Impacts of hand sanitizer on human health and environment: a review
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Published
May 10, 2023
Shashi Bala
Faheem Ahamad
Abstract
Although the use of sanitizer starts around the middle of twentieth century but it becomes popular in early twenty first century (second decade of twenty first century during COVID-19 pandemic). To prevent the spread of COVID-19, World Health Organisation (WHO) recommended the use of sanitizers made up with different combinations of isopropyl alcohols, ethanol and hydrogen peroxides. Literature suggests some toxic effect of use and misuse of these components of sanitizers. Therefore, in the present study an attempt has been made to investigate the use of available hand sanitizers and their adverse effects on human body as well as to collect and correlate the gathered information with their occupation which may further trigger the adverse effect of sanitizer on human being. Out of the total respondents, 98% are using but very few (2%) are not using any type of sanitizer. Age group 2 (16-25 years) is the largest user of hand sanitizer which shows the maximum awareness of this age group related to sanitation and hygiene. Data obtained suggests that males (57.5%) are more aware to sanitization in comparison to female (41.8%). Among the total respondents, house wives were very few (0.8%) which shows lack of awareness among them may be due to their busy schedule and household works. The obtained data revealed that education plays a key role in the spread of sanitation and hygiene awareness. Most of the peoples are using the sanitizers of established brands (Dettol). The data also revealed that 88% of the respondents were observing the various impacts on the body (49% skin dryness, 16% skin allergy 12% skin irritation and itching while 12% respondents are not sure about the impacts). Only 12% peoples responded that they are not observing any impacts of sanitizer. Besides this, different components used in sanitizers pose threat to the different spheres of the environment. Based on the findings of the present study, we can conclude that sanitizer is impacting the human health and environment in various. Therefore there is a need of mass awareness regarding the use and disposal of disinfectants.
How to Cite
Bala , S., & Ahamad , F. (2023). Impacts of hand sanitizer on human health and environment: a review . Environment Conservation Journal, 24(2), 413–422. https://doi.org/10.36953/ECJ.23572619
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Keywords
Alcohol, COVID-19 pandemic, Coronavirus, Respondents, Sanitizer, Disinfectants, Environment
References
Abo-Zeid, Y., Bakkar, M. R., Elkhouly, G. E., Raya, N. R., & Zaafar, D. (2022). Rhamnolipid Nano-Micelles versus Alcohol-Based Hand Sanitizer: A Comparative Study for Antibacterial Activity against Hospital-Acquired Infections and Toxicity Concerns. Antibiotics, 11(5), 605.
Altunisik Toplu, S., Altunisik, N., Turkmen, D., & Ersoy, Y. (2020). Relationship between hand hygiene and cutaneousfindings during COVID‐19 pandemic. Journal of cosmetic dermatology, 19(10), 2468-2473.
Aodah, A. H., Bakr, A. A., Booq, R. Y., Rahman, M. J., Alzahrani, D. A., Alsulami, K. A., & Tawfik, E. A. (2021). Preparation and evaluation of benzalkonium chloride hand sanitizer as a potential alternative for alcohol-based hand gels. Saudi Pharmaceutical Journal, 29(8), 807-814.
Atolani, O., Baker, M. T., Adeyemi, O. S., Olanrewaju, I. R., Hamid, A. A., Ameen, O. M., ... & Usman, L. A. (2020). COVID-19: Critical discussion on the applications and implications of chemicals in sanitizers and disinfectants. EXCLI journal, 19, 785.
ATSDR, (2002). Hydrogen peroxide [CAS #7722-84-1]. Available at: https://www.atsdr.cdc. gov/toxfaqs/tfacts174.pdf.
BABEC, (2001). Material safety data sheet: isopropanol, reagent ACS. Bay Area biotechnology education consortium. Retrieved 2020 from: http://babec.org/files/MSDS/ isopropanol.pdf.
