Hand sanitizer happy hour

By: February 4th, 2009 Email This Post Print This Post

Have you ever considered that the same stuff you are using to bump up your hand hygiene could lead to an intoxicated staff?

Don’t worry; you won’t have to start giving sobriety tests to your employees. A study published in the American Journal of Infection Control in 2006, found out for certain that alcohol-based hand sanitizers don’t have any effect on your blood-alcohol level.

The case report highlights a 38-year-old emergency physician who tested the tolerability of an alcohol-based hand sanitizer, containing 62% denatured alcohol typically found in most hand sanitizers. The doctor used it under extreme conditions, rubbing the gel on his hands and forearms 25 times over the course of 2 hours. After each application, a blood alcohol level was drawn, but results never approached the minimal detection level for the laboratory (5 mg/dL).

In short, you’d probably need to soak in an alcohol gel bath for a few hours before you even got a slight buzz. So don’t hesitate to lather on the gel to bolster your facilities infection control practices.

Also check out the Tools page for a free hand hygiene data collection worksheet.

Comments

No..Alcohol hand sanitizers will not lead to increased blood alcohol level. But the fact that you are promoting “lathering it on” is frightening. Its a documented fact that alcohol destroys protective skin cells, causes dry/irritated skin (in turn, leading to increased risk of infection), has no persistency, and ineffective on soiled/dirty hands.
Before suggesting that “CDC recommends…” Senior CDC Spokesperson Kathleen Stewart has repeatedly stated that CDC does NOT recommend anything other than washing with soap and water and that their ‘hand hygiene guide’ is completely outdated. Not to forget that these products introduce flash point risk and are toxic.

Exactly why many infection control experts are migrating to alcohol-free, rinse free alternatives; primarily those that incorporate benzalkonium chloride as the active ingredient.

We know this because our company has been contacted unsolicited by government agencies, extended health care facilities, and educational venues from across the US and Canada.
BAC-based products are documented to be equally, if not more effective i.e. broad spectrum of pathogens, and these products are non-irritating, non-toxic, hypoallergenic and antiseptic.
Yes..some studies have suggested that BAC-based products, in excess, might introduce resistency issues. Too much of anything is no good, but hand sanitizers aren’t in the same category as chemotherapy, and if having to choose between alcohol and BAC-based products, experts that have researched the topic in detail are voting hands down in favor of non-alcohol formulations.

We’d be happy to share the independent data and studies-and provide samples to those interested. Or simply go to http://www.handhygienefacts.blogspot.com

Jay Berkman
MGS Brands
http://www.SoapyUSA.com

What about psych patients who want to eat it???

By Darlene Ehley on February 4th, 2009 at 4:26 pm

I think everyone should read the Guideline for Hand Hygiene in Health Care Settings by the CDC. The only time alcohol based hand sanitizers are not recommended is for “visibly soiled hands” or if taking care of a patient with C-diff

my question does not pertain to your article, which I hope to share with our staff, so I appeal to your expertise as I have been unsuccessful finding a resource to answer: we have a MT in the lab that has proven every glove made by every manufacter causes her to break out in an allergic reaction, she applies the barrier cream and continues to work in the lab, are there any guidlines to address this?

thank you,
Doris

By David LaHoda on February 5th, 2009 at 1:03 am

Sounds like a difficult situation. Maybe you have tried this already, but both OSHA and the FDA mention cotton or nylon glove liners. The documents are: Potential for Sensitization and Possible Allergic Reaction To Natural Rubber Latex Gloves and other Natural Rubber Products and Medical Glove Powder Report. Perhaps some of our other blogger/readers have faced similar problems with co-workers who just can’t find a glove that works.

By Scott Wallask, HCPro on February 5th, 2009 at 1:38 pm

Regarding Jay’s comment, do you know where or in what publication the CDC’s Kathleen Stewart said to only use soap and water? If what she said is true, that is an about-face from the agency and a big, big story.

Scott-
Jay here…
I had 3 separate conference calls with Kathleen Stewart in Sep, Oct and Nov of 2007. I also told her in advance that I was recording the conversations so as to make sure that I didn’t misconstrue anything that she said. She amicably agreed to that.

Of course its astounding.
Here are some excerpts..

“…I get calls from people every day, and I keep telling them they are misinterpreting the document…there are several places where CDC cautions AGAINST using alcohol..”

