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

Friday, February 26, 2010

Poor hand hygiene caused C diff outbreak that claimed five lives

Courtesy of

Poor hand hygiene has been blamed for a deadly outbreak of C diff which killed two patients and contributed to the deaths of three others.
An internal report into hygiene compliance at Ninewells Hospital in Dundee found that hand hygiene standards had dropped to 85% in the month before the strain of Clostridium difficile (C diff) took hold in the ward.

We'd suggest that hand hygiene compliance in hospitals are impacted by the simple fact that nurses are sick and tired of destroying their skin by applying alcohol-based products to their hands...

Tuesday, February 23, 2010

WHO on Swine Flu:

WASHINGTON (Reuters) - Has the swine flu pandemic peaked globally? World Health Organization experts have decided and will tell the world on Wednesday.

The WHO is taking a big risk in making the announcement at all, and the wording of the decision will affect whether governments, companies and the public pay attention, or decide, wrongly, that the crisis is all over, public health experts say.

No matter what happens, some public health officials fear that the moderate nature of the H1N1 pandemic, which emerged in April and is dying down in the Americas and Europe, may make people complacent about the next one.

And the risk remains that H1N1 could come roaring back -- something viruses have done in past pandemics.

Click the title link for the full story courtesy of Reuters

Monday, February 22, 2010

University Of Michigan Says NO to Alcohol-Hand Sanitizer; Recommends Alcohol-Free For Students

Hand Sanitizer Recommendations for Campus

Following the advice of the University's Chief Health Officer, we are recommending that hand sanitizers be made more available in common areas on campus this fall and that those hand sanitizers be non-alcohol based containing 0.13% benzalkonium chloride (BAK). Studies have shown that BAK's are effective at killing the influenza virus. The non-alcohol based sanitizers are being recommended for public spaces because the alcohol based products are classified as a flammable liquid.
Departments are strongly encouraged to place non-alcohol based hand sanitizers in common areas such as dining facilities, shared equipment spaces (computer labs), child care facilities, service counters, and other high traffic public areas.

The cheapest and probably easiest way to order this hand sanitizer is through OfficeMax. Attached is a spreadsheet with more detailed information about where and how to order sanitizers. If you decide to find an alternative vendor, please ensure the non-alcohol product contains the recommended 0.13% BAK. Individual staff members may continue to have alcohol based sanitizer on their desks.
If you have any questions, please contact me at or 313-593-4914.

CDC Provides Thumbs Up : Non-Alcohol Sanitizers


What if soap and water are not available, and alcohol-based products are NOT ALLOWED in my facility?

A: Though the scientific evidence is [perhaps] not as extensive* as that i.e. hand washing and alcohol-based sanitizers, other hand sanitizers that do not contain alcohol may be useful for killing flu germs on hands.

*CDC has informally indicated that the definition of "extensive evidence" includes historical studies providing up to 10 years of research data.

Friday, February 19, 2010

Soup Kitchen To Stop Dispensing Alcohol Hand Sanitizer: Seeks Non-Alcohol Product

To our friends at GOJO Industries that love to visit this blog on a daily basis, this story, including the photo image, comes courtesy of Winnipeg, Canada NewsRadio 980....So, if this story gets your dander up, we recommend that you complain to the FDA about the news station, instead of complaining to them about this blog!

Saskatoon Soup Kitchen Removes Hand Sanitizer

Move comes after reports of abuse
Story Tools
Hand sanitizer dispensers started showing up almost everywhere after fears of the H1N1 flu virus spread in 2009.  But lately, some dispensers have been allowed to run dry after reports of people drinking the alcohol based antiseptic.  The Friendship Inn, a Saskatoon soup kitchen, stopped offering hand sanitizer about two weeks ago, according to Executive Director Giselle Doell.

"At this point we are trying to source out a hand sanitizer that is not alcohol based,"  Doell said.  "We're here to help people, not to harm them."

Doell says the discovery that some people were drinking the gel was "alarming".

