Hand sanitizers: A review of ingredients, mechanisms of action, modes of delivery, and efficacy against coronaviruses

doi:10.1016/j.ajic.2020.06.182

Review

. 2020 Sep;48(9):1062-1067.

doi: 10.1016/j.ajic.2020.06.182. Epub 2020 Jun 18.

Hand sanitizers: A review of ingredients, mechanisms of action, modes of delivery, and efficacy against coronaviruses

Andrew P Golin¹, Dexter Choi¹, Aziz Ghahary²

Affiliations

¹ Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
² BC Professional Firefighters' Burn & Wound Healing Research Laboratory, Department of Surgery, Division of Plastic Surgery, iCORD, Vancouver, British Columbia, Canada. Electronic address: aghahary@mail.ubc.ca.

PMID: 32565272
PMCID: PMC7301780
DOI: 10.1016/j.ajic.2020.06.182

Review

Hand sanitizers: A review of ingredients, mechanisms of action, modes of delivery, and efficacy against coronaviruses

Andrew P Golin et al. Am J Infect Control. 2020 Sep.

. 2020 Sep;48(9):1062-1067.

doi: 10.1016/j.ajic.2020.06.182. Epub 2020 Jun 18.

Authors

Andrew P Golin¹, Dexter Choi¹, Aziz Ghahary²

Affiliations

¹ Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
² BC Professional Firefighters' Burn & Wound Healing Research Laboratory, Department of Surgery, Division of Plastic Surgery, iCORD, Vancouver, British Columbia, Canada. Electronic address: aghahary@mail.ubc.ca.

PMID: 32565272
PMCID: PMC7301780
DOI: 10.1016/j.ajic.2020.06.182

Abstract

Background: The emergence of the novel virus, SARS-CoV-2, has posed unprecedented challenges to public health around the world. Currently, strategies to deal with COVID-19 are purely supportive and preventative, aimed at reducing transmission. An effective and simple method for reducing transmission of infections in public or healthcare settings is hand hygiene. Unfortunately, little is known regarding the efficacy of hand sanitizers against SARS-CoV-2.

Methods: In this review, an extensive literature search was performed to succinctly summarize the primary active ingredients and mechanisms of action of hand sanitizers, compare the effectiveness and compliance of gel and foam sanitizers, and predict whether alcohol and non-alcohol hand sanitizers would be effective against SARS-CoV-2.

Results: Most alcohol-based hand sanitizers are effective at inactivating enveloped viruses, including coronaviruses. With what is currently known in the literature, one may not confidently suggest one mode of hand sanitizing delivery over the other. When hand washing with soap and water is unavailable, a sufficient volume of sanitizer is necessary to ensure complete hand coverage, and compliance is critical for appropriate hand hygiene.

Conclusions: By extrapolating effectiveness of hand sanitizers on viruses of similar structure to SARS-CoV-2, this virus should be effectively inactivated with current hand hygiene products, though future research should attempt to determine this directly.

Keywords: COVID-19; Foam; Gel; Hand hygiene; SARS-CoV-2.

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Figures

**Fig 1**
Generic structure of a virus with a lipid envelope. Image by Graham Beards, distributed under a CC BY-SA 3.0 license.

**Fig 2**
Generic structure of a gram-negative bacterium. Image by Ali Zifan, distributed under a CC-BY-SA 4.0 license.

**Fig 3**
Gram-positive versus gram-negative bacteria. Image by Julian Onions, Wikimedia Commons, Public Domain.

See this image and copyright information in PMC

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References

1. Coronavirus disease 2019 (COVID-19) Situation Report-101. 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2.... Accessed July 10,2020.
1. Pittet D, Allegranzi B, Boyce J. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol. 2009;30:611–622. - PubMed
1. Boyce JM, Pittet D, Healthcare Infection Control Practices Advisory Committee. Society for Healthcare Epidemiology of America. Association for Professionals in Infection Control. Infectious Diseases Society of America. Hand Hygiene Task Force Guideline for hand hygiene in health-care settings: recommendations of the healthcare infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force. Infect Control Hosp Epidemiol. 2002;23(12 Suppl):S3–40. - PubMed
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1. Wentworth AB, Yiannias JA, Davis MDP, Killian JM. Benzalkonium chloride: a known irritant and novel allergen. Dermatitis. 2016;27:14–20. - PubMed

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[1] Coronavirus disease 2019 (COVID-19) Situation Report-101. 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2.... Accessed July 10,2020.

[2] Coronavirus disease 2019 (COVID-19) Situation Report-101. 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2.... Accessed July 10,2020.

[3] Pittet D, Allegranzi B, Boyce J. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol. 2009;30:611–622. - PubMed

[4] Pittet D, Allegranzi B, Boyce J. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol. 2009;30:611–622. - PubMed

[5] Boyce JM, Pittet D, Healthcare Infection Control Practices Advisory Committee. Society for Healthcare Epidemiology of America. Association for Professionals in Infection Control. Infectious Diseases Society of America. Hand Hygiene Task Force Guideline for hand hygiene in health-care settings: recommendations of the healthcare infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force. Infect Control Hosp Epidemiol. 2002;23(12 Suppl):S3–40. - PubMed

[6] Boyce JM, Pittet D, Healthcare Infection Control Practices Advisory Committee. Society for Healthcare Epidemiology of America. Association for Professionals in Infection Control. Infectious Diseases Society of America. Hand Hygiene Task Force Guideline for hand hygiene in health-care settings: recommendations of the healthcare infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force. Infect Control Hosp Epidemiol. 2002;23(12 Suppl):S3–40. - PubMed

[7] Gold NA, Avva U. StatPearls Publishing; 2018. Alcohol Sanitizer. Available at: http://www.ncbi.nlm.nih.gov/pubmed/30020626. Accessed July 10,2020. - PubMed

[8] Gold NA, Avva U. StatPearls Publishing; 2018. Alcohol Sanitizer. Available at: http://www.ncbi.nlm.nih.gov/pubmed/30020626. Accessed July 10,2020. - PubMed

[9] Wentworth AB, Yiannias JA, Davis MDP, Killian JM. Benzalkonium chloride: a known irritant and novel allergen. Dermatitis. 2016;27:14–20. - PubMed

[10] Wentworth AB, Yiannias JA, Davis MDP, Killian JM. Benzalkonium chloride: a known irritant and novel allergen. Dermatitis. 2016;27:14–20. - PubMed

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Hand sanitizers: A review of ingredients, mechanisms of action, modes of delivery, and efficacy against coronaviruses

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Hand sanitizers: A review of ingredients, mechanisms of action, modes of delivery, and efficacy against coronaviruses

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