, Handclenz, and handstogo...

We recommend the former two (Soapopular and Hy5; both are fragrance free and dye free...and in a price comparison, Soapopular is the fairest price of any of the products we've canvassed. Hy5 is packaged in vacuum-sealed cartridges that insert into wall mounted dispensing devices, making it an ideal device for food preparation facilities that are concerned about salmonella.

Both products are foam format, fragrance free and dye free.

Alcohol Gels: NO Impact on Cold-related viruses

Click on the link to the story from NPR. It otherwise says that alcohol-based hand sanitizer gels have no effectiveness insofar as viruses associated with the common cold.

Aside, leading experts, including those from the Mayo Clinic, have repeatedly pointed out that alcohol-based products have NO residual germ-killing effect and that cold-related viruses thrive in dry conditions.

Dry conditions necessarily include skin that becomes dry/irritated after applying alcohol-based gels.

All exactly why experts that have researched the topic are recommending alcohol-free hand sanitizers; primarily those that incorporate the organic compound benzalkonium chloride.

You know that our favorite products include those that have no fragrance and no dye imbedded in the formulation. And, we recommend price comparison shopping. Products such as Hy5 and Soapopular continue to prove to be the most compelling when compared to the various brands on the market.