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Published on: 15/09/2011

Handwashing education and promotion are well established as effective strategies to reduce diarrhea and respiratory illness in countries around the world. However, access to reliable water supplies has been identified as an important barrier to regular handwashing in low-income countries. Alcohol-based hand sanitizer (ABHS) is an effective hand hygiene method that does not require water, but its use is not currently recommended when hands are visibly soiled. This study [1] evaluated the efficacy of ABHS on volunteers’ hands artificially contaminated with Escherichia coli in the presence of dirt (soil from Tanzania) and cooking oil. ABHS reduced levels of E. coli by a mean of 2.33 log colony forming units (CFU) per clean hand, 2.32 log CFU per dirt-covered hand, and 2.13 log CFU per oil-coated hand. No significant difference in efficacy was detected between hands that were clean versus dirty or oily. ABHS may be an appropriate hand hygiene method for hands that are moderately soiled, and an attractive option for field settings in which access to water and soap is limited.

[1] Pickering, A.J., Davis, J. and Boehm, A.B. (2011). Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil. Journal of water and health ; vol. 9, no. 3 ; p. 429–433. doi:10.2166/wh.2011.138 (pay per view)

See also: Pickering, A.J., Boehm, A.B., Mwanjali, M. and Davis, J. (2010). Efficacy of waterless hand hygiene compared with handwashing with soap : a field study in Dar es Salaam, Tanzania. American journal of tropical medicine and hygiene ; vol. 82, no. 2 ; p. 270-278.  doi:10.4269/ajtmh.2010.09-0220 (open access)

Related news:

  • Enabling Technologies for Handwashing with Soap, E-Source, 08 Feb 2011
  • Hygiene: observed handwashing behaviour in Bangladesh lower than reported, E-Source, 03 Nov 2010
  • Global Handwashing Day: 200 million lather up for clean hands, E-Source, 01 Nov 2010

Related web sites:

Contact: Amy Janel Pickering, Emmet Interdisciplinary Program in Environment and Resources, School of Earth Sciences, Stanford University,

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