title: The relative influences of product volume, delivery format and alcohol concentration on dry-time and efficacy of alcohol-based hand rubs.
abstract: BACKGROUND
  Alcohol-based hand rubs (ABHR) range in alcohol concentration from 60-95% and are available in a variety of delivery formats, such as rinses, gels, and foams. Recent studies suggest that some ABHR foams dry too slowly, thereby encouraging the use of inadequate volumes. This study investigates the influence of product volume, delivery format, and alcohol concentration on dry-time and antimicrobial efficacy of ABHR foams, gels and rinses.
  
  
  METHODS
  ABHR dry-times were measured using volunteers to determine the influences of product volume, delivery format, and alcohol concentration. ABHR efficacies were evaluated according to the European Standard for Hygienic Hand Disinfection (EN 1500) using 3-mL application volumes rubbed for 30 s, and additionally, using volumes of the products determined to rub dry in 30 s.
  
  
  RESULTS
  Volumes of six ABHR determined to rub dry in 30 s ranged from 1.7 mL to 2.1 mL, and the rate of drying varied significantly between products. ABHR dry-times increased linearly with application volume and decreased linearly with increasing alcohol concentration, but were not significantly influenced by product format. An ABHR foam (70% EtOH), rinse (80% EtOH), and gel (90% EtOH) each met EN 1500 efficacy requirements when tested at a volume of 3 mL, but failed when tested at volumes that dried in 30 s.
  
  
  CONCLUSIONS
  Application volume is the primary driver of ABHR dry-time and efficacy, whereas delivery format does not significantly influence either. Although products with greater alcohol concentration dry more quickly, volumes required to meet EN 1500 can take longer than 30 s to dry, even when alcohol concentration is as high as 90%. Future studies are needed to better understand application volumes actually used by healthcare workers in practice, and to understand the clinical efficacy of ABHR at such volumes.
authors.affiliation: GOJO Industries, Inc, One GOJO Plaza, Suite 500, Akron, OH 44311, USA. macingad@gojo.com.
authors.forename: David R
authors.initials: DR
authors.lastname: Macinga
authors.forename: David J
authors.initials: DJ
authors.lastname: Shumaker
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Werner
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Edmonds
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Leslie
authors.forename: Albert E
authors.initials: AE
authors.lastname: Parker
authors.forename: James W
authors.initials: JW
authors.lastname: Arbogast
mesh_terms: D001419:Bacteria / Q000187:drug effects; D002626:Chemistry, Pharmaceutical; D004202:Disinfectants / Q000737:chemistry* / Q000494:pharmacology; D000431:Ethanol / Q000737:chemistry* / Q000494:pharmacology; D006235:Hand Disinfection / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D013997:Time Factors; D014835:Volatilization
chemical_list: D004202:Disinfectants; D000431:Ethanol