"Germs"

[quarky]

Being at war with microbes is fairly hopeless.
Understanding habitat is useful, as is trying to maintain a state of health.

The world's biggest microscopic killers could be circumvented with ease, if we had the collective will. Clean water for all would be a great start. Acheiving this alone would be like beating aids, as far as human survival goes. But said goal is not sexy.

 

[Eos of the Eons]

MRSA does not care one whit about water. You can have the cleanest water everywhere in the world, and you'll still have killer microbes. Hospitals have sterile environments all over the place, and are still have a problem with MRSA.

 

[casebro]

I'm not saying that alcohol does not kill germs. It does.

I'm asking for proof that the sanitizers have actually been shown to lower infection rates.

Anybody find anything?

 

[Eos of the Eons]

Check out the linkies. Reduced illness in homes too.

 

[casebro]

Your links in post #19?

The first is a consensus.

The second states that "The CDC recommendations have not been updated to include no rinse sanitizers" at all. And it's a CDC guideline, not a study.

The third was a study which showed a 59% improvement in in home infections. 290 families in the study group, but no mention of how many infections. So what was the actual sample size? But the study group was also given instructions on "hand hygiene".

ETA: (OH, and that study was particularly of stomach 'flu', usually caused by a virus that the hand sanitizers don't even kill. So the benefit must have been from more hand washing, not the alcohol.)

Sounds like the diet pill scams with the disclaimer of "also include sensible eating and exercise".

Was the benefit the sanitizer, or from the hand washing? Was there any frequency of hand washing data? How to separate the two, when having sanitizer around would remind you to wash your hands more often? Hmm, I wonder if those electronic sensor faucets could count the uses, meaning frequency, of hand washes?

Can we state that hand sanitizers don't do any good if you don't also wash your hands more often?

"Hand sanitizers work as part of a sensible hand hygiene plan". The fine print on the bottles perhaps?

 

[Eos of the Eons]

Argh, my post!! It's gone, frac frac frac

Okay, posted studies, but now gonna wait until I get home, drat drat drat.

In the meantime, look through pubmed. Dangggg.

 

[rwp]

This is the article I referenced:
http://www.webmd.com/news/20070817/plain-soap-as-good-as-antibacterial

 

[blutoski]

Yes, but: Has anybody actually proved that hand sanitizers cut down on human infections?

Do you mean the OTC brands? I would say that the evidence is that they are no more effective than washing with soap.

If you mean the hospital grade products: there is evidence that they have reduced infection over and above ordinary handwashing.

Like Atheist said, I'm still walking to work through gobbets of TB sputum. And killing 99.9% of those 200,000 germs on the doorknob still leaves me with 200, 2000% more than the 10 he said are needed to infect.

I can't benefit from the killing of germs that I have already built up immunity to.

By definition, no. But you don't know whether you've actually built an immunity or if you only have partial immunity until after the fact, right? Even if you've established an immune memory, immunity can be defeated by overwhelming numbers or infection complications. We're exposed to tetanus all the time, but we become infected when it enters a wound. And immunity declines over time, so an infectious agent like TB may be harmless today, but deadly for the same person twenty years later.

Also: there are people who through no fault of their own will have a weak or failed immune system. Specifically, newborns, the sick, and the elderly. The immune system is an organ just like the eye, and it starts to become weak with age. The responsibility of health professionals is to use sanitizers to reduce the transmission of infectious agents, not just to reduce our personal risk of infection.

The reason hospitals see benefit from handwashing and increased benefit from commercial-grade hand sanitizing gels is that these practices reduce the transmission from (healthy) employee to (vulnerable) patient.

 

[Eos of the Eons]

Hand sanitizer is not meant to replace hand washing. It is meant to be used in addition to. It has been proven to at least be as effective as hand washing. Some people will say it is more effective in some settings because it is easier to dab it on than to find some place to wash your hands properly and effectively. It has proven benefits, and does not cause harm-for all the reason already outlined in my above previous post. Office personell in hospitals are encouraged to use it to help prevent the spread of disease-causing bugs. It has been tested elsewhere as well.

