ArticleBMC infectious diseases2007
Quantity of ethanol absorption after excessive hand disinfection using three commercially available hand rubs is minimal and below toxic levels for humans.
Article in BMC infectious diseases, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 110 citations in OpenAlex.
- Inhalation of Alcohol Vapor: Measurement and Implications.Alcoholism, clinical and experimental research · 2017Pooled it
- "We have to clean ourselves to ensure that our children are healthy and beautiful": findings from a qualitative assessment of a hand hygiene poster in rural Uganda.BMC public health · 2019Trial
- Preventing neonatal sepsis in rural Uganda: a cross-over study comparing the tolerance and acceptability of three alcohol-based hand rub formulations.BMC public health · 2018Trial
- Transdermal absorption of ethanol- and 1-propanol-containing hand disinfectants.Langenbeck's archives of surgery · 2011Trial
- Contribution of dermal ethanol absorption during laboratory-controlled high-frequency use of alcohol-based hand rubs followed by glove use.Archives of toxicology · 2026Article
- Development of the active ingredient composition of hand antiseptics in Germany from 2004 to 2022 with special consideration of ethanol as active agent.GMS hygiene and infection control · 2025Article
- Study on hand disinfection in inpatient geriatric care on the superiority of cold plasma aerosol versus alcohol-based disinfection methods in a parallel group design.Scientific reports · 2024Article
- "Not everything that can be counted counts" in ethanol toxicological results: an antemortem and postmortem technical interpretation focusing on driving under the influence.Forensic sciences research · 2024Review
- Effect of Long-Term Use of Alcohol-Containing Handwashing Gels on the Biofilm-Forming Capacity ofInternational journal of environmental research and public health · 2023Article
- Ethanol is indispensable for virucidal hand antisepsis and without toxic risks in daily use.GMS hygiene and infection control · 2023Article
- On the emergence of a health-pollutant-climate nexus in the wake of a global pandemic.Environmental science and pollution research international · 2022Article
- Biosurfactants in the sustainable eradication of SARS COV-2 from the environmental surfaces.3 Biotech · 2022Review
- Assessment of ethanol exposure from hand sanitizer use and potential for developmental toxicity in nursing infants.Journal of applied toxicology : JAT · 2022Review
- Ethanol is indispensable for virucidal hand antisepsis: memorandum from the alcohol-based hand rub (ABHR) Task Force, WHO Collaborating Centre on Patient Safety, and the Commission for Hospital Hygiene and Infection Prevention (KRINKO), Robert Koch Institute, Berlin, Germany.Antimicrobial resistance and infection control · 2022Review
- Analysis of Consumer Exposure Cases for Alcohol-Based Disinfectant and Hand Sanitizer Use against Coronavirus Disease 2019 (COVID-19).International journal of environmental research and public health · 2021Article
- Review
- Raising awareness about the unintended consequences of hand sanitiser in children.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2021Article
- COVID-19 and frequent use of hand sanitizers; human health and environmental hazards by exposure pathways.The Science of the total environment · 2020Review
- Potential methanol toxicity and the importance of using a standardised alcohol-based hand rub formulation in the era of COVID-19.Antimicrobial resistance and infection control · 2020Article
- Molecular mechanism of the skin permeation enhancing effect of ethanol: a molecular dynamics study.RSC advances · 2020Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the increasing promotion of alcohol-based hand rubs and the worldwide use of ethanol-based hand rubs in hospitals only few studies have specifically addressed the issue of ethanol absorption when repeatedly applied to human skin. The aim of this study was to assess if ethanol absorption occurs during hygienic and surgical hand disinfection using three different alcohol-based hand-rubs, and to quantify absorption levels in humans.
methodsTwelve volunteers applied three hand-rubs containing 95% (hand-rub A), 85% (hand-rub B) and 55% ethanol (hand-rub C; all w/w). For hygienic hand disinfection, 4 mL were applied 20 times for 30 s, with 1 minute break between applications. For surgical hand disinfection, 20 mL of each hand rub was applied to hands and arms up to the level of the elbow 10 times for 3 minutes, with a break of 5 minutes between applications. Blood concentrations of ethanol and acetaldehyde were determined immediately prior and up to 90 minutes after application using head space gas chromatography.
resultsThe median of absorbed ethanol after hygienic hand disinfection was 1365 mg (A), 630 mg (B), and 358 mg (C). The proportion of absorbed ethanol was 2.3% (A), 1.1% (B), and 0.9% (C). After surgical hand disinfection, the median of absorbed ethanol was 1067 mg (A), 1542 mg (B), and 477 mg (C). The proportion of absorbed ethanol was 0.7% (A), 1.1% (B), and 0.5% (C). The highest median acetaldehyde concentration after 20 hygienic hand disinfections was 0.57 mg/L (hand-rub C, after 30 min), after 10 surgical hand disinfections 3.99 mg/L (hand-rub A, after 20 minutes).
conclusionThe overall dermal and pulmonary absorption of ethanol was below toxic levels in humans and allows the conclusion that the use of the evaluated ethanol-based hand-rubs is safe.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.