A rather odd question came to mind after I began investigating the role of hand sanitizer in combating bacteria, germs and viruses amidst media-stoked fears that a 1918-like flu outbreak could surface this fall: “Does your baby have an alcohol problem?”
Why? Because, when applied per instructions, the ethyl alcohol contained in the vast majority of alcohol-based hand sanitizer products removes the body’s natural oils from the surface of the skin and, within only a few hours, fosters an environment within which bacteria actually returns in quantities larger than originally present. With repeated use, it actually damages the skin. So who wants to apply it to babies and other small children?
Most people — including mothers of young children — appear not to realize is that the leading brands of alcohol-based hand sanitizer (i.e., Purell®, Germ-X® et al) contain a minimum of 62 percent and as much as 95 percent ethyl alcohol. I use the caveat, “appear not to realize”, due to the fact two facts:
(1) Manufacturers of those products combine to sell tens of millions of dollars worth of product every year after more than 20 years on the market, and
(2) Many of those products are sold to mothers of young children.
One would think government agencies such as the Food and Drug Administration and Centers for Disease Control would pursue aggressively — or, at a minimum, promote — the development of alcohol-free hand sanitizer solutions. But, alas, they do not. Instead, they recommend alcohol-based hand sanitizer products be used when washing with soap and water is not possible.
Their confusion is evident in the e-mail below which came in response to my questions about the CDC’s apparent love affair with alcohol:
The FDA in their Tentative Final Monograph (TFM) judged there were adequate clinical trials data to prove alcohol-based (hand sanitizers) are effective in interrupting the transmission of bacteria in healthcare settings.
The FDA judged there were inadequate clinical trials data to prove AB-HS are effective in interrupting transmission of viruses (note: it is not that there are any clinical data to suggest AB-HS won’t be effective, just a lack of data).
However, there are laboratory data that show AB-HS are effective in killing viruses, especially enveloped viruses such as influenza, to a degree similar to which they kill bacteria. It is on the basis of such laboratory data that CDC recommends AB-HS for controlling transmission of viruses as well as bacteria in healthcare settings.
According to the FDA in their TFM, the available clinical and laboratory data were inadequate to prove non-alcohol based HS are effective in interrupting transmission of bacteria or viruses.
The CDC guidance recommending AB-HS is focused on the needs of healthcare workers. The benefits of AB-HS in community settings have been extrapolated from this guidance.
L. Clifford McDonald, MD, FACP
Chief, Prevention and Response Branch
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
Most manufacturers of alcohol-based hand sanitizer products boast that their products offer Log 4 efficacy, a standard represented 99.99 percent effective against germs. Some claim their products meet only Log 3 efficacy (99.9 percent). Still others tout Log 6 efficacy (99.9999 percent) and higher, though I suspect many of the latter claims are exaggerated.
Are better, safer alternatives available? Indeed they are.
A simple Google Search of the phrase, “alcohol-free hand sanitizer”, yielded nearly 2.5 million results this afternoon. Among those results, at least a handful — perhaps hundreds — must hold some promise.
If only the “experts” at the CDC and FDA would exercise a bit more due diligence. Instead, it appears they promote hand washing and alcohol as “solutions” to promote hand hygiene. In turn, members of the mainstream news media parrot their guidance when reporting on efforts to combat bacteria, germs and viruses, including the much-feared H1N1 virus (a.k.a., “Swine Flu”), Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA) and Norovirus. Then the public buys products based upon what they see, hear and read in the news media.
Stories like this one show up as “bogies” on my follow-the-money radar screen. In other words, they make me wonder whether or not much the big manufacturers of alcohol-based hand sanitizers are funneling to policy makers in Washington, D.C., to ensure government agencies continue to recommend only their products. Hmmm?
2 responses so far ↓
1 Always On Watch // Jul 16, 2009 at 5:35 am
Interesting.
Back during the anthrax murders following 9/11, I became obsessed with washing my hands. I used antibacterial dish soap. After a few days, the skin between my fingers started breaking down. Of course, I panicked and thought I had anthrax, so I headed to the doctor’s office. He told me to stop using that antibacterial soap.
Now, if the skin on my tough old hands could break down like that, what would happen to a baby’s skin?
2 hotoffthepress2 // Jul 16, 2009 at 5:36 am
Exactly!
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