Best Hand Sanitiser Gel - 5 Litre

For the last two years, the sales of hand sanitiser and protective hygiene medical equipment like masks, gloves, suits and so forth have significantly increased due to the coronavirus pandemic outbreak.

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Why are hand sanitisers essential?

Using hand sanitisers and protective medical equipment is essential for protecting people’s health and safety during this pandemic. You most likely didn’t need to experience the outbreak of a pandemic to understand that germs are everywhere. Even though COVID-19 is transmitted through respiratory droplets, those tiny organisms can and do land on a huge variety of different surfaces.

Because those different types of surfaces can sustain the coronavirus for several hours. That does give you enough time to touch things you do daily such as door handles, money, gas pumps, debit card machines, light switches, phones, ATMs and toilets that have all been touched by a COVID-19 infected person. When you come into serious contact with the COVID-19 virus, you significantly increase the risk of you contracting the virus. Taking care of your and especially your hand hygiene is the primary step to prevent getting infected or helping the spread of coronavirus. Following a consistent hand hygiene routine that does include the use of hand rub sanitisers that is based on alcohol or using normal soap and water, is the simplest and the most effective way to prevent the spread of germs and infections to the people around you. You should always avoid touching surfaces that are touched by many, especially in public sites or even health facilities, just in case if people who are infected with COVID-19 have touched them, and you should always consistently clean surfaces with standard disinfectants. In most healthcare centres, alcohol-based gel hand sanitisers are preferred compared to handwashing with water and soup, because it may be more accepted and is significantly more effective at fighting bacteria and of course faster and more mobile. However, handwashing with soap and water should be carried out if an infection can be seen, or following the use of the toilet. The general use of non-alcohol based hand sanitisers is not much recommended.

Alcohol-based hand sanitisers typically contain some combination of isopropyl alcohol, ethanol (ethyl alcohol), or n-propanol, with hand sanitisers containing 60% to 95% alcohol the most effective. You should always be careful while applying hand sanitiser as they are dangerously flammable. Alcohol-based hand sanitiser does work against a very wide variety of microorganisms but not the same way with spores. Compounds such as glycerol may be added to prevent drying of the skin and reducing the possibility of getting irritation. Some hand sanitisers contain fragrances; however, these are discouraged due to the risk of allergic reactions. Non-alcohol based versions typically contain benzalkonium chloride or triclosan but are less effective than alcohol-based ones.

The history of hand sanitisers.

Alcohol has been used as a disinfectant as early as 1363 with evidence to support its use becoming available in the late 1800s. Alcohol-based hand sanitiser has been used commonly in Europe since at least the 1980s. The alcohol-based hand sanitiser is on the World Health Organization’s (The World Health Organization is a specialized agency of the United Nations responsible for international public health.) List of Essential Medicines, and it’s considered as the safest and most effective medicines needed in any health system.

Hand sanitisers were first introduced in the sixties in medical settings such as hospitals and healthcare facilities. The product was popularized in the early nineties.

Are hand sanitisers more effective than water and soap?

Alcohol-based hand sanitiser is more convenient compared to normal handwashing with soap and water in most situations in healthcare sites. It is generally more effective for hand antiseptics, and better tolerated than soap and water Among healthcare workers. Hand washing should still be carried out if contamination can be seen or following the use of the toilet.

So most probably you don’t know what is an antiseptic.

An antiseptic is an antimicrobial substance or compound that is applied to the skin to reduce the possibility of infection, sepsis, or putrefaction. Antiseptics are generally distinguished from antibiotics by the latter’s ability to safely destroy bacteria within the body, and from disinfectants, which destroy microorganisms found on non-living objects.

Types of antiseptics

Antiseptics can be subdivided into about eight different types of materials. These types can be subdivided according to their way of action as they vary: small molecules that indescribably react with organic compounds and kill microorganisms (peroxides, iodine, phenols) and more complex molecules that disrupt the cell walls of the bacteria.

Phenols such as phenol itself (as introduced by Lister) and triclosan, hexachlorophene, chlorocresol, and chloroxylenol. The latter is used for skin disinfection and cleaning surgical instruments. It is also used within several household disinfectants and wound cleaners.

