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PRACTICE: John R H Archer, David M Wood, Zoe Tizzard, Alison L Jones, and Paul I Dargan Alcohol hand rubs: hygiene and hazard BMJ 2007; 335: 1154-1155 [Full text]

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Another Danger of Alcohol Hand Rubs

Aubrey J Cunnington   (5 December 2007)

One in the eye for alcohol hand rubs

Oliver J Baylis, Scott Fraser   (6 December 2007)

Another Danger of Alcohol Hand Rubs 5 December 2007
Aubrey J Cunnington, SpR in Paediatric Infectious Diseases Imperial College Healthcare NHS Trust Send response to journal: Re: Another Danger of Alcohol Hand Rubs	In my experience some alcohol hand rubs appear to pose a threat to the user. In several Trusts I have worked in the alcohol rub is dispensed from a container with an angulated nozzle. Sometimes residue accumulates on the end of the nozzle, which results in the alcohol hand rub squirting in unintended directions. On a couple of occasions I have been hit in the face by stray alcohol hand rub, although none yet in my eyes. This appears to be a design flaw with the dispensers. I wonder if Archer and colleagues found any records of calls to the poisons service regarding eye injuries in hospital staff? Competing interests: None declared
One in the eye for alcohol hand rubs 6 December 2007
Oliver J Baylis, SpR in Ophthalmology Sunderland Eye Infirmary, SR2 9HP, Scott Fraser Send response to journal: Re: One in the eye for alcohol hand rubs	Archer and al 1 only briefly mention the hazard of eye exposure to alcohol hand gel. We have previously reported a case in which alcohol hand rub dropped into the eye of a four-year-old girl who stood beneath it as the dispenser was operated 2. This immediately caused pain and redness, and she required irrigation of her eyes and medical assessment. Fortunately, there were no long term sequelae. Alcohol hand rub dispensers are widely available in patient areas and posters encourage patients, relatives, carers and visitors to use them. Alcohol is harmful to the cornea and can easily debride epithelium; a property that is utilized in some refractive surgery procedures 3. Whilst the use of alcohol hand gel seems to have been almost universally accepted, it is essential that full risk assessment is undertaken when considering the placement and the design of the dispensers. Our case would probably have been avoided if the dispenser had been fitted with a drip tray. References 1. John R H Archer, David M Wood, Zoe Tizzard, Alison L Jones, and Paul I Dargan. Alcohol hand rubs: hygiene and hazard. BMJ 2007; 335: 1154- 1155 2. Baylis O, Fraser S. When alcohol hand rub gets in your eyes. J Hosp Infect. 2006 Oct;64(2):199-200. 3. Yanoff M, Duker J. Excimer laser photorefractive keratectomy. Ophthalmology. 2nd Edn. Mosby;1999. Competing interests: None declared