Alcohol vs. Non-Alcohol Sanitiser: Which One is Right for You?

The Importance of Hand Hygiene: Alcohol vs. Non-Alcohol Sanitizers

Hand hygiene has long been a cornerstone of infection control. As early as the 19th century, its role in preventing the spread of infections in hospitals was recognized—long before the discovery of microorganisms as disease agents. Despite this knowledge, adherence to proper hand hygiene has often been inadequate, even among healthcare professionals.

The Evolution of Hand Hygiene

Advances like antibiotics once gave a false sense of security, leading to poor compliance with handwashing guidelines. Studies showed that only about 50% of medical professionals consistently followed hand hygiene protocols. Many were also skeptical of alcohol-based hand rubs, preferring antiseptic soaps.

By the early 2000s, rising concerns over antibiotic resistance reignited focus on basic hygiene. In 2009, the WHO launched the Save Lives: Clean Your Hands initiative, promoting the Five Moments for Hand Hygiene and endorsing alcohol-based sanitizers when soap and water were unavailable.

Public Awareness and Compliance

Outside medical settings, awareness of hand hygiene remained low. A 2015 study found that fewer than 50% of people washed their hands after using the toilet, and only 14% of food handlers followed hygiene protocols.

The COVID-19 pandemic drastically changed this. With heavy promotion by governments and health organizations, hand hygiene became a global priority. Demand for sanitizer soared, leading to mass production shifts in distilleries, chemical companies, and perfumeries. In February 2020 alone, Google searches for "hand sanitizer" increased 100-fold.

Handwashing vs. Hand Sanitizer: Which is Better?

Washing with soap and water for at least 20 seconds remains the preferred method, as it effectively removes dirt, bacteria, and viruses. Soap molecules break apart the lipid membranes of viruses like influenza and coronaviruses, neutralizing them.

However, frequent handwashing can cause skin irritation, leading to cracks where microorganisms can reside. In such cases—or when soap and water aren't available—hand sanitizers provide an effective alternative.

Alcohol-Based Hand Sanitizers

Alcohol-based sanitizers are highly effective against enveloped viruses like SARS-CoV-2, Zika, and Ebola. Studies show that ethanol at concentrations of 30% or higher can inactivate SARS-CoV-2 within 30 seconds.

These sanitizers also cause less skin irritation than repeated exposure to detergent-based soaps. However, excessive use can lead to dryness, which is why humectants like glycerin are added. But high glycerin content can reduce antimicrobial effectiveness and leave a sticky residue.

While effective, alcohol-based sanitizers pose risks, including:

• Fire hazards due to their flammable nature.

• Poisoning risks, particularly for children. In 2020, Spain reported 874 cases of alcohol sanitizer intoxication, mostly among young children. The UK saw a 157% rise in such cases compared to 2019.

• Methanol contamination, which has led to poisoning and fatalities in several countries.
  

Non-Alcohol Sanitizers: A Safer Alternative?

Non-alcohol sanitizers, such as those containing quaternary ammonium compounds (QACs) like benzalkonium chloride, offer a viable alternative. These compounds:

• Are effective against bacteria and viruses, including SARS-CoV-2.

• Provide longer-lasting protection on the skin compared to alcohol-based sanitizers.

• Are gentler on the skin, reducing dryness and irritation.

• Eliminate poisoning risks, making them safer for children.

While the FDA has yet to update its guidance to include non-alcohol sanitizers, the EU and UK allow their use under strict efficacy standards.

So, Which is Better?

Both alcohol and non-alcohol hand sanitizers can be effective when used correctly. However, alcohol-based options are fast-acting and widely available, while non-alcohol sanitizers offer longer protection, are gentler on the skin, and pose fewer safety risks.

For businesses and individuals, choosing the right sanitizer depends on the specific setting and needs. Interested in enhancing hygiene at your workplace? Visit our hand hygiene hub for tailored solutions to keep staff and visitors safe.