In this article, industry manufacturers answer common questions asked by in-house custodial/facility managers.

Other than the obvious, what are the differences between alcohol-based sanitizers and those without alcohol?

Alcohol-based hand sanitizers are a better choice for a number of reasons. Scientific data indicate that alcohol-based hand sanitizers outperform non-alcohol based formulations based on antimicrobial and clinical effectiveness. Alcohol-based formulations are more skin friendly and dry faster. That leads to more frequent use, and ultimately better outcomes. Additionally, there is a large body of research that suggests that non-alcohol formulations can lead to antimicrobial resistance. Alcohol based formulations do not carry that risk.
Also compelling is the fact that alcohol-based hand sanitizers are recommended by leading health organizations, such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), to help fight the spread of germs.
— Joe Drenik, marketing communications and services senior director, GOJO Industries, Inc., Akron, Ohio

Our studies have shown that alcohol hand sanitizers are more effective than non-alcohol hand sanitizers in real use conditions, using actual hands contaminated with germs and then applying the hand sanitizer and measuring germ kill. Both do well in laboratory test test-tube studies, but the alcohol hand sanitizers will outperform the non-alcohol hand sanitizers when applied to actual skin. From a convenience standpoint, alcohol-based hand sanitizers dry quicker and don’t leave your hands feeling sticky.
— Ronald Lewis, associate brand manager, Henkel Consumer Goods, Inc., Scottsdale, Ariz.

The CDC recommends the use of alcohol-based sanitizers that contain at least 60% alcohol. The FDA does not include non-alcohol sanitizers in the tentative final monograph and thus has not approved the claim that non-alcohol products can be labeled as sanitizers. Non-alcohol options are under review right now and there may be some that are effective and others that are not. However, the FDA has continued to issue warning letters to various companies for marketing non-alcohol based sanitizers. End users are taking a risk in using these types of products because they are not included in the monograph, they may not be an effective sanitizer and they may be forced to pull them from the market. Until those that are effective are identified, alcohol, at the recommended levels, provides the best germ kill possible.
— Lori Huffman, head of marketing, NAFTA, STOKO Skin Care, Greensboro, N.C.

Non-alcohol sanitizers have similar efficacy to alcohol sanitizers. In addition, non alcohol sanitizers are Non-Flammable, cost considerably less and do not have the strong alcohol odor. They cannot be distilled and there is no temptation to drink them like alcohol sanitizers. Most people recommend alcohol gel for hospital use.
— Bob Bernet, vice president of sales, Kutol Products Company, Sharonville, Ohio

Some facilities are sensitive to the use of alcohol. In what facilities do you suggest they use sanitizers with alcohol and in what type of facilities do you suggest they stay away from sanitizers with alcohol content?

Alcohol is the best active to provide germ kill and thus far is the only type hand sanitizer recommended by the CDC and FDA. Facilities such as pre schools, elementary schools and prison facilities where the incidence of ingestion could be higher, should consider using just soap and water. It should be emphasized that the Tentative Final Monograph for Health Care Antiseptic Drug Products (21 CFR Parts 333 and 369) does not allow the use of active ingredients such as benzylchonium choride or triclosan in non-rinse off applications, such as sanitizers, and they have cited several manufacturers for marketing these types of products. End users could be taking a risk in using these types of non-approved products. Manufacturers of professional skin care and hand hygiene products do add ingredients to alcohol based sanitizers that do not taste good and are careful to not add fragrances that tempt a person to ingest the product. Regardless of these measures by the manufacturers and the supervision within facilities, it may be assumed that the risk of ingestion outweighs the benefit of the germ kill that alcohol provides. All other facilities should use alcohol based sanitizers especially in high risk areas such as food service/handling/processing and all healthcare facilities.
— Lori Huffman, head of marketing, NAFTA, STOKO Skin Care, Greensboro, N.C.

