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

SummaryBackgroundDespite the increasing use of Alcohol-Based Hand Rub solutions, few studies have quantified the concentrations of inhaled ethanol.ObjectiveThe aim of this study was to assess ethanol exposure during hygienic and surgical hand disinfection practices.MethodEthanol 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.ResultsThe 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).ConclusionEthanol 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.

► The exposure to ethanol vapors during hand disinfection by healthcare workers was assessed.
► Gas chromatography and photoionization detector quantified the inhaled concentrations.
► An acute exposure of short duration at high ethanol concentration was measured.
► Exposure values are below the limitations on ethanol exposure enacted in different countries.