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PubMed1986

Efficacy of alcohol-based hand rinses under frequent-use conditions.

Fifty volunteers randomly assigned to one of five hand washing agents (10 subjects per agent)--a nonantiseptic liquid soap (control), an antiseptic hand rinse containing 60% isopropyl alcohol (IPA) with emollients (Alc A), an antiseptic hand rinse containing 70% IPA and 0.5% chlorhexidine gluconate with emollients (Alc B), an antiseptic containing 4% chlorhexidine gluconate and 4% IPA (CHG), and 70% IPA--washed their hands 15 times per day for 5 days under supervision by using a standardized technique and measured amounts of test agent. Microbiologic samples of hand flora were obtained at base line and after hand washes 1 and 15 on test days 1 and 5. After the initial hand wash there were significant reductions over base line in aerobic and anaerobic log CFU among those using Alc A, CHG, and IPA. By the end of the first day of hand washing (15 washes), there were 2-log or greater reductions in aerobic counts among subjects using all antiseptics, but no significant reductions in controls. By the end of day 5, all agents produced significant reductions in aerobic (P = 0.0002) and anaerobic (P = 0.002) counts over control soap. Subject assessment of effects of hand washing on the skin and overall satisfaction varied significantly by product (P = 0.04 and 0.05, respectively). We conclude that alcohol-based hand rinses are highly efficacious, and such products are recommended as a health care personnel hand wash, particularly when sink and running water are inaccessible.

1-Propanol↗
PubMed1987

Comparison of four antiseptic products containing chlorhexidine gluconate.

The purpose of this study was to compare the antimicrobic efficacies of four formulations of chlorhexidine gluconate (CHG) for handwashing under frequent-use conditions. Fifty volunteers were assigned by block randomization to one of five products: one of two liquid detergents containing 4% CHG, a liquid detergent containing 2% CHG, a foam containing 4% CHG, and a nonantiseptic soap (control). Subjects washed their hands by a standardized technique 15 times per day for 5 days. After days 1 and 5 of handwashing, there was a significant reduction in log CFU for subjects using all four CHG-containing products compared with subjects using control soap and for subjects within each group after days 1 and 5 compared with the base-line CFU counts (all P less than 0.05). There were no significant differences between the four CHG products at any testing time. We conclude that all four formulations are satisfactory for clinical use.

Adult↗
PubMed1961

Factors affecting the activity of phenolic disinfectants.

Low challenge phenol coefficient and high challenge use-dilution tests were made on a neutral cocoanut oil soap emulsion of o-phenylphenol and aqueous solutions of sodium o-phenylphenate prepared in the laboratory from the phenol using a stoichiometric amount of NaOH as well as with increasing amounts of excess NaOH. The phenol had considerably greater activity in both test methods when emulsified with the neutral soap than when converted to the phenate and dissolved in water. Use dilution test results against Salmonella choleraesuis with both the phenol and the phenate were within the range which would have been predicted from the Salmonella typhosa coefficient results employing the conventional conversion multiple of 20 to determine the maximal number of parts of water to which one part of germicide could be added. With the emulsified phenol this was also true where Staphylococcus aureus was employed in both procedures. With the aqueous solution of the phenate the maximal safe use-dilution by the phenol coefficient found for S. aureus and the same conventional conversion procedure was roughly five times higher than the maximal safe use-dilution found by the use-dilution method. Results with aqueous solutions of the phenate to which increasing amounts of excess NaOH were added showed no significant differences in the phenol coefficient method with either S. typhosa or S. aureus. In the use-dilution method, significant decreases in activity were found as the excess NaOH was increased to 4% with both S. choleraesuis and S. aureus. Although the pH values of aqueous solutions of the phenate were raised as the amount of free NaOH was increased, the decreases in pH observed as the dilution with water was increased were such that only small differences existed at the high critical killing dilutions found in the low challenge phenol coefficient method, whereas rather large differences existed at the lower critical killing dilutions in the high challenge use-dilution method.

Anti-Infective Agents↗
PubMed1987

Gram-negative bacilli as nontransient flora on the hands of hospital personnel.