Recently, there have been reports out of Winnipeg of people using salt to separate the alcohol from the hand sanitizer

Thursday, February 18, 2010

Hospital to lock up alcohol hand-sanitizer dispensers

Once again, folks--we just can't make these things up!

Courtesy of the Canada's Winnipeg Free Press--here's the short, excerpted version:

THE Health Sciences Centre will begin padlocking some of its hand-sanitizer dispensers in an effort to cut down on theft and potential abuse. The move came after the province's largest hospital realized as many as 116 bags of alcohol-based sanitizer were disappearing monthly from its wall dispensers.

Police say people are misusing sanitizer by adding salt to it and then drinking the liquid, which poses serious health risks. "Theft has been a big issue," said Craig Doerksen, HSC divisional director of facility management and maintenance services.

Police said the growth of hand-sanitizer abuse came in the wake of the H1N1 flu virus last April when the dispensers suddenly became ubiquitous. However, Doerksen said, in early 2009 the hospital had already started installing the 150-plus public dispensers before H1N1 hit. But locking up the sanitizer might not solve the theft issue, said Doerksen.
"If we lock the containers up, that might just mean the person kicks the whole thing off the wall and steals the product anyways, and now I have a broken wall to fix in addition to a dispenser."

An HSC spokeswoman said they'll also be introducing signs on some public dispensers that tell people sanitizer is for hand-use only and not for drinking.

Alternatively, HSC should consider a simpler approach: installing non-alcohol hand sanitizer products, that are clearly marked as being "NON-ALCOHOL-HAND SANITIZER".... it took us about two seconds to find just one competing product:   ..notice the logo and labeling on the dispenser-duh!

Wednesday, February 17, 2010

Retailer Removes Alcohol Hand Sanitizer From Shelves: Concerns about people drinking it for alcohol content

The news stories just go on and on and on...
Courtesy of Canada's CBC News

Last Updated: Wednesday, February 17, 2010 | 2:27 PM CT

A downtown Winnipeg store has pulled large bottles of hand sanitizer from its shelves after people were reportedly buying it to get drunk.

The 750-millilitre bottle of sanitizer at the store was being sold for $2 and empty bottles with the store's label were being found scattered in areas where addicts are known to drink.

"This would be replacing mouthwash right now [as an over-the-counter intoxicant]," said Wraylyn Black, a supervisor with the Downtown Biz security patrol.

"They seem to purchase it for a low cost of $2 or they tend to steal it and that's why we can find two to four to five bottles on one individual."
'They are like little chemists — they're finding ways to make it a liquefied drink and now it is hitting our streets.'—Wraylyn Black, Downtown Biz
Black has a collection of the empty bottles that have been gathered up by Biz patrol members.

The store's operators pulled the product after representatives from the Biz and the Manitoba Liquor Control Commission (MLCC) visited this week and advised them of the problem.

Although the sanitizer is sold in a gel form, addicts find ways to thin it into a liquid form, said Black.
"They've caught on to the fact that it has a lot of alcohol in it and they are finding ways. They are like little chemists — they're finding ways to make it a liquefied drink and now it is hitting our streets.
"They figured out what it can do and it is causing some problems."

The Biz, which advocates for downtown businesses and revitalization, police and MLCC are preparing to launch an education campaign for all downtown businesses about the product.
They want retailers to keep the sanitizer in a place where they can have an eye on it, or sell alcohol-free sanitizer.
They are also reminding storeowners that fines under Manitoba's Liquor Control Act for people who knowingly sell hand sanitizer to people intending to ingest it range from $2,000 to $20,000.

H1N1's Unintended Effect: Sanitizer High Addicts Abusing Alcohol Hand Sanitizer after Product Flooded onto Store Shelves, Police and Social Groups Say


(AP)  It's an unintended consequence of the fight against germs during the recent outbreak of the H1NI virus.

Police and social advocates say addicts are abusing hand sanitizer after the product flooded onto store shelves and into dispensers in most public buildings last year.