“I wish “they” would take the document down from the website…but I have no control over that..”

“CDC does not research products, we advise people to do their own research..”

“Yes, we mention BAC based products in that document (originally prepared in 1996 and modified slightly in 2003), but that was before benzalkonium chloride started to emerge as an alternative, and there are so many different kinds, we don’t have the resources to make qualified comments..”

We’ve been pounding the table and shouting from the highest mountains about this, and a significant majority within the hospital industry have preferred to avoid “rocking the boat” or “changing the way things are done”

But others, including federal agencies, including the US Naval Dept of Surface Warfare have reached out to us unsolicited…They’ve done their own analysis and have drawn the conclusion that amongst other things, putting something into your hands that destroys industrial floor wax doesn’t make much sense.

You can contact me via info displayed at http://www.SoapyUSA.com

back to the mental health and drinking question. I realize there is a tendency to purge after drinking these products however I would also like more information on oral ingestion of alcohol based hand care products as my hospital clientelle are known for their tolerance and consumption of anything hinting at alcohol. We have chosen not to place this product in patient rooms because of it and I would appreciate any insights.

To Lynette-
Aside from the fact consuming an alcohol-sanitizer cocktail provides a 120 proof libation, it takes a reasonably significant ‘dosage’ to create a problem. 4 oz would be a tipping point for most adults. Pun intended.
Exactly why most extended care facilities that we’ve encountered have never installed alcohol-based hand sanitizer dispensers, and do not make these products accessible to patients.

Most hospitals simply don’t want to disregard established protocols, which is why they are not migrating to alcohol free alternatives.
The US Association of Poison Control Centers published a report in Jan 2007 that linked alcohol hand sanitizers to almost 12,000 cases alcohol poisoning in kids 6 and under. Granted, only a few hundred instances required emergency medical attention, but gee whiz..

By David LaHoda on February 24th, 2009 at 10:40 pm

Jay Berkman’s comment above attracted interest with my safety colleagues at HCPro, so we inquired with the CDC about his comment that “Senior CDC Spokesperson Kathleen Stewart has repeatedly stated that CDC does NOT recommend anything other than washing with soap and water and that their ‘hand hygiene guide’ is completely outdated”
Here is what Nicole Coffin, spokesperson for the CDC, said in a voicemail message in respone Jay Berkman’s comment above:

“The bottom line is that CDC’s guidelines have not changed. The ones that you see on the website, I think that were released in 2002, stand. The only thing I can think of that might relate is we’ve definitely published in MMWRs and other places—but I do think is also consistent with the guidelines—that if you are experiencing a C-difficile outbreak, that traditional soap and water is best to use because the alcohol rubs don’t kill spores. But again, that’s something that we’ve been saying for a really long time, so that shouldn’t be new news to your audience.

On that whole blogging front thing, I’m not quite sure what to say about that other than the person they’re speaking about is not a CDC employee. It’s actually a contractor who answers the public inquiry line. So the person’s definitely not a spokesperson for CDC, but does work here and help with public inquiries.”

David-
Jay here. Congrats for your success i.e. breaking through the communications obstacles at CDC. No easy task. We had sent 3 different correspondences with no reply, and ultimately lobbed in 10 calls over a two week period before we were put in touch with anyone that was willing to comment at all.

Ms. Stewart actually didn’t disclose that she was a contractor (not a full time employee)–but, respectfully suggest that the response you received from Nicole Coffin does confirm the observation made i.e. the antiquated status of the CDC’s position–which while released in 2002, were actually prepared in 1996; 13 years ago.

An unlucky number perhaps, but also negates to take into consideration the numerous studies that have taken place since, where findings have documented the limited effectiveness of alcohol in certain situations. The guidelines Ms. Coffin referenced also cautioned about flash-point risk issues, and underscored concerns about destruction of protective skin cells. The ‘paper’ made scant mention of the non-alcohol alternatives and merely referenced them as “emerging” and “not enough research done”. Again, those comments were drafted thirteen years ago, and since that time, more than substantial research i.e. the compelling benefits of using quat-based hand sanitizers vs. alcohol gels.

