Short-term effects of alcohol-based disinfectant and detergent on skin irritation

The most important risk factor for occupational contact dermatitis in hospital personnel is the exposure to irritants such as water, detergents and alcohol-based solutions. This study was undertaken to evaluate the short-term effects of repeated exposure to an alcohol-based disinfectant, to a detergent and to an alcohol-based disinfectant/detergent alternately. The hardening effect in preirritated skin after a 4-week interval was also evaluated. Detergent, disinfectant and disinfectant/detergent alternately were applied daily every 15 min for 6 h for 2 days to the flexor upper arms and forearms of 15 volunteers. A control area was included. After 4 weeks, a sodium lauryl sulfate patch was applied to each area. Irritant reactions were quantified by visual score, transepidermal water loss (TEWL) and skin colour at baseline, D3, D8, D35 and D37. As evaluated by clinical assessment, detergent caused more redness of the skin than both disinfectant applied alone and disinfectant/detergent alternately at D3 and D8, P < 0.001 and P < 0.001, respectively. An increased irritant response for detergent as compared to disinfectant alone and disinfectant/detergent was confirmed by TEWL and colour evaluations, P = 0.001 and P = 0.001 and P = 0.006 and P = 0.009, respectively. No hardening effect in preirritated skin was found after a 4-week interval. In conclusion, hand disinfection with alcohol-based disinfectant or alternate use of disinfectant/detergent causes less skin irritation than hand disinfection with a detergent. This study evaluated the short-term effects of disinfectant and detergent exposure only, and more long-term studies are necessary before recommendations can be made.