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Alcohol Is Your Friend

Alcohol-based hand sanitizers.

Photo by Phil Zeltzman.

No, neither VPN nor myself would ever encourage anyone to drink.

Rather, I wanted to discuss the popular alcohol-based hand sanitizers that have now become ubiquitous.  You may have some at home, in your car, in your purse, in various locations in your clinic. It’s hard to find a store or a health professional’s office which doesn’t have one on the counter.

How did we survive without them in the 20th century and before?  They have actually reduced the frequency of nosocomial infections in human facilities.  So there is no reason we couldn’t do the same in vet clinics.

Although it is definitely better to wash your hands with warm water and soap (as long as it is done appropriately as we recently discussed), alcohol-based hand sanitizers are an acceptable alternative when your hands are not grossly dirty.

The CDC recommends using them in the following manner:

* Apply product to the palm of one hand.
* Rub the product over all surfaces of hands and fingers until hands are dry.

The Mayo Clinic is a little more specific:

* Apply enough of the product to the palm of your hand to wet your hands completely.
* Rub your hands together, covering all surfaces, for up to 25 seconds or until they're dry.

All alcohol-based gels are not created equal.  One study* showed that products with 40% ethanol did not reduce bacteria count effectively.  The FDA has established that they should have a concentration greater than 62% of ethanol.

You may have heard urban legends such as “These gels are bad for your health, as the alcohol is absorbed through your skin.”

Hogwash (no pun intended).  This is a myth according to one study with a very clever title.**  The alcohol in hand sanitizers evaporates, as you certainly have noticed. In the study, minimal amounts could be found in people’s breath, but not in their serum. Therefore, it certainly cannot make you drunk.

If you still have concerns, the study implies that you should choose gels with isopropanol, and not those with ethanol.

So if you won’t take the time to wash your hands between appointments, at least rub your hands with an alcohol-based hand sanitizer.

Here is the executive summary:
* prefer isopropanol
* with a concentration greater than 62%
* and rub for 25 seconds.

Dr. Phil Zeltzman is a mobile, board-certified surgeon in Allentown, PA. His website is www.DrPhilZeltzman.com. He is the co-author of “Walk a Hound, Lose a Pound: How You and Your Dog Can Lose Weight, Stay Fit, and Have Fun Together (Purdue University Press).”

* S. A. Reynolds et al. "Hand Sanitizer Alert." Emerging Infectious Diseases 2006, Vol 12, N 3.

** T. L. Brown et al.  “Can Alcohol-Based Hand-Rub Solutions Cause You To Lose Your Driver's License? Comparative Cutaneous Absorption of Various Alcohols.” Antimicrob Agents Chemother. 2007, Vol 51, N 3, p. 1107–1108. Accessible by clicking here

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