Some links:

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Our study demonstrates that introduction of a hand sanitizer can both reduce SSI rates in neurosurgical patients, with particular impact on superficial SSIs, and reduce the overall postoperative length of stay and the duration of antimicrobial use. Hand hygiene programs in developing countries are likely to reduce SSI rates and improve patient outcomes.

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

the results demonstrated a 36.1% decrease in infection rates for the 10-month period that the hand sanitizer was used. CONCLUSION: This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program in acute care facilities.

http://www.ncbi.nlm.nih.gov/pubmed/11029132

Elementary school absenteeism due to infection is significantly reduced when an alcohol gel hand sanitizer is used in the classroom as part of a hand hygiene program.

 

[casebro]

Eos's latest links:

#1, pilots don't wash thier hands enough. So having bright plastic reminders of hand hygiene help.

#2, no improvement over hand washing

#3, Not an OTC product but one with chlorhexidene.

#4, any apparent improvement could have been due to better hand hygiene in general.

NONE of the studies anywhere in this thread were blinded, not double nor even single.

NONE have accounted for the confounding of having bright plastic dispensers allovertheplace to reminding people to wash up.

If thats the best studies, then the efficacy is dubious.

 

[Eos of the Eons]

What are you talking about? There were control groups. It is not unscientific to compare groups that are using the product over those that aren't. It is not like it needs to be demsonstrated that it kills more microbes than a placebo like water. We know it does.

It is NOT meant as an improvement over hand washing.

It is as effective as hand washing, and an improvement when no hand washing is going on.
You just proved the point of it all with your points... it's better than doing nothing.
The studies show that it is effective at what it is supposed to do, and that is to reduce illness. That is the point of it all, and why it is being implemented. The study in the acute care department outlines that. The study in the surgery department showed the benefits when patients used it.

It is meant to reduce rates of illness, and does.

It is better than doing nothing.

It kills microbes.

It won't cause decreased immunity or superbugs.

What is not to love?

 

[Gurdur]

....Like Atheist said, I'm still walking to work through gobbets of TB sputum. And killing 99.9% of those 200,000 germs on the doorknob still leaves me with 200, 2000% more than the 10 he said are needed to infect.

I can't benefit from the killing of germs that I have already built up immunity to.

I don't think you understand immunity very well at all. Most immunities are only partial; give someone a huge dose of bacteria that they are normally partially immune to, and they will still very likely have big problems; the partial immunity works only so far, and sheer quantity of bacteria also plays a big part (not only in partial immunity, but also in bacterial/human ecology, which most certainly also plays a big part in keeping off infection).

The biggest role of hygiene, BTW, is purely mechanical; to physically wash off and wash away bacteria and viruses, using soap or detergent; or to stop the evildoers getting in in the first place, i.e. e.g. by seperating drinking water networks from waste-water networks, again a mechanical job.

Killing the offenders off is far harder and of very secondary importance.

 

[Skeptic Ginger]

My take is that you already have immunity to the germs you are confronted with in your daily life. ...

If that were true no one would ever get infections.

 

[Skeptic Ginger]

Handwashing alone (and properly done) is superior. The gels are useful when soap and running water is not available.

The claims about the % of "germs" killed is BS in all these ads from Lysol to Listerine. I'm not sure how the ads are allowed by the FTC, but there must be some loophole. Usually the false claims are stopped after a few months by the FTC, but it seems that % of germs killed has never been cited by either the FDA or the FTC. I've been meaning to look into why that is so perhaps I will see what I can find about it now that someone is asking.

I'll try to catch up on the rest of this thread tonight.

 

[blutoski]

Handwashing alone (and properly done) is superior. The gels are useful when soap and running water is not available.

