Are You Using The Right Hand Sanitizer?



News came out in May of this year when a worker suffered first and second-degree burns to her hands after touching a metal surface right after using a hand sanitizer. This has caused concerns to the general public about the safety of hand sanitizers.

Handwashing with soap and water is very important in combatting Covid-19. Hands should be washed for at least 20 seconds with soap and water before eating and after using the restroom.

A lot of times, there are no available sinks especially in public places, hence, the use of hand rub, also called hand sanitizer, cannot be avoided and has become essential and part of the new normal.   

What type of hand sanitizer should you use?

CDC (Centers for Disease Control and Prevention) recommends using ABHR (alcohol-based hand rub) with 60-95% alcohol. Unless hands are visibly soiled, an alcohol-based hand rub is preferred over soap and water in most clinical situations due to evidence of better compliance compared to soap and water.

Hand rubs are generally less irritating to hands and are effective in the absence of a sink.

WHO (World Health Organization) recommends alcohol-based hand rubs based on the following factors: 

1. Evidence-based, intrinsic advantages of fast-acting and broad-spectrum microbicidal activity with minimal risk of generating resistance to antimicrobial agents; 
2. Suitability for use in resource-limited or remote areas with lack of accessibility to sinks or other facilities for hand hygiene (including clean water, towels, etc.); 
3. Capacity to promote improved compliance with hand hygiene by making the process faster, more convenient, and immediately accessible at the point of patient care; 
4. Economic benefit by reducing annual costs for hand hygiene, representing approximately 1% of extra-costs generated by healthcare-associated infection 
5. Minimization of risks from adverse events because of increased safety associated with better acceptability and tolerance than other products.

(Source: WHO Guidelines on Hand Hygiene in Health Care 2009)

Last March, 2020 FDA has issued a policy allowing for the temporary compounding of certain alcohol-based hand sanitizer products using either ethanol or isopropyl as the main ingredients for those entities that are not yet FDA approved.

Secondly, the solution must have emollients (softening agent) to protect the health of the skin, reduce pathogens on the hands, and avoid inadvertent exposure to organisms not killed by alcohol (e.g., spores).

According to WHO, there are two kinds of allowed formulation. 

One is Ethanol based on which final concentrations must be 80%.

The other one is Isopropyl which should have final concentrations of 75%.

What is the Difference Between Ethanol and Isopropyl Alcohol?

Isopropyl is the most common household alcohol and it cannot be drunk.

Ethanol, also called ethyl or grain alcohol, is the main ingredient in making drinking alcohol like whiskey but the ethanol-based hand sanitizer is denatured and cannot be drunk.

Both isopropyl and ethanol are effective in fighting SarsCov2 and other germs by disrupting the lipids and proteins in viruses and bacteria. 

Why Not Use 100% Alcohol?

You cannot use 100% alcohol simply because any percentage above the ones recommended by WHO results in a higher concentration of alcohol which makes the alcohol evaporate more quickly. This does not allow enough time for the skin to absorb the sanitizer thus making it less effective in protecting the hands. 

Adding other ingredients and water, which is slower in evaporation, make the sanitizer more effective.

Is ABHR flammable?

The reason for the case of the worker that was reported in the news this year was due to the static electricity that resulted when the worker did not allow the liquid to dry well before touching the metal surface. The alcohol ignited an almost invisible flame on her hands.

Health authorities warn that you should allow some time for the alcohol to evaporate before touching conductors of electricity and flammable materials.

Safety Measures When Using ABHR:

ABHR is generally safe and essential in combating Covid-19 when safety measures are observed and in place.

1. Alcohol, like any other chemicals, whether industrial or for household use, should be kept away from the source of heat or fire.
2. Store the alcohol in a tightly closed container in a cool, dry, and well-ventilated area.
3. Quantities of more than 5 gallons should be stored in a cabinet where there is an installed automatic fire sprinkler system nearby.
4.  As with any other chemicals, it must be kept out of reach of children.