Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
7 Jan

Assessing Sanitizers: Cleaning Up the Confusion

If you believe the ads, we live in a squalid hotbed of menacing microbes. Evil germs are everywhere and out to get us – especially the innocent, well-dressed children playing nearby. The smart ones among us, the marketers tell us, navigate this ominous world armed with the right sanitizing defense. Even the grimiest restroom, the ad images show, can become as innocuous as a sparkling, surgery-ready space if we only have the security of hand sanitizer. Yes, the power of the imagination…

Sure, the marketing gurus make their buck by coaxing rampant, misplaced fear in the populace. (Funny how we don’t seem as terrified by a “Biggie” order of French fries as we do our own door knobs.) However, let’s put aside the cautionary ads and look at the facts. Sales have risen some 70% since last year. Part of it is the whole H1N1 alarm, but it’s a general trend as well. Even if the craze isn’t warranted, what about more moderate use of the products? Do these things even work? Do they really keep us healthier? Are we breeding so-called “superbugs” every time we use a squirt or spray? As always, let’s break it down.

The vast majority of hand sanitizers out there are alcohol based (like Purell) with one or more of the typical n-propanol, isopropanol or ethanol. To be effective, they contain anywhere from 60-90% alcohol. The alcohol “kills” (i.e. deactivates) the germs but requires the full drying time to do so. Additionally, sanitizers offer some ongoing, residual protection by making the skin surface inhospitable for bacteria and viruses. Ethanol-based sanitizers do a better job at killing certain viruses like the norovirus. Natural sanitizers like CleanWell use extracts from herbs (thyme being one) with inherent antiseptic properties and show effectiveness rates similar to chemical-based products (PDF Press Release).

Next, are you less likely to get the cold or flu if you use them regularly? Research suggests that college dorm residents (PDF) and elementary students given instruction and ready access to hand sanitizers show fewer overall infections and absentee rates than control groups. (It’s worth noting that the elementary school students used an herbal, alcohol-free sanitizer.) One randomized cross-over comparison of traditional hand-washing measures versus sanitizer use in an elementary school showed similar effectiveness in reducing absenteeism.

What are the cons of these products? Although alcohol-based sanitizers appear to be easier on the skin than soap and water washing, some people react to the products. Aside from the alcohol itself, other ingredients can be suspect, particularly the fragrances used in some formulas. There’s also some concern about the use of ethanol-based sanitizers, particularly on children. A safety review out last year suggested additional research was necessary to confirm topical safety for regular use products. Herbal-based sanitizers don’t dry hands as much as alcohol-based products, and they’re generally viewed as safe options across the board. One up and coming category I’d definitely recommend skipping is the silver nanoparticle sanitizer. The research shows too many risks to make these products worthwhile by a long shot.

As for the risk of encouraging “superbugs,” the whole of the research suggests that sanitizers are in the clear. The real culprit here is triclosan (PDF), an anti-bacterial ingredient found in everything from anti-bacterial soaps to mouthwash to lunch boxes to running shoes (look for the “microban” label). It’s a potent endocrine-disruptor. If you have a choice of washing with a triclosan-based soap or using a regular hand sanitizer, I’d go with the sanitizer – hands down. (Sorry – couldn’t resist.)

Personally, I don’t think sanitizers are necessary for normal, everyday circumstances, but I don’t see too much harm in them, particularly the natural herb-based brands. Maintaining a strong immune system and using good old soap and water are your best defenses. That old advice about not rubbing your eyes, nose or mouth was right on as well. A study published this fall linked nearly one third of flu risk to participants’ hand to face contact. If you’re traveling and worry you might not have access to a washroom, I don’t see a problem with taking along a bottle of natural sanitizer. At worst, it’s simply an unnecessary measure. At best, it might give you some peace of mind. And, of course, if you’re the one who’s sick and you want to exercise some extra precaution/courtesy, go ahead and use it as a backup to hand washing when you need to. All that said, I fear that hand sanitizers represent a growing trend to sterilize anything and everything when sometimes all we need is a little dirt, dust and dishevelment.

