Com­ing Clean

The dirt on hand san­i­tiz­ers and an­tibac­te­rial soaps.

Health & Nutrition - - CONTENTS -

Know the ef­fec­tive­ness of hand san­i­tiz­ers and an­tibac­te­rial soaps

Hand san­i­tiz­ers (not to be con­fused with an­tibac­te­rial soaps) are ubiq­ui­tous. Per­haps you carry a small bot­tle with you when you’re on the go. Avail­able in gels, foams, sprays, and wipes th­ese prod­ucts, which are typ­i­cally al­co­hol­based, are con­ve­nient since they don’t re­quire wa­ter. But how ef­fec­tive are they in pre­vent­ing colds, food­borne ill­ness, and other in­fec­tions? Are they harm­ful in any way? Here are an­swers to some ques­tions.

Is us­ing a hand san­i­tizer a good sub­sti­tute for soap and wa­ter?

It can be – depend­ing on the par­tic­u­lar prod­uct and sit­u­a­tion. The best way to clean your hands is to wash them with plain soap and run­ning wa­ter for at least 20 sec­onds, es­pe­cially if they are vis­i­bly dirty. This cre­ates me­chan­i­cal fric­tion to loosen and rinse away mi­crobes. If you don’t have ac­cess to soap and wa­ter, the next best thing is an al­co­hol-based hand san­i­tizer that con­tains a min­i­mum of 60 per cent al­co­hol (typ­i­cally listed as ethyl al­co­hol). Th­ese prod­ucts kill most (but not all) bac­te­ria and viruses on con­tact. They also work well against fungi but not against bac­te­rial spores (such as those cre­ated by C. dif­fi­cile bac­te­ria). Hav­ing soiled or greasy hands, as from gar­den­ing or cooking, makes the prod­ucts less ef­fec­tive be­cause the grime cre­ates a bar­rier to them.

Is there ev­i­dence they ac­tu­ally pre­vent colds and other in­fec­tions?

Yes. For in­stance, in a study in BMC In­fec­tious Dis­eases in 2010, of­fice work­ers who were en­cour­aged to use an al­co­hol-based hand san­i­tizer at least five times each work­day were about two-thirds less likely to get sick than those who con­tin­ued to just wash their hands. An ear­lier study found that fam­i­lies given hand san­i­tiz­ers had about 60 per cent fewer gas­troin­testi­nal in­fec­tions over the next five months than fam­i­lies that did not re­ceive them. But the prod­ucts are not as ef­fec­tive against norovirus (the most com­mon cause of gas­troin­testi­nal ill­ness world­wide, no­tably on cruise ships). A 2011 study in the Amer­i­can Jour­nal of In­fec­tion Con­trol, for ex­am­ple, found that there were more norovirus out­breaks in long-term care fa­cil­i­ties that fa­vored al­co­hol hand san­i­tiz­ers over soap and wa­ter.

What’s bet­ter: a foam, gel, or hand wipe?

As long as the prod­uct con­tains at least 60 per cent al­co­hol and you use it cor­rectly, that shouldn’t mat­ter. A small study in the Amer­i­can Jour­nal of In­fec­tion Con­trol in 2012 found that th­ese three forms of an al­co­hol based san­i­tizer sig­nif­i­cantly re­duced H1N1 flu virus on hands. In ad­di­tion, the au­thors posit that wipes may have added benefits be­cause they phys­i­cally re­move micro­organ­isms that sur­vive the al­co­hol treat­ment.

What other in­gre­di­ents are in them?

They typ­i­cally have clar­i­fy­ing agents, thick­en­ing agents, fra­grances, dyes, preser­va­tives, and other “in­ac­tive” in­gre­di­ents. Some con­tain mois­tur­iz­ers (such as glyc­erin, vi­ta­min E, and aloe) to counter al­co­hol’s dry­ing ef­fects and sup­pos­edly “leave hands soft.” If you have an ad­verse re­ac­tion to a prod­uct, switch to an­other for­mula to see if that helps.

How do you use a hand san­i­tizer?

A com­mon mis­take is not us­ing enough. Ap­ply the prod­uct (at least a coin-size amount) to the palm of one hand and then rub your hands to­gether, cov­er­ing all sur­faces of both hands, in­clud­ing be­tween your fin­gers and up around your fin­ger­tips and nails. It should take about 30 sec­onds of rub­bing your hands to­gether for the prod­uct to com­pletely dry. Do not touch food or any­thing else un­til your hands are dry.

What about al­co­hol-free san­i­tiz­ers?

In­stead of al­co­hol, some hand san­i­tiz­ers con­tain qu­a­ter­nary am­mo­nium com­pounds (no­tably ben­za­lko­nium chlo­ride or ben­zetho­nium chlo­ride) to re­duce mi­crobes. Th­ese agents are less ef­fec­tive than al­co­hol, plus they lack ev­i­dence of real-life benefits. More­over, they may be con­tribut­ing to bac­te­rial re­sis­tance ( see box). Other al­co­hol-free hand san­i­tiz­ers con­tain “nat­u­ral” in­gre­di­ents like tea tree oil and thyme, which may kill some germs but not enough for them to be good al­ter­na­tives to an al­co­hol-based hand san­i­tizer.

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