Analysis of alcohol-based hand sanitizer delivery systems: efficacy of foam, gel, and wipes against influenza A (H1N1) virus on hands.
BACKGROUND
Minimal research has been published evaluating the effectiveness of hand hygiene delivery systems (ie, rubs, foams, or wipes) at removing viruses from hands. The purposes of this study were to determine the effect of several alcohol-based hand sanitizers in removing influenza A (H1N1) virus, and to compare the effectiveness of foam, gel, and hand wipe products.


METHODS
Hands of 30 volunteers were inoculated with H1N1 and randomized to treatment with foam, gel, or hand wipe applied to half of each volunteer's finger pads. The log(10) count of each subject's treated and untreated finger pads were averaged. Log(10) reductions were calculated from these differences and averaged within treatment group. Between-treatment analysis compared changes from the untreated finger pads using analysis of covariance with treatment as a factor and the average log(10) untreated finger pads as the covariate.


RESULTS
Log(10) counts on control finger pads were 2.7-5.3 log(10) of the 50% infectious dose for tissue culture (TCID(50)/0.1 mL) (mean, 3.8 ± 0.5 log(10) TCID(50)/0.1 mL), and treated finger pad counts for all test products were 0.5-1.9 log(10) TCID(50)/0.1 mL (mean, 0.53 ± 0.17 log(10) TCID(50)/0.1 mL). Treatments with all products resulted in a significant reduction in viral titers (>3 logs) at their respective exposure times that were statistically comparable.


CONCLUSIONS
All 3 delivery systems (foam, gel, and wipe) produced significantly reduced viral counts on hands.
School of Nursing, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. Ell23@columbia.edu
Elaine L
EL
Larson
Bevin
B
Cohen
Kathleen A
KA
Baxter
D000293:Adolescent; D000328:Adult; D000368:Aged; D000438:Alcohols / Q000008:administration & dosage*; D004202:Disinfectants / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D005260:Female; D006225:Hand / Q000821:virology*; D006235:Hand Disinfection / Q000379:methods*; D006805:Human Experimentation; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D019562:Viral Load; D055815:Young Adult
D000438:Alcohols; D004202:Disinfectants