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Observation of everyday hand-washing behavior of Japanese, and effects of antibacterial soap.

People wash their hands only for a short time outside the home and when preparing meals at home. This may not be sufficient for those who prepare meals because of possible secondary contamination from food. Although washing with a placebo soap for a short period (lathering 3 s and rinsing 8 s) cleansed from hands about 95% of the total coliforms transferred from ground meat, an antibacterial soap further reduced the coliform count significantly (p < 0.01). To effectively avoid secondary contamination, it is recommended that people should more frequently wash their hands, using an antibacterial soap on the areas that have been in contact with raw meat, poultry, seafood, eggs, vegetables and other foods.

Anti-Infective Agents, Local↗

A risk assessment framework for the evaluation of skin infections and the potential impact of antibacterial soap washing.

Antibacterial soaps may have an important role in the control of skin infection. However, quantitative estimation of their benefit is difficult because of the problems associated with conducting epidemiologic studies. An alternative benefit estimation approach, quantitative microbial risk assessment, has application to this problem. This article sets forth the quantitative microbial risk assessment method and applies it specifically to the estimation of the reduction in risk of dermal infection from Staphylococcus aureus resulting from use of antibacterial soaps. A dose-response model was formulated by using available information on growth kinetics of the organism on the skin and dose data based on the inoculation of the forearm skin in volunteers. A predictive relationship for microbial growth on the skin was developed. These data were limited, and clearly more studies are needed on inoculation at more than one site and growth leading to infection on the skin with and without the use of germicidal soaps.However, by using relationships based on extant data sets, it was estimated that the use of germicidal soap could result in a substantial reduction in the risk of infection by S aureus. The estimated risk reduction was in general concordance with published results from epidemiologic studies conducted on military cadets. The methodology of quantitative microbial risk assessment has thus been shown to be applicable to this problem and may have broader applicability in other personal hygiene contexts.

Adult↗

Effect of washing hands with soap on diarrhoea risk in the community: a systematic review.

We set out to determine the impact of washing hands with soap on the risk of diarrhoeal diseases in the community with a systematic review with random effects meta-analysis. Our data sources were studies linking handwashing with diarrhoeal diseases. Seven intervention studies, six case-control, two cross-sectional, and two cohort studies were located from electronic databases, hand searching, and the authors' collections. The pooled relative risk of diarrhoeal disease associated with not washing hands from the intervention trials was 1.88 (95% CI 1.31-2.68), implying that handwashing could reduce diarrhoea risk by 47%. When all studies, when only those of high quality, and when only those studies specifically mentioning soap were pooled, risk reduction ranged from 42-44%. The risks of severe intestinal infections and of shigellosis were associated with reductions of 48% and 59%, respectively. In the absence of adequate mortality studies, we extrapolate the potential number of diarrhoea deaths that could be averted by handwashing at about a million (1.1 million, lower estimate 0.5 million, upper estimate 1.4 million). Results may be affected by the poor quality of many of the studies and may be inflated by publication bias. On current evidence, washing hands with soap can reduce the risk of diarrhoeal diseases by 42-47% and interventions to promote handwashing might save a million lives. More and better-designed trials are needed to measure the impact of washing hands on diarrhoea and acute respiratory infections in developing countries.

Adolescent↗

The analysis of the impact of a mild, low-iodine, lotion soap on the reduction of nosocomial methicillin-resistant Staphylococcus aureus: a new opportunity for surveillance by objectives.

A significant unremitting increase in the incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections in a 500-bed acute care community teaching hospital prompted reevaluation of the efficacy of the infection control measures used. A well-accepted, low-iodine, antimicrobial soap was used to replace a liquid natural handsoap in two areas with the highest incidence of MRSA--the intensive care unit, and a medical division. Over a two-year period, an analysis was made of the effect of soap replacement on nosocomial infections and pathogens. Soap changeover occurred at the midpoint of the two-year period. From year to year, the nosocomial MRSA rate decreased 80% (t test, P = 0.005). Other pathogens that demonstrated a dramatic decrease included methicillin-sensitive Staphylococcus aureus (MSSA), infections where no pathogens were isolated, and various gram-negative infections. Categories of nosocomial infections that decreased included surgical wound infections, primary bacteremias, and respiratory tract infections. The overall nosocomial infection rate of the two combined areas decreased 21.5%, representing a year-to-year savings of $109,500. As a result, the decision was made to install the low-iodine handsoap permanently at all sinks within the hospital.

Costs and Cost Analysis↗

Effect of cleaning dentine with soap and pumice on shear bond strength of dentine-bonding agents.