Bakkar, M. R., Faraag, A. H. I., Soliman, E. R., Fouda, M. S.,Sarguos, A. M. M., McLean, G. R., & Abo-Zeid, Y. (2021). Rhamnolipids nano-micelles as a potential hand sanitizer. Antibiotics, 10(7), 751.
Bashir, M. F., Ma, B., & Shahzad, L. (2020). A brief review of socio-economic and environmental impact of Covid-19. Air Quality, Atmosphere & Health, 13, 1403-1409.
Beiu, C., Mihai, M., Popa, L., Cima, L., & Popescu, M. N. (2020). Frequent hand washing for COVID-19 prevention can cause hand dermatitis: management tips. Cureus, 12(4).
Bhat, S. A., Sher, F., Kumar, R., Karahmet, E., Haq, S. A. U., Zafar, A., & Lima, E. C. (2021). Environmental and health impacts of spraying COVID-19 disinfectants with associated challenges. Environmental Science and Pollution Research, 1-10.
CDC (2020). Hand Hygiene Recommendations Guidance for Healthcare Providers about Hand Hygiene and COVID-19.China Ministry of Ecology and Environment (2020). Will viruses and disinfection affect water quality? The Ministry of Ecology and Environment responded. www.mee.gov.cn/ywgz/ssthjbh/dbssthjgl/202003/t2020031 1_768408.shtml [in Chinese]. Accessed 29June 2020.
Chojnacki, M., Dobrotka, C., Osborn, R., Johnson, W., Young, M., Meyer, B., & Dunman, P. M. (2021). Evaluating the antimicrobial properties of commercial hand sanitizers. MSphere, 6(2), e00062-21.
Cohen, G., Kreutzer, N., Mowat, K., Hassan, A. A., & Dvorak,B. (2021). Compliance with hand sanitizer quality during the SARS-CoV-2 pandemic: Assessing the impurities in an ethanol plant. Journal of Environmental Management, 297, 113329.
Dhama, K., Patel, S. K., Kumar, R., Masand, R., Rana, J., Yatoo, M. I., ... & Harapan, H. (2021). The role of disinfectants and sanitizers during COVID-19 pandemic: advantages and deleterious effects on humans and the environment. Environmental Science and Pollution Research, 28(26), 34211-34228.
Dharan, S., Hugonnet, S., Sax, H., & Pittet, D. (2003). Comparison of waterless hand antisepsis agents at short application times: raising the flag of concern. Infection Control & Hospital Epidemiology, 24(3), 160-164.
Du, Y., Tu, L., Zhu, P., Mu, M., Wang, R., Yang, P., & Xu,G. (2020). Clinical features of 85 fatal cases of COVID-19 from Wuhan. A retrospective observational study. American journal of respiratory and critical care medicine, 201(11), 1372-1379.
Duane, B., Pilling, J., Saget, S., Ashley, P., Pinhas, A. R., & Lyne, A. (2022). Hand hygiene with hand sanitizer versus handwashing: what are the planetary health consequences?. Environmental Science and Pollution Research, 29(32), 48736-48747.
Emami, A., Javanmardi, F., Keshavarzi, A., & Pirbonyeh, N. (2020). Hidden threat lurking behind the alcohol sanitizers in COVID‐19 outbreak. Dermatologic therapy, 33(4), e13627.
FDA (2021). https://www.fda.gov/drugs/drug-safety-and- availability/fda-updates-hand-sanitizers-consumers-should- not-use.
Geller, C., Varbanov, M., & Duval, R. E. (2012). Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses, 4(11), 3044-3068.
Ghafoor, D., Khan, Z., Khan, A., Ualiyeva, D., & Zaman, N. (2021). Excessive use of disinfectants against COVID-19 posing a potential threat to living beings. Current Research in Toxicology, 2, 159-168.
Ghannoum, M., Hoffman, R. S., Mowry, J. B., & Lavergne, V. (2014, July). Trends in toxic alcohol exposures in the United States from 2000 to 2013: a focus on the use of antidotes and extracorporeal treatments. In Seminars in dialysis (Vol. 27, No. 4, pp. 395-401).
