Alcohol-based Hand Disinfectants Research Articles

Study on hand disinfection in inpatient geriatric care on the superiority of cold plasma aerosol versus alcohol-based disinfection methods in a parallel group design

The introduction of fundamental hygiene protocols within the healthcare sector during the nineteenth century led to a significant reduction in mortality rates. Contemporary advancements, such as alcohol-based sanitizers, have further enhanced hand hygiene practices. However, these measures are often overlooked in nursing facilities, resulting in low staff compliance rates and increased cross-infection rates. Novel approaches, such as cold plasma hand disinfection, present promising alternatives due to their minimal skin damage and economic benefits. This study aims to compare the disinfectant efficacy of cold plasma aerosol under practical application conditions with an alcoholic hand disinfectant listed by the Association for Applied Hygiene. The microbial count on participants’ hands was measured, with particular attention paid to the spontaneous occurrence of fecal indicators and the presence of potentially infectious bacteria. A t-test for independent samples was conducted to determine whether there was a significant difference between the two cohorts regarding the research question. Statistical analysis revealed that the mean log colony-forming unit (CFU) values were significantly lower in the test cohort using only the cold plasma method for hand disinfection compared to the cohort using conventional alcohol-based hand disinfection. Moreover, it was demonstrated that, unlike alcohol-based hand disinfection, cold plasma application ensures the effective elimination of Staphylococcus aureus. The findings indicate that staff utilizing plasma disinfection have an average bacterial count that is 0.65 log units lower than those who regularly use alcohol-based hand disinfection. In addition to the efficacy of cold plasma disinfection, its superiority over alcohol-based hand disinfection was also established. Beyond offering economic and logistical advantages, cold plasma disinfection provides additional health benefits as it does not induce skin damage, unlike alcohol-based hand disinfection.

The relationships between knowledge levels, health-protective practices, and anxiety in nurses in the workplace during the COVID-19 pandemic.

It is important to determine nurses' levels of knowledge, health-protective practices for work and social life, and mental health states at the beginning of the COVID-19 pandemic to combat the pandemic and minimize further problems. To determine the relationships between knowledge levels, health-protective practices, and anxiety among nurses during the COVID-19 pandemic. This cross-sectional study was carried out with the online participation of 605 nurses in Turkey. The researchers prepared a questionnaire form to evaluate the participants' knowledge of COVID-19 and their awareness and health-protective behaviours in work and social life. The mental health statuses of the participants were assessed with the Generalized Anxiety Disorder (GAD-7) questionnaire. Most of the participants (87.8%) had high levels of knowledge of COVID-19, while 28.8% had severe levels of anxiety disorder. The use of alcohol-based hand disinfectants (88.2%) and the use of N95 or N99 masks (88.5%) were the least frequently practiced protective behaviours at work, while in social life, a healthy and balanced diet (61.6%), social distancing (72.8%), and paying attention to one's sleep pattern (77.3%) were the least frequently practiced protective behaviours. Older age (41-50 years), higher education (master's degree) and having a work experience of 10 years or more were determined to increase the knowledge levels of the participants about COVID-19 (p < 0.001). Anxiety levels were higher in those with a history of mental illness (p < 0.001). Determining the knowledge levels, health-protective practices, and anxiety levels of nurses who are struggling in the frontlines in the field of health during the pandemic period can make a great contribution to the management of different current epidemics and pandemics and future ones by showing the areas in which nurses need to be empowered.

Real-Time Measurement of Alcohol Vapours Released from Alcohol-based Hand Disinfectants and User Habits Study of Hong Kong Residents in the Pandemic of COVID-19

Based on the information suggested by World Health Organization (WHO) and Hong Kong Special Administrative Region (HKSAR) government, wearing a mask and sterilizing hands with alcohol-based hand disinfectants are effective ways to maintain good personal hygiene to prevent viral infections. This study focused on the real-time concentrations of alcohol vapor in the air associated with five alcohol-based hand disinfectants. The results indicated that the alcohol concentrations increased dramatically (max. ~46,000 ppb/g sample) in the hand-rubbing process. Hong Kong residents' survey on habits of using such disinfectants showed that 65% of people use them daily and 34% of people use them ≥ 5 times per day, indicating a high frequency of usage. About 79% of respondents claimed to have skin problems, and 18% got eyes discomfort when using these disinfectants. Despite the potential health risks of using alcohol disinfectants remaining unclear, such a large amount and frequent usage should be aware of potential health problems in the long term.