This in vitro study reports on the cleaning effect of different soaps on the shear bond strength of various dentine-bonding agents. Human teeth were coated with provisional cements for 24 h or for 14 days. After removing the provisional cements with a scaler, the dentinal surface was cleaned with a cotton pellet and non-fluoridated flour of pumice and soap for 10 sec. Different dentine-bonding agents and a luting resin were bonded to the dentinal surface according to manufacturers' instructions with the bonding agent and the composite material being light-cured at the same time. The bonding agents were tested under intrapulpal pressure and with thermal cycling to imitate physiological conditions. Compared with cleaning the dentine with water and pumice, all soaps investigated in this study decreased the shear bond strength values of the tested dentine-bonding agents considerably.

Dental Bonding↗

Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness.

BACKGROUND: The effectiveness of an alcoholic solution compared with the standard hygienic handwashing procedure during regular work in clinical wards and intensive care units of a large public university hospital in Barcelona was assessed. METHODS: A prospective, randomized clinical trial with crossover design, paired data, and blind evaluation was done. Eligible health care workers (HCWs) included permanent and temporary HCWs of wards and intensive care units. From each category, a random sample of persons was selected. HCWs were randomly assigned to regular handwashing (liquid soap and water) or handwashing with the alcoholic solution by using a crossover design. The number of colony-forming units on agar plates from hands printing in 3 different samples was counted. RESULTS: A total of 47 HCWs were included. The average reduction in the number of colony-forming units from samples before handwashing to samples after handwashing was 49.6% for soap and water and 88.2% for the alcoholic solution. When both methods were compared, the average number of colony-forming units recovered after the procedure showed a statistically significant difference in favor of the alcoholic solution (P <.001). The alcoholic solution was well tolerated by HCWs. Overall acceptance rate was classified as "good" by 72% of HCWs after 2 weeks use. Of all HCWs included, 9.3% stated that the use of the alcoholic solution worsened minor pre-existing skin conditions. CONCLUSIONS: Although the regular use of hygienic soap and water handwashing procedures is the gold standard, the use of alcoholic solutions is effective and safe and deserves more attention, especially in situations in which the handwashing compliance rate is hampered by architectural problems (lack of sinks) or nursing work overload.

1-Propanol↗

Severe colitis induced by soap enemas.

A patient had severe colitis after soap enemas for five days. Elimination of the soap enemas resulted in resolution of the colitis. We suggest that soap enemas be avoided.

Colitis↗

False-positive cryptococcal antigen latex agglutination caused by disinfectants and soaps.

Five disinfectants or soaps were tested to determine if any could be responsible for false-positive results obtained with the Latex-Crypto Antigen Detection System kit (Immuno-Mycologics, Inc., Norman, Okla.). Three disinfectants or soaps (Derma soap, 7X, and Bacdown) produced false-positive agglutination after repeated washing of ring slides during testing of a known negative cerebrospinal fluid specimen.

Antigens, Fungal↗

Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial.

OBJECTIVE: To compare the efficacy of handrubbing with an alcohol based solution versus conventional handwashing with antiseptic soap in reducing hand contamination during routine patient care. DESIGN: Randomised controlled trial during daily nursing sessions of 2 to 3 hours. SETTING: Three intensive care units in a French university hospital. PARTICIPANTS: 23 healthcare workers. INTERVENTIONS: Handrubbing with alcohol based solution (n=12) or handwashing with antiseptic soap (n=11) when hand hygiene was indicated before and after patient care. Imprints taken of fingertips and palm of dominant hand before and after hand hygiene procedure. Bacterial counts quantified blindly. MAIN OUTCOME MEASURES: Bacterial reduction of hand contamination. RESULTS: With handrubbing the median percentage reduction in bacterial contamination was significantly higher than with handwashing (83% v 58%, P=0.012), with a median difference in the percentage reduction of 26% (95% confidence interval 8% to 44%). The median duration of hand hygiene was 30 seconds in each group. CONCLUSIONS: During routine patient care handrubbing with an alcohol based solution is significantly more efficient in reducing hand contamination than handwashing with antiseptic soap.

Alcohols↗

Comparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds. A prospective, randomized study.

