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Posts Tagged ‘hand sanitizer’

 

Lather, Rinse, and Repeat

Tuesday, December 2nd, 2014

By Logan Conkey, PharmD Student

Students are in the swing of things now that fall has begun. Students are at a higher risk of spreading sickness to others because of the environment they are in.  October is here and this month initiates flu season as well as a time where more illness is being shared.1 To prevent the spread of illness, the CDC recommends cleaning hands frequently, including after using the restroom.2 Many people do not like to wash their hands and a survey reported by the American Society for Microbiology reported 1 in 5 teenagers and adults claimed they do not wash their hands after they use the restroom.3 With so many germs being passed around, students often become sick and have to miss school. Recently, a group of researchers in New Zealand wanted to see if there was a relationship between the amount of school days missed due to illness and hand hygiene that included hand sanitizer combined with normal and frequent hand washing.

CNN Health published the article; Hand sanitizer doesn’t help in schools in August this year.4 The article was based on a study that took place in elementary classrooms in New Zealand and compared students who hand washed only and students using alcohol based hand sanitizer along with normal hand washing. All classrooms were taught proper washing techniques to ensure a standard practice and the alcohol sanitizer was provided to make certain it was the same strength throughout. The trial was conducted in 68 elementary schools, during the winter term, with children ages 5-11 The control group was instructed only to use regular hand washing with soap and water when cleaning their hands. The intervention group was instructed to wash their hands with soap and water and include the use of an alcohol-based sanitizer after they coughed, sneezed, and before meals. The outcome was to be determined by comparing the amount of total days students missed due to illness only. The results suggested there was not a significant difference between the groups regarding total days missed. The study did not look at specific illnesses such as flu when collecting data and the study may have been limited because there was a flu epidemic during this season. Another limitation included parental direction and whether the parents were instructing students to differ from the provided procedure. Some students also complained about the taste of the sanitizer on their hands when eating and this believed to have made the children less compliant when using it. The complaints came from a handful of schools and the sanitizer was replaced with an equivalent.5

The CDC says hand washing with soap should be the first option and hand sanitizer should be used if soap and water are not available. Alcohol-based sanitizers do not eliminate all forms of germs.6 It is confirmed that proper hand washing and/or the use of alcohol-based hand sanitizers has shown to reduce the risk of infection from certain viruses.7 Alcohol based sanitizers must be strong enough to be effective. Not all sanitizers are created the same and the recommended strength should be at least 60%.8 Other studies performed in the classroom regarding the used of alcohol based hand sanitizers has not persuaded researchers to consider them beneficial enough to place high priority on them and that hand hygiene education is the largest benefactor.9

The study performed in New Zealand provides proof we should not be putting a high priority on placing alcohol-based hand sanitizer in classrooms. Parents should encourage proper hand hygiene and instruct children when the most important times are to wash hands. If hand washing is not an option then hand sanitizer is a good second choice. While there does not seem to be a great benefit to sanitizer in the classroom, there have been no reported risks or problems with using it. The parent or teacher must decide if they want to incorporate sanitizer. There is no way of eliminating illness in children but parents and teachers can work together to improve the health of the classroom.

Are you and your students taking the proper precautions to prevent sickness?

 

References

  1. The Flu Season. CDC Website. Available at: http://www.cdc.gov/handwashing/when-how-handwashing.html. Accessed October 3, 2014.
  2. Preventing Seasonal Flu Illness. CDC Website. Available at: http://www.cdc.gov/flu/about/qa/preventing.htm. Accessed October 3, 2014.
  3. Hand Sanitizer doesn’t help in schools. CNN Health Website. Available at: http://thechart.blogs.cnn.com/2014/08/12/hand-sanitizer-doesnt-help-in-schools/?iref=allsearch. Accessed October 3, 2014.
  4. Bratsis M. Flu Season: The Best Defense. Science Teacher [serial online]. October 2012;79(7):68. Available from: Education Research Complete, Ipswich, MA. Accessed October 3, 2014.
  5. Priest P, McKenzie J, Audas R, Poore M, Brunton C, Reeves L. Hand Sanitiser Provision for Reducing Illness Absences in Primary School Children: A Cluster Randomised Trial. Plos Medicine [serial online]. August 2014;11(8):1-14. Available from: Academic Search Complete, Ipswich, MA. Accessed October 3, 2014.
  6. When & How to Wash Your Hands. CDC Website. Available at: http://www.cdc.gov/handwashing/when-how-handwashing.html. Accessed October 3, 2014.
  7. Prazuck T, Compte-nguyen G, Pelat C, Sunder S, Blanchon T. Reducing gastroenteritis occurrences and their consequences in elementary schools with alcohol-based hand sanitizers. Pediatr Infect Dis J. 2010;29(11):994-8.
  8. Roy K. Rethinking the use of hand sanitizers. Science Scope [serial online]. September 2009;33(1):74-76. Available from: Education Research Complete, Ipswich, MA. Accessed October 3, 2014.
  9. Meadows E, Le Saux N. A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children. BMC Public Health [serial online]. January 2004;4:50-11. Available from: Academic Search Complete, Ipswich, MA. Accessed October 3, 2014.

Hand Sanitizer: Effective or Toxic?