Sgt. Darrall Randy Kotchon, a Winnipeg police officer who works in a community support unit, said his officers have received reports that addicts are consuming the gel and have found a lot of discarded bottles of the stuff. Experts say people are adding salt to the sanitizer, which separates pure alcohol from the product with potentially dangerous results. 
Reports of hand sanitizer abuse began last year, said police, when officers encountered the issue on patrol and from reports by residents. Business owners need to be particularly vigilant, he said.

"What unfortunately has happened is people are realizing this is something they can use to get drunk and intoxicated on," Kotchon said.

Brian Bechtel, executive director of Main Street Project, a city homeless shelter, said staff confiscated four jugs of sanitizer this week alone. Some clients steal sanitizer from public places, he said, though staff members are now seizing more consumer bottles.

"It seems like it's almost daily now," said Bechtel.

Staff decided to use non-alcoholic sanitizer at the shelter to discourage misuse.

Tuesday, February 9, 2010

Not Your Mother’s Hand Sanitizer: A New Trend in the Jan San Market

Not Your Mother’s Hand Sanitizer: A New Trend in the Jan San Market
For years, the health care industry, along with government, municipal, and corporate professionals have been indoctrinated with the notion that alcohol gels and rubs are the “recommended” hand sanitizing alternative when washing with soap and water is not readily convenient.

And, as anyone in the “Jan San” industry will appreciate, the 2009 Swine Flu “pandemic” inspired not only an unprecedented focus on hand hygiene, but a massive spike in hand sanitizer product sales. According to a recent Nielsen Co. report, retail market sales of hand sanitizer for the 52 week period ending in October 2009 generated as much as $180 million; a staggering 70% increase from the prior year. While Neilsen does not include sales figures from institutional markets, the reader will appreciate that sales from the institutional sector is equivalent to, if not greater than consumer-market figures.

That said, this revitalized focus on hand hygiene and the related surge in hand sanitizer product sales included a game-changing headline; non-alcohol hand sanitizer manufacturers reported as much as ten-fold sales increases from 2008.
Up until recently, alcohol-free alternatives have been considered a nascent and “still emerging” product category, and thanks to the US Centers For Disease Control long-standing (but recently modified) position that benefited a select number of companies known for their alcohol-based sanitizers, the non-alcohol sector has, until recently, represented no more than 1%-2% of the overall market.

But, the combination of a continuous stream of academic and research studies pointing to the “downside” of alcohol-based hand sanitizers, coupled with heightened awareness on equally-effective, yet safer, environmentally friendlier, and arguably, more cost-efficient hand sanitizer products has resulted in a major shift away from flammable, alcohol-based products, and towards alcohol-free products, most of which utilize the organic compound benzalkonium chloride (a/k/a BAC, a/k/a BZK) as the active ingredient.

A quaternary ammonium, BAC, and its cousins, are long-recognized to be effective antibacterial and antiseptic agents proven to be upwards of 99.99% effective against a broad spectrum of pathogens, including enveloped and non-enveloped viruses. Unlike alcohol, these products do not cause the skin to become dry/irritated, they are not flammable, and they provided extended persistency.

While the hospital industry has remained reticent at best to adopt these not terribly new formulations, procurements of non-alcohol sanitizers on behalf of government, municipal, military, correctional, corporate, senior care and educational venues has, according to many, taken distributors by surprise. In turn, they’ve been inspired to reach out with both hands to well-equipped manufacturers of alcohol-free products and dispensing systems.

According to the Chief Medical Officer for Kalamazoo County Michigan, “.. I don't know why we always seem to stress alcohol -based hand sanitizes. It may be to keep public education easier/ less complicated. I personally don't like them because I have eczema and it really dries and inflames my skin (increasing my risk for infection!)...”

This new movement comes despite the fact that for years, the US Centers For Disease Control (CDC) has provided nominal guidance on alcohol-free hand sanitizer alternatives. And, while CDC did update its position on alcohol-free alternatives in a August 2009 memo directed to K-12 educational systems [“..for those that prohibit alcohol-based sanitizers, non-alcohol products can be useful..”], CDC’s long-standing, and seemingly exclusive endorsement of alcohol-based hand sanitizer has been heavily discounted, if not completely disregarded by a continually growing audience representing a broad spectrum of facilities and procurement officers; all of whom have either restricted or out-right banned alcohol hand sanitizer products from their venues. Case in point: in January 2009, the U.S. Naval Submarine Command officially prohibited alcohol sanitizers on board the fleet of submarines.