Diguanides including chlorhexidine gluconate, a bacteriocidal antiseptic which (with an alcoholic solvent) is the most effective at reducing the risk of infection after surgery. It is also used in mouthwashes to treat inflammation of the gums (gingivitis). Polyhexanide (polyhexamethylene biguanide, PHMB) is an antimicrobial compound suitable for clinical use in critically colonized or infected acute and chronic wounds. The physicochemical action on the bacterial envelope prevents or impedes the development of resistant bacterial strains.

Quinolines such as hydroxyquinoline, aquarium chloride, or chlorquinaldol.

Alcohols, including ethanol and 2-propanol/isopropanol, are sometimes referred to as surgical spirit. They are used to disinfect the skin before injections, among other uses and that is what we are talking about

Peroxides, such as hydrogen peroxide and benzoyl peroxide. Commonly, 3% solutions of hydrogen peroxide have been used in household first aid for scrapes, etc. However, the strong oxidization causes scar formation and increases healing time during fetal development.

Iodine, especially in the form of povidone-iodine, is widely used because it is well-tolerated, does not negatively affect wound healing, leaves a deposit of active iodine, thereby creating the so-called “remnant”, or persistent, effect, and has a wide scope of antimicrobial activity. The traditional iodine antiseptic is an alcohol solution (called tincture of iodine) or Lugol’s iodine solution. Some studies do not recommend disinfecting minor wounds with iodine because of concern that it may induce scar tissue formation and increase healing time. However, concentrations of 1% iodine or less have not been shown to increase healing time and are not otherwise distinguishable from treatment with saline. Iodine will kill all principal pathogens and, given enough time, even spores, which are considered to be the most difficult form of microorganisms to be inactivated by disinfectants and antiseptics.

Octenidine dihydrochloride, currently increasingly used in continental Europe, often as a chlorhexidine substitute.

Quat salts such as benzalkonium chloride/Lidocaine (trade name Bactine among others), cetylpyridinium chloride, or cetrimide. These surfactants disrupt cell walls.

Hand sanitiser that contains at least 60% alcohol or does contain a “persistent antiseptic” should be used. Alcohol rubs kill many different kinds of bacteria, including antibiotic-resistant bacteria and TB bacteria. They also kill many kinds of viruses, including the flu virus, the common cold virus, coronaviruses, and HIV.

Almost 90% of alcohol rubs are more effective against viruses than most other forms of hand washing. Isopropyl alcohol will kill 99.99% or more of all non-spore-forming bacteria in less than 30 seconds, both in the laboratory and on normal human skin.

In too low quantities (0.3 ml for instance) or concentrations (below 60%), the alcohol in hand sanitisers may not have the 10–15 seconds exposure time required to denature proteins and lyse cells. In environments with high lipids or protein waste (such as food processing), the use of alcohol hand rubs alone may not be enough to ensure proper hand hygiene.

For health care settings, like hospitals and clinics, the optimum alcohol concentration to kill bacteria is 70% to 95%. Products with alcohol concentrations as low as 40% are available in American stores, according to researchers at East Tennessee State University.

Alcohol rub sanitisers kill most bacteria, and fungi, and stop some viruses. Alcohol rub sanitisers containing at least 70% alcohol (mainly ethyl alcohol) kill 99.9% of the bacteria on hands 30 seconds after application and 99.99% to 99.999% in one minute.

For health care, optimal disinfection requires attention to all exposed surfaces such as around the fingernails, between the fingers, on the back of the thumb, and around the wrist. Hand alcohol should be thoroughly rubbed into the hands and on the lower forearm for at least 30 seconds and then allowed to air dry.

Use of alcohol-based hand gels dries skinless, leaving more moisture in the epidermis, than handwashing with antiseptic or antimicrobial soap and water.

Why are hand sanitisers used rather than normal soap and water?

Alcohol-based hand rubs are extensively used in the hospital environment as an alternative to antiseptic soaps because soap wastes time and effort and a lot more. Hand-rubs in the hospital environment have two types of applications: hygienic hand rubbing and surgical hand disinfection. Alcohol-based hand rubs provide a better skin tolerance as compared to antiseptic soap. Hand rubs also prove to have more effective microbiological properties as compared to antiseptic soaps.

