Differentiation of Alcohol-based Hand Rubs: Assessment of Proclivity and Efficacy
Kristen Green1, Christine Claighen1, S Steve Zhou2, Richard Martinello3, Rachel Leslie1, William Jarvis4, James Arbogast1
1GOJO Industries, Inc., Akron, United States
2Microbac Laboratories, Inc., Sterling, United States
3Yale School of Medicine, New Haven, United States
4Jason and Jarvis Associates, LLC, Hilton Head, United States
Introduction: Alcohol based hand rubs (ABHRs) are ubiquitous in healthcare, leveraged for ease of use, safety, and effectiveness. The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) advocate ABHRs containing 60%-95% alcohol as standard of care when hands are not visibly soiled. CDC has maintained these recommendations during the COVID-19 pandemic. However, dose and formulary decisions beyond alcohol concentration often are detrimental to ABHR performance.
Methods: Eleven commercially available ABHRs were evaluated by ASTM International E1174 (Health Care Personnel Handwash [HCPHW]) for bacterial efficacy. ABHRs ranged from 60%-90% alcohol. Products that passed were assessed for SARS-CoV-2 efficacy by suspension testing per ASTM E1052 method. An observational study was conducted with 53 nurses to measure preferred ABHR volumes and real-life use efficacy implications.
Results: Two 70% ethanol formulas (gel and foam) met E1174 requirements using 2-mL applications. All other test products failed to meet HCPHW criteria at 2-mL. Both 70% ethanol ABHRs reduced SARS-CoV-2 virus below detectable limits (>3 log10) by E1052. The observational study determined nurses’ preferred volume of ABHR per use was 1.09 mL.
Conclusion: HCPHW testing shows that neither higher alcohol concentration nor product format (gel or foam) is indicative of product performance. Our SARS-CoV-2 results further support the use of a well-formulated ABHR against COVID-19. Nurses’ preferred use volume is similar to what is dispensed from some leading automatic dispensers (1.1 mL) found in hospital settings and emphasizes necessity to achieve broad efficacy with this dose.
Biography:
Kristen Green is a Clinical Scientist with GOJO Industries, Inc. She has been on the Research & Development team since 2011, involved with in vivo and in vitro testing of hand hygiene products. She is responsible for testing in accordance with standard methods and practices, within EPA or FDA guidelines, and providing support for FDA OTC Antiseptic Monograph. Kristen holds a Masters of Science in Clinical Research from Drexel University and an undergraduate degree in Biology from Coastal Carolina University.