Questioning the sanitation craze

Hand sanitizer manufacturers are turning serious profits as H1N1 fears propel people to keep their hands clean, but some experts are skeptical

As students protect themselves against swine flu, Purell stations like this one have been installed all over campus, but some health experts wonder whether hand sanitizer’s ubiquity is justified.
As students protect themselves against swine flu, Purell stations like this one have been installed all over campus, but some health experts wonder whether hand sanitizer’s ubiquity is justified.

Walking around campus, it’s hard to deny we live in an age of commercialized sanitation. Because of the H1N1 pandemic, hand sanitizer dispensers have been installed at the entrance of nearly every building on campus. But is this a good thing? Although hand hygiene is an important means of preventing the contact transmission of viruses and flus such as H1N1 some question our obsession with sanitation.

Hand sanitizer manufacturers are swiftly capitalizing on their surge in popularity since the outbreak of swine flu. GOJO Industries, the makers of Purell, can’t meet the demand as Purell outlets have been stationed and bottles distributed all over North America. EcoLab and Steris predict sales may triple over the next year, according to a CBC report last month. The sales of Clorox disinfectant wipes have also risen 23 per cent.

Dr. Jacalyn Duffin, professor in the department of the history of medicine, is skeptical of hand sanitizers because people place more confidence in them than they should.

Duffin said hand sanitizer has become a panacea in our society—a solution to all our health problems analogous to the ancient Greek rituals to ward off plagues.

“I am a little bit skeptical because I’m skeptical of all panaceas,” she said.

Duffin said she agrees it’s important people keep their hands clean to prevent the spread of germs that make us sick, but the commercialization of hand sanitizers is a sign people are falling prey to marketing scare tactics.

“It’s not that I have anything against good hand hygiene and hand sanitizer, I’m not opposed to using it,” she said. “It’s just that companies have an incentive to make us use it. We’re being duped a little bit.”

Duffin said she also takes issue with the fact that hand sanitizers don’t kill all germs. Most say they kill 99.9 per cent of germs. The other 0.1 per cent may thrive.

“I’m worried that they kill off the ones that are easy to kill … and therefore leave some ground for resistant strains to flourish. If they are like organisms they can multiply,” Duffin said.

The other contention with hand sanitizers lies in a general skepticism about hygiene. According to the ‘hygiene hypothesis,’ first proposed in a 1989 article in the British Medical Journal, children raised in a rigorously sanitized environment due to the prevalence of household cleaning products, an increase in antibiotic use and widespread vaccinations are at an increased risk of contracting allergic diseases. The hypothesis suggests this trend occurs in some children living in developed countries because they aren’t properly exposed to common bacteria that’s important to develop their immune systems.

Cary Fan, MD ’11, said although many hold the opinion that the ‘hygiene hypothesis’ is worth delving into, there isn’t enough evidence to suggest it should discourage good hand hygiene. “Washing your hands before dinner has always been folk wisdom before we knew about germs and bacteria,” Fan said. Hand sanitizers work by removing the top layer of oil from your hands with an active alcohol ingredient—usually ethanol—that kills bacteria and germs. Soap and water also does this, additionally removing any dirt from your hands that hand sanitizers are unable to remove. This is because of the important mechanical element of hand washing—scrubbing your hands for at least 20 seconds, rinsing well and drying all play an important part in ensuring your hands are properly cleaned. For hand sanitizers, it’s essential to rub your hands together until they are completely dry, or it may be ineffective.

Fan said medical professionals unanimously agreed hand washing is more effective than hand sanitizing and would never suggest that hand sanitizers be used in place of hand washing. However, using hand sanitizers is still very important, because it’s convenient and time efficient in a way that hand washing isn’t. Cary points out placing sinks around campus wouldn’t be a feasible means of reminding people to wash their hands, but with the installation of hand sanitizer dispensers during the H1N1 pandemic, people are developing good preventative habits. “This time next year, we won’t be bombarded by the same alarmism, but I hope that the same habits we picked up this year such as washing our hands constantly and coughing into our sleeves will carry over, and that’s a positive thing,” he said. “I don’t see any risk to washing our hands.”

—With files from Ashleigh Ryan

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