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How Effective Are Alcohol-Based
Hand Cleaners?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

This article originally appeared on page 22 in the August 16-17, 2003 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.

The sudden microbial awakening in our community has sent alcohol-based hand cleaners flying off the shelves. They seem to be everywhere: entrances to health care facilities, funeral home restrooms, restaurants, police cars, and so on. These products are not all the same. But they do appear to be slightly more effective than soap to control bacterial contamination. These products are not meant for soiled or dirty hands. Dirt sticks to the small proteins that are found in the oily layer of our skin. Soap reduces surface tension and helps the water liberate and wash away the bound dirt. It takes at least 10 to 15 seconds of soap application along with warm water for this to occur. Homes equipped with kids may recognize the thunderous plumbing "boom" indicating that a two-second fingertip wash has taken place somewhere. This scenario serves only to contaminate the faucet for the next person. Communal hand towels are also a poor idea.

The head nurse in any operating room wears the black belt of hygiene. It takes a full three minutes of scrubbing with a brush and disinfectant soap to pass her inspection and gain entrance into the operating room. Scratch your nose or touch your mask, and you're humbly reminded to start the cycle over again.

Liquid soap is superior to bar soap. It is easier to apply over the entire hand surface, whereas repeated application of alcohol-based glycerin lotions tend to dry out the skin. Not all alcohol-based soaps are the same. The alcohol type and carrier solution can vary, changing the price and effectiveness. Furthermore, alcohol impregnated hand wipes fare worse than soap in removing skin bacteria.

When washing, get in the habit of silently counting to ten. Use paper towels or heat fans to dry the hands. Try to avoid touching the faucet, light switch or door handles with wet hands. Infections rarely gain entry into the body through the intact skin of our hands. How often should you wash your hands? As often as you can, despite my daughter's contention that this may jeopardize the world's supply of clean water!

Related resources:

What is the best hand-cleaning agent? from NHS (National Health Service, UK).
Guideline for Hand Hygiene in Health-Care Settings from Centers for Disease Control and Prevention (CDC).

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