How Safe is Sanitizer?

Our children will probably never remember a time when hand sanitizer, which hit the market in 1996, wasn’t everywhere they looked. Plastic gel bottles bedeck just about every desk, bathroom, and car cup holder they come across, and holding out their hands for a squirt before snack time has become as routine as raising their hand in class. One of my son’s first multisyllabic utterings was “han-i-tizer.” (At six, he still calls it that.)

At the same time, we’ve been hearing a lot about how cleanliness may not be all that it’s cracked up to be. Turns out that babies who are exposed to an array of dirt and bacteria—through farm settings or pets, for instance—are less likely to develop allergies and asthma than children raised in spotless surroundings. Antibacterial soaps, which seem like such an excellent idea, have likely contributed to the growth of antibiotic-resistant bacterial infections in recent years, and may affect kids’ hormonal development, according to the FDA, which advises against them.

And yet, even as we start to go easier on the Lysol and chuck the Triclosan, hand sanitizer is still ubiquitous. Which got my friend Stacey and I wondering at school pickup the other day: Just how effective—and safe—is the habitual slathering of alcohol on our kids’ skin? Luckily, Thomas Sandora, MD, MPH, a pediatric infectious disease specialist at Boston Children’s Hospital, just down the road from us, is one of the world’s experts when it comes to hand hygiene. Dr. Sandora took time out of his busy schedule yesterday to gave me the scoop on sanitizer.

1. Sanitizers that include at least 60 percent alcohol reduce the risk of GI bugs, in particular. Dr. Sandora led two studies—one in which families with children in child care received hand sanitizer to use at home, and one in which sanitizer was used in elementary school classrooms. The groups who received and regularly used the sanitizer had fewer gastrointestinal illnesses. Alcohol can also fight many other forms of bacteria and some viruses (including the seasonal flu, and interestingly, Ebola).

2. …But it doesn’t defend against everything. Some viruses aren’t affected by alcohol—like norovirus, a particularly nasty and common GI illness. Cleansing thoroughly with ordinary soap and water does seem to be effective in killing norovirus and most other germs from skin surfaces, however, so if you’re able, wash your kids’  hands well before—or in lieu of—using sanitizer.

3. Alcohol-based sanitizers aren’t contributing to the superbug problem. Because alcohol essentially obliterates bacteria on contact, these bugs don’t have an opportunity to mutate into more resistant forms. Overused antibiotics and “antibacterial” products, on the other hand, seem to promote these adaptations, leading to hard-to-treat “superbugs” like MRSA and C. difficile.

4. The amount of sanitizer you apply counts. A couple drops on the center of your palm isn’t necessarily going to get the job done. Use about a dime size amount, and be sure to rub it all over your child’s hands, including the backs and fingertips. In Dr. Sandora’s research, he found that families who used sanitizer liberally were less likely to pass around respiratory illnesses than families who used just a little. But be sure to use it only on kids 24 months and older, and no more than about 5 to 10 times a day, to reduce the chance that excess alcohol is absorbed by the skin.

5. Keep the pumps out of kids’ reach. Between 2005 and 2009, the National Poison Data System received nearly 69,000 reports of potential sanitizer ingestion. Young kids may be drawn to the jelly-like fluid, so make sure to keep your sanitizer bottles in places little children can’t access. While a lick or a suck on a sanitized thumb shouldn’t cause a problem, a toddler who’s ingested the equivalent of a couple teaspoons or more should receive medical attention. (Skin irritation, notes Dr. Sandora, is mild and not common.)

6. Think of sanitizer as a team player rather than solo act. Hand hygiene is perhaps our key defense against a variety of illnesses, says Dr. Sandora. But it’s also helpful to remember to cough or sneeze into your elbow instead of your hand, use (and promptly toss) tissues, and avoid close contact with people who are sick. And don’t forget to get your flu vaccine—everyone 6 months and older should get it every year.

Photo credits: Niquimerret via Photo Pin, cc; Valerie Everett via Photo Pin, cc