The possibility that gram-negative bacilli (GNB) are part of the nontransient flora on hands was examined by using a broth rinse technique to detect low titers of GNB after a hygienic hand wash with soap and water. A total of 100 nurses who had direct patient contact and 40 controls without patient contact had a similar rate of recovery of GNB (46 and 55%, respectively). GNB persisted on the hands of 10 nurses throughout five successive hand washes with soap and water. Hand cultures were obtained daily from 12 nurses before and after a work shift in a surgical intensive care unit. GNB were recovered from 57% of individuals before patient contact and from only 24% after the work shift. Nontransient GNB on the hands of hospital personnel are a potential reservoir for hospital strains, and patient contact is not an obvious source for the acquisition of nontransient GNB.

Acinetobacter↗
PubMed1997

Randomised controlled trial of a synthetic triglyceride milk formula for preterm infants.

AIMS: To test whether use of infant formula containing synthetic structured triglycerides results in: (i) increased palmitate absorption; (ii) increased total fat absorption; (iii) reduction in calcium soap formation in the gut; and hence (iv) increased calcium absorption. METHODS: A randomised study was made of 24 infants comparing three formulas, one containing the synthetic fat Betapol with 74% of palmitate in the 2-position, which was substantially higher than in the two comparison diets (8.4% and 28%). The hypothesised outcomes were tested using balance studies, detailed chemical analysis of stool specimens and dual calcium isotope tracers (44calcium orally and 46calcium intravenously). RESULTS: Three of the four hypotheses were confirmed: use of a formula rich in 2-position palmitate (i) improved palmitate (16:0) and also (18:0) absorption; (ii) reduced the formation of insoluble calcium soaps in the stool; and (iii) improved calcium absorption, determined by the dual tracer technique from 42 (SE 3)% to 57 (7)%. CONCLUSION: Synthetic triglycerides that mimic the stereoisometric structure of those in breast milk may have a valuable role in the design of formulas used for preterm infants in neonatal intensive care units.

Animals↗
PubMed1978

A test for 'hygienic' hand disinfection.

A standardised test procedure is described in which finger-tips are inoculated with broth cultures of organisms (Staphylococcus aureus, Staphyloccocus saprophyticus, Escherichia coli, and Pseudomonas aeruginosa): counts are made from washings of hands after disinfection with various antiseptic-detergents, alcoholic solutions, or unmedicated soap. 70% alcohol, with or without chlorhexidine, was the most effective preparation. The two antiseptic detergents showed variable results, but against Gram-negative bacilli neither was significantly more effective than plain soap. Some tests were also made on the death rate of organisms dried on the skin without disinfection.

Anti-Infective Agents, Local↗
PubMed2001

Sexually transmitted infections and vaginal douching in a population of female sex workers in Nairobi, Kenya.

OBJECTIVE: To assess the association between vaginal douching and sexually transmitted infections (STI) among a group of female sex workers (FSWs) in Nairobi, Kenya. METHODS: This study was part of a randomised, placebo controlled trial of monthly prophylaxis with 1 g of azithromycin to prevent STIs and HIV infection in a cohort of Nairobi FSWs. Consenting women were administered a questionnaire and screened for STIs. RESULTS: The seroprevalence of HIV-1 among 543 FSWs screened was 30%. HIV infection was significantly associated with bacterial vaginosis (BV), trichomoniasis, gonorrhoea, and the presence of a genital ulcer. Regular douching was reported by 72% of the women, of whom the majority inserted fluids in the vagina, generally after each sexual intercourse. Water with soap was the fluid most often used (81%), followed by salty water (18%), water alone (9%), and a commercial antiseptic (5%). Douching in general and douching with soap and water were significantly associated with bacterial vaginosis (p = 0.05 and p = 0.04 respectively). There was a significant trend for increased frequency of douching and higher prevalence of BV. There was no direct relation observed between douching and risk for HIV infection or other STIs. CONCLUSION: The widespread habit of douching among African female sex workers was confirmed. The association between vaginal douching and BV is of concern, given the increased risk of HIV infection with BV, which has now been shown in several studies. It is unclear why we could not demonstrate a direct association between douching and HIV infection. Further research is required to better understand the complex relation between douching, risk for bacterial vaginosis, and risk for HIV and other STIs.

