The number of hospitals using waterless alcohol hand sanitizer has doubled since 2001. These findings apply to nurses washing hands during routine patient-care activities on the general patient floor as well as to pre-op surgical preparation and post-op hand washing in the hospital operating recovery room. Hand hygiene is widely acknowledged as the single most important activity for reducing the spread of disease. (Boyce J M, Pittet D 2002) Hand washing is a simple habit that requires minimal training and no special equipment and is one of the best ways to avoid getting sick. Despite the proven health, benefits of hand washing many people do not practice this habit as often. Infectious diseases commonly spread through hand-to-hand contact as the common cold, flu and several gastrointestinal disorders such as infectious diarrhoea. (A A P, 2003)
Inadequate hand hygiene also contributes to food-related illnesses such as Salmonella and E.Coli infection. Hand washing is considered the most effective way of reducing cross infection and the number one way to prevent disease. (Boyce J M, 2001).Earlier people washed their hands with water, sand, animal products, sanitary wipes, bar, liquid, flake and foam soaps.The waterless hand sanitizer gels and sprays is the most recent development in hand washing products. Alcohol-based hand sanitizers that do not require water are an excellent alternative to hand washing particularly when soap and water are not available. (Kelliher S, Vallande N, 2000) They are actually more effective than soap and water in killing bacteria and viruses that cause disease. There is decreased skin irritation and dryness. (Kampf G, et al 2005) The active ingredient in these sanitizers is alcohol.
1.1 There are two different products for hand hygiene:
1.1.1 Antiseptic wash lotions: rinse-off products
1.1.2 Alcohol based liquids: leave-on products used for hand disinfection.
The European requirement for medicated soaps in bacterial suspension testing, require a reduction of at least 3 log 10 steps against the test bacteria. Alcoholic hand disinfectants are required to reduce the count of test bacteria by a minimum of 5 log 10 steps within the same application time. The safety margin for the user is 100-fold higher with alcohol-based rub-in products.
1.2 Alcoholic hand wash gels are transparent, uniform, easily deformed dispersed systems consisting of at least two components. One is a fluid acting as a dispersing agent and the other a structure-giving component, a solid colloidal material. This stabilizes the fluid part by forming a three dimensional network. There are many types of gels:
1.2.1 Hydro gels: consist of fluid and water.
1.2.2 Alcohol gels: consist of fluid and alcohol.
1.2.3 Lipogels: fluid and liquid fats e.g. Paraffin.
1.2.4 Surfactant gels: fluid and water or surfactant mixture.
Hydro gels and Alcohol gels have a distinct cooling effect mainly due to the evaporation of the water or alcohol. The structure-giving component is organic or inorganic, hydrophilic or lipophilic, synthetic or natural. Polyacrylic acid that has a marked penetration effect is used in alcohol gels.
1.3 Antiseptics and disinfectants are extensively used in hospitals and other health care settings for a variety of topical and hard-surface applications. A wide variety of active chemical agents called