One of the foundations of infection control is hand hygiene. It was recognized as necessary to prevent the transmission of infections in healthcare facilities as early as the 19th century – long before it was recognized that microorganisms seem to have been responsible for disease transmission. Although we’ve known for very well over a century how microscopic creatures – bacteria, viruses, fungi, protozoans, and parasitic worms – can be transmitted through infected hands, even among medical professionals, the actual practice of hygiene practices has not been optimal. Even in the twenty-first century, new medications such as antibiotics misled individuals into a false feeling of security.
Let’s discuss hand rub alcohol sanitizers more in detail:
- Alcohol-based hand sanitizers have long been believed to be more antimicrobial than antiseptic soaps, which are widely used in healthcare institutions. Their convenience of use as well encourages better hand hygiene practices.
- Hand sanitizers with advised alcohol levels effectively inactivate enveloped viral infections such as Zika, Ebola, and coronaviruses (SARS, MERS). A recent study discovered that the WHO sanitizer compositions inactivated SARS-CoV-2 and that ethanol has been efficacious at 30% and increased concentration with just a 30-second exposure.
- H1N1 infection and Hepatitis C are much more resistant than other enveloped viruses, whereas non-enveloped viruses like norovirus, poliovirus, and adenovirus are far more resistant.
- When repeated exposure to an alcohol hand sanitizer and a detergent was compared over several days, the alcohol hand sanitizer ended up causing less skin irritation as well as disruption towards the skin barrier.
- However, the alcohol in hand sanitizers can cause skin dryness if used frequently, so humectants (moisture retainers) or skin conditioners are added. Glycerine is among the most commonly used humectant in sanitizers and cosmetics.
- The more that’s added, the larger the impact, but there must be a combination of both the impact on efficacy, sanitizer feel, and humectant properties.
- When used repeatedly, elevated levels slow down the fast drying of the hand sanitizer and start giving it a sticky feel.
On the contrary, let’s talk about non-alcohol-based sanitizers:
- Non-alcohol sanitizers are less well-known than alcohol-based ones, and the FDA just recommends the use of alcohol in the United States (ethanol and isopropyl alcohol). “The use of other inactive or active additives otherwise not stated in the guidelines for the usage of hand sanitizer” is not covered by the FDA’s policies. Regrettably, these policies were not revised throughout the pandemic.
- Other compounds, however, are efficient against not just the more well-known – pre-pandemic – bacteria, viruses, and fungi, and also coronaviruses such as SARS-CoV-2.
- Because SARS-CoV-2 is still so new as well as infectious, little research has been conducted on it instead of safer surrogate viruses like feline or cow coronavirus. A recent study of quat-containing products discovered that they were efficient against SARS-CoV-2 with shorter response times, which reflects real-world use.
- Benzalkonium chloride also is non-toxic when used on the skin, less aggravating than alcohol, and non-flammable. Quats, like alcohol and detergents, are efficient against enveloped viruses but less so against non-enveloped viruses.
- The persistence of quats just on the skin after application is a significant advantage.
Both types of hand sanitizer can be a convenient and effective item for inactivating or killing micro-organisms if used properly – that is, using the right amount, covering the hands properly, and staying on the skin for the appropriate amount of time for alcohol-based formulae can be the best alcohol for hand sanitizer.
