title: Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption.
abstract: During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase.
  
  
  
  We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs.
  
  
  
  The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models.
  
  
  
  The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary.
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Gessner
authors.affiliation: Institute of Forensic Science, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Below
authors.affiliation: Department of Surgery, Clinic of General, Visceral, Vascular and Thoracic Surgery, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Diedrich
authors.affiliation: Department for Information Technology Systems, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wegner
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Gessner
authors.affiliation: Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kohlmann
authors.affiliation: Department of Surgery, Clinic of General, Visceral, Vascular and Thoracic Surgery, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Claus-Dieter
authors.initials: CD
authors.lastname: Heidecke
authors.affiliation: Department for Information Technology Systems, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Britta
authors.initials: B
authors.lastname: Bockholdt
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
authors.affiliation: Institute for Skin Integrity and Infection Prevention, School of Human & Health Sciences, University of Huddersfield, Huddersfield, UK. Electronic address: o.assadian@hud.ac.uk.
authors.forename: Ojan
authors.initials: O
authors.lastname: Assadian
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Below
mesh_terms: D000428:Alcohol Drinking; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000652:urine*; D000431:Ethanol / Q000008:administration & dosage* / Q000652:urine*; D005260:Female; D005965:Glucuronates / Q000652:urine*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D008297:Male; D014838:Volunteers
chemical_list: D000891:Anti-Infective Agents, Local; D005965:Glucuronates; C093924:ethyl glucuronide; D000431:Ethanol
keywords: Absorption; Alcohol dehydrogenase; Alcohol-based handrub; Hand hygiene; Pregnant