Saturday, November 23rd, 2013

by Joseph Newman, PharmD student

Hand sanitizer is often used as a quick and convenient alternative to washing your hands. Whether it is a quick squirt after leaving the gym or the super market, or pulling it out after shaking lots of hands or coughing, it has become one of the most common ways to clean hands and get rid of germs. But is using all of this hand sanitizer actually preventing you from getting the flu or a cold? Is it any more or less effective when compared to washing with soap and water?

In his recent article1 on CNN, Bob Barnett evaluates the use of hand sanitizer and suggests that there are safety and efficacy concerns for hand sanitizers containing triclosan. Barnett states that according to Allison Aiello, an associate professor of epidemiology at the University of Michigan, there is no evidence that products containing triclosan have any benefit and that hospitals won’t use them. He goes on to cite other sources saying that there is little benefit of triclosan-containing products over washing with soap and water. Barnett claims that triclosan can disrupt the endocrine system and reduce muscle strength, as shown in animal studies. He also claims that triclosan does not protect against viruses and fungi. Barnett makes the distinction that alcohol-based hand sanitizers are good at killing bacteria and some viruses and can be used as an alternative to hand washing, but concludes by emphasizes the fact that washing with soap and water is the most effective way to eliminate germs.

I agree with most of this article. According to the World Health Organization, hand washing is “the most important hygiene measure in preventing the spread of infection.”2 I also agree that alcohol-based hand sanitizer is a good idea if you can’t wash your hands. Barnett’s recommendation for hand washing and alcohol-based hand sanitizer is one that is consistent with the standard for self-care in regards to hand hygiene. However, there are some limitations to his article, especially in his evaluation of triclosan-containing products. For one, he only cites a couple different sources. His claims of potentially harmful effects of triclosan and its limited effectiveness cannot be backed up without further research. Furthermore, Barnett says that studies support his claims, but then fails to provide information about or references to those studies.

Upon further research, I found that alcohol-based hand sanitizers are an “appropriate alternative to hand washing for hand cleansing”3 and that they improve hand hygiene practices within the home setting.4 Another study showed that alcohol-based hand sanitizers are safe. In this study, volunteers applied hand-rubs with varying amounts of ethanol onto their hands before being tested for blood concentrations of ethanol and acetaldehyde. According to the study, any alcohol absorbed through the skin was below toxic levels in humans.5 This supports Barnett’s claim that alcohol-based hand sanitizers can be safe and effective. As far as triclosan containing hand sanitizers, the FDA states that triclosan is not known to be hazardous to humans6 and according to one study, is “well tolerated by a variety of species, including human beings.”7 According to this research, it appears as though triclosan is not toxic, contrary to the research that Barnett refers to in his article.

Hand sanitizers that are alcohol-based appear to be safe to use as well as effective at promoting hand hygiene and preventing some illnesses, and while triclosan appears to be non-toxic, there was not very much research available on the effectiveness of hand sanitizers containing that ingredient. So what does this mean for me and you in terms of using these products to prevent colds, the flu and other common diseases? As a pharmacist, these types of questions come up often when discussing over-the-counter treatment of colds. Alcohol-based hand sanitizer can be a very useful tool in self-care of colds to prevent the transmission of germs while on-the-go. However, washing your hands is still the most important measure in preventing the spread of infection.2

So what do you think? Should we continue to use hand sanitizer? Should we switch to only soap and water? Or do you think there should be more research done on this issue?

 

References:

  1. Barnett, B. Is hand sanitizer toxic? CNN. October 16, 2013. Available at http://www.cnn.com/2013/10/16/health/hand-sanitizer-toxic-upwave/index.html?hpt=he_bn3. Accessed November 13, 2013
  2. Hospital Infection Control Guidance. World Health Organization Web site. 2003 Available at: http://www.who.int/csr/surveillance/infectioncontrol/en/print.html. Accessed November 13, 2013
  3. Vessey J, Sherwod J, Warner D, Clark D. Comparing Hand Washing to Hand Sanitizers in Reducing Elementary School Student’s Absenteeism. Pediatric Nursing [serial online]. July 2007;33(4):368-372. Available from: Consumer Health Complete – EBSCOhost, Ipswich, MA. Accessed November 14, 2013
  4. Sandora TJ, Taveras EM, Shih MC, et al. A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home. Pediatrics. 2005;116(3):587-94. Available at http://pediatrics.aappublications.org/content/116/3/587.long. Accessed November 14, 2013
  5. Kramer A, Below H, Bieber N, et al. Quantity of ethanol absorption after excessive hand disinfection using three commercially available hand rubs is minimal and below toxic levels for humans. BMC Infect Dis. 2007;7(1):117. Available at http://www.biomedcentral.com/1471-2334/7/117/. Accessed November 14, 2013
  6. Consumer Updates > Triclosan: What Consumers Should Know. Federal Drug Administration Website. August 29, 2012. Available at http://www.fda.gov/forconsumers/consumerupdates/ucm205999.htm. Accessed November 14, 2013
  7. Bhargava H, Leonard P. Triclosan: Applications and safety, American Journal of Infection Control, Volume 24, Issue 3, June 1996, Pages 209-218, ISSN 0196-6553, Available at http://www.sciencedirect.com/science/article/pii/S0196655396900176. Accessed November 14, 2013