It isn’t uncommon today to see hand sanitizer stations in building lobbies or near elevator banks. This is especially true in hospitals and healthcare facilities that are trying to prevent the spread of infection among patients. But recently, serious concern is being expressed that the prevalence of these hand sanitizers is actually contributing to an increase in communicable infections, including nosocomial infections.
Nosocomial infections are infections that patients contract within hospitals. Because patients are typically fighting an illness, their immune systems are often stressed or suppressed, making them more susceptible to contracting infections inadvertently spread by staff and visitors. According to the Center for Disease Control, as many as 2 million Americans die each year from nosocomial infections.
Beginning in the 1970’s, scientists identified a strain of bacteria that was resistant to normal antibiotics. MRSA (Methicillin-resistant Staphylococcus aureus) is a bacterial skin infection that is spread by human contact. Over the years, cases of MRSA have been reported arising within hospitals, nursing homes, schools, cruise ships and office buildings. Today, about 100,000 cases of MRSA are recorded each year in the U.S. Each new case of MRSA, it seems, warrants sensationalized news coverage, that tends to spread fear and confusion. It is this fear and confusion that has led to the popularity of hand sanitizer and the sanitizer stations now appearing in most commercial buildings.
According to researchers, a problem has arisen among people who have come to believe that hand sanitizer alone is sufficient to protect both themselves and others from contracting infection. Having reduced their use of soap and water in favor of these hand gel sanitizers, some of which contain moisturizing lotions that are not as abrasive to the skin as are many soaps, infection rates are increasing both among the general public and in healthcare facilities. This change from soap and water to hand sanitizers seems especially true among healthcare workers who move from patient to patient and have come to rely on a dab of sanitizing gel to cleanse their hands and protect their patients.
Antibacterial gels have no effect on viruses. Viruses are not living organisms, but are fragments of genetic material that cannot replicate outside of a cellular host. The most effective way to remove viruses from ones hands is through hand washing with soap and water. The friction created during hand washing, coupled with soap’s ability to make water wetter, loosens viruses from one’s hands and sends them down the drain. The friction created by applying hand sanitizers may also loosen and move viruses around on the hands, but ultimately, they remain on your hands and are unaffected by antibacterial gel.
Bacteria are living organisms and typical stains of bacteria can indeed be killed by antibacterial gel. Unfortunately, however, some bacteria are resistant to the antibacterial properties contained in hand sanitizers. It is these “superbugs” that are causing increased alarm among medical professionals.
Ironically, the overuse of antibiotics is blamed as the cause for the rise in drug resistant bacteria like MRSA. Bacteria that was once effectively eliminated by antibiotics have developed resistance to these same antibiotics. This mutation by bacteria is not a new phenomenon. That bacteria have been developing resistance to antibiotics is true since penicillin first became used for combating infections in the 1940s. As bacteria has mutated, scientists were able to develop different antibiotics that overcame such resistances. The problems encountered today is that bacteria is doing a better job at developing resistance to the antibiotics than science is at developing newer antibiotics.
Beside MRSA, Streptococcus, E-coli, Pseudomonas aeruginosa, Salmonella and other pathogens have developed high resistance to antibiotics. Recently, Clostridium difficile has made news reports because of large outbreaks of diarrheal disease within hospitals, nursing homes and other commercial facilities. Clostridium difficile or C-diff as it is sometimes called, is a highly contagious disease.
The C-diff pathogen stems from human excrement and can remain active on furniture, hardware and other surfaces for weeks before being picked up by human contact. Spread by contact, it is specifically the type of bacteria that most people would expect a hand bacterial gel to eliminate. But C-diff is completely impervious to antibacterial hand sanitizers as are many other forms of bacteria.
According to the Food and Drug Administration, no medical studies exist that demonstrate a relationship between the use of antibacterial products and a decrease in the rate of infections. In other words, there is no medical or scientific evidence anywhere that demonstrate a relationship between the use of antibacterial gels and a decrease in the number of infections spread between people. While most of these antibacterial gels claim to remove 99.9% of bacteria, in fact those claims pertain to tests done under laboratory conditions using non-porous surfaces. One study that tested these products effectiveness on human hands found that there was no actual difference between the use of these products for removal of bacteria and plain old hand washing.
While most drug resistant pathogens can still be treated through advanced forms of antibiotics, scientists remain concerned that new mutations will arise that defy eradication by all known antibiotics. This means that reducing the use of products containing antibiotics in favor of more conventional methods to cleanse our hands is important not just for protecting ourselves but also for protecting future generations that may come into a world without the benefit of antibiotic treatments that have saved so many lives since the 1940s.
While engineers are naturally concerned about protecting their tenants and facility occupants from all the dangers that can be encountered in large facilities, one of the more common ways that we can offer protection is by insuring that washroom facilities are always equipped with the soap and hot water and by reducing or eliminating entirely the presence of hand sanitizer within our facilities. Outside of nursing homes and healthcare, the use of these products can attribute to more problems than they may solve.