Hepatitis E virus is highly resistant to alcohol-based disinfectants

Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide and is mainly transmitted via the fecal-oral route or through consumption of contaminated food products. Due to the lack of efficient cell culture systems for the propagation of HEV, limited data regarding its sensitivity to chemical disinfectants are available. Consequently, preventive and evidence-based hygienic guidelines on HEV disinfection are lacking. We used a robust HEV genotype 3 cell culture model which enables quantification of viral infection of quasi-enveloped and naked HEV particles. For HEV genotype 1 infections, we used the primary isolate Sar55 in a fecal suspension. Standardized quantitative suspension tests using end point dilution and large-volume plating were performed for the determination of virucidal activity of alcohols (1-propanol, 2-propanol, ethanol), WHO disinfectant formulations and 5 different commercial hand disinfectants against HEV. Iodixanol gradients were conducted to elucidate the influence of ethanol on quasi-enveloped viral particles. Naked and quasi-enveloped HEV was resistant to alcohols as well as alcohol-based formulations recommended by the WHO. Of the tested commercial hand disinfectants only 1 product displayed virucidal activity against HEV. This activity could be linked to phosphoric acid as an essential ingredient. Finally, we observed that ethanol and possibly non-active alcohol-based disinfectants disrupt the quasi-envelope structure of HEV particles, while leaving the highly transmissible and infectious naked virions intact. Different alcohols and alcohol-based hand disinfectants were insufficient to eliminate HEV infectivity with the exception of 1 commercial ethanol-based product that included phosphoric acid. These findings have major implications for the development of measures to reduce viral transmission in clinical practice. Hepatitis E virus (HEV) showed a high level of resistance to alcohols and alcohol-based hand disinfectants. The addition of phosphoric acid to alcohol was essential for virucidal activity against HEV. This information should be used to guide improved hygiene measures for the prevention of HEV transmission.

Canadian policy changes for alcohol-based hand rubs during the COVID-19 pandemic and unintended risks.

The COVID‐19 pandemic led to major changes in public policies to address supply chain disruption and escalated the price of consumer disinfectant products. To address market demands on alcohol‐based hand rubs and disinfectants, Health Canada implemented major changes to the regulations regarding composition, handling, transportation, and packaging to insure product availability. Furthermore, accelerated licensing of ingredients and packaging did not meet standard medical quality guidelines yet were authorized for manufacturing and packaging of alcohol‐based hand rubs and disinfectants. The accountability associated with these policy changes were reactive, including industry self‐reporting, consumer reporting, and Health Canada advisories and recalls that were responsive to products after they were available in the market. Nonetheless, Canadian public health policy increased hand sanitizers availability. However, some of the interim policies have raised major public health concerns associated with ethanol quality, packaging, and labeling, and enforcement of regulations. In this paper, we review the changes in the Canadian regulations amid the current pandemic and we evaluate the unintended health risks that might arise from these changes.

Production of first- and second-generation ethanol for use in alcohol-based hand sanitizers and disinfectants in India.