Adult↗
PubMedDate not supplied

The effects of chlorhexidine irrigation solution on contaminated bone-tendon allografts.

The purpose of this study was to determine an expedient and effective method for disinfecting contaminated human bone-tendon allografts. The first part of this study used beef muscle and cadaveric human tissues to determine the most effective solution and volume to decontaminate tissues inoculated with four different organisms: Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Of the solutions tested (benzalkonium chloride, castile soap, castile soap followed by benzalkonium chloride, triple antibiotic, chlorhexidine gluconate, and chlorhexidine gluconate/triple antibiotic), only the 4% chlorhexidine power irrigation solution and 4% chlorhexidine/triple antibiotic bath completely disinfected all tissues. Work in part 2 revealed that a 2% chlorhexidine irrigation solution was equally effective as the 4% solutions. Part 3 of the study involved human Achilles tendon-calcaneus allografts. We found similar results: 3 liters of 2% chlorhexidine power irrigation solution thoroughly removed all microorganisms from the contaminated tissues. All control allografts irrigated with normal saline solution alone revealed positive bacterial growth for all four organisms after 72 hours' growth on sheep blood agar. Total decontamination time was 10 to 12 minutes. Two percent chlorhexidine irrigation solution may be an effective method for decontaminating human bone-tendon allografts challenged with a polymicrobial inoculum. This method of disinfecting bone-tendon allografts is at least five times more expeditious than methods in previously reported studies.

Animals↗
PubMed2002

Domestic hygiene behaviour of mothers with children aged 0-5 years old in Tayabo village, Nueva Ecija, the Philippines.

A cross-sectional survey was carried out in a rural village in Nueva Ecija province in the Philippines to identify the association between mothers' hygiene behaviour and their socioeconomic status and household environment. A total of 206 mothers with children aged 0-5 years old participated in this study. Household visits with face-to-face interviews using a structured questionnaire and observation of household environments were conducted. Logistic regression analysis revealed that the frequency of water boiling in mothers was significantly associated with children aged under two years old and the availability of domestic electricity. Availability of domestic electricity, mother's educational level, possession of a private lavatory and of a private well were significant predictors of whether hand-washing with soap was practiced after defecation. For hand-washing with soap before feeding children, child's age under one year old and the volume of the water supply were statistically significant. The volume of the water supply was identified as a significant predictor. Although health educational programme participation rates were very high (83.2%), no significant association with hygiene behaviour was observed. This study indicates that improvements in water availability, household environment and health education may contribute to more frequent hand-washing.

Adult↗
PubMed1998

Adverse effect of air pollution on respiratory health of primary school children in Taiwan.

This study is a part of the Study On Air Pollution and Health In Taiwan (SOAP&HIT), an ongoing research project involving cooperation of several universities in Taiwan. In this study, the objective was to evaluate the effects of ambient air pollution on respiratory symptoms and diseases of school children, in addition to considering indoor air pollution. Six communities were selected: one community located in a rural area (Taihsi), two in urban areas (Keelung and Sanchung), and the other three in petrochemical industrial areas (Toufen, Jenwu, and Linyuan). We sampled 5,072 primary school students in six communities from the main study population of SOAP&HIT. Respiratory health was assessed by evaluation of the children's respiratory symptoms and diseases using a parent-completed questionnaire. Data were analyzed using logistic regression analysis to compute odds ratios of adverse effect. The school children in the urban communities had significantly more respiratory symptoms (day or night cough, chronic cough, shortness of breath, and nasal symptoms) and diseases (sinusitis, wheezing or asthma, allergic rhinitis, and bronchitis) when compared with those living in the rural community. However, only nasal symptoms of children living in the petrochemical communities were more prevalent than in those living in the rural community. Although the association with ambient air pollution is suggestive, the cross-sectional study cannot confirm a causal relationship; thus further studies are needed.

Air Pollution↗
PubMed1999

Formula tolerance in postbreastfed and exclusively formula-fed infants.