The same ingredients used in over-the-counter hand-rubs are also used in hospital hand-rubs: alcohols such as ethanol and isopropanol, sometimes combined with quaternary ammonium cations (quats) such as benzalkonium chloride. Quats are added at levels up to 200 parts per million to increase antimicrobial effectiveness. Although allergy to alcohol-only rubs is rare, fragrances, preservatives and quats can cause contact allergies. These other ingredients do not evaporate like alcohol and accumulate leaving a “sticky” residue until they are removed with soap and water.

The most common brands of alcohol hand rubs include Aniosgel, Avant, Sterillium, Desderman and Allsept S. All hospital hand rubs must conform to certain regulations like EN 12054 for hygienic treatment and surgical disinfection by hand-rubbing. Products with a claim of “99.99% reduction” or 4-log reduction are ineffective in hospital environment since the reduction must be more than “99.99%”.

The hand sanitiser dosing systems for hospitals are designed to deliver a measured amount of the product for staff. They are dosing pumps screwed onto a bottle or are specially designed dispensers with refill bottles. Dispensers for surgical hand disinfection are usually equipped with elbow controlled mechanisms or infrared sensors to avoid any contact with the pump.

Which hand sanitisers are the best for me?

Hand sanitisers containing a minimum of 60 to 95% alcohol are efficient germ killers and they are the best for you. Alcohol rub sanitisers kill bacteria, multi-drug resistant bacteria (MRSA and VRE), tuberculosis, and some viruses (including HIV, herpes, RSV, rhinovirus, vaccinia, influenza, and hepatitis) and fungi. Alcohol rub sanitisers containing 70% alcohol kill 99.97% (3.5 log reduction, similar to 35-decibel reduction) of the bacteria on hands 30 seconds after application and 99.99% to 99.999% (4 to 5 log reduction) of the bacteria on hands 1 minute after application.

But are all hand sanitisers alcohol-based? Some hand sanitiser products use chemicals other than alcohol to kill microorganisms, such as povidone-iodine, benzalkonium chloride or triclosan. The World Health Organization (WHO) and the CDC recommend “persistent” antiseptics for hand sanitisers. Persistent activity is defined as the prolonged or extended antimicrobial activity that prevents or cancels the proliferation or survival of microorganisms after the application of the product. This activity may be demonstrated by sampling a site several minutes or hours after application and demonstrating bacterial antimicrobial effectiveness when compared with a baseline level. This property also has been referred to as residual activity. Both substantive and nonsubstantive active ingredients can show a persistent effect if they substantially lower the number of bacteria during the wash period.

Laboratory studies have shown lingering benzalkonium chloride may be associated with antibiotic resistance in MRSA. Tolerance to alcohol sanitisers may develop in faecal bacteria. Where alcohol sanitisers utilize 62%, or higher, alcohol by weight, only 0.1 to 0.13% of benzalkonium chloride by weight provides equivalent antimicrobial effectiveness.

Triclosan has been shown to accumulate in biosolids in the environment, one of the top seven organic contaminants in wastewater according to the National Toxicology Program Triclosan leads to various problems with natural biological systems, and triclosan, when combined with chlorine e.g. from tap water, produces dioxins, a probable carcinogen in humans. However, 90–98% of triclosan in wastewater biodegrades by both photolytic or natural biological processes or is removed due to sorption in wastewater treatment plants. Numerous studies show that only very small traces are detectable in the effluent water that reaches rivers.

A series of studies show that photodegradation of triclosan produced 2,4-dichlorophenol and 2,8-dichlorodibenzo-p-dioxin (2,8-DCDD). The 2,4-dichlorophenol itself is known to be biodegradable as well as photodegradable. For DCDD, one of the non-toxic compounds of the dioxin family, a conversion rate of 1% has been reported and estimated half-lives suggest that it is photolabile as well. The formation-decay kinetics of DCDD is also reported by Sanchez-Prado et al. (2006) who claim “transformation of triclosan to toxic dioxins has never been shown and is highly unlikely.”