Offer stands–we’re happy to facilitate any professional that would like courtesy samples of products or documentation that we’ve aggregated from third parties that support the observations we’ve made.
Worth pointing out, of the several hundred facilities that have requested non-alcohol hand sanitizers, the US Navy Department of Surface Warfare implemented our alcohol-free alternative at the recommendation of one of their senior civilian employees, a Georgetown University Ph.d that has numerous white papers to his credit on the topic of chemical formulations.

We can be reached via http://www.SoapyUSA.com or via phone 203 255 0034
Jay Berkman

By LouAnn Savage on February 27th, 2009 at 5:36 pm

Electrolyzed water effectively disinfects skin and surface areas. There is scientific data that supports this in “Applied and Environmental Microbiology, Sept. 1999. My experience in my own kitchen supports these principles and I am able to maintain freshness of greens and other produce for up to 4 weeks. We’ve done even more practical application when it comes to MRSA situations and gotten resounding results when antibiotics fail and electrolyzed water is the last line of defense. There is no risk to environment, no issues with bacterial strain becoming resistant. Better than all the hand sanitizers on the market and no chemicals.

I can be reached via phone: 800-685-2644.

The topic of hand sanitizers, and the repeated insertion of the word alcohol is a source of consternation for many. This misconception is driven by the fact that whenever CDC makes reference to hand sanitizer, they insert the word “alcohol.” Despite the fact that CDC is well-aware of alternative formulas, but they say they “neither research nor recommend products.”

What’s my point?

Over the past three years, our company has received unsolicited requests for our non-alcohol hand sanitizer product from amongst others, four federal government agencies, tens of dozens of schools (from elementary to university), countless correctional facilities, day care centers, senior care centers, and a variety of corporate venues.

Each of these groups has informed us that they prohibit alcohol-based sanitizers for at least 1 of 3 primary reasons—and that CDC’s communication messages are not only outdated, but off point.
The three reasons:
1. Flash point risk / property damage liability. (Ask any facility manager at a major hospital how much they spend on repairing floors and walls that have been subjected to alcohol hand sanitizer drippage)
2. Toxicity. Go to Youtube.com and search hand sanitizer for illustrative videos i.e. how alcohol-based sanitizers are being repurposed
3. Product safety/Efficacy. It’s a widely-accepted scientific fact that alcohol destroys protective skin cells. Makes one scratch their head in wonder when reading that CDC recommends rubbing your hands with it. Couple that with realizing that alcohol has a persistency of no more than a few seconds, and that it doesn’t have any efficacy when applied to dirty/soiled hands.

And, as any dermatologist will attest to: alcohol causes the skin to become dry/irritated, otherwise increasing the risk of exposure to easily transmitted pathogens.

Which is exactly why people have contacted us (and why others have contacted manufacturers that compete with us). The product that we manufacture, much like competing products, utilizes an organic compound that’s been used in dozens of health care products for years; including Bactine antiseptic. The compound is benzalkonium chloride and its been tested against a broad spectrum of pathogens,MRSA, Staph, Salmonella and even H1N1.

As such, many infection control experts are quick to acknowledge that certain non-alcohol hand sanitizers are not only equally if not more effective, but they’re necessarily safer to the skin (does not cause dry/irritation like alcohol does), they’re antiseptic, hypoallergenic, non-toxic, and non-flammable.

The ‘story’ might in the fact that in the midst of the Swine Flu scare, we exchanged emails with then interim CDC Director Rich Besser, and pointed out that while CDC keeps publishing statements referencing “use alcohol hand sanitizers”, we were being contacted by federal government agencies that sought product for their immediate delivery—and again, have prohibited alcohol-based hand sanitizers from their facilities.

Besser was kind enough to reply on a Saturday morning before 7 am, and acknowledged “We have a communication issue at CDC that we’re working on. Thanks much for your help on this..” He concluded with a note indicating that he was appointing someone to follow up accordingly.

2 hours later, the staffer he designated to follow up delivered an email that said:
Per your communication with Dr. Besser..
1. CDC recommends alcohol hand sanitizer products
2. CDC does not recommend products
3. Your request (re: qualifying CDC position on non-alcohol alternatives) is beyond the scope of the Infection Control Desk to respond to.

Does anybody have a guide that translates Washington-speak into English?

wouldn’t the addition of baby oil or some other type of moisturizer to the formula solve the problem of alcohol causing the skin to become dry?

 

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