The popularity of hand sanitizer has increased in recent years as a result of virus outbreaks such as H1N1 flu. Formerly, hand sanitizer was used mostly in clinical and food service settings, as an adjunct to soap and water. Pandemic information commercials and infection control policies for public buildings and workplaces have ensured that you probably have hand sanitizer somewhere in your home or purse.
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Historically, erasing bacteria completely from most environments has been thought unnecessary. According to Amy Simonne of the University of Florida, doing so can be harmful. You need some bacteria to digest food and ward off illness. The most important use of hand sanitizer has traditionally been to prevent fecal matter and food-borne bacteria from spreading. Prior to the last decade, its use was restricted to hospitals and restaurants.
Since the recent, repeated outbreaks of aggressive viruses and public concern regarding pandemics, more attention has been paid to the contribution everyone can make to the prevention of cross-infection. Public places, shops and work environments all contain sites, such as door handles and elevator buttons, that many people touch in the course of a day. Hand sanitizer has become a replacement for hand-washing when soap and water are not available.
The most common sanitizer brands have alcohol as their active ingredient. The alcohol may be ethanol, isopropanol or a mix of the two compounds. Alcohol works by removing the surface oil from the skin of your hands, which contains bacteria and viruses. It also kills most of these microorganisms by denaturing the proteins they contain. The product also contains a moisturizer to prevent the alcohol from drying your skin.
Some organizations, such as schools, have concerns with supplying alcohol-based products. Sanitizers without alcohol are now available. The active ingredient in these is benzalkonium chloride, which traditionally was used as a topical wound antiseptic. Researchers in California have tested the effectiveness of alcohol-free sanitizer compared to hand-washing in an elementary school, and have found a considerable reduction in illness among children.
Hand sanitizer should not replace normal hand washing. Simonne stresses that soap and water, where practical, are still sufficient and best. She adds that an additional application of sanitizer is advisable when working with people whose immunity may be compromised or who may be ill with an infection. Overuse of sanitizers may be contributing to resistant organisms. A study in Norway shows an increased tolerance to benzalkonium chloride in some E. coli bacteria.