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This is a very interesting article, it’s nice to see the topic of antimicrobials and resistances discussed more often. I 100% agree with a lot of the points you made, especially about the single use plastic waste in the purse pack hand sanitizers. There were a few things I wanted to point out however.

The article you linked to is excellent, although I noticed that it’s focusing primarily on the food industry and one of the first comments they make is about how a lot of evidence gathered on the effectiveness of alcohol as a disinfectant is tailored to the health industry, and so they wanted better evidence on their industry. For the food industry they’re right - hand washing is more effective than alcohol rubs. I’m guessing partly because of residues left on the hands from the food, but of course you don’t want to be then touching food with the residue from alcohol rubs.

Another thing to consider is what is actually used in hospitals. I realise this may vary a lot, so I can only speak for Australia and even then it could vary between hospitals. They generally use a 90% alcohol rub, which is capable of killing almost all bacteria and viruses other than rabies and possibly TB. 70% alcohol however can’t kill enveloped viruses (if I recall correctly, that includes influenza, HIV and the common cold virus).

Something I disagreed on was the statement about triclosan. I definitely don’t think it’s good, but it isn’t used in hand sanitizers with alcohol in (at least not here) because the whole purpose of triclosan is to be an alternative that’s used in alcohol free hand sanitizers. So while it is definitely not a good compound, as far as I know it is definitely not a primary ingredient in most sanitizers, just the alcohol free kind. Glycerin is used to offset the dryness from the alcohol and can indeed dry out the skin, but only in low humidity environments. This is because it is forming a protective barrier against the skin, so if your hands are already dry then it can end up drawing further moisture from the dermis. It’s kind of like how you can become “dependent” on cheap/bad lip balms. The environmental impact of glycerin is definitely another downside to it though.

Just recently in our labs we did an experiment on just this - the efficacy of hand washing vs. alcohol rubs. Our experiment showed very different results to the article linked, and I have a few theories why. The experiment was done with agar plates how samples of unwashed hands, and then several different combinations (1: hand washed, 2: alcohol rub, 3: handwashed then alcohol rub, 4: handwashed then handwashed, 5: alcohol rub then handwash, 6: alcohol rub then alcohol rub). Our obvious winner was 6, followed by 3, 2, 4 and then 1. One of the main things we had to consider was that hand washing almost always removes the outer layer of oil/protection on your skin, and potentially exposes more bacteria to others (your own skin flora) than to begin with. In the samples for number 1, all but one agar plate showed higher bacteria levels after handwashing than before. If you’re after a very thorough wash I’d be inclined to recommend treatment 3, as it would remove residues, and possibly compounds that the alcohol rub couldn’t kill. We also found that bacteria could be picked up from the hand drying source, and the soap bar (I see that you have mentioned liquid soap though, so this problem would be resolved).

I guess my point here though is that alcohol rubs (80% and above) are an amazing way to quickly disinfect already (mostly) clean hands. So no, not effective in the food industry and no, not effective for doctors and people working in hospitals. But for speed and cleanliness for visitors, I feel they’re very effective. Aside from the environmental downsides of glycerin, alcohol rubs are cheap to produce, extremely effective when around the 90% mark, and don’t promote antimicrobial resistance in any way (they are bactericidal, and kill bacteria which means the bacteria don’t have a chance to develop resistance. Ethyl alcohol uses a process known as “denaturation” wherein the cell membrane is effectively dissolved, along with the insides. Resistance occurs [generally] when the antimicrobial compound is only bacteriostatic, and just disables the bacteria). The problem arises with alcohol-free rubs and the triclosan in them, and thankfully they aren’t used in hospitals, at least over here :)

Thanks for such a detailed response. 😍

I guess the observation needs to be made that in Australia (where I grew up & lived for many years) the standard of labeling & ingredients in the sanitizers is (hopefully) more tightly controlled than Thailand. I say "hopefully" because of the illusion of control & standards. I export natural products into Oz now & it's one of the easiest countries and requires almost zero manufacturing or ingredient disclosure. Truly.

