2011/05/03 by Amy J. Pickering, Jennifer Davis, Alexandria B. Boehm · 1 citation
Nursing · Medicine · Agricultural and Biological Sciences · Engineering · #Child Nutrition and Water Access #Infection Control in Healthcare #Food Safety and Hygiene #Hand sanitizer #Dirt #Hand washing #Hygiene #Clean water #Palm oil #Medicine #Environmental health #Diarrhea #Toxicology #Environmental science #Waste management #Biology #Agricultural science #Ecology #Engineering
paper · pdf · doi:10.2166/wh.2011.138
openalex publication_date 2011/05/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/05/21
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 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.