Emergence of “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)” causing “COVID-19” or “coronavirus disease 19” as pandemic has got worldwide attention towards hygiene as the first line of defense for the infection control. It is first line of defense not only from COVID-19 but also from other infectious diseases caused by deadly pathogens such as cholera, hepatitis, tuberculosis, polio, etc. Absence of any particular vaccine or treatment let World Health Organization (WHO) recommend to the public to maintain social distancing along with regularly washing their hands with soap, sanitize their hands (where washing is not possible), and disinfect their belongings and buildings to avoid the infection. Out of various formulations available in the market, WHO has recommended alcohol-based hand sanitizers, which mainly comprise of ethanol, isopropyl alcohols, and hydrogen peroxides in different combinations due to their high potential to kill the broad range of pathogens including bacterial, viral, fungal, helminthes, etc. Therefore, alcohol-based sanitizers are in high demand since centuries to prevent infection from pathogenic diseases. Ethanol is the most common and popular alcohol in terms of vanishing wide range of pathogens, convenient to use and its production. Ethanol is produced worldwide and is used in various sectors, e.g., beauty and cosmetics, food and beverages, and as the most demanding gasoline additive. The present review is focused on the ethanol production in India, its diversified applications emphasizing hand sanitizers with discussions on formulation of sanitizer and disinfectants, and viability of lignocellulosic and food grain–based ethanol. The review article also emphasizes on the technological details of 1G and 2G ethanol production, their associated challenges, and inputs for the improved ethanol yields so as to strengthen the supply chain of ethanol in India, and making “Atmanirbhar Bharat” (Self-reliant India) campaign of Indian government successfully viable.

Analytical examination of alcohol-based hand disinfectants in our country and evaluation with respect to COVID-19 pandemic

Objectives: The use of alcohol-based hand disinfectants (ABHD) is recommended in the COVID-19 pandemic. This study, it was aimed to analyze the content of ABEDs in our country and to discuss the findings in the light of literature. Materials and Methods: ABHDs in our country were searched on the Google search engine. Content information of the commercial product was saved. Data were analyzed under 5 headings: according to the alcohol ratio, the presence of ethyl and/or isopropyl alcohol, the presence of other disinfectants, the presence of the moisturizer, and the formulation recommended according to the World Health Organization (WHO). Results: The most frequently observed alcohol ratios were as follows: 70%, 75%, 65%, and 80%. 21% of the products have only ethanol, 15% have only isopropyl alcohol, 34% have ethanol and isopropyl alcohol. Hydrogen peroxide was observed in 6.5% of the products. 44% of the products had glycerin, 10% had glycerin and lanolin. The formulation suggested by WHO was exactly observed in one product. Conclusion: Sars-CoV-2 virus can be inactivated by ethanol (> 75%) and isopropanol (> 70%). One of the WHO formulations contain 80% ethanol and the other 75% isopropanol. The alcohol ratio was 70% and above in more than half of ABHDs in our country. These were ethyl and/or isopropyl alcohol. Only one product complied with the WHO formulation. As a result, the most important step for hand hygiene in the COVID-19 pandemic should be the selection of ABHD with the appropriate formulation. © 2021 Ankara Yildirim Beyazit University.

Skin Exposures, Hand Eczema and Facial Skin Disease in Healthcare Workers During the COVID-19 Pandemic: A Cross-sectional Study

The COVID-19 pandemic has led to enhanced hygiene procedures and use of personal protective equipment, but also to increased attention to occupational skin disease in healthcare workers. The occurrence of hand and facial skin disease in > 5,000 Swedish healthcare workers was investigated in a questionnaire survey. Levels of skin exposure related to hygiene procedures and personal protective equipment were recorded. Caring for patients with COVID-19 entailed higher levels of wet work and face mask exposures, and was associated with higher 1-year prevalence of both hand eczema (36%) and facial skin disease (32%) compared with not being directly engaged in COVID-19 care (28% and 22%, respectively). Acne and eczema were the most common facial skin diseases; for both, a dose-dependent association with face mask use was found. Dose-dependent associations could be shown between hand eczema and exposure to soap and gloves, but not to alcohol-based hand disinfectants.

Awareness on Washing Hands to Prevent Spread of Disease Among Common People

Proper and regular hand hygiene can reduce the spread of infection in the family of children raised at home. Alcohol-based hand disinfectants usually eliminate viruses associated with systemic infections like respiratory and gastrointestinal infections. The study aimed to investigate a multicultural factor that focused on the use of alcohol-based hand sanitizers to reduce the transmission of diseases at home and further education in hand hygiene. The study was conducted to raise awareness among the general public about the importance of hand washing to prevent the spread of the disease. The survey was conducted among the people in Chennai using a standard questionnaire. The sampling method in the present study was a convenient sampling method. The minimum bias for sampling is done based on selection criteria. Internal justification is a group of pairs, which can normalize the pattern with similar external credibility and exposure. Data is collected and aggregated. The results of this study relate to individual behavior and perception of hand washing. However, the commitment to hand washing is low and needs to be increased. Although self-reporting has increased in the community with hand washing in the community, it is suspected that there is still a risk of developing the disease.