But let me turn it over to all of you. Do you use sanitizers on an occasional or regular basis? Do you skip them altogether? Let me know what you think. Thanks for reading.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. The local hospital did some research using elementary school kids as both subjects and method. The kids were being taught about science. They used hand sanitizer or old fashioned soap and water, then were swabbed and left to grow in a Petri dish with nutrient.

    Guess which was more effective?

    Yup.

    OnTheBayou wrote on January 8th, 2010
  2. I’m guessing the soap. Although the sanitizer may get rid of allot of germs, it doesn’t take away the fact that we also need germs to live. We can’t kill all the bacteria or we’d always be sick, and probably dead. I’m no nutritionist, but from what I understand, this is what I know to be true.

    Esther Anders wrote on January 8th, 2010
  3. “You know when I wash my hands? When I shit on them! That’s the ONLY time. And that only happens.. two to three times a week, tops — TOPS!”

    – George Carlin, RIP

    I’m with Michelle.

    If my hands get filthy, I’ll wash them. Otherwise, I don’t bother.

    Carlin’s results of swimming in the Hudson River as a child?

    “I don’t get upset stomachs…
    And you know why? ‘Cause I’ve got a good, strong immune system, and it gets a lot of practice! My immune system is equipped with the biological equivalent of fully-automatic military assault rifles, with night vision and laser scopes! And they have recently acquired phosphorous grenades, cluster bombs and anti-personal fragmentation mines!”

    That’s what I’m talkin’ about!

    Aaron Fraser wrote on January 8th, 2010
  4. I thought using antibacterial wasn’t a big deal until I ended up with staph infection and ring worm.

    Cut the primal bullshit and take advantage of modern science.

    Samson wrote on January 10th, 2010
  5. My 74 yr. old mother was just diagnosed with a MRSA infection. Many large boils, lots of pain. Initially, she thought the rash was shingles until it exploded. Now she’s on super strong antibiotics and has to wash her whole body with strong antibacterial body wash, even her hair. She has to disinfect her apartment and her clothing/towels/linens, etc. And she’ll probably never be free of it. She most likely contracted it from her small grandchildren, who’ve also had to be hospitalized with MRSA boils (surgical intervention). I think it would’ve been a lot easier had some of my family members bothered to use a few antibacterial wipes and some alcohol hand sanitizer. For those of you who believe that you won’t be or are not affected, many people are carriers of MRSA, and they can pass it on to the unsuspecting even though they have no symptoms themselves.

    Katy wrote on January 19th, 2010
    • “I think it would’ve been a lot easier had some of my family members bothered to use a few antibacterial wipes and some alcohol hand sanitizer”

      You do realise that MRSA is just a bacteria that has become resistant to antibiotics, so whether your family used antibacterial soaps or handwashes or not (which, by the way, aren’t as effective as antibiotics) they STILL could have got MRSA.

      Tepimonster wrote on March 30th, 2010
  6. I work with a ton of people with droplet precautions, and merca. If it weren’t for my hand sanitizing and washing.. my kids and I both would be sick right now. I do not want merca, therefore I even wear a mask around people who have it. A lot of people I work with that get scabies and such from patients because aren’t big on hand washing…. serves them right! No matter what, you are going to pick up germs, however it is foolish to go out of your way to pick them up. Its like touching a door handle at walmart then thinking ” I got food stuck in my teeth, I think I’ll just pick out the food, then I can have a better immune system!” Screw washing first!”…. Think of it this way, would you want a doctor operating on your insides who just had his hands on every door in the facility and didn’t bother to wash? hmmm… P.s Sanitizer kills microorganisms.. Pathogens ! aka.. HIV.. AIDS… and the most deadly diseases.. Trust me, its a good thing to wash and sanitize.. I study this stuff.

    Nicole Pritchard wrote on March 31st, 2010
  7. I learned my lesson with hand sanitizers. After a week of using an alcohol-chemical based spray, I got cracked, bleeding skin on my hands. Just moving my fingers was painful and made the cracks bleed. It was horrible. Now I buy Quash which is based on Manuka Honey. It also has the upside of not smelling like a dental clinic >.<

    Milla wrote on November 3rd, 2011

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