So much to consider. My biggest response is that while your particular alcohol rub might be effective, it's the repeated use of an environmentally damaging product that denatures & harms the skin which sets that particular individual repeat user up for future bacterial issues, as rough dry skin harbours more bacteria than healthy functioning skin.

In my natural products biz where hand sanitation issues are a daily thing, we (like the food industry) would never allow hand sanitizer due to contamination - same as we dont allow latex gloves due to powder contamination. If I wouldnt contaminate a product with that icky chemical residue, why would I contaminate my immune compromised grandma or a newborn baby by touching them?

I think you win Epic Comment of the Week. 💚

Sometime i wonder, why do they do so many artificial things when nature are so fantastic? Especially when the artificial products are poisoning the world...

Tough question & a very valid one. I guess we can only ever be diligent ourselves so that "we" don't become "they". Thanks for stopping by.

Thank you @artemislives! I knew I never liked the stuff, and avoid it, as much as possible. I did not know this:

Effect of soap and water compared with alcohol gel sanitizer. As shown in Figure 5, a 20-s wash with the non-medicated liquid soap and water was more effective at removing bacteria from palms than application of a gel sanitizer containing 70% alcohol (study E). Interestingly, use of both products in sequence resulted in more bacteria being transferred versus soap and water alone. This suggests that use of alcohol on the hands after washing them may increase transfer of bacteria that are normally sequestered.

That part is insane...literally. Thank you for sharing such important information.

It IS insane, especially when we see the horrendous bacterial resistance developing in the world.

I was faced with this issue when my sister was in the hospice,me and my family were told to use the hand sanitizer before entering the room, my children too. I never did and certainly did not want my girls too. I know what they contain and how damaging they are, thank you for sharing this and helping to promote awareness xxx

How awful to require the sacred process of dying to be tainted by that yucky chemical smell! I didn't even post about the dangerous endocrine-disrupting fragrance factor in some brands! So glad we have some smart moms out there, protecting their girls and their tender young skin.

Well done, @artemislives! It is important to bring voices of alert to products designed more to fill the pockets of companies behind the curtain, than by lending a real aid, economic and friendly to the environment and people. The fierce marketing behind a product makes it suspicious.
Greetings and a warm hug, my dear.

Yes, the intensity of the marketing is already a big red flag. Thank you for that HUGE FAT UPVOTE! LOL.

Greetings and a warm hugs back. x

Interestingly, this is something I've only just started discovering more about. My daughter has been learning about it and her essays have been on antibiotic resistance, so we've been having conversations on it. I think she'll be interested in reading this.

I was interested to discover that hand sanitisers are also completely ineffective against some viruses (due to a thicker fat coating which protects them, if I reminder correctly). The virus in question in the case I was reading about was influenza A and washing your hands under running water alone is more affective than using an alcohol sanitizer.

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Honestly, I could have written a book about this. Yes, there is so much research out there to show that hand sanitizers are NOT effective and yet we still have Big Pharma and so-called leading hospitals pedaling this stuff. We have not yet BEGUN to understand what we have done to the environment, as we continue to merrily wash these dangerous biocides into our waterways.

I'm glad your daughter is learning about this - just so glad.

It is a very complete article that goes beyond a simple anecdote of your visit to the hospital @artemislives, is informative and educational, hopefully in countries like mine could be informed of the damage that brings this kind of things to the environment, thank you for this excellent material, we thank you and send you a big hug.

Sadly I know in Venezuela this is now hypothetical, as most hospitals lack the most basic of supplies. I'm glad they can't afford this one. Big hugs back to you and the children.

Welcome... & thanks for stopping by. 😊

Hate Glycerine. Hate tricolsan. Hate the misplaced neurosis and misinformation of modern medical practice.... Love you post.

We need to plug away at showing people the science of why glycerine appears to soften skin (whilst actually destroying it) and how triclosan is a bacterial and environmental nightmare that's just beginning. Thanks for stopping by and your support. Much appreciated.

When you put it like that, it sounds valid. Almost counterintuitive.

P.D: I'd appreciate your review on my latest post btw

Really GOOD post @zen-fit - following you from Chiang Mai in Northern Thailand. More obesity related content please!!

working on my next article, stay tuned. hint: the best times to workout

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