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Hand sanitizer

"Hand rub" redirects here. For the gesture, see Hand rubbing.

Hand sanitizer
A typical pump bottle dispenser of hand sanitizer gel
Clinical data
Other namesHand sanitizer, hand antiseptic,[1] hand disinfectant, hand rub, handrub[2]

Hand sanitizer (also known as hand antiseptic, hand disinfectant, hand rub, or handrub) is a liquid, gel or foam generally used to kill many viruses/bacteria/microorganisms on the hands.[3][4] It can also come in the form of a cream, spray, or wipe.[5] In most settings, hand washing with soap and water is generally preferred.[6][7][8] Hand sanitizer is less effective at killing certain kinds of germs, such as norovirus and Clostridium difficile, and unlike hand washing, it cannot physically remove harmful chemicals.[6] People may incorrectly wipe off hand sanitizer before it has dried,[6] and some are less effective because their alcohol concentrations are too low.[6]

Alcohol-based hand sanitizer that is at least 60% (v/v) alcohol in water (specifically, ethanol or isopropyl alcohol/isopropanol (rubbing alcohol)) is recommended by the United States Centers for Disease Control and Prevention (CDC), but only if soap and water are not available.[9] The CDC recommends the following steps when using an alcohol-based hand sanitizer:

  1. Apply product to the palm of one hand.
  2. Rub hands together.
  3. Rub the product over all surfaces of hands and fingers until hands are dry.[9]
  4. Do not go near flame or gas burner or any burning object during application of hand sanitizer.

In most healthcare settings, alcohol-based hand sanitizers are preferable to hand washing with soap and water,[10][11] because it may be better tolerated and is more effective at reducing bacteria.[4] Hand washing with soap and water, however, should be carried out if contamination can be seen, or following the use of the toilet.[12] The general use of non-alcohol-based hand sanitizers is not recommended.[10] Although non-alcohol-based hand sanitizer is not recommended, it is not flammable and is generally safer for children to use.[5]

Alcohol-based versions typically contain some combination of isopropyl alcohol, ethanol (ethyl alcohol), or n-propanol, with versions containing 60% to 95% alcohol the most effective.[4] Care should be taken as they are flammable.[10] Alcohol-based hand sanitizer works against a wide variety of microorganisms but not spores.[4] Compounds such as glycerol may be added to prevent drying of the skin.[4] Some versions contain fragrances; however, these are discouraged due to the risk of allergic reactions.[13] Non-alcohol based versions typically contain benzalkonium chloride or triclosan; but are less effective than alcohol-based ones.[14][15][16]

Alcohol has been used as an antiseptic at least as early as 1363 with evidence to support its use becoming available in the late 1800s.[17] Alcohol-based hand sanitizer has been commonly used in Europe since at least the 1980s.[18] The alcohol-based version is on the World Health Organization's List of Essential Medicines.[19][20]