With hands in their faces, these decision makers have inspected the irritated skin caused by repeated application of alcohol sanitizers, and they’ve researched the connection between dry/irritated hands and increased risk of exposure to easily-transmitted pathogens. When reviewing the [ironic] cautionary statements provided by makers of alcohol-based products that include “recommend washing hands before applying”, coupled with their acknowledging flash-point liability, and the increasing news media reports connecting alcohol-based products to unintended ingestion and alcohol-poisoning, as well as intended product “re-purposing” by those with substance abuse issues, the decisions to switch to non-alcohol products have been easily supported. One need only search with key phrase “alcohol hand sanitizer” to appreciate the preponderance of after-affect application and product misuse.

Consequently, these facility managers have migrated to well-documented and well-researched non-alcohol hand sanitizer products, as these products have proven to be (i) equally if not more effective insofar as killing pesky pathogens when compared to alcohol-based products,(ii) safer to the skin (iii) non-flammable (iv) non-destructive to material such as industrial floor wax, paint, clothing, (v), more persistent, and (vi), 2x-3x more cost efficient, as non-alcohol, foam-formatted products require less frequent application, and the foam format is widely-accepted to be more efficient when compared to gel and/or lotion-based products. With more than two dozen products in the market, leading brand names within the space include among others, “Hy5”, “Soapopular”, DEB SBS’s “InstantFoam” , “SafeHands”, and “HandClens” made by Woodward Labs.

Before reviewing the product and price comparisons of any particular alcohol-free brands vs. alcohol-based alternatives, it is critically important to put the topic of hand sanitizers into proper perspective.

We’re not talking about chemotherapy or a vaccination to ward off Ebola; we’re talking skin safe, facility-safe hand hygiene products that can successfully protect adults and children against easily transmitted pathogens when washing with soap and water is not readily convenient.

At this point, the under-informed reader might be swayed to embrace the arguments in favor of non-alcohol formulas, and otherwise “sold” on the above value propositions. The more informed are inclined to ask “And what are the negative ‘features’ of benzalkonium chloride?” Or, the very informed reader might be familiar with a memorandum submitted in 2003 by GOJO Industries, Inc., the manufacturer of Purell hand sanitizers, to the Federal Drug Administration (FDA), in which GOJO solicited the FDA to prohibit the registration of benzalkonium chloride-based hand sanitizer products. This request, which was denied by FDA, suggested, but failed to demonstrate, that BAC-based products were “ineffective and potentially dangerous.”

1. Even if BAC is a common active ingredient in cleaning formulas used for hot tubs and swimming pools, this writer does not recommend continuously swimming in high concentrations of benzalkonium chloride. Certain studies have found that while BAC is one of the safest organic compounds, excessive inhalation can have a negative effective on those suffering from asthma. Merely proving the common wisdom that too much of anything is not good. Including tap water.

2. While BAC has been the active ingredient in contact lens solutions, enough studies have found that excessive application within eye drops can have negative effects on the cornea. This writer wears eye glasses, and wouldn’t think of applying a hand sanitizer product to the eyes, and most responsible manufacturers of BAC-based hand sanitizer products caution against product coming into contact with eyes. If inadvertently applied to the eyes, manufacturers’ labels recommend washing the eyes with water. One need not be a trained health care professional to opine on the impact of applying an alcohol gel to the eyes.

3. Select independent lab studies have found that certain pathogens develop a resistance to benzalkonium chloride when applied in high doses and with excessive frequency. Again, and however much those studies might be taken out of context when factoring in the concentration levels used in those studies, it merely confirms that “too much of anything is no good”. For any nurse that has an extended history of applying alcohol gel or rub to their hands, take a look at your hands while you’re reading this article.

