Hand sanitizer is standard equipment in many purses, and its use skyrockets during flu season and during outbreaks of germ-related health problems. The Nielsen research company reports that in 2009, hand sanitizer revenue soared 70 percent over the prior year in the wake of the swine flu pandemic, with $180 million in sales. Most sanitizers contain alcohol in varying concentrations, but some brands advertise themselves as alcohol free, leaving consumers with the challenge of choosing an effective product.
Hand sanitizers are used to clean the hands when soap and water are not readily available, as it does not have to be rinsed away. They are readily available in small bottles that can be stored in a purse or pocket and used in public environments. Alcohol is a standard ingredient, but it can dry the skin, so some companies have introduced nondrying, alcohol-free sanitizers.
Alcohol-based hand sanitizers may contain several different types of alcohol. Hand Hygiene, a patient care website, says the Food and Drug Administration, or FDA, recommends a 60 to 90 percent concentration of either ethanol or isopropanol. Alexa Nemeth of "Food Safety News" says many sanitizers contain benzalkonium chloride, a recognized antiseptic and antibacterial agent.
Hand Hygiene says it's difficult to assess the effectiveness of alcohol-free hand sanitizers because no standardized ingredient exists. Researchers at the Los Alamitos Unified School District in California conducted a five-week study in 2001 and found that students who used hand sanitizer containing benzalkonium chloride at scheduled times each day were 33 percent less likely to be absent due to illness.
Alcohol-based hand sanitizers are only effective if they contain enough alcohol. Elaine Larson, a professor of pharmaceutical and therapeutic research at Columbia University in New York, recommends a concentration of at least 60 percent. The amount is listed on the product label. Alcohol-free products should contain benzalkonium chloride because it is a known bacteria-killer, although no specific FDA recommendation exists for the amount that hand sanitizers should contain.
Deborah Franklin, a New York Times consumer columnist, says hand sanitizers are not meant to remove dirt and grime effectively. Soiled hands need to be cleaned with soap and water. A sanitizer can then be applied to kill any remaining germs. Otherwise, the dirt just gets moved around. Scott Reynolds, an infection control specialist at James H. Quillen Veterans Affairs Medical Center in Tennessee, discovered that ineffective hand sanitizers can actually spread harmful germs to a wider area, whether or not the hands are visibly dirty.