Hand hygiene has come to play a much more central role in our lives since the emergence of COVID-19 — though awareness campaigns have reminded us that hand hygiene saves lives for many years now, we finally believe it.
In the process, most of us will have become deeply familiar with hand sanitizing stations set up everywhere, from the supermarket and the local ATM to your dentist's office and probably your workplace. Chances are that you carry a personal supply of hand sanitizer around, as well.
1. Even good hand sanitizer does not kill all germs
While running soap and water mechanically remove germs and dirt, a good hand sanitizer serves to inactivate (or kill) them. The problem is that even the best hand sanitizers do not kill all germs. Yes, research has shown that hand sanitizers with 80 percent ethanol or 75 percent isopropyl alcohol do inactivate COVID-19 — good news. But even these high-quality, potent, hand sanitizers do not kill norovirus, Clostridioides difficile, or Cryptosporidium — all germs that can cause sometimes fatal forms of diarrhea.
2. You may not be sure the hand sanitizer you are using is strong enough
We have all heard the recommendations to choose hand sanitizers that contain at least 60 (or 70, depending on where you live) percent alcohol by now. Are you sure that is what you are using? People making use of alcohol-based hand rub stations set up in public spaces may have no idea what they are putting on their hands. For that matter, you may not have closely examined the hand sanitizer you purchased for personal use, either.
3. Hand sanitizers can cause poisoning
Some hand sanitizers are manufactured using methanol — wood alcohol that can be toxic when it is either ingested or absorbed into the skin, something that happens as part of your regular use. This lesser-known danger of hand sanitizers has recently caused the US Food and Drug Administration (FDA) to send out a warning against alcohol-based hand rubs with labels like "Eskbiochem" and "Made in Mexico".
Even "normal" hand sanitizers pose a poisoning risk, however. While poison control makes it quite clear that licking your hand after using hand sanitizer won't poison you (or your children), kids who accidentally ingest hand sanitizer could suffer complications ranging from low blood sugar levels to seizures, coma, and even death. This is true for any strong alcohol-based product. To put things in perspective, poison control centers in the United States alone receive thousands of worried calls after children ingested hand sanitizer every year.
4. User error: Are you actually using your hand sanitizer correctly?
Quickly dabbing a miniscule amount of alcohol-based hand rub on your hand and swishing it around a bit may make you feel like you're doing your bit to flatten the curve and keep you safe, and therein lies one of the biggest dangers of hand sanitizers.
For hand sanitizer to be effective, you need to use large enough amounts to cover your entire hands, and thoroughly rub their palms, tops, between the fingers, and around the fingernails — until the product dries completely. The research that showed (the correct kind of) hand sanitizer to be effective against COVID-19 was based on people rubbing their hands together vigorously for exactly 30 seconds.
5. Hand sanitizers simply aren't suitable for all situations
Alcohol-based hand rubs play a tremendously important role in minimizing the spread of germs in health care settings, in which they are almost always actively recommended. "If it's good enough for doctors and nurses," you may think, "it's got to be good enough for me, too". The truth is more complicated.
Hospital workers have a high risk of exposure to bacteria, viruses, and parasites when they touch patients and surfaces. Their circumstances could be significantly different than yours, though — their hands are less often soiled, greasy, or contaminated with dangerous chemicals.
Hand sanitizers are not suitable in situations where your hands are:
- Greasy
- Visibly dirty
- Subject to contact with chemicals such as pesticides or heavy metals, whether in a workplace or personal setting
In all these cases, you will want to rely on the mechanics of washing your hands with soap and water — because washing your hands physically flushes whatever was on your hands down the drain, and soap degreases.
Also keep in mind that even in health care settings, the CDC still very much recommends that people wash their hands with soap and water, rather than turning to hand sanitizers, before eating and after using the bathroom.
6. Hand sanitizers are a fire hazard
The "alcohol" in "alcohol-based hand rubs" is what kills germs, but anything with that much alcohol in it is also inherently highly flammable. The risk that your hands will catch on fire significantly decreases after your hand sanitizer has dried, but if you have — like many people — gone on coronavirus-induced panic buying sprees, you may have to be worried about the fire risk your personal stockpile poses.
Hospitals, which store large quantities of hand sanitizer, would be subject to health and safety regulations as well as inspections from the local fire department or other relevant authority. Nobody is going to inspect your home to see how you store your hand sanitizer, but the fire risk involved should still be considered.
A final word
Hand sanitizers are here to stay — and they play a vital role in advancing public health and preventing the spread of infections. They are not suitable for all circumstances, however, and their correct use depends on you. As long as you are aware of the potential dangers of hand sanitizers, you can use them responsibly. Soap and water should still, however, be most people's main source of hand hygiene.
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- Photo courtesy of SteadyHealth