{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T06:05:52Z","timestamp":1771826752665,"version":"3.50.1"},"reference-count":66,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2010,7,30]],"date-time":"2010-07-30T00:00:00Z","timestamp":1280448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Hand disinfection with alcohols-based hand rubs (ABHRs) are known to be the most effective measure to prevent nosocomial infections in healthcare. ABHRs contain on average 70% by weight of one or more alcohols. During the hand rubbing procedure, users are exposed to these alcohols not only through dermal contact, but also via inhalation, due to the physical and chemical properties of alcohols volatilizing from alcoholic solutions or gels into the air. Ethanol ingestion is well known to increase risks of several diseases (affecting the pancreas, liver, cardiovascular system\u2026), but there is a lack of knowledge about the effects of exposure to other alcohols (including n- or isopropanol) via inhalation and dermal contact, despite the worldwide use of ABHRs. This work aims at discussing possible health effects related to unintentional alcoholization (via inhalation and dermal contact) from professional ABHR usage to suggest the need for more research in this area (but not to question the value of ABHRs). Based upon an average of 30 hand rubbings per healthcare professional per day, it can be assumed that a healthcare worker may be exposed to a maximum 5,500 mg\/m3 per work shift, five times above the recommended occupational time weighted average limit. Thus, in order to answer the question posed in the title, studies on spatial and temporal variability of alcohol emission from ABHRs in real world situations and studies on certain high risk individuals are needed.<\/jats:p>","DOI":"10.3390\/ijerph7083038","type":"journal-article","created":{"date-parts":[[2010,7,30]],"date-time":"2010-07-30T11:07:54Z","timestamp":1280488074000},"page":"3038-3050","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Can Intensive Use of Alcohol-Based Hand Rubs Lead to Passive Alcoholization?"],"prefix":"10.3390","volume":"7","author":[{"given":"Vincent","family":"Bessonneau","sequence":"first","affiliation":[{"name":"Environment and Health Research Laboratory, French School of Public Health, Avenue du Professeur L\u00e9on Bernard, 35043 Rennes Cedex, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Cl\u00e9ment","sequence":"additional","affiliation":[{"name":"Environment and Health Research Laboratory, French School of Public Health, Avenue du Professeur L\u00e9on Bernard, 35043 Rennes Cedex, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Thomas","sequence":"additional","affiliation":[{"name":"Environment and Health Research Laboratory, French School of Public Health, Avenue du Professeur L\u00e9on Bernard, 35043 Rennes Cedex, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2010,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1016\/S0195-6701(01)90004-0","article-title":"Arguments for alcoholic hand disinfection","volume":"48","author":"Rotter","year":"2001","journal-title":"J. Hosp. Infect"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1078\/1438-4639-00257","article-title":"State-of-the-art hand hygiene in community medicine","volume":"206","author":"Kampf","year":"2003","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1128\/CMR.17.4.863-893.2004","article-title":"Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs","volume":"17","author":"Kampf","year":"2004","journal-title":"Clin. Microbiol. Rev"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1136\/bmj.325.7360.362","article-title":"Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial","volume":"325","author":"Girou","year":"2002","journal-title":"BMJ"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.jhin.2004.10.014","article-title":"Microbiological evaluation of two hand hygiene procedures achieved by healthcare workers during routine patient care: a randomized study","volume":"60","author":"Kac","year":"2005","journal-title":"J. Hosp. Infect"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.jaad.2008.07.033","article-title":"Hand hygiene in the dermatologist\u2019s office: To wash or to rub?","volume":"59","author":"Messina","year":"2008","journal-title":"J. Am. Acad. Dermatolo"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1086\/501784","article-title":"Using alcohol for hand antisepsis: dispelling old myths","volume":"21","author":"Boyce","year":"2000","journal-title":"Infect. Control Hosp. Epidemiol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1053\/jhin.2002.1281","article-title":"Spectrum of antimicrobial activity and user acceptability of the hand disinfectant agent Sterillium \u201cGel\u201d","volume":"52","author":"Kampf","year":"2002","journal-title":"J. Hosp. Infect"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0195-6701(03)00223-8","article-title":"Dermatological aspects of a successful introduction and continuation of alcohol-based hand rubs for hygienic hand disinfection","volume":"55","author":"Kampf","year":"2003","journal-title":"J. Hosp. Infect"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jhin.2003.09.001","article-title":"Dermal tolerance of Sterillium\u00ae, a propanol-based hand rub","volume":"55","author":"Kampf","year":"2003","journal-title":"J. Hosp. Infect"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2307\/30141985","article-title":"No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance?","volume":"3","author":"Voss","year":"1997","journal-title":"Infect. Control Hosp. Epidemiol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1067\/mic.2002.130391","article-title":"Guideline for hand hygiene in health-care settings","volume":"30","author":"Boyce","year":"2002","journal-title":"Am. J. Infect. Control"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.2146\/ajhp060647","article-title":"Understanding the health impact of alcohol dependence","volume":"64","author":"Cargiulo","year":"2007","journal-title":"Am. J. Health Syst. Pharm"},{"key":"ref_14","unstructured":"International Agency for Research on Cancer (IARC) (1988). Alcohol drinking. IARC Monogr. Eval. Carcinog. Hum, 44, 1\u20138."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/1471-2334-7-117","article-title":"Quantity of ethanol absorption after excessive hand disinfection using three commercially available hand rubs is minimal and below toxic levels for humans","volume":"7","author":"Kramer","year":"2007","journal-title":"BMC Infect. Dis"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1093\/infdis\/63.3.301","article-title":"Bacteriology of normal skin: a new quantitative test applied to a study of the bacterial flora and the disinfectant action of mechanical cleansing","volume":"63","author":"Price","year":"1939","journal-title":"J. Infect. Dis"},{"key":"ref_17","unstructured":"Block, SS (1991). Disinfection, Sterilization and Preservation, Lea & Febiger."},{"key":"ref_18","unstructured":"Block, SS (2001). Disinfection, Sterilization, and Preservation, Lippincott Williams & Wilkins. [5th ed]."},{"key":"ref_19","unstructured":"(2009). WHO guidelines on hand hygiene in health care, World Health Organization."},{"key":"ref_20","unstructured":"Hazardous Substances Data Bank (2002). Aminomethylpropanol, US National Library of Medecine."},{"key":"ref_21","unstructured":"Hazardous Substances Data Bank (2009). Benzyl alcohol, US National Library of Medecine."},{"key":"ref_22","unstructured":"International Programme on Chemical Safety (1990). Environmental Health Criteria 103: 2-propanol, World Health Organization."},{"key":"ref_23","unstructured":"Institut National de Recherche et de S\u00e9curit\u00e9 (2004). N-propanol; fiche toxicologique FT 211, INRS."},{"key":"ref_24","unstructured":"Institut National de Recherche et de S\u00e9curit\u00e9 (2007). Ethanol; fiche toxicologique FT 48, INRS."},{"key":"ref_25","unstructured":"Institut National de Recherche et de S\u00e9curit\u00e9 (2008). 2-Phenoxyethanol; fiche toxicologique FT 269, INRS."},{"key":"ref_26","unstructured":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Hygi\u00e8ne Hospitali\u00e8re (2008). Liste positive d\u00e9sinfectants 2008. Hygienes, 16, 95\u2013118."