4. Product executives at Johnson and Johnson Inc., undeniably a prominent and highly-respected health care product company, and the marketing licensee for the Purell brand, continue to affirm the position taken by its licensor GOJO Industries with regard to their opinion i.e. purported “dangers” of benzalkonium chloride-based sanitizers. Yet, when J&J executives overseeing the Purell brand were recently reminded that a separate division of J&J markets “BandAid” brand Foaming Antiseptic, a foam-formatted product that not only uses .13 concentration of benzalkonium chloride as its active ingredient, but is otherwise identical in composition to many alcohol-free hand sanitizer products, the same executives indicated they “can’t speak for other divisions of the corporation or other products marketed under the corporate umbrella.”

In summary, this writer maintains the view that washing with soap and water remains the most effective hand hygiene protocol, yet when soap and water is not readily available, one need not be an epidemiologist to recognize that certain non-alcohol hand sanitizer formulas are more pragmatic than alcohol.

Saturday, February 6, 2010

Exploring Current CDC Recommendations: The Myth About Alcohol-Based Sanitizers

Below is perhaps one of the better-written reports that causes one to wonder what the CDC is really thinking..or who is "influencing" them.

But then again, if you're a company with a four-letter name that begins with "G" is followed by an "O", then a "J", and ending in "O", you should rejoice now that the Supreme Court has lifted the ceiling on the amount of money that you can spend to improperly influence politicians and hence, regulators into drinking your potion!

For everyone else, the following is actually a good read, prepared by a distributor of alcohol-free hand sanitizer products. We won't mention their name, as we've found that by mentioning the names of other distributors and respective manufacturers of non-alcohol sanitizers, they've found themselves on the receiving end of court orders and persecutions by government regulators--all, we suspect, after the company noted above, exerted its influence.. (a corporate strategy that company is notorious for..)

Sanitizing hands and eliminating the transfer of bacteria and germs, in a medical
or dental setting, are of the utmost importance in the prevention of infection in a
hygienic environment. In order to better understand how bacteria quickly multiply,
a review of the rapid nature of bacterial contamination is necessary by
understanding important facts given by the Department of Health (MN):
• Viruses can be transferred from dry smooth surfaces up to 20 minutes after
being contaminated.
• E. coli, salmonella, and other bacteria can live up to two hours on surfaces
like doorknobs, keyboards, and tables.
• Bacteria double every 20 minutes. Five bacteria in a sandwich at noon will
total over 10 million by 7p.m. After three days, with no bacteria dying, there
would be enough to cover the earth.
A Basic Understanding of the CDC's recommendations:
In 2002, the Centers for Disease Control advised the use of alcohol-based hand
rubs as necessary in a non-surgical medical environment. The CDC made this
recommendation based on eliminating infections in a medical environment.
Medical professionals were encouraged to use such antibacterial alcohol-based
agents, on unsoiled hands, as a replacement for washing hands with soap and
water. Unsoiled hands are considered those that are not visibly soiled or have not
come into contact with bodily fluids, which could cause the subsequent spread of
infection. The following suggestion was given about the appropriate use of alcohol-
based hand sanitizers outside of medical facilities, in the general public, and inside
a medical facility:
• Sanitization appropriate outside of a medical facility: The use of soap
and water, when lathered for up to 15 seconds, scrubs bacteria spores and
literally washes them down the drain.
• Sanitization appropriate inside a medical facility: The use of a "mild
detergent containing antiseptic" (CDC), or the use of alcohol based hand
sanitizers containing 60 % – 95 % ethanol or isopropanol when hands are
not visibly soiled.