OBJECTIVE: Perceived intolerance to infant formula is a frequently reported reason for formula switching. Formula intolerance may be related to perceived symptoms of constipation, fussiness, abdominal cramps, and excessive spit-up or vomit. Commercially available formulas differ from each other in processing and in sources and levels of protein, lipids, and micronutrients. These differences may affect tolerance. The objective of this article was to compare the tolerance of two commercially available powder infant formulas that differ in composition. Measures of tolerance in exclusively breastfed infants weaned to an infant formula and exclusively formula-fed infants were evaluated. METHODS: Two clinical studies were conducted. In study 1, 82 healthy, full-term infants who were exclusively breastfed at the time of enrollment were randomized at weaning to formula A (commercially available Similac With Iron Powder) or formula B (previously available Enfamil With Iron Powder). Parents completed daily records of tolerance during exclusive breast milk feeding, during the weaning period, and for a 2-week exclusive formula-feeding period. In study 2, 87 healthy, full-term infants who were exclusively formula-fed at the time of study enrollment (by 2 weeks of age) were fed a standard cow milk-based formula (previously commercially available Similac With Iron Powder) and then randomized to receive formula A or B for a 2-week period. Parents completed daily records of tolerance throughout the study. Formula A was a cow milk-based formula with a whey:casein ratio of 48:52 and a fat blend of 42% high-oleic safflower, 30% coconut, and 28% soy oils. Formula B was a cow milk-based formula with a whey:casein ratio of 60:40 and a fat blend of 45% palm olein, 20% soy, 20% coconut, and 15% high-oleic sunflower oils. Both formulas had lactose as the source of carbohydrate and contained 12 mg of iron per liter. Only formula A contained nucleotides at the time of the study. Measures of tolerance included volume of each formula feeding, occurrences of spit-up and/or vomit, and the color (yellow, green, brown, or black) and consistency (water, loose/mushy, soft, formed, or hard) of each stool. RESULTS: In both studies, volume of formula intake, weight gain, and incidence of spit-up or vomit did not differ between feeding groups. In study 1, stool frequency decreased significantly from the exclusive breast milk period to weaning. Stools also became firmer as infants moved from breast milk to weaning and to exclusive formula feeding. When formula was introduced into the diet, stools became less yellow and more green. Infants weaned to formula B had less frequent stools, fewer brown stools, and more yellow stools than did infants fed formula A. In both studies, infants fed formula B experienced significantly firmer stools than did those fed formula A. CONCLUSIONS: The present clinical studies indicate that the composition and/or processing of milk-based powder iron-fortified infant formulas affect stool characteristics experienced by infants. The inclusion of palm olein oil in formula B may be the reason for the observed differences in stool characteristics. Palm olein is used in infant formulas to provide palmitic acid at a level similar to that found in breast milk. However, palmitic acid from palm olein is arranged differently from that in breast milk triglyceride and is poorly absorbed. Unabsorbed palmitic acid tends to react with calcium to form insoluble soaps, and the level of these soaps is correlated with stool hardness. The pattern of softer stools and greater frequency of stooling associated with formula A is similar to the stool pattern in the exclusively breastfed infant. Thus, the use of formula A may ease the transition from breast milk to formula feeding and ameliorate parents' perception that constipation is associated with iron-fortified formula.

Animals↗
PubMed2003

Structure-function relationships affecting the insecticidal and miticidal activity of sugar esters.