Behaviour and perception of hand hygiene practice among dental students- A cross-sectional study

Hand hygiene is the act of cleaning one’s hands to remove oil, grease, microorganisms (or) other unwanted substances. Hand hygiene is considered as a primary practice which is used to reduce the risk and spread of infections to some extent. Washing hands with soap and water are considered the best way to remove germs. It helps in preventing diarrhea and uncomfortable intestinal diseases and reduces bacterial content on our hands. Health care professionals use alcohol-based hand disinfectant to prevent healthcare-associated infections and transmission of pathogens. Another widely used standard precautionary measure is wearing protective gloves. The main aim of this study is to assess the knowledge of hand hygiene practice of dental students. The present study is a cross-sectional study conducted among 100 dental students. The questionnaire consisted of 15 questions which were circulated among dental students through an online survey link. The questions were read carefully, and the answers were marked accordingly. The data was then collected and statistically analyzed. 93% of the participants think that hand hygiene is really necessary for day to day life. 88% of the participants think that maintaining proper hand hygiene helps us to be free from infections. The present-day dental students have very good knowledge about hand hygiene practice.

Fast deployment of COVID-19 disinfectant from common ethanol of gas stations in Brazil

ObjectivesCoronavirus COVID-19 is spreading very fast in Brazil, requiring innovative strategies for the fast deployment of disinfectants. Panic in population triggered by COVID-19 has caused a shortage of alcohol-based hand sanitizers and disinfectants in many cities of Brazil. Despite the governmental reaction against the outbreak, a risk of shortage of disinfectants still exists. The objective of this research is to investigate an alternative method for the fast deployment of alcohol-based disinfectants to protect the population against COVID-19. Methods and resultsThis research highlights the feasibility of disinfectant production from common ethanol available in Brazilian gas stations, as a last resort. A four-by-one (4:1) ratio of common alcohol diluted in water meets the minimum requirements set by health agencies for the alcoholic concentration of disinfectants. Risks factors on alcohol dilution process are associated with corresponding measures of risk mitigation for public health and safety. Conclusions and perspectivesThis research proposes a process for the production and deployment of ethanol-based disinfectant from gas stations. However, the implementation is not timely possible for the COVID-19 pandemic due to complexities in the productive process. For the post-COVID-19 period, the authors give three perspectives: (a) future investigation of human dermal toxicity of common ethanol, (b) establishment of a program for the ethanol decontamination, and (c) countries such as the US, Sweden, Thailand, and Colombia to rethink their energy policy for the adoption of biofuel E100 (ethanol and water) instead of E85 (blend of ethanol, gasoline, and water), as part of their biodefense strategy.

Ethanol-Based Disinfectants Containing Urea May Reduce Soap Sensitivity.

The use of disinfectants is crucial to preventing the spread of nosocomial infections in health care workers. As many as 25 applications of hand disinfectants is a realistic default value during a working day. However, alcohol-based hand disinfectants may weaken skin barrier function and induce dryness and eczema, which decrease their acceptance. To evaluate the effect of ethanol-containing disinfectants with 5% urea on skin barrier function and on sensitivity to an irritant soap (sodium lauryl sulfate [SLS]). Twenty healthy volunteers treated one of their forearms twice daily for 17 days with an ethanol-containing gel with 5% urea. Two types of gels with urea were tested. Treatment was randomized to left or right forearm, and the contralateral forearm served as untreated control. Transepidermal water loss, skin capacitance (dryness), and sensitivity to SLS were evaluated. Twice-daily application of the urea-containing ethanol gels lowered transepidermal water loss, prevented dryness, and reduced sensitivity to SLS compared with the untreated control skin. Improved barrier function using this ethanol gel with urea may have relevance in daily disinfectant procedures.

