With the ongoing coronavirus pandemic we’re all rightly becoming much more vigilant about how to prevent the spread of the virus. How can we best protect ourselves and others? Good hand hygiene is one of the most effective ways. Especially important right now as many Brits, businesses and instutions are contemplating how to return to work safely.

Using soap and water with proper hand washing technique remain the best option to deactivate the virus and stop it spreading. Watch this video from the NHS below for a demonstration.

Why use hand sanitizer?

It’s not always possible to access a sink to use soap and water. If your hands are visibly clean you can use hand rub or hand sanitizer instead. An effective and safe hand sanitizer is likely to be a key part of controlling the spread of the virus in the workplace and at home going forward. With this in mind, it’s important to understand a bit about what to look for in a hand sanitizer, especially one that you may be using multiple times per day. This guide will explains everything you need to know. To help you understand exactly what works best and why.

Right now supplies of PPE including hand sanitizer in the UK are very volatile and it can be difficult to get hold of the things you need. However, there are many local businesses that are adpating to the crisis to supply protective equipment and supplies. One of the quickest and widest responses to the coronavirus outbreak has been from the distilling community in the UK facilitated by the timely derogations issued by HMRC and the Health & Safety Executive (HSE). Many distillers and distilleries have switched some or all of their production over to hand sanitizer. If you’re struggling to get hold of hand sanitizer then we suggest reaching out to your local distillery.

How does hand sanitizer work?

Let’s examine the science behind coronavirus hand hygiene. Covid-19 is a type of virus called an enveloped virus. This means that the ribonucleic acid (RNA) that contains the viral genetic material, the inner workings of the virus, is contained within a phospholipid bilayer. In other words, a bit of borrowed cell membrane from an infected cell is worn by the virus like a shield as it moves between hosts. This protective layer is made up of hydrophillic heads and long fatty tails that can be disrupted or dissolved by ionic surfactants like soap and nonionic surfactants or solvents like alcohol. This exposes and eventually washes away or deactivates the sensitive viral material. Alcohol is able to denature the viral proteins and genetic material in situ which is why you do not need to wash your hands after using hand rub. These similar and effective modes of action are why soap and alcohol-based hand sanitizer are particularly effective at disrupting the virus.

Image credit to: Jonathan Corum and Ferris Jabr/The New York Times

How do I know it’s effective against coronavirus?

Does it matter which hand sanitizer you buy? Yes, you need at least 60% alcohol content for hand sanitiser to work properly. You can check the label to find out the alcohol content. It depends on the type of alcohol used, typically ethanol or isopropanol, but the range is from 60-95% alcohol content to be effective across a broad spectrum of viruses and bacteria. Although it’s important to understand that higher alcohol content formulations can be more effective and faster acting.

There are various levels or standards that are used to assess efficacy for biocidal hand disinfectant products which fall into two parent categories: hand wash (to be used with water) and hand rub (to be used without water) and two subcategories: hygienic (general use) and surgical. Depending on their use cases and the different microorganisms they need to be effective against, various appropriate testing standards are used. However, in regards to coronavirus, normal soap and water is as effective as special antibacterial soaps or hand wash as long as proper technique and duration is used. The standards to be aware of are for alcohol-based hand sanitizer or hand rub. The hygienic hand rub standard is EN1500 for even more rigorous use cases like pre-surgical hand preparation the standard EN12791 is used, both standards involve passing strict efficacy tests in human trials. For the majority of users and use cases, outside of specific medical settings, EN1500 is sufficient. Look out for products that have at least passed that standard.

How to hand wash? Poster by the World Health Organisation
Guidance poster on hand hygiene from the World Health Organisation – How to hand wash?

When doesn’t hand sanitizer work?

Most importantly hand sanitizer doesn’t work or is much less effective if your hands are greasy, sweaty or visibly dirty. That’s one reason why you shouldn’t think of hand sanitizer as a replacement for soap and water, but as part of an effective hand hygiene strategy. It’s also important to check the expiry date as many formulations will have a shelf-life and may become less effective over time. Lastly, please pay attention to storage instructions. Alcohols tend to be very volatile, so if stored for prolonged periods at elevated temperatures (e.g. in your car all summer) it’s possible they could start to evaporate and rapidly become less effective as well as posing an increased fire risk.

We’ve been asked before for alcohol-free hand sanitizers and whilst such formulations do exist, typically containing active substances such as benzalkonium chloride or chlorhexidine digluconate, recent research shows such compounds have varying degrees of efficacy. It’s important that hand sanitizer has a wide-range of biocidal activity and the evidence for alcohols is much clearer (as well as soap and water) which is why the NHS and World Health Organisation guidance prioritises alcohol-based sanitizers.

Is hand sanitizer safe?

Yes, as long as the product formulation has been tested properly. This is really important to be aware of right now as many new products are coming to market. But it’s equally important to know that many hand sanitizers contain a high percentage of ethanol or isopropanol which are highly flammable as a liquid or vapour and seriously irritating to eyes. Also toxic if ingested, particularly at high concentrations. If you have any broken skin on your hands it can also be rather uncomfortable to use.

Care should be taken when using hand sanitizer, always follow the directions for storage, use and disposal responsibly. As long as you follow the guidance and directions for use, alcohol-based hand sanitizer is one of the safest & most effective methods available for hand disinfection.

Flammable and irritating hazard pictograms.
Common hazard pictograms for alcohol-based hand sanitizers.

Many hand sanitizer formulations contain additives. These range from emolients or moisturisers to help prevent the alcohol from defatting or drying hands, gelling agents to thicken the formula and fragrances to make them more pleasant to use. If you suffer from sensitive skin or simply need to use the hand sanitizer very frequently it may be best to avoid additives, particularly any scents or fragrances as some may cause sensitivity or skin sensitisation.

What’s the best hand sanitizer?

At Slake Spirits we’ve chosen to produce a hand sanitizer formulation recommended by the World Health Organisation (WHO) for ethanol-based hygienic hand rub, which contains 80% ethanol, 1.45% glycerin and 0.125% hydrogen peroxide. These three key components all have a roll to play in terms of safety and efficacy. Ethanol is the active ingredient that deactivates the virus, glycerin is a gentle emolient and moisturiser to prevent your hands from drying out, without leaving a sticky residue and hydrogen peroxide is effective at disrupting biofilms and bacterial spores. After a 72 hour hold, bottles filled with the WHO formulation are effectively internally sterile.

The WHO tested the formulation against EN1500 standards which it passed and in their expert opinion it’s also suitable for pre-surgical use. We believe this is the best, safest and most effective formula for repeated use. Whilst there may be no frills in terms of fragrances or gelling agents, at 80% ethanol by volume, there are no compromises either. Being unscented it’s less likely to cause skin sensitisation and may be suitable for sensitive skin. With no added gelling agents it’s also more free flowing so you don’t have to spend time cleaning the spout on your lotion pump either as it wont slowly dry out and block it, eventually creating something rather like a hand sanitizer spitting cobra!

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Cover image by Hatice EROL from Pixabay

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