BACKGROUND: Irrigation of open fracture wounds is a commonly performed procedure, and irrigation additives have been used in an attempt to reduce the risk of infection. In vitro and animal studies have suggested that irrigation with detergent solution is more effective than irrigation with a solution containing antibiotic additives. This study was performed to compare the efficacy of those two solutions in the treatment of open fractures in humans. METHODS: Adult patients with an open fracture of the lower extremity were prospectively randomized to receive irrigation with either a bacitracin solution or a nonsterile castile soap solution. The patients were followed clinically to assess for the development of infection, healing of the soft-tissue wound, and union of the fracture. RESULTS: Between 1995 and 2002, 400 patients with a total of 458 open fractures of the lower extremity were entered into the study. One hundred and ninety-two patients were assigned to the bacitracin group (B), and 208 were assigned to the castile soap group (C). Outcomes were available for 171 patients with a total of 199 fractures in group B and 180 patients with a total of 199 fractures in group C. The mean duration of follow-up was 500 days. There was no difference between groups B and C in terms of gender, the Gustilo-Anderson grade of the open fracture, the time between the injury and the irrigation, smoking, or alcohol use. There were significant differences in the mean age (thirty-eight compared with forty-two years, p = 0.01), duration of follow-up (560 compared with 444 days, p = 0.01), prevalence of hypotension (23% compared with 14%, p = 0.04), and duration of treatment with intravenous antibiotics (eleven compared with nine days, p = 0.02). An infection developed at thirty-five (18%) of the 199 fracture sites in group B and at twenty-six (13%) of the 199 fracture sites in group C. This difference was not significant (p = 0.2). Bone-healing was delayed for forty-nine (25%) of the 199 group-B fractures and forty-six (23%) of the 199 group-C fractures (p = 0.72). Wound-healing problems occurred in association with nineteen group-B fractures (9.5%) and eight group-C fractures (4%). This difference was significant (p = 0.03). CONCLUSIONS: Irrigation of open fracture wounds with antibiotic solution offers no advantages over the use of a nonsterile soap solution, and it may increase the risk of wound-healing problems.

Adult↗

Rapid study of fragrance loss from commercial soap after use by solid phase microextraction-GC/MS and olfactory evaluation.

A quick and reliable approach was reported to measure the perfume loss in a commercial soap sample after continued use. This work firstly studied the fragrance loss profile in soap scientifically combined and compared with traditional olfactory evaluation. Solid-phase microextraction (SPME), as a simple and effective adsorption and desorption technique, was selected here to eliminate the needs of organic solvents or complicated apparatus; more importantly, SPME kept the soap intact and made it available for continued study. Thanks to control of the sampling time and other extraction parameters, a consistent and reliable result was achieved, which was much better and more detailed than traditional olfactory evaluation done by human beings.

Calibration↗

No advantage to delaying the introduction of calcium soaps of palm oil fatty acids to early lactation dairy rations.

Holstein cows (n = 105, 39 primiparous) were blocked by parity (1 vs. > 1) and assigned randomly at calving to receive supplemental Ca soaps of palm oil (2.9% fatty acids in dietary DM), commencing on DIM 1, 29, or 57 and ending on DIM 112. Effects on DMI, BW and condition score, and milk yield and composition were studied during 1 to 140 DIM. Control TMR contained 4.4% ether extract (mainly from corn meal and dried distillers grains with solubles), was fed using four grain to forage ratios, and, in early lactation, averaged 60% concentrate, 25% corn silage, and 15% wilted grass silage DM. Delayed supplementation of soaps did not promote higher dietary DMI, resulted in reduced milk fat percentage and yield, tended to decrease 4% FCM yield, and did not significantly influence milk protein content. Supplementation of soaps in wk 1 to 8 did not spare postpartum BW loss, hasten BW regain, or affect the normal change in body condition score. Ad libitum DMI and 4% FCM yield were significantly and negatively correlated (r = -.3) with the proportion of dietary CP that was ruminally undegradable.

Animal Nutritional Physiological Phenomena↗

Effect of calcium soaps of fatty acids and administration of somatotropin on milk production, preovulatory follicular development, and plasma and follicular fluid lipid composition in high yielding dairy cows.

The effect of fat and bovine somatotropin (bST) on preovulatory follicular hormones and lipids was evaluated by feeding cows for 150 d from parturition a control diet, a control diet plus 0.55 kg/d of calcium soaps of fatty acids, or a control diet with 500 mg of bST injected every 14 d. Fourteen days after a synchronized or natural estrus, cows were injected with a PGF2 alpha analogue; 48 h later, follicular fluid from all ovarian follicles > 8 mm was aspirated. Cows fed fat or injected with bST produced more milk and milk solids than did control cows, and cows on the bST treatment lost more body condition after calving than did cows on the other treatments. Both treatments changed the proportion of estradiol-active follicles (> 400 ng of estradiol/ml of follicular fluid) and the correlation between follicular fluid estradiol concentration and the total number large follicles per cow. In follicles aspirated between 60 and 90 DIM the percentage of estradiol-active follicles was 67, 40, and 0 for cows on the control, calcium soaps of fatty acids, and bST treatments, respectively. After 90 DIM, no differences existed between treatments in the percentage of estradiol-active follicles. Estradiol concentration in follicular fluid was correlated with DIM at follicle aspiration (r = 0.51). The proportion of oleic acid in free fatty acids in plasma at 50 DIM was lower in control cows and was lower in follicular fluid of estradiol-active follicles. Both calcium soaps of fatty acids and bST had a considerable effect on follicular development and activity and the composition of fatty acids in follicles.

Androstenedione↗

Pollution control of industrial wastewater from soap and oil industries: a case study.

