title: Efficacy of hand rubs with a low alcohol concentration listed as effective by a national hospital hygiene society in Europe.
abstract: BACKGROUND
  Some national hospital hygiene societies in Europe such as the French society for hospital hygiene (SFHH) have positive lists of disinfectants. Few hand disinfectants with a rather low concentration of ethanol are listed by one society as effective for hygienic hand disinfection with 3 mL in 30 s including a virucidal activity in 30 s or 60 s, but published data allow having doubts. We have therefore evaluated the efficacy of three commonly used hand disinfectants according to EN 1500 and EN 14476.
  
  
  METHODS
  Products 1 (Aniosgel 85 NPC) and 2 (Aniosrub 85 NPC) were based on 70% ethanol, product 3 (ClinoGel derma+) on 60% ethanol and 15% isopropanol (all w/w). They were tested in 3 laboratories according to EN 1500. Three mL were applied for 30 s and compared to the reference treatment of 2 × 3 mL applications of isopropanol 60% (v/v), on hands artificially contaminated with Escherichia coli. Each laboratory used a cross-over design against the reference alcohol with 15 or 20 volunteers. The virucidal activity of the products was evaluated (EN 14476) in one laboratory against adenovirus and poliovirus in different concentrations (80%, 90%, 97%), with different organic loads (none; clean conditions; phosphate-buffered saline) for up to 3 min.
  
  
  RESULTS
  Product 1 revealed a mean log10-reduction of 3.87 ± 0.79 (laboratory 1) and 4.38 ± 0.87 (laboratory 2) which was significantly lower compared to the reference procedure (4.62 ± 0.89 and 5.00 ± 0.87). In laboratory 3 product 1 was inferior to the reference disinfection (4.06 ± 0.86 versus 4.99 ± 0.90). Product 2 revealed similar results. Product 3 fulfilled the requirements in one laboratory but failed in the two other. None of the three products was able to reduce viral infectivity of both adenovirus and poliovirus by 4 log10 steps in 3 min according to EN 14476.
  
  
  CONCLUSIONS
  Efficacy data mentioned in a positive list published by a society for hospital hygiene should still be regarded with caution if they quite obviously contradict published data on the same or similar products.
authors.affiliation: Bode Science Center, Bode Chemie GmbH, Melanchthonstraße 27, Hamburg, 22525, Germany ; Institut für Hygiene und Umweltmedizin, Ernst-Moritz-Arndt Universität Greifswald, Walther-Rathenau-Straße 49a, Greifswald, 17489, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Kampf
authors.affiliation: Microbiology, Bode Chemie GmbH, Melanchthonstraße 27, Hamburg, 22525, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Ostermeyer
authors.affiliation: HygCen International GmbH, Werksgelände 24, Bischofshofen, 5500, Austria.
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Werner
authors.affiliation: Institut für Hygiene und Angewandte Immunologie, Medizinische Universität Wien, Kinderspitalgasse 15, Vienna, 1090, Austria.
authors.forename: Miranda
authors.initials: M
authors.lastname: Suchomel
keywords: EN 14476; EN 1500; Efficacy; Hand disinfection; Virucidal activity