Saved by the gel

Saturday, June 30, 2012

HAVE you been forgetting to squirt? Is your anti-bacterial hand gel rolling about in the bottom of your handbag, its sell-by date well expired? Anti-bacterial hand sanitisers claim to kill 99.9% of germs but the Irish populace seems just a tad switched off.

When swine flu struck in 2009 and the Department of Health’s chief medical officer warned one-in-four of us could catch it, pharmacists had a hard time keeping these products on their shelves. Now very few people are buying it,” says Kerry-based pharmacist Jack Shanahan.

Andrew Maher, MD of Co Meath-based Pharmaher Healthcare, tells a similar story. His company was the first pharmacy distributor to launch a hand sanitiser into Irish retail pharmacies back in 2004. By the time Swine Flu hit, Pharmaher’s non-alcohol hand sanitising spray — active ingredient is benzethonium chloride — was well placed to take the lion’s share of the market.

“The sales surge was 100 times the norm,” says Mr Maher, who confirms that “with no real urgency out there now, no massive scares”, demand has dropped by 90% from its 2009 high.

Calls to the National Poisons Information Centre (NPIC) also reflect the rise and relative fall in popularity of anti-bacterial hand gels. In pre-swine flu 2006 and 2007, the NPIC received nine calls a year from people concerned about accidental ingestion of hand sanitiser. “The calls generally came from care homes and hospitals,” says a NPIC spokesperson. In 2009, when — according to Andrew Maher — “every conscientious mum was buying hand sanitiser for each individual child”, calls to the NPIC surged to 54 — 39 of them involving children. By 2011, calls had dropped — 30 in total, 18 were paediatric cases.

By neglecting to squirt and spray ourselves with germ-fighting gels it seems we’re bucking an international trend. The hand sanitising market stood at $80m in the US in 2006 — by 2015, it’s expected to be worth around $402m. In Britain, Superdrug has reported a 12% increase in hand sanitiser sales compared with spring 2011. By contrast, Boots Ireland sees “an increase in purchases of hand gel at the end of August when children are going back to school”.

A study carried out by the Royal College of Surgeons at Dublin’s Connolly Hospital last September found visitors were more likely to clean their hands if they were reminded.

Forty four percent of people used the alcohol hand sanitising dispensing unit in the hospital foyer, where a large free-standing sign said ‘clean hands, save lives’. Where there were no hand hygiene prompts, use fell to 2.7%.

Some might contend that anti-bacterial hand sanitisers are just a fad but there’s no arguing with the vital importance of keeping your hands clean. Experts say effective hand hygiene can cut, almost by half, the spread of diarrhoea and other gastrointestinal nasties. “Compliance with hand hygiene is the corner stone of infection prevention,” says consultant microbiologist Dr Eoghan O’Neill. “It’s the most effective way of reducing infectious organisms, bacteria and fungi.”

What you want to do is reduce the load of the bugs that can harm you and those around you, says Dr Fidelma Fitzpatrick, a consultant microbiologist at the Health Protection Surveillance Centre. But is plain old soap and water just as good as anti-bacterial hand gels? Yes, says Dr Fitzpatrick, who points out that these products don’t get rid of all harmful bacteria.

“If a patient’s infected with clostridium difficile, which causes diarrhoea, we’d preferentially use antiseptic soap and water because anti-bacterial hand gels don’t kill the very hardy spores created by the bug. And if your hands are dirty or visibly soiled, you need to wash them.”

Alcohol-based hand sanitisers need to have a 65% concentration of alcohol to be effective at killing micro organisms, says Dr O’Neill. While these promise to kill 99.9% of germs, the research validating this claim was done on inanimate lab surfaces, which often don’t represent what happens on the human hand. No matter how good a product is, bacteria and viruses still colonise, if it’s not properly applied,” says Dr O’Neill.

Hand gels can dry the skin and cause cracking and redness. More worryingly, many contain the chemical triclosan. US-based Food and Drug Administration say scientific studies have raised questions as to whether it can disrupt the body’s endocrine system and help create antibiotic-resistant bacteria.

So — to gel or not to gel? It seems one of the best things hand sanitisers have got going for them is convenience. “If you’re out and about and you start sneezing, a lot of the time you can’t get to a sink and soap and water,” says Dr Fitzpatrick. “And if you’re a mother of young children and you’re out and about changing nappies, hand gels are very convenient.”

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