HSDB, (2012). National library of medicine, TOXNET. Isopropanol. Hazardous substances.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet, 395(10223), 497-506.
Jing, J. L. J., Pei Yi, T., Bose, R. J., McCarthy, J. R., Tharmalingam, N., & Madheswaran, T. (2020). Hand sanitizers: a review on formulation aspects, adverse effects, and regulations. International journal of environmental research and public health, 17(9), 3326.
Kratzel, A., Todt, D., V’kovski, P., Steiner, S., Gultom, M., Thao, T. T. N., ... & Pfaender, S. (2020). Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO- recommended hand rub formulations and alcohols. Emerging infectious diseases, 26(7), 1592.
Kumar, A., Jain, V., Deovanshi, A., Lepcha, A., Das, C., Bauddh, K., & Srivastava, S. (2021). Environmental impact of COVID-19 pandemic: more negatives than positives. Environmental Sustainability, 1-8.
Kumar, S., & Das, A. (2021). Hand sanitizers: Science and rationale. Indian Journal of Dermatology, Venereology and Leprology, 87(2), 309-314.
Lee, K. P., Girijala, R. L., & Chon, S. Y. (2022). Phytophotodermatitis due to a Citrus-Based Hand Sanitizer: A Case Report. Korean Journal of Family Medicine, 43(4), 271.
Mahmood, A., Eqan, M., Pervez, S., Alghamdi, H. A.,Tabinda, A. B., Yasar, A., ... & Pugazhendhi, A. (2020). COVID-19 and frequent use of hand sanitizers; human health and environmental hazards by exposure pathways. Science of the Total Environment, 742, 140561.
MassDEP, (2011). Large volume ethanol spills– environmental impacts & response options. Available at: https://www.mass.gov/files/2017-08/ethanol-spill-impacts- and-response- 7-11.pdf.
Meyers, C., Kass, R., Goldenberg, D., Milici, J., Alam, S., & Robison, R. (2021). Ethanol and isopropanol inactivation of human coronavirus on hard surfaces. Journal of Hospital Infection, 107, 45-49.
Nabi, G., Wang, Y., Hao, Y., Khan, S., Wu, Y., & Li, D. (2020). Massive use of disinfectants against COVID-19 poses potential risks to urban wildlife. Environmental research, 188, 109916.
New England Interstate Water Pollution Control Commission (NEIWPCC), 2001. Health, environmental, and economic impacts of adding ethanol to gasoline in the northeast states.Water Resources and Associated Health Impacts. Available at:https://www. neiwpcc.org/ neiwpcc_docs/NEI_ResourceGuide.pdf.
Olson, K. R., Anderson, I. B., Benowitz, N. L., Blanc, P. D.,Clark R. F., Kearney T. E., Wu, A. H. (Eds.) (2012). Poisoning & drug overdose New York, NY, USA: McGraw Hill Medical.p. 287.
Pendlington, R. U., Whittle, E., Robinson, J. A., & Howes, D. (2001). Fate of ethanol topically applied to skin. Food and Chemical Toxicology, 39(2), 169-174.
Saha, T., Khadka, P., & Das, S. C. (2021). Alcohol-based hand sanitizer composition, proper use and precautions . Germs, 11(3), 408.
Sedlak, D. L., & von Gunten, U. (2011). The chlorine dilemma. Science, 331(6013),42-43.
Singh, P., Potlia, I., Malhotra, S., Dubey, H., & Chauhan, H. (2020). Hand sanitizer an alternative to hand washing—a review of literature. Journal of Advanced Oral Research, 11(2), 137-142.
Subpiramaniyam, S. (2021). Outdoor disinfectant sprays for the prevention of COVID-19: Are they safe for the environment?. Science of the Total Environment, 759, 144289.