Alcohol sanitizers have been the product of choice in hospitals for many years. Most other facilities should use non alcohol sanitizers due to the advantages mentioned above.
— Bob Bernet, vice president of sales, Kutol Products Company, Sharonville, Ohio

Healthcare facilities and Foodservice areas should definitely use alcohol-based hand sanitizers, which provide proven high levels of germ kill.
We understand why schools are interested in non-alcohol hand sanitizers. Unfortunately, we have not found a non-alcohol hand sanitizer that achieves the same high level of germ kill provided by alcohol-based hand sanitizers.
— Ronald Lewis, associate brand manager, Henkel Consumer Goods, Inc., Scottsdale, Ariz.

With flu season right around the corner, what recommendations do you have for custodial departments using sanitizers to minimize infection?

Prior to the start of the winter germ season, custodial departments should look for ideal locations to place hand sanitizer throughout a facility and ensure dispensers are installed where they are needed. Now is also a good time to ensure the latest technology is being provided in both formulation and dispensing.
Dispenser quality is a critical factor. Dispensers using cartridge-style refills are the most sanitary and easiest to maintain. Battery life is an important consideration in touch-free dispensers. GOJO recently introduced a new line of touch-free PURELL dispensers with batteries that are guaranteed for life — a benefit to all facilities but especially those with numerous dispensers.
— Joe Drenik, marketing communications and services senior director, GOJO Industries, Inc., Akron, Ohio

To help minimize the spread of infection during cold and flu season, we recommend custodial departments provide hand sanitizer dispensers in high traffic areas, such as near stairwells, elevators, outside restrooms, in break rooms and in the cafeteria. Using Touch free dispensers mounted on portable stands is a convenient option.
— Ronald Lewis, associate brand manager, Henkel Consumer Goods, Inc., Scottsdale, Ariz.

Place alcohol based sanitizers at all entrances and exits. Use stands to place dispensers in easy to use places where a person can’t forget to sanitize.  Place signage up on bulletin boards, hallways, and restrooms to remind either to wash hands or fight germs and stay well by using sanitizer.
— Lori Huffman, head of marketing, NAFTA, STOKO Skin Care, Greensboro, N.C.

Proper hand washing is the best prevention. Sanitizers should be used where water is not available or when time constraints prohibit proper hand washing.
— Bob Bernet, vice president of sales, Kutol Products Company, Sharonville, Ohio

What role do hand sanitizers play in a proper hand washing program?

Sanitizers should be used in lieu of hand washing when water is not available or time constraints prohibit hand washing
— Bob Bernet, vice president of sales, Kutol Products Company, Sharonville, Ohio

Hand sanitizers are critical for effective hand hygiene programs. Hand sanitizers are effective at killing germs, gentle on the skin and convenient when they are placed in easily accessible locations. Because many people don’t wash their hands properly, it is possible they can leave germs on their skin. Hand sanitizer used in conjunction with soap-and-water washing helps reduce the risk of spreading germs.
Also, when hands need to be washed because of sneezing, coughing or touching something unsanitary, people often aren’t near soap and water, so hand sanitizers will do the job.
— Joe Drenik, marketing communications and services senior director, GOJO Industries, Inc., Akron, Ohio

Any good hand hygiene program should include both hand washing and hand sanitization. Hand sanitizers offer convenience, reduced usage time, and possibly a gentler application to the skin if applied very frequently. However, hand washing is still important, particularly as soils build up during the day and need to be removed.
— Ronald Lewis, associate brand manager, Henkel Consumer Goods, Inc., Scottsdale, Ariz.

Sanitizers can play an important role in a good hand hygiene program. When soap and water are not available, alcohol based hand sanitizers can be used to kill germs. However, if the hands are visibly soiled, soap and water should be used. The hands are a main transporter of germs from one point to the next and the next etc., By consistently washing with soap and water and using alcohol based hand sanitizers in between washings, you can effectively cut down on the transmission of germs, decrease the risk of cross contamination, and above all else, keep yourself and those around you healthy and well.
— Lori Huffman, head of marketing, NAFTA, STOKO Skin Care, Greensboro, N.C.