The Spread of Infection in Medical Environments:
The majority of medical facilities today, have rigid government and private
standards. These standards make the containment of both bacteria and infection
the utmost priority. However, even with the most stringent efforts, medical settings
cannot control every negative outcome when working with illness and infection.
The following are a few examples (via private research), in which bacteria and
illness is spread in a medical setting:
• Invasive surgical treatment which exposes the body to other outside
• Medical professionals constantly work in and around biohazards which
spread bacteria in the air, causing more infections
• The patients seeking treatment in medical facilities have an already
weakened immunity and can contract infection more easily
• The possibility of transmitting disease from one contagious patient to
• Time constraints placed on medical professionals in a small, sometimes
confined setting
The Purpose of Alcohol-Based Hand Sanitizers:
In an effort to eliminate such occurrences in medical settings from occurring, hand
washing over the last 100 years has become standard protocol in the elimination
of bacteria and subsequent infection. Alcohol is the standard sanitizing agent used
by the majority of hospitals to prevent infection from occurring in a hospital setting.
Alcohol is cheap and widespread in its uses, especially in medical facilities. The
CDC made recommendations in 2002, citing the use of alcohol-based hand rubs
as effective in fighting bacteria and infection.
Thus, the CDC defined hand sanitation that included the use of alcohol-based rubs
to replace the traditional method of soap and water. The objective of moving
forward with the use of alcohol-based rubs had several objectives. Primarily, the
use of alcohol-based sanitizers was an effort to decrease time constraints placed
on a system that is already lacking enough medical staff to care for patients. The
CDC estimated that this practice alone (alcohol sanitizer use) saved staff over an
hour a day.

The CDC also made such recommendations in an attempt to decrease the
percentage of non-compliance by medical professionals. The purpose was to
eliminate the spread of bacteria with alcohol-based hand sanitizers in a timely
and effective manner. Bacteria eliminated by the use of alcohol-based sanitizing
agents include, but are not limited too: streptococcus, salmonella,
staphylococcus, E. coli, and shigella.
Alcohol-Based Hand Sanitizers Ineffectiveness:
In order to be most effective, alcohol-based hand sanitizers must completely
cover the surface of the hand and dry completely. When considering the limited
time of health care professionals, rarely is it possible to move from one patient to
the next and allow complete coverage of the given product. In addition, many
professionals do not give an ample amount of time for disinfection to take place
(>10 seconds). However, it is more likely that portions of the skin have not been
touched by the sanitizing solutions, leaving areas on hands prone to existing

The result, with certain types of alcohol-based sanitizers, is their tendency to
crumble off after repeated use. This, caused by build-up after multiple and
consistent use. In a busy area of the hospital (e.g., Emergency Care), one may not
have the time to cleanse hands to eliminate such debris. According to the 2nd
edition of Hospital Epidemiology and Infection Control, "[...such buildup from
alcohol based sanitizers, in gel form, leave hands soiled and with possible viruses,
bacteria, fungi, and parasites]".

Reviewing the CDC's Recommendation 6 Years Later:
According to the Healthcare Infection Control Practices Advisory Committee, the
broader context of hand sanitization is educating the medical community on
adhering to hand sanitizing in an effort to prevent higher rates of infection. More
specifically, the committee believes inclusive factors are those which educate the
medical community on "knowledge concerning the appropriateness, efficacy, and
understanding of the use of hand hygiene and skin care protection agents"
(Healthcare Infection Control Practices Advisory Committee).
The recommendation made by the CDC has only been replaced one time in the
last 13 years. The last recommendation, made prior to 2002, was in 1985. While
advances, in the medical world continue to progress at lightening speed, this
advice can be considered somewhat archaic. A culture that looks for newer and
better procedures and treatments necessitates looking for better alternatives, to
the use of alcohol based sanitizers, in overcoming a lack of education about the
necessity of better alternatives.

Benzalkonium Chloride as an Alternative to Alcohol-Based Hand Sanitizers:
Benzalkonium chloride has a long history in the medical and pharmaceutical
community. It is known as extremely effective in the long term elimination of
bacteria without evaporation. The compound is extremely effective against "gram-
positive bacteria in concentrations as low as 0.00050/0 and against gram negative
bacteria as low as 0.0330/0. Its specific uses are as antibacterial hand
rubs and moist towel lets, as well as preoperative preparation of skin, surgeons
skin and arm soak, treatment of wounds, preservation of contact lens solution, and
irrigations of the eye, body cavities, bladder, and urethra." (
Benzalkonium chloride has been used in the medical field for decades and was
originally used prior to surgery. It is under the umbrella of quaternary ammonium
compounds (a.k.a., "Quats") and is excellent in the fight against bacteria
specifically inhibiting the growth of bacteria and it's multiplying affect. The
sanitizing agent has parallel uses to alcohol, without its drying affects, and lacks the evaporative nature of alcohol, staying on hands approximately 30 -90 minutes longer ( Current estimates report even a greater bacteria kill time,
upwards of 3-4 hours after application.