Traore, O., Hugonnet, S., Lübbe, J., Griffiths, W., & Pittet, D. (2007). Liquid versus gel handrub formulation: a prospective intervention study. Critical care, 11, 1-8.
United States Environmental Protection Agency (USEPA), (2011). ECOTOX database. [Online database]. (Accessed 2020).Available at: http://cfpub.epa.gov/ecotox/.
Van Doremalen, N., Bushmaker, T., Morris, D. H., Holbrook,M. G., Gamble, A., Williamson, B. N., & Munster, V. J. (2020). Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England journal of medicine, 382(16), 1564-1567.
Vermeil, T., Peters, A., Kilpatrick, C., Pires, D., Allegranzi, B., & Pittet, D. (2019). Hand hygiene in hospitals: anatomy of a revolution. Journal of Hospital Infection, 101(4), 383- 392.
Watt, B. E., Proudfoot, A. T., & Vale, J. A. (2004). Hydrogen peroxide poisoning. Toxicological reviews, 23, 51-57.
Weaver, J. M. (2005). The increasing use of alcohol-based hand sanitizers. Anesthesia progress, 52(3), 85-85.
WHO (2010).https://www.who.int/gpsc/5may/ Guide_to_Local_ Production.pdf.
WHO (2020). Interim Recommendation on obligatory hand hygiene against transmission of covid-19.
Altunisik Toplu, S., Altunisik, N., Turkmen, D., & Ersoy, Y. (2020). Relationship between hand hygiene and cutaneousfindings during COVID‐19 pandemic. Journal of cosmetic dermatology, 19(10), 2468-2473.
Aodah, A. H., Bakr, A. A., Booq, R. Y., Rahman, M. J., Alzahrani, D. A., Alsulami, K. A., & Tawfik, E. A. (2021). Preparation and evaluation of benzalkonium chloride hand sanitizer as a potential alternative for alcohol-based hand gels. Saudi Pharmaceutical Journal, 29(8), 807-814.
Atolani, O., Baker, M. T., Adeyemi, O. S., Olanrewaju, I. R., Hamid, A. A., Ameen, O. M., ... & Usman, L. A. (2020). COVID-19: Critical discussion on the applications and implications of chemicals in sanitizers and disinfectants. EXCLI journal, 19, 785.
ATSDR, (2002). Hydrogen peroxide [CAS #7722-84-1]. Available at: https://www.atsdr.cdc. gov/toxfaqs/tfacts174.pdf.
BABEC, (2001). Material safety data sheet: isopropanol, reagent ACS. Bay Area biotechnology education consortium. Retrieved 2020 from: http://babec.org/files/MSDS/ isopropanol.pdf.
Bakkar, M. R., Faraag, A. H. I., Soliman, E. R., Fouda, M. S.,Sarguos, A. M. M., McLean, G. R., & Abo-Zeid, Y. (2021). Rhamnolipids nano-micelles as a potential hand sanitizer. Antibiotics, 10(7), 751.
Bashir, M. F., Ma, B., & Shahzad, L. (2020). A brief review of socio-economic and environmental impact of Covid-19. Air Quality, Atmosphere & Health, 13, 1403-1409.
Beiu, C., Mihai, M., Popa, L., Cima, L., & Popescu, M. N. (2020). Frequent hand washing for COVID-19 prevention can cause hand dermatitis: management tips. Cureus, 12(4).
Bhat, S. A., Sher, F., Kumar, R., Karahmet, E., Haq, S. A. U., Zafar, A., & Lima, E. C. (2021). Environmental and health impacts of spraying COVID-19 disinfectants with associated challenges. Environmental Science and Pollution Research, 1-10.
CDC (2020). Hand Hygiene Recommendations Guidance for Healthcare Providers about Hand Hygiene and COVID-19.China Ministry of Ecology and Environment (2020). Will viruses and disinfection affect water quality? The Ministry of Ecology and Environment responded. www.mee.gov.cn/ywgz/ssthjbh/dbssthjgl/202003/t2020031 1_768408.shtml [in Chinese]. Accessed 29June 2020.