Alcohol-free hand sanitisers may be effective immediately while on the skin, but the solutions themselves can become contaminated because alcohol is an in-solution preservative and without it, the alcohol-free solution itself is susceptible to contamination. However, even alcohol-containing hand sanitisers can become contaminated if the alcohol content is not properly controlled or the sanitiser is grossly contaminated with microorganisms during manufacture. In June 2009, alcohol-free Clarion Antimicrobial Hand Sanitizer was pulled from the US market by the FDA, which found the product contained gross contamination of extremely high levels of various bacteria, including those which can “cause opportunistic infections of the skin and underlying tissues and could result in medical or surgical attention as well as permanent damage”. Gross contamination of any hand sanitiser by bacteria during manufacture will fail the effectiveness of that sanitiser and possible infection of the treatment site with the contaminating organisms.

Are hand sanitisers safe?

Well, Alcohol gel can catch fire, producing a translucent lite blue flame. This is due to the flammable alcohol in the gel. Some hand sanitiser gels may not produce this effect due to a high concentration of water or moisturizing chemicals. There have been some rare events where alcohol has been implicated in starting fires in the operating room, including a case where alcohol used as an antiseptic pooled under the surgical drapes in an operating room and caused a fire when a cautery instrument was used. Alcohol gel was not implicated.

To minimize the risk of fire, alcohol rub users are instructed to rub their hands until dry, which indicates that the flammable alcohol has completely evaporated. Igniting alcohol hand rub while using it is tremendously rare, but the need for this is underlined by one case of a health care worker using hand rub, removing a polyester isolation gown, and then touching a metal door while her hands were still wet; static electricity produced an audible spark and ignited the hand gel. Some fire departments suggest refills for the alcohol-based hand sanitisers can be stored with cleaning supplies away from heat sources or open flames.

There are certain situations during which handwashing with soap and water are preferred over hand sanitiser, these include: eliminating bacterial spores of Clostridioides difficile, parasites such as Cryptosporidium, and certain viruses like norovirus depending on the concentration of alcohol in the sanitiser (95% alcohol was seen to be most effective in eliminating most viruses). In addition, if hands are contaminated with fluids or other visible contaminants, hand washing is preferred as well as after using the toilet and if discomfort develops from the residue of alcohol sanitiser use. Furthermore, CDC states hand sanitisers are not effective in removing chemicals such as pesticides.

Since families began buying more hand sanitiser during the COVID-19 pandemic, the National Poison Data System has been getting many more reports of unintentional exposures in children. Many are for children ages 5 years and younger.

Health experts recommend using hand sanitiser that is 60% to 95% alcohol to kill the virus that causes COVID-19. Drinking alcohol typically has 5% to 40% alcohol.

Always make sure to check the label

The FDA began letting companies that do not normally produce hand sanitiser make and sell it during the pandemic. Before buying or using a hand sanitiser, make sure it has a label that lists the ingredients, warnings and precautions. In addition, it’s a good idea to check the do-not-use list at www.fda.gov/handsanitizerlist.

To reduce the risk of injury from children drinking hand sanitisers, producers should add ingredients to make them taste bitter. This important step helps prevent children from eating the product. However, the FDA has been alerted that some young people have tried drinking hand sanitisers from distilleries that have not taken the step to make them taste bad.

To help make sure the sanitiser’s taste will not appeal to children, look for the word “denatured” on the bottle. You can also check for bitter ingredients such as denatonium benzoate (Bitrex); sucrose octaacetate; or butanol (also called tert-butyl alcohol).

Be especially careful with hand sanitisers made with isopropyl alcohol (isopropanol) around children. These can be more toxic than those made with ethanol or ethyl alcohol.

Emergency rooms in New York City have also seen cases of teenagers who ingested hand sanitisers. In both Los Angeles and New York, teenagers’ symptoms included: slurred speech, a burning sensation in the stomach, dizziness, nausea and vomiting. Although there was no smell of alcohol on their breath and they denied drinking alcohol, their blood alcohol level was elevated.

In Albuquerque, New Mexico, the deaths of two homeless men earlier this year were linked to a lethal cocktail of mouthwash and hand sanitiser. The New Mexico Poison Center has received 14 reports this year of people who ingested hand sanitiser. Nationwide, more than 3,700 cases of hand sanitiser poisoning are reported each year. About 2,900 of these cases are accidents involving children under the age of five.

A lot of doctors believe that warning labels should be placed on hand sanitisers to alert the public to the potential risk. As more teens learn about the intoxicating effects of hand sanitisers, parents may want to consider purchasing foam-type hand sanitisers since alcohol is harder to extract from foam than from gel sanitisers.