title: Effects of disinfectants and detergents on skin irritation.
abstract: We investigated the biological response of regular human skin to alcohol-based disinfectants and detergents in a repetitive test design. Using non-invasive diagnostic tools such as transepidermal water loss, laser-Doppler flowmetry and corneometry, we quantified the irritative effects of a propanol-based hand disinfectant (Sterillium), its propanol mixture (2-propanol 45% w/w and 1-propanol 30% w/w), sodium lauryl sulfate (SLS) 0.5% and distilled water. The substances were applied in a 2-D patch test in a repetitive occlusive test design to the back. Additionally, we performed a wash test on the forearms that was supposed to mimic the skin affection in the normal daily routine of health care workers. In this controlled half-side test design, we included the single application of the hand rub, SLS 0.5% and water as well as a tandem application of the same substances. Patch test and wash test showed similar results. The alcohol-based test preparations showed minimal irritation rather comparable to the application of water. However, the detergent SLS produced stronger barrier disruption, erythema and dryness than the alcohol-based preparations. There was no additional irritation at the combined use of SLS and disinfectants. By contrary, there was even a decrease in barrier disruption and erythema induced by the tandem application of SLS followed by alcohol-based disinfection compared with the use of SLS alone. These findings show a less irritant effect of alcohol-based disinfectants on the skin than detergents. Our study shows that there is no summation of irritating effects of a common detergent and propanol and that the combination of washing and disinfection has a rather protective aspect compared with washing alone.
authors.affiliation: Department of Dermatology, Philipp-University, Marburg, Germany. weimerc@med.uni-marburg.de
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Slotosch
authors.forename: Günter
authors.initials: G
authors.lastname: Kampf
authors.forename: Harald
authors.initials: H
authors.lastname: Löffler
mesh_terms: D000293:Adolescent; D000328:Adult; D017453:Dermatitis, Irritant / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000209:etiology*; D003902:Detergents / Q000009:adverse effects*; D004202:Disinfectants / Q000009:adverse effects*; D004890:Erythema / Q000209:etiology; D005260:Female; D006229:Hand Dermatoses / Q000209:etiology*; D006235:Hand Disinfection; D006282:Health Personnel; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D000644:Quaternary Ammonium Compounds / Q000009:adverse effects; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply; D012967:Sodium Dodecyl Sulfate / Q000009:adverse effects; D014867:Water; D014870:Water Loss, Insensible
chemical_list: D003902:Detergents; D004202:Disinfectants; D000644:Quaternary Ammonium Compounds; D014867:Water; C522448:ethylhexadecyldimethylammonium; D012967:Sodium Dodecyl Sulfate