Industrial wastewater from soap and oil industries represents a heavy pollution source on their receiving water body. This paper studies a case of pollution control at Tanta Soap and Oil Company, Banha Factory, Egypt. The factory production includes soap, edible oil, and animal fodder. About 4,347 m3/day of industrial wastewater effluent was discharged via gravity sewers to the public sewerage system. Most of the effluent was cooling water because the cooling process in the factory was open circle. In spite of the huge quantity of cooling water being disposed of, disposal of wastewater was violating pertinent legislation. Three procedures were used for controlling the pollution at the Banha Factory. Firstly, all open circuit cooling systems were converted to closed circuit thus reducing the quantity of the discharged wastewater down to 767 m3/day. Secondly, the heavily polluted oil and grease (O&G) wastewater from the refinery unit is treated via two gravity oil separator (GOS) units, dissolved air floatation (DAF), and biological units in order to reduce the high levels of O&G, BOD, COD, and SS to the allowable limits. Thirdly, the heavily polluted waste effluent from the 'red water' saponification unit is treated separately by acidification to convert the emulsified fatty acid to free form in order to be separated through an oil separation unit. The effluent is then passed to liming stage to neutralize excess acidity and precipitate some of the dissolved matters. The mixture is finally clarified and the pH is adjusted to the allowable limits. The effluent wastewater from the three processes is collected and mixed in a final equalization tank for discharging effluent to the public sewerage system. The characteristics of the effluent water are very good with respect to the allowable Egyptian limits for discharging effluent to the public sewerage system.

Bioreactors↗

Influence of repeated washings with soap and synthetic detergents on pH and resident flora of the skin of forehead and forearm. Results of a cross-over trial in health probationers.

Ten healthy individuals washed their forehead and forearm twice a day over consecutive periods of four weeks with soap and synthetic detergents or vice versa (cross-over design). In general the pH values were higher during the period when soap was applied (the mean pH differed by 0.3 units, p less than 0.01). As a rule the counts of coagulase-negative staphylococci were not much altered. The number of propionibacteria, however, was markedly higher when soap was used (p = 0.02 and 0.01 resp.). At the forehead there was a clear correlation between bacterial counts and skin pH both with propionibacteria (0.56, p less than 0.001) and staphylococci (0.51, p less than 0.001). At the forearm only the former proved true (0.24, p less than 0.05). Thus the skin pH seems to be open to long-standing changes according to the preferred washing habits which may also be of major influence on the composition of the cutaneous bacterial flora.

Adult↗

Steel ball effect-investigation of shooting at blocks of soap.

Standard commercial glycerin soap was penetrated using 6 mm steel spheres. The impact velocities (VU) varied from 240 to 1700 m/s. The velocity of sphere within the soap (v), resistance force (F), cavity in soap (Z), and the maximal cavity diameter (D) were evaluated. Within the range of impact velocities used, the following functions have been determined F = a v2 X = b Vun, and D = c + d Vu Based on experimental evidence, the values a, b, c, d and n have been determined.

Biophysical Phenomena↗

Soaps and shampoos in pediatric practice.

Cleansing of the skin and hair is part of the daily routine of all neonates, infants, toddlers, children, and adolescents. Numerous soap and shampoo products are available to the consumer. The pediatrician is often asked to comment on the safety and efficacy of these products. Little information is available to help the pediatrician make a rational decision. The list of ingredients on the package are seldom useful and can be confusing. The theoretical and practical considerations leading to the addition of the major constituents of soaps and shampoos are reviewed and guidelines for the use of soaps and shampoos under normal circumstances and in a few selected conditions are suggested.

Baths↗

[Microbial contamination of liquid-soap wall dispensers with one-way bottles].

Hygienic examinations were performed relating to microbial contaminations of different kinds of fluid soaps in relation to various systems of dispensers. Totally 492 specimens of fluid soap were examined comprising 14 different kinds of trade names (Code A-O), sampled in 14 different hospitals including 4 different systems of dispensers. Out of 14 trade name products--containing antimicrobial additives--8 proved to be sterile. The rest--declared as free from antimicrobial additives--showed bacterial contaminations of different grade. One of them (Code "O"), without antimicrobial additives) proved to be excessively contaminated with P. cepacia in 108 specimens out of 281, i.e. 38% in the range from 10(3)-10(6) CFU/ml. Further investigations on origin and mechanism of this alarming event revealed, that the cause for this dilemma was a failure in the dosing system of the one-way bottle dispensers used. This seems to be of fundamental importance for a great number of one-way-dispensers used at presence for fluid soaps or disinfectants: Changing only the emptied bottles out of the wall-attached device of dispenser causes inevitably a rapid recontamination of the new bottles, if not the dosing-device is as well removed and effectively cleaned and disinfected before reinserting.

Bacteria↗