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- PubMed: Microbiology: Adapted tolerance to benzalkonium chloride in Escherichia coli K-12 studied by transcriptome and proteome analyses
- PubMed: Microbiology: Adapted tolerance to benzalkonium chloride in Escherichia coli K-12 studied by transcriptome and proteome analyses
- PubMed: Family Medicine: Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism
- PubMed: Family Medicine: Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism
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Hand Sanitizer & Its Chemical Properties
The popularity of hand sanitizer has increased in recent years as a result of virus outbreaks such as H1N1 flu. Formerly, hand sanitizer was used mostly in clinical and food service settings, as an adjunct to soap and water. Pandemic information commercials and infection control policies for public buildings and workplaces have ensured that you probably have hand sanitizer somewhere in your home or purse.
History
Historically, erasing bacteria completely from most environments has been thought unnecessary. According to Amy Simonne of the University of Florida, doing so can be harmful. You need some bacteria to digest food and ward off illness. The most important use of hand sanitizer has traditionally been to prevent fecal matter and food-borne bacteria from spreading. Prior to the last decade, its use was restricted to hospitals and restaurants.
- Historically, erasing bacteria completely from most environments has been thought unnecessary.
- According to Amy Simonne of the University of Florida, doing so can be harmful.
Cross-Infection
The Disadvantages of Hand Sanitizers
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Since the recent, repeated outbreaks of aggressive viruses and public concern regarding pandemics, more attention has been paid to the contribution everyone can make to the prevention of cross-infection. Public places, shops and work environments all contain sites, such as door handles and elevator buttons, that many people touch in the course of a day. Hand sanitizer has become a replacement for hand-washing when soap and water are not available.
Alcohol-Based Sanitizer
The most common sanitizer brands have alcohol as their active ingredient. The alcohol may be ethanol, isopropanol or a mix of the two compounds. Alcohol works by removing the surface oil from the skin of your hands, which contains bacteria and viruses. It also kills most of these microorganisms by denaturing the proteins they contain. The product also contains a moisturizer to prevent the alcohol from drying your skin.
- The most common sanitizer brands have alcohol as their active ingredient.
- The product also contains a moisturizer to prevent the alcohol from drying your skin.
Alcohol-Free Sanitizer
Ingredients in Hand Sanitizer
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Some organizations, such as schools, have concerns with supplying alcohol-based products. Sanitizers without alcohol are now available. The active ingredient in these is benzalkonium chloride, which traditionally was used as a topical wound antiseptic. Researchers in California have tested the effectiveness of alcohol-free sanitizer compared to hand-washing in an elementary school, and have found a considerable reduction in illness among children 2.
- Some organizations, such as schools, have concerns with supplying alcohol-based products.
- Researchers in California have tested the effectiveness of alcohol-free sanitizer compared to hand-washing in an elementary school, and have found a considerable reduction in illness among children 2.
Overuse
Hand sanitizer should not replace normal hand washing. Simonne stresses that soap and water, where practical, are still sufficient and best. She adds that an additional application of sanitizer is advisable when working with people whose immunity may be compromised or who may be ill with an infection. Overuse of sanitizers may be contributing to resistant organisms. A study in Norway shows an increased tolerance to benzalkonium chloride in some E. coli bacteria 1.
- Hand sanitizer should not replace normal hand washing.
- She adds that an additional application of sanitizer is advisable when working with people whose immunity may be compromised or who may be ill with an infection.
Related Articles
References
- PubMed: Microbiology: Adapted tolerance to benzalkonium chloride in Escherichia coli K-12 studied by transcriptome and proteome analyses
- PubMed: Family Medicine: Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism
- Centers for Disease Control and Prevention. CDC Statement for Healthcare Personnel on Hand Hygiene during the Response to the International Emergence of COVID-19. Updated March 14, 2020.
- Centers for Disease Control and Prevention. Chemical disinfectants. Updated September 18, 2016.
- Centers for Disease Control and Prevention. When and How to Wash Your Hands. Updated October 3, 2019.
- Vermeil T, Peters A, Kilpatrick C, Pires D, Allegranzi B, Pittet D. Hand hygiene in hospitals: anatomy of a revolution. J Hosp Infect. 2019;101(4):383-392. doi:10.1016/j.jhin.2018.09.003
- McEgan R, Danyluk MD. Evaluation of aqueous and alcohol-based quaternary ammonium sanitizers for inactivating Salmonella spp., Escherichia coli O157:H7, and Listeria monocytogenes on peanut and pistachio shells. Food Microbiol. 2015;47:93-98. doi:10.1016/j.fm.2014.11.010
- Inaida S, Shobugawa Y, Matsuno S, Saito R, Suzuki H. Delayed norovirus epidemic in the 2009-2010 season in Japan: potential relationship with intensive hand sanitizer use for pandemic influenza. Epidemiol Infect. 2016;144(12):2561-2567. doi:10.1017/S0950268816000984
- Stebbins S, Cummings DA, Stark JH, et al. Reduction in the incidence of influenza A but not influenza B associated with use of hand sanitizer and cough hygiene in schools: a randomized controlled trial. Pediatr Infect Dis J. 2011;30(11):921-926. doi:10.1097/INF.0b013e3182218656
- Azor-Martinez E, Yui-Hifume R, Muñoz-Vico FJ, et al. Effectiveness of a hand hygiene program at child care centers: A cluster randomized trial. Pediatrics. 2018;142(5):e20181245. doi:10.1542/peds.2018-1245
- Blaney DD, Daly ER, Kirkland KB, Tongren JE, Kelso PT, Talbot EA. Use of alcohol-based hand sanitizers as a risk factor for norovirus outbreaks in long-term care facilities in northern New England: December 2006 to March 2007. Am J Infect Control. 2011;39(4):296-301. doi:10.1016/j.ajic.2010.10.010
- Wilson AM, Reynolds KA, Jaykus LA, Escudero-Abarca B, Gerba CP. Comparison of estimated norovirus infection risk reductions for a single fomite contact scenario with residual and nonresidual hand sanitizers. Am J Infect Control. 2019;S0196-6553(19)30846-6. doi:10.1016/j.ajic.2019.09.010
- Centers for Disease Control and Prevention. Handwashing: Clean hands save lives. Updated January 14, 2020.
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Writer Bio
Carolyn Steele began writing about healthcare in 1995. She has designed training courses in first aid and emergency planning, and her work has appeared in various online publications. She later became a travel writer, and has been published by the Rough Guides, "Emigrate Magazine" and British and London Mensa magazines.