The claims about the % of "germs" killed is BS in all these ads from Lysol to Listerine. I'm not sure how the ads are allowed by the FTC, but there must be some loophole. Usually the false claims are stopped after a few months by the FTC, but it seems that % of germs killed has never been cited by either the FDA or the FTC. I've been meaning to look into why that is so perhaps I will see what I can find about it now that someone is asking.

I'd like to learn about your findings, because I always felt they worded their claim ambiguously. eg: mouthwashes that claim to "kill 99% of germs that cause bad breath" could be interpreted to mean they have identified 100 species of bacteria that cause bad breath and their product has at least some lethal effect on all but one. ie: kill 99% of the kinds of bacteria, as opposed to killing 99% of the actual individual bacterias.

 

[robinson]

My take is that you already have immunity to the germs you are confronted with in your daily life. Your mate can't give you an infection- you've already shared germs with each other. Same holds for your kitchen floor, your dog,...

Good point. Of course we are immune to the pathogens we come into contact with daily. Otherwise we would all be sick, all the time.

 

[skepHick]

I'd like to learn about your findings, because I always felt they worded their claim ambiguously. eg: mouthwashes that claim to "kill 99% of germs that cause bad breath" could be interpreted to mean they have identified 100 species of bacteria that cause bad breath and their product has at least some lethal effect on all but one. ie: kill 99% of the kinds of bacteria, as opposed to killing 99% of the actual individual bacterias.

I'm rather curious as well. Although, IIRC such statements are usually qualified with something like "on contact." So even if all manner of microbial hell breaks out like 3 seconds later, they've still been truthful. I always figured that was the workaround.

 

[blutoski]

Good point. Of course we are immune to the pathogens we come into contact with daily. Otherwise we would all be sick, all the time.

That's a common misunderstanding.

The immune system's most important component is the integument. This is the skin and the protection that surrounds its openings. Be mindful that the bowel is outside the body, not inside. There are some tissues that are sort of blendy, and these tend to be mucousy. Examples are salivary glands, eye sockets, ENT surface, lung surface, lactating nipples...

Some particles can colonize these exterior surfaces, but are not a problem until they penetrate through a wound. Again, tetanus is a good example. Others can infect via mucous membrane, but are not a problem unless you are exposed to a minimum threshold concentration of them. A common mechanism for infecting a mucous membrane is that your completely protected finger gets covered in a minimum threshold concentration and then you stick it in your eye, nose or mouth for god knows what reason. Handwashing reduces the number of particles on the finger, and reduces the risk of infection through these primary routes.

Granted, mucous is awash with IgA antibodies, but they are rarely specific immunity. ie: they bind to anything and if it's an infectious agent, they may neutralize it out of sheer luck.

So, no: we're not 'immune' to these pathogens. We are, however, protected by our integument barrier and mucous under normal circumstances, and by good hygene.

 

[Skeptic Ginger]

Good point. Of course we are immune to the pathogens we come into contact with daily. Otherwise we would all be sick, all the time.

emphasis mine

This is where your error is, rob, (besides what Bluto said) not all microbes are pathogens. The vast majority of the organisms on the planet are not pathogens. If they were we likely wouldn't have survived as a species.

Occasionally people are colonized with bacterial pathogens that are not causing active disease. But even those will cause disease if they enter into a wound.

Lot's of viral pathogens cause variable disease as they interact with individual genomes since viruses are more specific pathogens genetically. But you are exposed to new ones all the time. People are great spreaders of organisms. And organisms that multiply as rapidly as microbes are great evolvers. So you are continually exposed to news microbes and occasionally exposed to new pathogens.

We know hand washing prevents disease because it has been tested.

 

[Skeptic Ginger]

Not sure what findings you are referring to blutoski.

It takes at least 30-60 minutes to cold sterilize anything with the most potent disinfectants and it requires the item be submersed in the disinfectant. So there is no way any of these products kill everything so thoroughly on contact.

As for how the advertisers get away with the claims, I need to do more investigating.