As common bacteria and infections, in parts of the world, become increasingly
difficult to identify the necessity of an antibacterial agent with staying power is an absolute necessity. This becomes a dangerous situation when considering that
"unidentified infectious agents" can cause incurable diseases, such as HIV and
hepatitis C. This information coupled with the CDC's efforts to lower infections
from bacterial exposure is a powder keg waiting to explode. Research indicates
that changing bacteria are from a variety of sources, which include, but are not
limited to the following:
• Rapid population growth, combined with increased poverty
• Expansion of the population into 'remote areas'
• Environmental degradation
• Improved transportation, leading to easier spread of disease
• Inadequate or deteriorating public health infrastructure
• Widespread, and often inappropriate, availability and use of antibiotics
• Poor disease control and disease prevention

Switching from Alcohol-Based Hand Sanitizers to Benzalkonium Chloride-Based

Benzalkonium chloride based sanitizers have quickly become a popular alternative
in K-12 schools as a replacement to traditional alcohol-based
sanitizers because of its ability to kill staph. Infections like staph are
commonplace in locations like school gyms and locker rooms where multiple
users have exposure to the same equipment. In addition to eliminating multiple
strains of staph (including MRSA), the sanitizing agent is effective in the
elimination of Hepatitis A and Hepatitis B, HIV, herpes, salmonella, E. coli, as well as many other infectious agents.

Containing the spread of bacteria with this product (benzalkonium chloride) will
increase the likelihood that attempts to prevent infection will be successful in
medical, school, and social facilities.

Furthermore, the rates of staph infection are higher in patients with differing
ailments. Dry and cracked hands, which can be caused by alcohol-based
sanitizers, have higher rates of staph infection. Diabetics and individuals receiving dialysis for kidney failure also "are likely to have areas of intact skin colonized with S. aureus," according to the CDC.

Looking more closely at benzalkonium chloride as an antibacterial agent, this
quaternary ammonium compound can be viewed as a successor/replacement
standard alcohol-based sanitizers. In fact, The American College of Toxicology
describes it as "safely used as an antimicrobial at concentrations of up to 0.10/0".

Ending the CDC's "Alcohol Recommendation":

Again, the most recent (2002) recommendation by the CDC for hand hygiene does
not take into account the advances in the arena of hand hygiene. Nor does it
adequately evaluate the efficacy of other hand sanitizing agents, like
benzalkonium chloride. The fact remains -alcohol-based sanitizers are cheap to
produce and manufacture despite their many short comings.
Additionally, only twice in the last 13 years has the CDC made recommendations
for alcohol-based sanitizers. However, since these recommendations, hundreds of
Westerners continue to deal with the discomfort, dangers, and potential lethality of alcohol sanitizers. Furthermore, current studies find that alcohol sanitizers are now providing a false sense of protection, as most adults and health care professionals fail to sanitize their hands correctly (below).

The above cited report supports the long held belief that many health care
professionals perceive a persistent effect with alcohol-based hand sanitizers.
Statistics back these recent findings, as well. However, this is not the case.
Alcohol sanitizers evaporate quickly and do not protect for significant durations of time.

To compound the issue, a notable study in 2000 reported that less than half
(48%) of health care workers in hospitals adhered to the CDC's recommended
hand hygiene regimen (Pittet D, Lancet 2000:356;1307-1312.). This includes
inadequate hand washing times, or the lack thereof.

Moreover, a study conducted in 1997 showed that the median wash time for health
professionals in a clinical setting was 4.7 -5.3 seconds (J Clin Nursing 1997;6:55-
67). There is little evidence to show an improvement in these times today.
According to the CDC, times under 15 -20 seconds are ineffective at reducing the
risk and spread of bacterial and viral infection(s).

