THURSDAY, April 25, 2002 (HealthDayNews) -- The new and increasingly popular alcohol-based hand washing gels aren't as effective as older rinses in killing germs that can cause in-hospital infections, a Swiss study finds.
In a hand-to-hand comparison, 10 different gels did not meet a European standard for killing germs, while four rinses did, says a report in the April 27 issue of The Lancet.
If the difference is real, it is not trivial. In-hospital infections are a major health problem. The Centers for Disease Control and Prevention estimates there are 2.4 million of those infections annually, causing 30,000 deaths and costing $4.5 billion dollars because of extended hospital stays. And dirty hands are often responsible; it's been estimated that doctors, nurses and other hospital workers don't wash their hands properly 70 percent of the time.
Discomfort is one reason for that failure. Alcohol-based rinses can cause annoying dryness, and the gels were introduced to solve the problem. A group led by Dr. Didier Pittet of the University of Geneva Hospitals put the gels to the test.
Fifteen volunteers first washed their hands for a full minute, then dipped them into a microbe-contaminated solution. Then they washed their hands again, with either a gel or a rinse. Most of the rinses met the European standard for disinfection after 30 seconds, but the gels did not, the report says.
So switching from rinses to gels "would be a backward step and unnecessarily lower the hygiene standard," says a statement by Pittet. "An increased risk of cross-transmission [of germs] would certainly result because the application time in daily practice averages 8-15 seconds and is unlikely to exceed 30 seconds."
The study and its conclusion draw immediate criticism from Yusuf Ali, vice president of product development at GOJO Industries, which markets Purell, the leading gel-based product in the United States.
"What concerns me is the number of participants in the study," Ali says. "There were only 15 respondents, and when you talk about human hands, there can be a lot of variation in the efficacy of the product."
The journal report also states that an employee of a company that manufactures a rinse participated in the study and helped write the paper, Ali notes.
A mass of data in the United States supports the use of rinses, Ali says, and those data are cited in guidelines that are about to be released by CDC.
"If you look at the CDC rules that are being drafted, they recommend that these alcohol-based sanitizers be used in hospitals," he says. "There are 350 references in the CDC guidelines and they recommend both gels and rinses. Our product has been on the market for more than 10 years, and there are quite a few studies indicating its safety and effectiveness. We had our product tested by an independent laboratory, and it met the European standards very handily."
The draft CDC guidelines said an alcohol sanitizer should be "the primary method to clean hands except when they are very dirty." They also said that "routine use of moisturizing lotions helps maintain good skin health."
The guidelines are undergoing a final review and should be released "very soon," says Thomas Skinner, a CDC spokesman.
What To Do
What's good in the hospital is good at home, but no special equipment is necessary. Thorough washing with plain soap and water, especially after going to the bathroom, is a basic, essential sanitary measure.
The rationale and recommendations for hand washing at home are available from the Centers for Disease Control and Prevention, which also has a page on infections in the health care industry.
