- The Washington Times - Monday, February 5, 2007

Medical facilities, sports clubs and elementary schools sometimes use them. A few supermarkets have them on-site. Even politicians have been spotted with them in plain view.

Hand sanitizers turn up everywhere, although etiquette mavens would argue that using antiseptic potions in public is less than proper, and at least one politician — Gov. Bill Richardson of New Mexico, a noted handshaker — calls the act condescending to voters.

Sold in bottles, tubes, dispensers and packets, these liquid, gel, spray and foam substances often claim to be better at discouraging or getting rid of disease-causing germs than washing one’s hands with soap and water. For people wanting extra protection, there is a sprayer on the market called the HYSO that automatically disinfects public restroom door handles — where germs commonly lurk — and a device called the Air Supply Ionic Personal Air Purifier designed to be worn around the neck.

Sales figures back up claims of hand sanitizers’ increasing popularity. Information Resources Inc., a private market research firm, reports that their sales in the United States have doubled since 2003, with Purell from Johnson & Johnson (a brand created by Pfizer in 1997) claiming nearly half or $36.3 million of the total $70 million sold in 2006.

The not-so-secret antimicrobial ingredient in most of these is ethyl alcohol, mixed with water and softening agents to reduce harshness. The label on a 1-ounce bottle of Purell’s instant hand sanitizer reads, “Kills 99.9% of Germs.” This is qualified on the back as: “kills 99.9% of most common germs that may make you sick,” and the product’s main use is said to be “to help reduce bacteria on the skin.”

Hand sanitizers work by removing the outer layer of oil on the skin and thereby getting rid of so-called transient microorganisms on the surface. Ideally, such potions should be rubbed into the hands for 30 seconds. (No stickiness results.)

That is reassurance of a kind, for sure. Just don’t expect total protection or overdo the habit, say scientists and health professionals. Use depends upon the setting and the circumstances.

Their chief value is their convenience. GelFast, invented for health care workers by infectious disease specialist Dr. Shmuel Shoham of the Washington Hospital Center and now being marketed to consumers, is a clip-on cartridge dispenser resembling a cell phone that is worn on the body.

Another plus, says the doctor’s brother Gilad Shoham, president of Medonyx Inc., the Toronto firm producing GelFast, is that the cartridge holding the bio-based gel solution is made of recyclable materials.

The Centers for Disease Control and Prevention, the nation’s foremost voice in the protection of public health, has recommended that health care workers use high-quality, alcohol-based gels instead of soap and water as long as workers’ hands are not visibly soiled.

In doing so, the centers recognize the convenience of portable or wall-based gel devices but caution that workers should use soap and water first to get rid of obvious grime.

Guidelines for food-service workers differ because the kinds of pathogens are different. In addition, food workers’ hands often are covered with fatty substances that are difficult to erase without extensive washing and friction. Hand washing along with gels is best in such circumstances.

Elaine Larson, a professor at New York’s Columbia University School of Nursing who has written and lectured extensively on sanitation practices, urges consumers to check the percentage of ethyl alcohol because less than 60 percent would not be an effective cleansing agent.

Overall, she says, “alcohol soaps are faster acting and are preferred if people want maximum killing. They are faster, and you don’t have to have a clean towel. They are preferable for people on the go when you can’t always find a sink.”

Consumers may find confusing the competing claims of antibacterial soap products containing triclosan, a compound with a chemical base different from ethyl alcohol. It is commonly found in deodorants, toothpastes and cleaning supplies, but controversy has arisen over whether its overuse could cause resistant strains of bacteria to develop.

Spokesman Jim Sliwa says the American Society for Microbiology has taken no official position on such products. Unlike alcohol-based products, ordinary soaps don’t kill bacteria, he notes: “They are surfactants by nature. They bind to whatever is on our hands and bind that to the water,” thus removing the bacteria.

Alcohol gels work by vaporizing bacteria and viruses, confirms Charles P. Gerba, professor of environmental microbiology at the University of Arizona who is author of a 2006 book called “The Germ Freaks Guide to Outwitting Colds and Flus.”

Tricloan’s effectiveness has yet to be proved, he says: “Unfortunately, the manufacturer never has shown it really works on the hands. They need to present more data.”

Among questions that skeptics raise is how people actually make use of such products. Also, do germaphobes really have a case when arguing for their need? Mr. Gerba says studies have shown just 16 percent of the population ever wash their hands properly or use sanitizers.

Whole Foods Market on P Street Northwest has put two barely visible dispensers by the stairs and an entry-exit door on the ground floor.

“For your added shopping satisfaction,” reads the print on the device. “Sanitize Your Hands With Sani-Hands,” the latter a trademarked name. On a recent weekday morning, one of the dispensers was empty; the other mostly was ignored by shoppers hurrying in and out of the store.

The popularity of such devices may rest on a less than rational basis, says sociologist Barry Glassner, author of “The Culture of Fear” and a more recent title, “The Gospel of Food” that point out misleading fears about many food choices in American culture.

“An important question to ask is: Are we making ourselves more afraid by using the product?” he says. “Every time you use one, you remind yourself you are afraid of germs in your environment. … Though we have some dangers around us, we are living in the safest time and place in human history as far as we know.”

Few would disagree that the number of consumer disinfectant products in the pipeline or coming onto the market indicates wide unease about the environment, no doubt propelled by media reports of impending assaults by virulent invaders from afar as well as mysterious outbreaks of E. coli at home.

One example of this is a press release announcing approval by the Environmental Protection Agency of a machine to decontaminate large spaces. It reads: “In our frightening world of lurking deadly infectious diseases and ever-threatening biological warfare, it’s no small comfort that Vaprox Hydrogen Peroxide (VHP) Sterilant system eliminates nearly all hazardous germs and other biological contaminants in any controlled space, including hospital rooms, cruise ships, schools and subway trains.” At a cost of $200,000 and up, however, this is hardly a best-seller.

Marketing minds are ever ready to take advantage of trends. Clean Freak Patrol brand hand-sanitizing gel hopes that schools will use its product to raise money for school activities while raising children’s awareness of the importance of good hygiene in what the company calls “a low anxiety, child friendly way.”

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