  1. ^ "Tentative Final Monograph for Health-Care Antiseptic Drug Products; Proposed Rule" (PDF). United States Federal Food and Drug Administration. March 2009. pp. 12613–12617. Archived (PDF) from the original on 10 March 2010.
  2. ^ Cite error: The named reference WHO-LocalProduction was invoked but never defined (see the help page).
  3. ^ "hand sanitizer - definition of hand sanitizer in English". Oxford Dictionaries. Archived from the original on 18 September 2017. Retrieved 12 July 2017.
  4. ^ a b c d e Boyce JM, Pittet D (October 2002). "Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America" (PDF). MMWR. Recommendations and Reports. 51 (RR-16): 1–45, quiz CE1–4. PMID 12418624.
  5. ^ a b Jing JL, Pei Yi T, Bose RJ, McCarthy JR, Tharmalingam N, Madheswaran T (May 2020). "Hand Sanitizers: A Review on Formulation Aspects, Adverse Effects, and Regulations". International Journal of Environmental Research and Public Health. 17 (9): 3326. doi:10.3390/ijerph17093326. PMC 7246736. PMID 32403261.
  6. ^ a b c d "Show Me the Science – When & How to Use Hand Sanitizer in Community Settings". cdc.gov. 3 March 2020. Retrieved 16 March 2020. CDC recommends washing hands with soap and water whenever possible because hand washing reduces the amounts of all types of germs and chemicals on hands. But if soap and water are not available, using a hand sanitizer with at least 60% alcohol can help... sanitizers do not eliminate all types of germs... Hand sanitizers may not be as effective when hands are visibly dirty or greasy... Hand sanitizers might not remove harmful chemicals
  7. ^ de Witt Huberts J, Greenland K, Schmidt WP, Curtis V (July 2016). "Exploring the potential of antimicrobial hand hygiene products in reducing the infectious burden in low-income countries: An integrative review". American Journal of Infection Control. 44 (7): 764–771. doi:10.1016/j.ajic.2016.01.045. PMID 27061254.
  8. ^ Meadows E, Le Saux N (November 2004). "A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children". BMC Public Health. 4: 50. doi:10.1186/1471-2458-4-50. PMC 534108. PMID 15518593.
  9. ^ a b "Clean Hands Save Lives!". Centers for Disease Control and Prevention. 11 December 2013. Archived from the original on 18 August 2017.
  10. ^ a b c Bolon MK (September 2016). "Hand Hygiene: An Update". Infectious Disease Clinics of North America. 30 (3): 591–607. doi:10.1016/j.idc.2016.04.007. PMID 27515139. In 2002, the CDC released an updated hand hygiene guideline and, for the first time, endorsed the use of alcohol-based hand rubs for the majority of clinical interactions, provided that hands are not visibly soiled
  11. ^ Hirose R, Nakaya T, Naito Y, Daidoji T, Bandou R, Inoue K, et al. (September 2019). "Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients". mSphere. 4 (5). doi:10.1128/mSphere.00474-19. PMC 6751490. PMID 31533996. For many reasons, alcohol hand sanitizers are increasingly being used as disinfectants over hand washing with soap and water. Their ease of availability, no need for water or plumbing, and their proven effectiveness in reducing microbial load are just a few.
  12. ^ World Health Organization (2015). The selection and use of essential medicines. Twentieth report of the WHO Expert Committee 2015 (including 19th WHO Model List of Essential Medicines and 5th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization. hdl:10665/189763. ISBN 9789240694941. ISSN 0512-3054. WHO technical report series; no. 994.
  13. ^ "Guide to Local Production: WHO-recommended Handrub Formulations" (PDF). Retrieved 11 April 2020.
  14. ^ Long BW, Rollins JH, Smith BJ (2015). Merrill's Atlas of Radiographic Positioning and Procedures (13th ed.). Elsevier Health Sciences. p. 16. ISBN 9780323319652. Archived from the original on 18 September 2017.
  15. ^ Baki G, Alexander KS (2015). Introduction to Cosmetic Formulation and Technology. John Wiley & Sons. p. 173. ISBN 9781118763780. Archived from the original on 18 September 2017.
  16. ^ "Alcohol-free hand sanitizer prices are skyrocketing, but they don't actually work to prevent the coronavirus, Business Insider - Business Insider Singapore". www.businessinsider.sg. Retrieved 11 April 2020.
  17. ^ Block SS (2001). "Disinfection, Sterilization, and Preservation". Soil Science. 124 (6). Lippincott Williams & Wilkins: 14. Bibcode:1977SoilS.124..378B. doi:10.1097/00010694-197712000-00013. ISBN 9780683307405. Archived from the original on 18 September 2017.
  18. ^ Miller CH, Palenik CJ (2016). Infection Control and Management of Hazardous Materials for the Dental Team (5th ed.). Elsevier Health Sciences. p. 269. ISBN 9780323476577. Archived from the original on 18 September 2017.
  19. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  20. ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.

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