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A closer look at hand hygiene

During my toddler’s terrible, terrible 2s, I sidestepped the daily hand-washing battle by letting him use waterless hand sanitizer.

My husband objected because he didn’t think the alcohol-based products were as effective as good old soap and water. I argued that the gels, now found in schools, hospitals, and grocery stores, were better than nothing.

We were both right.

Alcohol-based hand sanitizers can be a great substitute for hand washing as long as they contain more than 60 percent ethyl alcohol or isopropanol.

And though they can kill bacteria, they differ from products labeled “antibacterial,” which require water.

Just in time for the picnic/ice cream season, here’s a closer look at hand hygiene.

Hand sanitizers

Hang gel is alcohol-based and doesn’t need to be rinsed off. Just a dime-sized dollop to dry hands kills micro-organisms by stripping away the outer layer of the oil on the skin.

After you’ve used it, the bacteria don’t regrow as fast, which keeps “residual micro-flora that reside in deeper layers of skin from coming to the surface,” according to the Colorado State University Cooperative Extension.

But hand sanitizers still don’t remove dirt; you need soap, water and friction for that. The setting and what’s already on your hands also is important, because soil, food and other substances make the gels less effective.

Like any product not meant to be ingested, eating the stuff can be dangerous.

It’s also not recommended for infants, but if you have a teether who has sucked on your hand-sanitized hands, don’t panic. “The alcohol part evaporates in just seconds as it air dries ... so your hands may still feel it but there is no alcohol touching your child’s lips,” said nurse epidemiologist Ed Goodwin at Rush University Medical Center.

One other caution for smokers: It’s flammable. Don’t light a match if your hands are still wet with hand sanitizer.

Antibacterial soap

Antibacterial soap, which contains the chemicals triclosan or triclocarban, must be used with water and is marketed as having the ability to kill bacteria. But it’s no more effective than non-antibacterial soap. Unless you’re in a hospital environment, using products with triclosan, a biocide that can destroy biological structures at random, is overkill, like using a jackhammer to kill an ant.

Moreover, triclosan, which mimics the thyroid hormone and is bioaccumulating in the environment, is present in 60 percent of U.S. waterways investigated.

Unfortunately, it’s nearly impossible to find liquid soap without triclosan. It’s also added to toothpaste, deodorant, dog shampoo, cutting boards, clothing, toys and other antibacterial products. The best way around this is to “just rub your hands with plain water,” said Sylvia Garcia-Houchins, manager of infection control at the University of Chicago. The key is the scrubbing action.

Soap and water

Soap and water is the gold standard, especially if your hands are visibly soiled or you’ve just changed a diaper and have fecal matter on them.

A common mistake is applying the soap to dry hands. Instead, first, wet your hands. (Hand sanitizers are just the opposite; make sure your hands are dry.)

Soap doesn’t necessarily kill germs; it makes your hands slippery so the germs slide down the drain, Garcia-Houchins said.

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