Hand sanitizers banned in schools?

The Pediatric Insider

© 2011 Roy Benaroch, MD

Shannon heard some odd news: “My daughter’s teacher informed me today that the CDC won’t allow them to use hand sanitizer at school? What’s up with that? I thought it would be a useful and a more effective killer of cold and flu germs so I’d think it’d be their ‘weapon’ of choice against such things. In addition, it doesn’t require a sink or paper towels.”

I assigned my crack research department to investigate this, and I don’t know what the school is talking about. The CDC recommends hand sanitizer as a way to control infections here and here, and specifically recommend hand sanitizers for use in schools as a way to control influenza. They even considered hand sanitizer a reasonable step in limiting exposure to a rabid bat at a school in Montana.

I could find no material from the CDC recommending against hand sanitizers at school. Perhaps the school was reacting to news about prison inmates abusing hand sanitizer to get drunk. They were caught with their hands clean.

We do know that hand sanitizers aren’t always as effective as good old soap and water. They won’t kill the spores of C. difficile (an intestinal infection often associated with hospitalized patients), and are ineffective at decontaminating visibly soiled hands. But as a back-up, especially when soap and water are unavailable, hand sanitizers can decrease the transmission of infections in schools, homes, and hospitals. Shannon, tell the school to stop making excuses and encourage the kids to wash their hands and use sanitizers to stay healthy!

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8 Comments on “Hand sanitizers banned in schools?”

  1. Mindy Says:

    Perhaps the school was mistaking hand sanitizer for anti-bacterial soap (with triclosan)? Anti-bacterial soap should not be used (I’ve tried unsuccessfully to get them to stop using it where I work)

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  2. cathy Says:

    I have been told by my daughter’s preschool director that they are not allowed to have hand sanitizer in the preschool per state regulations. She was told it was a “safety concern” because a preschooler could consume it resulting in death or serious injury. Jeesh!

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  3. Mark Engelberg Says:

    Several years ago, some preschools in our area were banning hand sanitizers because of a publicized incident in which a toddler died from drinking the hand sanitizer.

    I don’t know how great the risk really is, but it makes a certain amount of sense to ban sanitizers in a situation with young kids and a low adult:child ratio, where the kids can’t easily be supervised to not lick it off their hands or ingest great gobs of the stuff.

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  4. Dr. Roy Says:

    I can’t find any direct news reports of a child ever dying from ingestion of hand sanitizer. Plenty of rumors and people saying they’ve “heard of it”– but I don’t think it has actually happened. The stuff is deliberately flavored to taste horrible, but of course toddlers can an do sometimes eat horrible things! (Which is ironic, because they often won’t touch ordinary vegetables. They must know something we don’t!)

    Snopes’ take: http://www.snopes.com/medical/toxins/sanitizer.asp

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  5. Dr. Roy Says:

    I called the Georgia Poison Center (404-616-9000– BTW, those guys ROCK!). Their protocol for hand sanitizer ingestion by a child is that a little lick or squirt is harmless at any age. If an unwitnessed, unmeasured large amount is ingested, go to ER. If the actual volume can be estimated and the child’s weight and exact concentration of ethanol are known, there are formulas to help determine if an ER visit is necessary. For example, for a typical 2 year old (12 kg) ingesting a 60% ethanol sanitizer, they would instruct parents to take him to the ER if he had any significant symptoms OR ingested over about three teaspoons.

    The poison center staffer told me that significant ingestions by children are quite rare– they spit the stuff out, it tastes so bad. They do see, shall we say, motivated adults who sometimes chug the stuff, but that’s another problem!

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  6. Dr. Roy Says:

    Mindy makes a good point about triclosan, often found in “antibacterial” soaps, but also incorporated into surfaces, toothpastes, and all sorts of other things. Products made with triclosan are no more effective than ordinary soap and water in preventing infection, and these chemicals when widely dispersed in the environment can contribute to antibacterial resistance: http://www.scientificamerican.com/article.cfm?id=strange-but-true-antibacterial-products-may-do-more-harm-than-good

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  7. Some people arent familiar with the purpose of a hand sanitizer the idea is that we always want to wash our hands after using the restroom touching door handles in public places and after eating…. Now what happens when we leave we have to touch the door handles in order to leave. Imagine how many people have touched the door after washing their hands or perhaps not washing their hands at all.

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  8. Dr. Roy Says:

    Janice: If there are paper towels in a public bathroom, leave the water running, dry your hands, then use the somewhat-wet, used paper towel to turn off the water and open the door handle. Then toss the paper towel in the trash.

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