Chojnacki, M., Dobrotka, C., Osborn, R., Johnson, W., Young, M., Meyer, B., & Dunman, P. M. (2021). Evaluating the antimicrobial properties of commercial hand sanitizers. MSphere, 6(2), e00062-21.
Cohen, G., Kreutzer, N., Mowat, K., Hassan, A. A., & Dvorak,B. (2021). Compliance with hand sanitizer quality during the SARS-CoV-2 pandemic: Assessing the impurities in an ethanol plant. Journal of Environmental Management, 297, 113329.
Dhama, K., Patel, S. K., Kumar, R., Masand, R., Rana, J., Yatoo, M. I., ... & Harapan, H. (2021). The role of disinfectants and sanitizers during COVID-19 pandemic: advantages and deleterious effects on humans and the environment. Environmental Science and Pollution Research, 28(26), 34211-34228.
Dharan, S., Hugonnet, S., Sax, H., & Pittet, D. (2003). Comparison of waterless hand antisepsis agents at short application times: raising the flag of concern. Infection Control & Hospital Epidemiology, 24(3), 160-164.
Du, Y., Tu, L., Zhu, P., Mu, M., Wang, R., Yang, P., & Xu,G. (2020). Clinical features of 85 fatal cases of COVID-19 from Wuhan. A retrospective observational study. American journal of respiratory and critical care medicine, 201(11), 1372-1379.
Duane, B., Pilling, J., Saget, S., Ashley, P., Pinhas, A. R., & Lyne, A. (2022). Hand hygiene with hand sanitizer versus handwashing: what are the planetary health consequences?. Environmental Science and Pollution Research, 29(32), 48736-48747.
Emami, A., Javanmardi, F., Keshavarzi, A., & Pirbonyeh, N. (2020). Hidden threat lurking behind the alcohol sanitizers in COVID‐19 outbreak. Dermatologic therapy, 33(4), e13627.
FDA (2021). https://www.fda.gov/drugs/drug-safety-and- availability/fda-updates-hand-sanitizers-consumers-should- not-use.
Geller, C., Varbanov, M., & Duval, R. E. (2012). Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses, 4(11), 3044-3068.
Ghafoor, D., Khan, Z., Khan, A., Ualiyeva, D., & Zaman, N. (2021). Excessive use of disinfectants against COVID-19 posing a potential threat to living beings. Current Research in Toxicology, 2, 159-168.
Ghannoum, M., Hoffman, R. S., Mowry, J. B., & Lavergne, V. (2014, July). Trends in toxic alcohol exposures in the United States from 2000 to 2013: a focus on the use of antidotes and extracorporeal treatments. In Seminars in dialysis (Vol. 27, No. 4, pp. 395-401).
HSDB, (2012). National library of medicine, TOXNET. Isopropanol. Hazardous substances.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet, 395(10223), 497-506.
Jing, J. L. J., Pei Yi, T., Bose, R. J., McCarthy, J. R., Tharmalingam, N., & Madheswaran, T. (2020). Hand sanitizers: a review on formulation aspects, adverse effects, and regulations. International journal of environmental research and public health, 17(9), 3326.
Kratzel, A., Todt, D., V’kovski, P., Steiner, S., Gultom, M., Thao, T. T. N., ... & Pfaender, S. (2020). Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO- recommended hand rub formulations and alcohols. Emerging infectious diseases, 26(7), 1592.
Kumar, A., Jain, V., Deovanshi, A., Lepcha, A., Das, C., Bauddh, K., & Srivastava, S. (2021). Environmental impact of COVID-19 pandemic: more negatives than positives. Environmental Sustainability, 1-8.
Kumar, S., & Das, A. (2021). Hand sanitizers: Science and rationale. Indian Journal of Dermatology, Venereology and Leprology, 87(2), 309-314.
