About 15 to 20 times a day, Valerie Richberg reaches into her bag for a can of foaming hand sanitizer, before, after and sometimes during a patient visit.
"As long as you're sanitizing your hands, it keeps the germ factor down," said Mrs. Richberg, a case manager and home health nurse for University Health Care System Home Health Services. "And I think it makes the patient feel better when they actually see you cleansing your hands."
The foams and gels increasingly are showing up on office desks and in public places, including large airports. But not everyone thinks they are a good defense.
"The question is: What are you trying to do?" said James Wilde, the medical director and section chief for pediatric emergency medicine at Medical College of Georgia Hospital and Clinics.
"Are you trying to eliminate all the bacteria from your skin? If you are, you are making a big mistake because when you eliminate all bacteria from your skin, you are potentially opening up a niche that bad bacteria can then fit into."
But that's unlikely with the alcohol-based rubs if used properly, said Jack Austin, an infectious diseases specialist with University Health Care.
"The resident (bacteria) are deeper down into your skin, and there's no amount of handwashing or hand-rubbing that is going to get rid of those organisms," Dr. Austin said. "Then there's the transient (bacteria), the things that we're worried about, that has the cold and flu germs, the staph germs, things like that, that you can influence and get rid of."
A study presented in September at the annual meeting of the Infectious Diseases Society of America found that families that used hand sanitizers cut their spread of gastrointestinal disease by 59 percent in the first large-scale randomized test of their effectiveness.
Both Augusta physicians agree the alcohol rubs should not replace hand-washing and that using them in hospitals helps prevent cross-contamination between patients. Dr. Austin can cite another advantage to the cleansers, which can be used without water: less chafing and irritation.
"You actually have less chafing, less irritation with alcohol than you do with a lot of the soaps," he said.
But hand-washing achieves something the rubs can't, Dr. Wilde said.
"If you use soap and water, it's the water that is doing more for you in many cases than the soap," he said. "You're diluting out, you're washing away the bad bugs. To be carrying around (the hand sanitizer), it may be providing some psychological benefit, but it's really not doing a heck of a lot for you."
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.
Though physicians may disagree on the usefulness of carrying around an alcohol-based hand sanitizer, there are common ground rules and things you can do to reduce the risk of becoming infected or spreading infection.
• Wash hands often, especially after sneezing or coughing. Wash for 15-20 seconds.
• Avoid touching hands to the face, nose and mouth until your hands have been cleansed.
• Clip fingernails short to eliminate hiding places for bacteria.
• Cover your mouth and nose when you sneeze or cough.
• Stay home if you are sick, particularly with flulike symptoms. Get plenty of rest.
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