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What is the role of hand sanitizers or alcohol rubs and can they be used instead of hand washing?

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This question was submitted by a general dentist: What is the role of hand sanitizers or alcohol rubs and can they be used instead of hand washing?

Dr. Nita Mazurat, representing the Organization for Safety, Asepsis, and Prevention (OSAP) has provided this quick initial response

Hands with sanitizer gelHand hygiene practice is only efficacious when there is compliance. The simple message is “practice good hand hygiene for every patient, every time!”

As long as hands are not soiled, alcohol-based hand-rubs may be utilized for hand hygiene and can be used as an adjunct or an alternative to washing with soap and water. The key word is “soiled” which includes any organic or inorganic debris, including blood, saliva, powder, or soil. A systematic review of publications between 1992 and 2002 on the effectiveness of alcohol-based solutions for hand hygiene showed that alcohol-based hand-rubs remove organisms more effectively, require less time, and irritate skin less often than hand-washing with soap or other antiseptic agents and water. (Picheansathian, 2004)

The efficacy of alcohol-based hand-hygiene products is affected by a number of factors, including the type of alcohol used, concentration of alcohol, contact time, volume of alcohol used, and whether the hands are wet when the alcohol is applied. The ideal volume is unknown due to these variables. However, it is important that sufficient volume is used so that the hands remain wet for 30 seconds. (WHO Guidelines on Hand Hygiene in Healthcare). Consumers should be thoroughly familiar with the product they are using, including any testing that has been performed utilizing that product.

Further resources are available on the OSAP website, key-word search “hand hygiene”

References

Picheansathian W. A systematic review on the effectiveness of alcohol-based solutions for hand hygiene. Int J Nurs Pract. 2004;10(1):3-9.

World Health Organization. WHO guidelines on hand hygiene in health care; 2009. [Accessed 2013 Jun 5]. Available: http://www.who.int/gpsc/5may/tools/9789241597906/en/

 

Do you need further information on this topic? Do you have any comments or suggestions? Email us at oasisdiscussions@cda-adc.ca

Your are invited to comment on this post and provide further insights by posting in the comment box which you will find by clicking on “Leave a reply“ below. You are welcome to remain anonymous and your email address will not be posted.

3 Comments

  1. Robert Piedalue June 13, 2013

    As noted in the article the efficacy is highly variable by so many factors, (some as of yet unknown) that it really should be questioned as an acceptable means of disinfecting skin. Many different results have been obtained by the studies over the years. So too we should question the safety of the products. I can taste alcohol in my mouth for 30 minutes after using (on my hands only). That can’t be good!

    Reply
    1. Elaine June 17, 2013

      I believe that you must be sensing the odour of alcohol (because of its volatility) as taste (the sensation of taste relies heavily on odour). The alcohol in the hand sanitizers is not absorbed transdermally.

  2. Gloria Samuel September 5, 2019

    Thanks for the article. Very useful one

    Reply

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