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Comment by skue | Hacker News Reader

Can you provide references?

That may be true of your basic drugstore Purell, which just contains ethyl alcohol. But the literature does indicate that hospital-grade hand sanitizers (a blend of alcohols, and/or a non-alcohol equivalent) are far superior and immediately effective against most organisms.

See for example, http://cmr.asm.org/content/17/4/863.short

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No problem, from the CDC[0] report entitled "Guideline for Hand Hygiene in Health-Care Settings"[1] From that reference it says, we have:

"Alcohols are not appropriate for use when hands are visibly dirty or contaminated with proteinaceous materials." "Alcohols are rapidly germicidal when applied to the skin, but they have no appreciable persistent (i.e., residual) activity." "Despite its effectiveness against these organisms, alcohols have very poor activity against bacterial spores, protozoan oocysts, and certain nonenveloped (nonlipophilic) viruses. Similarly, certain accepted methods for evaluating waterless antiseptic agents for use as antiseptic hand rubs require that 3 mL of alcohol be rubbed into the hands for 30 seconds, followed by a repeat application for the same duration. This type of protocol also does not reflect actual usage patterns among HCWs."

The alcohol gels are good, but I think they're not a cureall was my point.

[0]:http://www.cdc.gov/ [1]:http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm

>but I think they're not a cureall was my point.

I honestly don't know a single nurse / medical staff or even IT person in a hospital or university that thinks they are, though. You might not be giving people enough credit. Anecdotal, yes, but I've never seen people think of them as a "cureall" or even as a replacement of washing hands. It is always in addition or inbetween things where you can't get to a handwashing immediately (e.g., candidates shaking hands)shrug

You're absolutely right, my evidence is anecdotal. But I'm 36 years old now, and I've been in and out of hospital probably thousands of times and had medical care each day in one form or another.

So yes, anecdotes for sure. But that's one hell of a lot of anecdotes. :-)

The difference between anecdote and systematically gathered data to resolve a question isn't one of how extensive the anecdote is, its about how representative it is. (And, of course, there's other issues with anecdote about what other people think, since what that really is is is one persons inferences about what lots of other people think.)

Absolutely, and I would imagine that once I'd made my mind up about this there was a fair degree of confirmation bias thrown in as well. Along with a whole host of other Things One Mustn't Do When Collecting Trustworthy Data™.

Hand washing should be done with runnin water and soap when possible. If you don't hav running water and soap you cannise handgels, but they don't kill everything. Alcoholgels don't kill c.diff. Alcohol gels only work on hands that are clean.

You need to be careful with the soap you chose because hands can be "too clean" - some soaps are harsh on the skin and cause conditions suitable for bugs.

http://www.nhs.uk/Conditions/Clostridium-difficile/Pages/Pre...

http://www.cdc.gov/handwashing/show-me-the-science-hand-sani...

Yeah this is correct for Noroviruses as well - good old soap and water is the most effective against Norovirus, more so than alcohol and disinfectant gels.

http://en.wikipedia.org/wiki/Norovirus#Prevention

My wife works as a paediatric doctor in the NHS, and has told me that the regular use of alcohol gels leaves a slimy residue after 2 or 3 uses, prompting her to properly wash her hands (as well as wearing new gloves for every patient, obviously).

Just from - terrible - experience, C. Diff is one bug which is certainly not sanitized by any sort of alcohol-based sanitizer. Spreading C. Diff throughout a hospital population (even one floor) is pretty devastating and dangerous.

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