Assessment of exposure to ethanol vapors released during use of alcohol-based hand rubs by healthcare workers

Despite the increasing use of Alcohol-Based Hand Rub solutions, few studies have quantified the concentrations of inhaled ethanol. The aim of this study was to assess ethanol exposure during hygienic and surgical hand disinfection practices. Ethanol concentrations were measured at the nose level of a wooden dummy and human volunteers. Two systems were used in parallel to determine short-term ethanol vapor exposures: activated charcoal tubes followed by gas chromatography analysis and direct reading on a photoionization detector [PID]. Exposure was assessed for 4 different sequences [N = 10] reproducing hand rubs for simple surgery, nursing care, intensive care and surgical scrub. The ethanol concentrations measured were of a similar order between the dummy and volunteers. The concentrations obtained by PID were higher than the gas chromatography values for the simple care [45%] and nursing care [27%] sequences and reflected specific exposure peaks of ethanol, whereas ethanol concentrations were continuously high for intensive care [440 mg m[-3]] or surgical scrub [650 mg m[-3]]. Ethanol concentrations were similar for these two exposure assessment methods and demonstrated a relationship between handled doses and inhaled doses. However, the ethanol vapors released during hand disinfection were safe for the healthcare workers

Factors determining poor practice in alcoholic gel hand rub technique in hospital workers

Hand hygiene of healthcare personnel is one of the most important interventions for reducing transmission of nosocomial pathogens. Previous studies have demonstrated that the use of alcohol-based hand gel increases hand hygiene compliance, but that effective use of this product cannot be taken for granted. Evaluate factors associated with poor hand hygiene effectiveness of hospital workers using an alcohol-based hand gel and the effect of an education program. A direct observational prospective study of hand hygiene effectiveness prior to training and immediately after training. 3067 hospital workers of different professional categories in several hospital units in the University Hospital of Nancy [France]. Time after program start [OR 0.97, 95%CI 0.96-0.97] and being female [OR 0.37, 0.24-0.58] were highly associated with increased effectiveness of hand hygiene prior to training. Wearing rings other than a wedding ring [OR 1.8, 1.2-2.7], a bracelet [OR 2.0, 1.1-3.6], a watch [OR 1.9, 1.3-2.9] and having long nails were associated with ineffective hand rub use. Professional background was also a strong predictor with nurses and especially senior nurses demonstrating much better effectiveness than all other professional groups. Wearing wedding rings or long sleeves, and having varnished nails, visibly dirty hands prior to washing and cutaneous lesions were not associated with effective gel use