title: Microbiological efficacy and tolerability of a new, non-alcohol-based hand disinfectant.
abstract: OBJECTIVE
  Alcohol-based hand disinfectants are widely used in hospitals. Occasionally, there is a need for non-alcohol-based products, but alternatives have been scarce. We studied the microbiological efficacy and tolerability of a water-based hand disinfectant for healthcare workers.
  
  
  METHODS
  A water-based hand disinfectant was introduced as the only hand disinfectant in 5 wards in Turku University Hospital, Finland. Ninety-nine healthcare workers participated in fingerprint sampling during the 7-week study period. In another ward, 26 healthcare workers who were using alcohol-based hand disinfectant acted as control subjects for the skin reaction studies. The water-based product was tested in the laboratory according to the European standard EN 12791. We obtained 292 fingerprint samples before disinfection and 302 after disinfection. The opinions of healthcare workers were collected by use of a questionnaire, and skin reactions were assessed subjectively by use of questionnaires and objectively by measuring moisture and transepidermal water loss.
  
  
  RESULTS
  When tested in accordance with the European standard, the product met the requirements for short-term and long-term efficacy. The results of the fingerprint test showed that there was a statistically significant decrease in colonization of the fingertips before and after disinfection (P<.001). The users of the water-based hand disinfectant reported dry skin more often than did control subjects, but visual inspection and the results of the moisture measurement showed no difference between the users of the water-based hand disinfectant and the control subjects. Transepidermal water loss measurement also showed no deterioration of skin condition.
  
  
  CONCLUSIONS
  The water-based hand disinfectant was shown to be an effective hand disinfectant that caused relatively little skin irritation and can serve as a hand hygiene alternative in situations in which alcohol-based disinfectant cannot be used.
authors.affiliation: Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Niina
authors.initials: N
authors.lastname: Agthe
authors.forename: Kirsi
authors.initials: K
authors.lastname: Terho
authors.forename: Tiina
authors.initials: T
authors.lastname: Kurvinen
authors.forename: Marianne
authors.initials: M
authors.lastname: Routamaa
authors.forename: Reijo
authors.initials: R
authors.lastname: Peltonen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Laitinen
authors.forename: Mari
authors.initials: M
authors.lastname: Kanerva
mesh_terms: D017453:Dermatitis, Irritant / Q000209:etiology; D004202:Disinfectants / Q000009:adverse effects* / Q000737:chemistry / Q000494:pharmacology* / Q000592:standards; D005387:Finland; D006225:Hand / Q000382:microbiology*; D006235:Hand Disinfection / Q000379:methods* / Q000592:standards; D006282:Health Personnel; D006785:Hospitals, University; D006801:Humans; D012867:Skin / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D011795:Surveys and Questionnaires; D014867:Water / Q000032:analysis; D014870:Water Loss, Insensible
chemical_list: D004202:Disinfectants; D014867:Water