Health Check: should we be using alcohol-based hand sanitisers?

Health Check: should we be using alcohol-based hand sanitisers?

This is a MUST READ post!

'...we touch our face up to 23 times each hour and, of these, ten touches are to our eyes, nose or mouth. So while touching your face with contaminated hands you could be contaminating your hands or yourself with many infections, including influenza, the common cold and diarrhoeal infections. In fact, contaminated hands can spread most infectious diseases.'

Mary-Louise McLaws, Professor of Epidemiology Healthcare Infection and Infectious Diseases Control, UNSW Australia, explains the strengths and weaknesses of hand washing with soap and alcohol-based hand sanitisers:

This article has some excellent tips on how to best care for both your hands and your overall health by judicious use of both alcohol based and soap washing. Some excerpts:

'Alcohol-based hand rub has the added bonus of providing an additional 20 minutes of residual action on the surface of the health workers’ hands to keep pathogens from multiplying to a level that can cause infection in vulnerable patients.'


'Public transport has now become air-conditioned, providing a better environment for keeping respiratory and diarrhoeal viruses on hand rails and seats for longer. If you touch your face (as most of us do), you might like to use a hand rub after leaving the train or bus, as hand hygiene can reduce the spread of respiratory illnesses by 20% and by 30% for gastrointestinal infections.'


'Remember, though, inside a closed train or bus flu viruses can spread up to 2.5 metres from a passenger who is in the very early stages of flu, just from breathing or talking. So sometimes there’s no escaping these bugs without vaccination.'


Photo: Some safe separation public seating :)

11 Replies

  • Yikes! Thanks for posting this. I seem to wash my hands constantly, especially after handling money, which I understand is crawling with bacteria.

  • I take public transit to work each day and since I was diagnosed and started treatment the first thing I do when I exit the train station is go for the green goo.

  • Neil,

    BTW, for those of us taking Imbruvica with elevated WBC levels (say, 10x normal) are we more vulnerable to infections? Or is the number somewhat of a "false positive"?

    I know I take some risks with work-related travel to remote foreign locations, but haven't had any problems. (I am writing this from a village in Laos somewhere along the old Ho Chi Minh Trail, across the border from Vietnam...)


  • Infection risk shouldn't be a consequence of an elevated WBC (from CLL cells spilling into the blood); it's more likely a consequence of a low neutrophil count. This is why it is important to monitor the individual white cell count numbers, not the overall count or the percentages.

    Neutrophils are 'dumb' infection fighters that hopefully kill off bacteria and fungi. Dealing with viruses plus bacteria and fungi that we have experienced before is reliant on adequate immunoglobulin levels. These take a hit with any CLL treatment, because healthy B-lymphocytes are the progenitors of plasma cells which manufacture immunoglobulins (antibodies) and all CLL treatments target all B-lymphocytes - both CLL cells and healthy B-cells. Immunoglobulins attach to known foreign infiltrators, marking them for destruction by our immune system. If we lack immunoglobulins, then invading pathogens can evade destruction and make you ill. Bacterial and fungal infections can be (hopefully) be brought under control by antibiotics. Virus infections generally rely on you being able to fight them off on your own - though there are antivirals for some illnesses.


  • Good to know! I had a blood test done in Beijing a week ago at a clinic. I didn't explain to them my CLL/Imbruvica status, but I did give them a heads up that I would have a crazy WBC level. They ended up running the tests several times and phoning me up in a panic, "If you get an infection you need to be rushed to the ER!" I told them that everything was part of the "new normal" and that they needn't worry about me.

  • This is a great article. If it's helpful to anyone, we stopped using the alcohol based sanitizers commonly found in pharmacies and switched to Zylast XP, which does not contain triclosan and (importantly) kills norovirus, which most alcohol based sanitizers do not. See: We order their antiseptic lotion product via Amazon after realizing it was what our doctor was using each time she entered and exited the exam room.

  • Thanks for the zylast link. My alcohol gel pump and wipes are running out so I think I will see if this works better. Some viruses got past my alcohol based products this past winter despite my best efforts and obsessive use.

  • FDA warning letter to the makers of Zylast XP...

  • Oh!! Appreciate the warning!

  • I had a hospital appointment today. It was good to see how many patients and visitors used the hand gel provided.


  • I find it interesting that everyone talks about using hand sanitizer when leaving an area that might be a source of infection, but no mention of using it after entering. You would be touching the same things getting on public transit, for example, as you would getting off, and you would probably touch your face or whatever (phone, etc.) while there for the ride.

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