As opposed to alcohol-based sanitizers, benzalkonium chloride lotions last for
hours and possess persistent and potent germicida1 activity. They have been
shown to be 99.99% effective against a broad spectrum of harmful bacteria in
clinical studies.

Finally, a report issued June 8th, 2008, again, contradicts CDC recommendations.
This time, regarding antimicrobial-impregnated wipes (Le., towelettes). In 2004,
the CDC stated that such wipes "may be considered as an alternative to washing
hands." The following article shows that not only are towelettes/wipes not effective at cleansing hands, they may also be spreading harmful and potentially life-threatening bacteria (below).

(Associated Press)
Published: Wednesday, Jan. 30,2008
OMAHA, Neb. -Doctors and nurses on the go often skip soap and water in favor of an
alcohol-based hand gel, thinking the quick-acting goo will kill bacteria on their hands and curb the spread of infection.
It turns out that's not enough. In a Nebraska hospital, medical workers nearly doubled their use of the alcohol-based gel, but their generally cleaner hands had no bearing on the rate of infections among patients.
The doctor who studied the problem pointed to many villains: Rings and fingernails that are too long and hard to clean, poor handling of catheters and treatment areas that aren't sanitized.

"Hand hygiene is still important, but it's not a panacea," said Dr. Mark Rupp, an
infectious disease specialist at the University of Nebraska Medical Center. He led the study at the adjoining Nebraska Medical Center.

The results of his study appear to contradict hospital guidelines from the Centers
for Disease Control and Prevention that say better hand hygiene -through frequent washing or use of [alcohol-based] hand gels -has been shown to cut the
spread of hospital infections.

The spread of infection-causing germs in U.S. hospitals is a huge health problem,
accounting for an estimated 1.7 million infections and 99,000 deaths each year, according to the CDC. These include drug-resistant staph, urinary tract infections and ventilator-associated pneumonia, among others.
He suggested hand gels be combined with other measures, such as better cleaning of
hospital units, proper insertion and maintenance of catheters, and doctors prescribing antibiotics only when necessary so more drug-resistant bacteria don't pop up. He also said hospital workers shouldn't wear rings and should trim their fingernails even more than the CDC, recommendation of no longer than a quarter of an inch. Rupp said bacteria showed up when nails extended just beyond the fingertip [...]

Published: Tuesday, June 3, 2008
Antibacterial wipes can spread superbugs: study
LONDON (Reuters) -Disinfectant wipes routinely used in hospitals may actually spread drug-resistant bacteria rather than kill the dangerous infections, British researchers said on Tuesday.
While the wipes killed some bacteria, a study of two hospitals showed they did not get them all and could transfer the so-called superbugs to other surfaces, Gareth Williams, a microbiologist at Cardiff University, said.
The findings presented at the American Society of Microbiology's General Meeting in
Boston focused on bacteria that included methicillin-resistant Staphylococcus aureus, or MRSA.

"What we have found is there is a high risk," Williams, who led the study, said by
telephone. "We need to give guidance to the staff on how to use the wipes because we found there is a possibility of cross transfer."

MRSA infections can range from boils to more severe infections of the bloodstream,
lungs and surgical Most cases are associated with hospitals, nursing homes or other
health care facilities. The superbug can cause life-threatening and disfiguring infections and can often only be treated with expensive, intravenous antibiotics.
Experts have been saying for years that poor hospital practices spread dangerous bacteria, and yet many studies have shown that health care workers, including doctors and nurses, often fail to even wash their hands as directed.

The findings from a study of intensive care units at two Welsh hospitals suggest that even cleaning with antin1icrobial wipes n1ay not be enough depending on how staff use them. The researchers found that many health care workers cleaned multiple surfaces near patients, such as bed rails, monitors and tables with a single wipe and risked sweeping the infections around rather than cleaning them up.
"We found that the most effective way to prevent the risk of MRSA spread in hospital wards is to ensure the wipe is used only once on one surface," Williams said.

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