Knowledge about hand hygiene in the Generation Z: A questionnaire-based survey among dental students, trainee nurses and medical technical assistants in training

Alcohol-based hand disinfection is the key measure to prevent healthcare-associated infections and nosocomial transmission of pathogens. We conducted a survey among dental students, trainee nurses and medical technical assistants in training from the Generation Z to determine their knowledge regarding hand hygiene and to optimize education. Overall knowledge was worthy of improvement. Females performed better than males. Specifically tailored efforts seem necessary to increase hand hygiene competence in the Generation Z.

Ozonized water as an alternative to alcohol-based hand disinfection

Hand hygiene plays a vital role in the prevention of transmission of micro-organisms. Ozone (O3) is a highly reactive gas with a broad spectrum of antimicrobial effects on bacteria, viruses, and protozoa. It can easily be produced locally in small generators, and dissolved in tap water, and quickly transmits into ordinary O2 in the surrounding air. To compare ozonized tap water and alcohol rub in decontamination of bacterially contaminated hands. A cross-over study among 30 nursing students. Hands were artificially contaminated with Escherichia coli (ATCC 25922), then sanitized with ozonized tap water (0.8 or 4 ppm) or 3 mL standard alcohol-based rub (Antibac 85%). The transient microbes from fingers were cultivated and colony-forming units (cfu)/mL were counted. The test procedure was modified from European Standard EN 1500:2013. All contaminated hands before disinfection showed cfu >30,000/mL. The mean (SD) bacterial counts in (cfu/mL) on both hands combined were 1017 (1391) after using ozonized water, and 2337 (4664) after alcohol hand disinfection. The median (range) values were 500 (0-6700) and 250 (0-16,000) respectively (non-significant difference). Twenty per cent of participants reported adverse skin effects (burning/dryness) from alcohol disinfection compared with no adverse sensations with ozone. Ozonized tap water is an effective decontaminant of E.coli, and it could be an alternative to traditional alcohol-fluid hand disinfectants both in healthcare institutions and public places. Ozonized water may be especially valuable for individuals with skin problems.

Efficacy of Different Alcohol-based Hand Disinfectants in Reduction of Hand Contamination among Food Handlers in Alexandria, Egypt

Efficacy of Different Alcohol-based Hand Disinfectants in Reduction of Hand Contamination among Food Handlers in Alexandria, Egypt

Scenario-based simulation health care education for performance of hand hygiene

Simulation health care education is widely used in medical education and has great potential. However, scenario-based simulation health care education for preventing health care-associated infections has not been described. A single-center, prospective cohort study was conducted at Tokyo Medical University Hospital (1,015 beds), an acute care teaching hospital, from January 2011 to December 2014. Each training course was held every month and lasted 2 hours. Trainees put on and removed personal protective equipment under scenarios of standard precaution (2 scenarios) and contact precaution with methicillin-resistant Staphylococcus aureus (1 scenario), while considering the timing of hand hygiene. We determined the correlations between the participation rate in the simulation education and the use of alcohol-based hand disinfection and reduction of catheter-related bloodstream infection. There were 1,077 trainees. The total participation rate for hospital staff, which increased gradually during the study period, was 76% by the end of the study. The overall correlation between the use of alcohol-based hand disinfection in the hospital and the course participation rate was significant (correlation coefficient, 0.97). An inverse correlation (-0.94) was observed for the relation between the training course participation rate and the incidence of catheter-related bloodstream infection. Our training course had a positive effect on hand hygiene. This study is the first effective scenario-based simulation health care education on hand hygiene and control of health care-associated infection.

