Assessment of exposure to ethanol vapors released during use of Alcohol-Based Hand Rubs by healthcare workers

Abstract

Summary: Background: Despite the increasing use of Alcohol-Based Hand Rub solutions, few studies have quantified the concentrations of inhaled ethanol. Objective: The aim of this study was to assess ethanol exposure during hygienic and surgical hand disinfection practices. Method: Ethanol concentrations were measured at the nose level of a wooden dummy and human volunteers. Two systems were used in parallel to determine short-term ethanol vapor exposures: activated charcoal tubes followed by gas chromatography analysis and direct reading on a photoionization detector (PID).Exposure was assessed for 4 different sequences (N = 10) reproducing hand rubs for simple surgery, nursing care, intensive care and surgical scrub. Results: The ethanol concentrations measured were of a similar order between the dummy and volunteers. The concentrations obtained by PID were higher than the gas chromatography values for the simple care (45%) and nursing care (27%) sequences and reflected specific exposure peaks of ethanol, whereas ethanol concentrations were continuously high for intensive care (440 mg m−3) or surgical scrub (650 mg m−3). Conclusion: Ethanol concentrations were similar for these two exposure assessment methods and demonstrated a relationship between handled doses and inhaled doses. However, the ethanol vapors released during hand disinfection were safe for the healthcare workers. Keywords: Ethanol, Alcohol-Based Hand Rub, Air exposure, Gas Chromatography, Photoionization detector