Synthetic sugar esters are a relatively new class of insecticidal compounds that are produced by reacting sugars with fatty acids. The objective of this research was to determine how systematic alterations in sugar or fatty acid components of sugar ester compounds influenced their insecticidal properties. Sucrose octanoate, sorbitol octanoate, sorbitol decanoate, sorbitol caproate, xylitol octanoate, xylitol decanoate and xylitol dodecanoate were synthesized and evaluated against a range of arthropod pests. Dosage-mortality studies were conducted on pear psylla (Cacopsylla pyricola Foerster) on pear, tobacco aphid (Myzus nicotianae) Blackman and tobacco hornworm (Manduca sexta [Johannson]) on tobacco, and twospotted spider mite (Tetranychus urticae Koch) on apple in laboratory bioassays. These sugar esters were compared with insecticidal soap (M-Pede, Dow AgroSciences L.L.C., San Diego, CA), to determine how toxicologically similar these materials were against the arthropod pests. Substitutions in either the sugar or fatty acid component led to significant changes in the physical properties and insecticidal activity of these compounds. The sugar esters varied in their solubility in water and in emulsion stability, yet, droplet spread upon pear leaves occurred at low concentrations of 80-160 ppm and was strongly correlated with psylla mortalities (R2 = 0.73). Sequentially altering the sugar or fatty acid components from lower to higher numbers of carbon chains, or whether the sugar was a monosaccharide or disaccharide did not follow a predictable relationship to insecticidal activity. Intuitively, changing the hydrophile from sorbitol (C6) to xylitol (C5) would require a decrease in lipophile chain length to maintain hydrophilic-lipophilic balance (HLB) relationships, yet an increase in lipophile chain length was unexpectedly needed for increasing insecticidal activity. Thus, the HLB of these materials did not correlate with pear psylla mortalities. Initial insect bioassays and dosage-mortality data found significant differences among sugar ester compounds' toxicity to the range of arthropod species. Sucrose octanoate high in monoester content had the highest activity against the range of arthropod pests at low concentrations of 1200-2400 ppm. No single chemical structure for the xylitol or sorbitol esters were optimally effective against the range of arthropods we tested and sorbitol octanoate and xylitol decanoate had the highest insecticidal activity of this group. All of the sugar ester materials produced high T. urticae mortalities on apple at very low concentrations of 400 ppm. Overall, most of the sugar esters that were examined had superior insecticidal activity compared with insecticidal soap. Sugar ester chemistry offers a unique opportunity to design an insecticide or miticide specific to certain arthropod pests which would be valuable in crop integrated pest management (IPM) programs. Sucrose esters are currently used as additives in the food industry which makes them especially attractive as safe and effective insecticides.

Animals↗
PubMed2005

Limonene, a citrus extract, for control of mealybugs and scale insects.

In a series of bioassays with mealybugs, aqueous solutions of 1% limonene were tested that used from 0.50 to 1.50% all purpose spray adjuvant (APSA)-80 as an emulsifier/surfactant. The two ingredients were added to water or to 0.1% Silwet L-77, an agricultural surfactant. Using 1% limonene, 0.75% APSA-80 and 0.1% Silwet L-77, a semitransparent mixture (primarily a microemulsion) was obtained that was safe for most plants and provided good control of mealybugs when sprayed or used in 1-min dips. Used at half strength, this mixture controlled > or =99% of whiteflies, whereas the full-strength mixture controlled from 69 to 100% of mealybugs and scales, including > or =93% control of root mealybugs. In side-by-side greenhouse tests, this mixture was superior to a 2% solution of insecticidal soap or a 2% solution of horticultural spray oil. Mortality of green scales on potted gardenia plants averaged 95, 89, and 88% on plants sprayed with limonene, insecticidal soap, or horticultural oil, respectively. In a related test, these same sprays killed 44.1, 22.7, or 12.5% of third and fourth instar clustering mealybugs, respectively. Limonene has promise as a safe, natural pesticide for insect pests on tolerant plants. Although 1% limonene solutions damaged certain species of ferns, gingers and delicate flowers, they caused no damage to ornamentals with thick, waxy leaves, such as palms, cycads, and orchids.

Animals↗
PubMed1982

Seasonal trends in reported poisonings.

Review of 2,339 Duke Poison Control Center records for calendar year 1977 revealed that preschool children had an autumn peak for all poisonings; older victims a summer predominance. When the reports were stratified by poisoning agent, significant summer predominance was noted in preschool victims for plants, pesticides, paints, and cosmetics; winter predominance for external medicines. In older victims, spring predominance was found for pesticides and soaps, summer predominance for envenomations, plants, internal medicines, ethanol, soaps, and external medicines.

Age Factors↗
PubMed1993

Water cost and availability: key determinants of family hygiene in a Peruvian shantytown.

OBJECTIVES: This study was conducted to determine whether poor hygiene practices are owing to difficulty in getting enough water and/or to ignorance of sanitary principles. METHODS: In a water-scarce shantytown in Lima, Peru, we observed in 12-hour periods over 3 consecutive days the amount of water and soap used for personal and domestic activities in 53 families and the frequency with which direct fecal contamination of hands was interrupted by washing. We also surveyed women in a similar shantytown concerning their knowledge of hygiene to ascertain whether noncompliance was owing to ignorance. RESULTS: Three hundred fecal contamination events were registered, of which only 38 (13%) were interrupted by hand washing within 15 minutes. The mean 12-hour per capita amount of water and soap used by the families was low. More than 80% of the water stored by these families had fecal coliforms. Yet the level of knowledge concerning the importance of hand washing and other hygienic practices was high. CONCLUSIONS: In water-scarce areas, sanitary education programs probably will not change hygiene practices. In these areas, an adequate supply of water is essential for good hygiene.