Lee, K. P., Girijala, R. L., & Chon, S. Y. (2022). Phytophotodermatitis due to a Citrus-Based Hand Sanitizer: A Case Report. Korean Journal of Family Medicine, 43(4), 271.
Mahmood, A., Eqan, M., Pervez, S., Alghamdi, H. A.,Tabinda, A. B., Yasar, A., ... & Pugazhendhi, A. (2020). COVID-19 and frequent use of hand sanitizers; human health and environmental hazards by exposure pathways. Science of the Total Environment, 742, 140561.
MassDEP, (2011). Large volume ethanol spills– environmental impacts & response options. Available at: https://www.mass.gov/files/2017-08/ethanol-spill-impacts- and-response- 7-11.pdf.
Meyers, C., Kass, R., Goldenberg, D., Milici, J., Alam, S., & Robison, R. (2021). Ethanol and isopropanol inactivation of human coronavirus on hard surfaces. Journal of Hospital Infection, 107, 45-49.
Nabi, G., Wang, Y., Hao, Y., Khan, S., Wu, Y., & Li, D. (2020). Massive use of disinfectants against COVID-19 poses potential risks to urban wildlife. Environmental research, 188, 109916.
New England Interstate Water Pollution Control Commission (NEIWPCC), 2001. Health, environmental, and economic impacts of adding ethanol to gasoline in the northeast states.Water Resources and Associated Health Impacts. Available at:https://www. neiwpcc.org/ neiwpcc_docs/NEI_ResourceGuide.pdf.
Olson, K. R., Anderson, I. B., Benowitz, N. L., Blanc, P. D.,Clark R. F., Kearney T. E., Wu, A. H. (Eds.) (2012). Poisoning & drug overdose New York, NY, USA: McGraw Hill Medical.p. 287.
Pendlington, R. U., Whittle, E., Robinson, J. A., & Howes, D. (2001). Fate of ethanol topically applied to skin. Food and Chemical Toxicology, 39(2), 169-174.
Saha, T., Khadka, P., & Das, S. C. (2021). Alcohol-based hand sanitizer composition, proper use and precautions . Germs, 11(3), 408.
Sedlak, D. L., & von Gunten, U. (2011). The chlorine dilemma. Science, 331(6013),42-43.
Singh, P., Potlia, I., Malhotra, S., Dubey, H., & Chauhan, H. (2020). Hand sanitizer an alternative to hand washing—a review of literature. Journal of Advanced Oral Research, 11(2), 137-142.
Subpiramaniyam, S. (2021). Outdoor disinfectant sprays for the prevention of COVID-19: Are they safe for the environment?. Science of the Total Environment, 759, 144289.
Traore, O., Hugonnet, S., Lübbe, J., Griffiths, W., & Pittet, D. (2007). Liquid versus gel handrub formulation: a prospective intervention study. Critical care, 11, 1-8.
United States Environmental Protection Agency (USEPA), (2011). ECOTOX database. [Online database]. (Accessed 2020).Available at: http://cfpub.epa.gov/ecotox/.
Van Doremalen, N., Bushmaker, T., Morris, D. H., Holbrook,M. G., Gamble, A., Williamson, B. N., & Munster, V. J. (2020). Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England journal of medicine, 382(16), 1564-1567.
Vermeil, T., Peters, A., Kilpatrick, C., Pires, D., Allegranzi, B., & Pittet, D. (2019). Hand hygiene in hospitals: anatomy of a revolution. Journal of Hospital Infection, 101(4), 383- 392.
Watt, B. E., Proudfoot, A. T., & Vale, J. A. (2004). Hydrogen peroxide poisoning. Toxicological reviews, 23, 51-57.
Weaver, J. M. (2005). The increasing use of alcohol-based hand sanitizers. Anesthesia progress, 52(3), 85-85.
WHO (2010).https://www.who.int/gpsc/5may/ Guide_to_Local_ Production.pdf.
WHO (2020). Interim Recommendation on obligatory hand hygiene against transmission of covid-19.
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