Effect of hand lotion on the effectiveness of hygienic hand antisepsis: Implications for practicing hand hygiene

Skin protection products should be used after washing hands with soap, during breaks, after work, and during leisure time. Aside from their beneficial effects, skin care products may also interact with alcohol-based hand disinfectants by reducing their efficacy. The aim of this study was to investigate the effect of a hand lotion on the effectiveness of hygienic hand antisepsis using an alcohol-based handrub. The effect of a protective hand lotion against an isopropyl alcohol-based handrub was investigated in 20 healthy volunteers according to the European standard test procedure EN 1500 in the following combinations: handwashing and application of hand lotion, only application of hand lotion, and no washing and no hand lotion (control), each for 5 minutes or 1 hour before hand antisepsis. The difference in microbiologic before-and-after values were expressed as log reduction factor. The effectiveness of hand antisepsis was not significantly affected in any of the groups using the tested hand lotion. Hand antisepsis may be delayed for 5 minutes after hand lotion application. Shorter time intervals might be possible but were not tested.

Development and virucidal activity of a novel alcohol-based hand disinfectant supplemented with urea and citric acid.

BackgroundHand disinfectants are important for the prevention of virus transmission in the health care system and environment. The development of broad antiviral spectrum hand disinfectants with activity against enveloped and non-enveloped viruses is limited due to a small number of permissible active ingredients able to inactivate viruses.MethodsA new hand disinfectant was developed based upon 69.39 % w/w ethanol and 3.69 % w/w 2-propanol. Different amounts of citric acid and urea were added in order to create a virucidal claim against poliovirus (PV), adenovirus type 5 (AdV) and polyomavirus SV40 (SV40) as non-enveloped test viruses in the presence of fetal calf serum (FCS) as soil load. The exposure time was fixed to 60 s.ResultsWith the addition of 2.0 % citric acid and 2.0 % urea an activity against the three test viruses was achieved demonstrating a four log10 reduction of viral titers. Furthermore, this formulation was able to inactivate PV, AdV, SV40 and murine norovirus (MNV) in quantitative suspension assays according to German and European Guidelines within 60 s creating a virucidal claim. For inactivation of vaccinia virus and bovine viral diarrhea virus 15 s exposure time were needed to demonstrate a 4 log10 reduction resulting in a claim against enveloped viruses. Additionally, it is the first hand disinfectant passing a carrier test with AdV and MNV.ConclusionsIn conclusion, this new formulation with a low alcohol content, citric acid and urea is capable of inactivating all enveloped and non-enveloped viruses as indicated in current guidelines and thereby contributing as valuable addition to the hand disinfection portfolio.

Reducing viral contamination from finger pads: handwashing is more effective than alcohol-based hand disinfectants

Hand hygiene is important for interrupting transmission of viruses through hands. Effectiveness of alcohol-based hand disinfectant has been shown for bacteria but their effectiveness in reducing transmission of viruses is ambiguous. To test efficacy of alcohol hand disinfectant against human enteric and respiratory viruses and to compare efficacy of an alcohol-based hand disinfectant and handwashing with soap and water against norovirus. Efficacies of a propanol and an ethanol-based hand disinfectant against human enteric and respiratory viruses were tested in carrier tests. Efficacy of an alcohol-based hand disinfectant and handwashing with soap and water against noroviruses GI.4, GII.4, and MNV1 were tested using finger pad tests. The alcohol-based hand disinfectant reduced the infectivity of rotavirus and influenza A virus completely within 30s whereas poliovirus Sabin 1, adenovirus type 5, parechovirus 1, and MNV1 infectivity were reduced <3 log10 within 3 min. MNV1 infectivity reduction by washing hands with soap and water for 30s (>3.0 ± 0.4 log10) was significantly higher than treating hands with alcohol (2.8 ± 1.5 log10). Washing with soap and water for 30s removed genomic copies of MNV1 (>5 log10), noroviruses GI.4 (>6 log10), and GII.4 (4 log10) completely from all finger pads. Treating hands with propanol-based hand disinfectant showed little or no reduction to complete reduction with mean genomic copy reduction of noroviruses GI.4, GII.4, and MNV1 being >2.6, >3.3, and >1.2 log10 polymerase chain reaction units respectively. Washing hands with soap and water is better than using alcohol-based hand disinfectants in removing noroviruses from hands.

Alcohol-based hand disinfectants and skin antiseptics contamination.

Alcohol-based hand disinfectants and skin antiseptics contamination.