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S0001-2092(06)62517-9","article-title":"Testing a new alcohol-free hand sanitizer to combat infection","volume":"68","author":"Dyer","year":"1998","journal-title":"AORN J"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jhin.2003.12.023","article-title":"The six golden rules to improve compliance in hand hygiene","volume":"56","author":"Kampf","year":"2004","journal-title":"J. Hosp. Infect"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1016\/S0195-6701(01)90012-X","article-title":"Compliance with hand disinfection and its impact on hospital-acquired infections","volume":"48","author":"Pittet","year":"2001","journal-title":"J. Hosp. Infect"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1016\/S0140-6736(00)02814-2","article-title":"Effectiveness of a hospital-wide programme to improve compliance with hand hygiene","volume":"356","author":"Pittet","year":"2000","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.ajic.2009.06.005","article-title":"Compliance with hand hygiene on surgical, medical, and neurologic intensive care units: Direct observation versus calculated disinfectant usage","volume":"37","author":"Scheithauser","year":"2009","journal-title":"Am. J. Infect. Control"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1086\/650451","article-title":"Systematic review of studies on compliance with hand hygiene guidelines in hospital care","volume":"31","author":"Erasmus","year":"2010","journal-title":"Infect. Control Hosp. Epidemiol"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1046\/j.1360-0443.2003.00467.x","article-title":"The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview","volume":"98","author":"Rehm","year":"2003","journal-title":"Addiction"},{"key":"ref_34","unstructured":"(2006). WHO Expert Committee on Problems Related To Alcohol Consumption, World Health Organization."},{"key":"ref_35","unstructured":"Anonymous (1994). Diagnostic and Statistical Manual of Mental Disorders, American Psychatric Association. [4th ed]."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0301-0082(98)00032-X","article-title":"Chronic ethanol consumption: from neuroadaptation to neurodegeneration","volume":"56","author":"Fadda","year":"1998","journal-title":"Prog. Neurobiol"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1159\/000213641","article-title":"Patterns of alcohol consumption and acute myocardial infarction: a case-crossover analysis","volume":"15","author":"Gerlich","year":"2009","journal-title":"Eur. Addict. Res"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1093\/aje\/155.3.242","article-title":"Alcohol volume, drinking pattern, and cardiovascular disease morbidity and mortality: is there a U-shaped function?","volume":"155","author":"Murray","year":"2002","journal-title":"Am. J. Epidemiol"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1161\/HYPERTENSIONAHA.107.104968","article-title":"Alcohol consumption and the risk of hypertension in women and men","volume":"51","author":"Sesso","year":"2008","journal-title":"Hypertension"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.neubiorev.2006.06.017","article-title":"Woman, alcohol and environment: emerging risks for health","volume":"31","author":"Mancinelli","year":"2007","journal-title":"Neurosci. Biobehav. Rev"},{"key":"ref_41","first-page":"170","article-title":"Effects of prenatal exposure to alcohol across the life span","volume":"20","author":"Connor","year":"1996","journal-title":"Alcohol Health Res. World"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.mam.2007.10.001","article-title":"Alcohol induced hepatic fibrosis: role of acetaldehyde","volume":"29","author":"Mello","year":"2008","journal-title":"Mol. Aspects Med"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/j.1530-0277.2007.00601.x","article-title":"Alcohol, psychological dysregulation, and adolescent brain development","volume":"32","author":"Clark","year":"2008","journal-title":"Alcohol. Clin. Exp. Res"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.alcohol.2009.10.003","article-title":"Mechanisms involved in the neurotoxic, cognitive, and neurobehavioral effects of alcohol consumption during adolescence","volume":"44","author":"Guerri","year":"2010","journal-title":"Alcohol"},{"key":"ref_45","first-page":"134","article-title":"The role of thiamine deficiency in alcoholic brain disease","volume":"27","author":"Martin","year":"2003","journal-title":"Alcohol Res. Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"197","DOI":"10.2174\/1566524013363870","article-title":"Molecular mechanisms of thiamine utilization","volume":"1","author":"Singleton","year":"2001","journal-title":"Curr. Mol. Med"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/alcalc\/agn118","article-title":"The Korsakoff Syndrome: clinical aspects, psychology and treatment","volume":"44","author":"Kopelman","year":"2009","journal-title":"Alcohol Alcohol"},{"key":"ref_48","first-page":"25","article-title":"Heavy alcohol consumption increased risk for prostate cancer","volume":"10","author":"Adams","year":"2009","journal-title":"Hem\/Onc Today"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.oraloncology.2005.02.004","article-title":"Alcohol consumption and risk of laryngeal cancer","volume":"41","author":"Altieri","year":"2005","journal-title":"Oral Oncol"},{"key":"ref_50","first-page":"263","article-title":"Alcohol consumption and the risk of cancer: a meta-analysis","volume":"25","author":"Bagnardi","year":"2001","journal-title":"Alcohol Res. Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1093\/aje\/kwp028","article-title":"Alcohol consumption and risk of pancreatic cancer in the Netherlands cohort study","volume":"169","author":"Heinen","year":"2009","journal-title":"Am. J. Epidemiol"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.canep.2009.10.015","article-title":"Baseline alcohol consumption, type of alcoholic beverage and risk of colorectal cancer in the European prospective investigation into cancer and nutrition-Norfolk study","volume":"33","author":"Park","year":"2009","journal-title":"Cancer Epidemiol"},{"key":"ref_53","unstructured":"(2000). International Guide for Monitoring Alcohol Consumption and Related Harm, World Health Organization."},{"key":"ref_54","first-page":"160","article-title":"Isopropanol exposure: environmental and biological monitoring in a printing works","volume":"40","author":"Brugnone","year":"1983","journal-title":"Br. J. Ind. Med"},{"key":"ref_55","first-page":"101","article-title":"Chronic and acute effects of solvents on central nervous system functions in floorlayers","volume":"43","author":"Ekberg","year":"1986","journal-title":"Br. J. Ind. Med"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1136\/oem.59.1.49","article-title":"Influence of solvent exposure and aging on cognitive functioning: an 18 year follow up of formerly exposed floor layers and their controls","volume":"59","author":"Hagberg","year":"2002","journal-title":"Occup. Environ. Med"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s00420-007-0192-1","article-title":"Self-reported symptoms and their effects on cognitive functioning in workers with past exposure to solvent-based glues: an 18-year follow-up","volume":"81","author":"Hagberg","year":"2007","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"401","DOI":"10.2478\/v10001-009-0038-z","article-title":"Irritant vocal cord dysfunction and occupational bronchial asthma: differential diagnosis in a health care worker","volume":"22","author":"Tonini","year":"2009","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_59","unstructured":"Anonymous (2009). Les expositions aux risques professionnels des personnels soignants en 2003-Premi\u00e8res informations synth\u00e8ses, Direction de l'Animation de la Recherche, des Etudes et des Statistiques (DARES)."},{"key":"ref_60","first-page":"38","article-title":"Alcohol metabolism and cancer risk","volume":"30","author":"Seitz","year":"2007","journal-title":"Alcohol Res. Health"},{"key":"ref_61","unstructured":"International Programme on Chemical Safety (1990). Environmental Health Criteria 102: 1-propanol, World Health Organization."},{"key":"ref_62","unstructured":"Clayton, GD, and Clayton, FE (2001). Patty\u2019s Industrial Hygiene and Toxicology, John Wiley and Sons. [5th ed]."},{"key":"ref_63","unstructured":"Hazardous Substances Data Bank (2001). N-propanol, US National Library of Medecine."},{"key":"ref_64","unstructured":"Hazardous Substances Data Bank (2001). Isopropanol, US National Library of Medecine."},{"key":"ref_65","unstructured":"International Programme on Chemical Safety (2002). Screening Information Data Set: 2-Propanol, World Health Organization."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.ajem.2006.05.006","article-title":"Does the clinical use of ethanol-based hand sanitizer elevate blood alcohol levels? A prospective study","volume":"24","author":"Miller","year":"2006","journal-title":"Am. J. Emerg. Med"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/7\/8\/3038\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T22:03:02Z","timestamp":1760220182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/7\/8\/3038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,7,30]]},"references-count":66,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2010,8]]}},"alternative-id":["ijerph7083038"],"URL":"https:\/\/doi.org\/10.3390\/ijerph7083038","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,7,30]]}}}