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Hand Sanitizing –Is It Safe?

A look at hand sanitizers and what it may mean for your health

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My patient once told me he could easily identify nurses — they have worn-looking hands and tired feet! That was an eye opening moment for me, I realized his statement rang true. My hands were looking a bit worn. Could it be from the excessive use of washing and hand sanitizers? As a healthcare worker I spend many moments per day applying hand sanitizer or washing my hands.

At any given moment your hand harbors anywhere from 10,000 to 10,000,000 microbes awaiting an opportunity to strike. While some are relatively harmless others like Clostridium difficile and Escherichia coli can cause you serious harm.

What it is hand sanitizer

A hand sanitizer is a disinfectant usually in liquid, foam or gel form that is used to kill microbes.

Alcohol-based disinfectants — are the gold standard in the fight against opportunistic infections within and without healthcare organization. The composition of hand sanitizer solutions typically utilizes no less than 70% (v/v) isopropyl or ethyl alcohol. Scientifically proven to kill at least 99.9% microbes.

The CDC recommends a percentage of at least 60% alcohol is an effective and recommended concentration for use in healthcare setting.

While alcohol-based hand sanitizers can effectively reduce the number of microbes on hands, sanitizers do not eliminate all types of germs. Soap and water has proven to be more effective in killing and removed microbes and preventing the spread of infections.

Dangers that lurk in your hand sanitizer?

  1. Ethyl alcohol no less than 70% concentration this is the “active” ingredient.
  2. Triclosan — Some short-term animal studies have shown that exposure to high doses of triclosan is associated with a decrease in the levels of some thyroid hormones. Triclosan is an active ingredient used to reduce or prevent bacterial contamination. It is commonly added antibacterial soaps and body washes, toothpastes, and some cosmetics. Causes hormone imbalance
  3. Water
  4. Phthalates — maintains pliability
  5. Isopropyl alcohol — another active ingredient
  6. Carbomer — creates the gel-like consistency
  7. Propylene glycol — pulls moisture from the air
  8. Tert-butyl alcohol —Tert-butanol is poorly absorbed through skin by inhalation or ingestion. Low toxicity seen at low doses and a sedative or anesthetic effect at high doses.
  9. Aminoethyl propanol — pH stabilizer
  10. Denatonium benzoate — a teratogenic (cancer causing) insecticide with a moderate toxicity to mammals
  11. Fragrance
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How to use hand sanitizers

The correct way to apply hand sanitizer is to apply it to the palm of one hand (the product label should provide the recommended amount per use). Rub the sanitizer over all surfaces of your hands for 30 seconds including your thumbs until your hands are dry. Rubbing for 30 seconds enhances its efficacy.

If your hands are visibly soiled do not use hand sanitizer, instead wash for 20 seconds with soap and water.

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How can it harm us?

  1. Overuse can lead to resistance to antimicrobials.
  2. Sanitizers often reduce the amount of microbes with actually destroying them.
  3. May actually lead to bacterial resistance.
  4. Alcohol is drying to your skin.
  5. My lead to skin allergies.
  6. Can be volatile and therefore highly flammable.
  7. Cause hormone imbalances.
  8. Can be cancer causing.
  9. Skin absorption — measured as increased blood alcohol levels after continuous use for four hours by healthcare workers.
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How we can protect ourselves

As a healthcare worker, I have used a lot of hand sanitizer to date. I naively assumed that our regulatory agencies are monitoring and ensuring that products put out for public consumption are safe for our use. While doing this research I was truly horrified that some the ingredients present in hand sanitizers have the propensity to cause as much harm as COVID-19.

How can we protect ourselves? — by using soap and water to wash our hands whenever possible and reduce the use of hand sanitizers. We must make every effort to then keep the sanitizer-infused hands away from our faces and mucus membranes as well as refrain from eating until such a time as we are able to physically wash our hands.

We should attempt to limit the exposure of our children to these known dangerous and teratogenic chemicals and in so doing perhaps we can reduce our incidences of the many cancers, hormonal imbalances and many diseases present in our world today.

To reduce the spread of microbes we must employ the use of soap and water in lieu of using hand sanitizers if at all possible.

While I appreciate the protection afforded by hand sanitizers when I am unable to wash with soap and water I realize that this is not the best practice for our long term health goals.

References

  1. https:/www.cdc.gov
  2. https://www.fda.gov
  3. https://www.sciencedirect.com
  4. https://stm.sciencemag.org
  5. https://www.ncbi.nlm.nih.gov
  6. https://www.ncbi.nlm.nih.gov/pmc