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Manufacturers may be the only ones cleaning up

Antibacterial products can't beat soap and water, scientists say.

February 11, 2007|Frank D. Roylance | Baltimore Sun

Awash in antimicrobial soaps and wipes, Americans seem to be fending off germs at every turn.

Rhode Island bought nearly 15,000 wall dispensers filled with alcohol-based hand sanitizer to combat a disease outbreak in its schools. Many supermarkets routinely offer wipes for sanitation-conscious customers.

At the entrance of a new Martin's Food Market in Eldersburg, Md., shoppers can disinfect their grocery carts at the door. "I use them all the time -- I'm a germ freak," Cindy Tack, 40, said as she wiped down the basket before sliding her son Ben, 3, into the seat. "And when I walk in the door at home, I wash my hands."

"I think it's overkill," she confessed. "But having kids, and as I've gotten older, I've gotten more like that. They're touching everything."

This bacterial backlash is fueling the introduction of 200 to 300 new or redesigned antimicrobial products each year. Consumers spend more than $200 million annually on antimicrobial wipes alone, said Mike Richardson, an industry analyst at the Freedonia Group in Cleveland. "We're expecting something close to double-digit annual growth for the next several years," he said.

On store shelves, alcohol-based cleaners join a growing variety of antibacterial soaps and other products aimed at snuffing out microscopic life wherever people perceive a threat to health.

Yet Rolf Halden, an environmental scientist at the Johns Hopkins Bloomberg School of Public Health, contends that the onslaught of products has had no discernible effect on the rates of infectious disease in the United States.

"Not a blip on the radar screen. The money's been spent, but the benefit is doubtful or absent," said Halden, co-founder of the school's Center for Water and Health. "The flood of antimicrobial products is driven by monetary profits and not by scientific evidence."

Germ-fighting hand cleaners are not all created equal.

In a scrub-off, scientists prefer plain soap and water, when used properly. Next are the alcohol-based gels and wipes, which they describe as adequate alternatives when vigorous hand washing at a faucet isn't possible. Studies have found that most hand sanitizers can reduce gastrointestinal illnesses in households, classrooms and dormitories.

Last are antibacterial soaps and related products, which, some research suggests, could generate problems for the environment and human health. And they don't kill viruses that cause colds, flu and intestinal illnesses. These include the "noro" viruses that have sickened cruise ship passengers.

Although there's debate about what people should use to clean their hands, there's no debate about the health benefits of doing it properly. The federal Centers for Disease Control and Prevention calls it "one of the most critical control strategies" in managing a disease outbreak. Pathogenic viruses and bacteria pass among us via our hands and can infect us when we touch our mouth, nose and eyes.

The gold standard for hand cleaning, experts agree, is to wash vigorously with soap and warm water. Do it for 15 to 20 seconds -- two verses of "Mary Had a Little Lamb."

The mechanics of rubbing all surfaces of the hands together loosens bacteria and viruses from the oils of the skin, suspends them in the soapy solution and rinses them away. Thorough drying with a single-use towel curbs transfer of any remaining germs. Use the towel to turn off the water and open the door.

"Plain soap is an antimicrobial," Halden said. It kills bacteria by causing cell membranes to leak.

"The biggest problem with hand hygiene is people don't do it," said L. Clifford McDonald, a medical epidemiologist at the Centers for Disease Control and Prevention.

Timing matters. Wash before eating. Wash after using the bathroom, sneezing or coughing into your hands, handling raw meat or caring for someone who has an infection.

Two years ago, an observational study of 6,000 people by the industry's Soap and Detergent Assn. found that 10% of women and 25% of men didn't wash their hands after using the bathroom. Even fewer washed after sneezing or coughing into their hands.

If people don't or can't wash at the sink, experts say, it's safe to use alcohol-based gels and wipes, which kill most viruses and bacteria. They degrade rapidly in the environment and have "a pretty good safety profile," Halden said.

But they have their shortcomings. McDonald said the alcohol products didn't work well on visibly dirty hands. They also won't kill some bacteria that form protective spores, such as Clostridium difficile, which can cause a life-threatening form of diarrhea and colitis.

Using them to clean your hands after handling drippy packages in the meat department makes sense, McDonald said, but added that "alcohol is not generally a good surface disinfectant." Shoppers would be better off using wipes to clean their hands after working with the cart than attempting to disinfect it first.

For some, such as Terry Powell, 60, the reason for using wipes on the grocery cart is simple if unscientific.

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