Adolescent↗
PubMed2006

Allergic contact dermatitis to chloroxylenol.

Chloroxylenol, also known as p-chloro-m-xylenol (PCMX), is a compound that has been used as a preservative in cosmetics and as an active agent in antimicrobial soaps. We present two patients with allergic contact dermatitis from PCMX, confirmed by positive (+++) patch-test reactions at 48 and 72 hours, identification of PCMX in a soap and in a hand cream used by the patients, and improvement following withdrawal of the incriminating products. The mechanism of action, structure, antimicrobial activity, and dangers of PCMX are reviewed.

Adult↗
PubMedDate not supplied

Influence of hygiene on gastrointestinal illness among wilderness backpackers.

BACKGROUND: Gastrointestinal illness is a common risk for wilderness travelers, even among those who consistently disinfect their water, yet the importance of hygiene has not been characterized. METHODS: In a prospective surveillance study, 334 Appalachian Trail backpackers who hiked for at least 7 days in 1997 were interviewed. Upon completion of their hike, a written questionnaire was sent, addressing illnesses, water disinfection methods, and hygiene. Hygiene inquiries focused on the frequency of behaviors concerning handwashing and cleaning cookware. RESULTS: Two hundred and eighty backpackers compiled 38,940 wilderness exposure days, with 56% (n=56) experiencing diarrhea. Diarrhea correlated with the frequency of drinking untreated surface water (relative risk (RR) 2.4, 95% confidence interval (CI) 1.0-4.7%, p5.03). Of those who consistently treated water, 45% suffered from diarrhea, whereas 69% of those who inconsistently treated water experienced diarrhea (RR 0.65, 95% CI 0.53-0.81%, p5.001). Hikers practicing "good hygiene", defined as handwashing post-defecation and cleaning cookware routinely, were less likely to ever experience diarrhea (RR 0.47, 95% CI 0.22-0.99, p5.04). Routine handwashing with soap and water after both urination and defecation reduced the risk of diarrhea (RR 0.11, 95% CI 0.04-0.31%, p,.001). In a case-control analysis of those experiencing diarrhea, decreased diarrhea was associated with routine consumption of multivitamins (RR 0.50, 95% CI 0.37-0.66%, p,.001), routine cleaning of utensils with warm, soapy water (RR 0.38, 95% CI 0.20-0.74%, p,.01), and post-defecation handwashing with soap and water (RR 0.61, 95% CI 0.39-0.93%, p5.006). CONCLUSIONS: Lack of hygiene, specifically handwashing and cleaning of cookware, should be recognized as a significant contributor to wilderness gastrointestinal illness. Hikers should routinely disinfect water and avoid untreated surface water.

Adult↗
PubMed2003

Sex differences in public restroom handwashing behavior associated with visual behavior prompts.

Handwashing after using the restroom is generally poor across the population, and one common method used to increase the frequency of handwashing is to place signs reminding individuals to wash their hands. The current study examined the association between the absence and presence of signs reminding one to wash their hands and handwashing in public restrooms. Signs prompting handwashing behavior remind restroom patrons of acceptable behavior, and the presence of these signs is hypothesized to be associated with an increase in handwashing. Observation of 175 individuals (95 women and 80 men) using public restrooms on a university campus indicated that 61% of the women and 37% of the men observed washed their hands, e.g., washing hands with soap, in the absence of the sign, and 97% of the women and 35% of the men observed washed their hands in the presence of the sign. Further, 53% of the men and 38% of the women observed rinsed their hands, e.g., washing hands without soap, in the absence of the sign, and 55% of the men and 2% of the women observed rinsed their hands in the presence of the sign. Results are discussed in terms of possible factors associated with sex differences in handwashing and the absence and presence of visual prompts for handwashing behavior.

Adult↗