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Hi there
Hoping to get your advice on staff with an allergy to Alcohol in ABHR . ICU would like to employee a nurse form NZ who has an allergy to ABHR and Latex gloves. The gloves are no problem as we use latex free gloves however I am not aware of non alcohol hand rub that meets EN1500 testing standard. The person is currently using Alcohol Free Hand Sanitising Foam By Reynard Health Services which is TGA approved as a cosmetic product. It is not TGA approved as a hand hygiene product.
ICU are insistent on employing the nurse as they believe handwashing is a viable option for 5 moment of hand Hygiene which Infection Prevention and Control unit do not endorse , Alice Springs has very hard water and hand issues are a problem from time to time .
There has been no assessment by dermatologist or formal report provided regarding this sensitivity.
Can you if you have experience with clinical staff who are unable to use AHBR and what are the options?
RegardsCate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
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Hi Cate
True allergy to alcohol is ‘very uncommon’ according to the WHO 2009 guidelines:
Allergic reactions to antiseptic agents including QAC, iodine or iodophors, chlorhexidine, triclosan, chloroxylenol and alcohols285,330,332,339,588,592-597 have been reported, as well as possible toxicity in relation to dermal absorption of products.598,599 Allergic contact dermatitis attributable to alcohol-based handrubs is very uncommon. Surveillance at a large hospital in Switzerland where a commercial alcohol-based handrub has been used for more than 10 years failed to identify a single case of documented allergy to the product.484 In late 2001, a Freedom of Information Request for data in the FDA’s Adverse Event Reporting System regarding adverse reactions to popular alcohol-based handrubs in the USA yielded only one reported case of an erythematous rash reaction attributed to such a product (J. M. Boyce, personal communication). However, with the increasing use of such products by HCWs, it is likely that true allergic reactions to such products will occasionally be encountered. There are a few reports of allergic dermatitis resulting from contact with ethyl alcohol600-602 and one report of ethanol-related contact urticaria syndrome.331 More recently, Cimiotti and colleagues reported adverse reactions associated with an alcohol-based handrub preparation. In most cases, nurses who had symptoms were able to resume use of the product after a brief hiatus.332 This study raises the alert for possible skin reactions to alcohol-based handrub preparations. In contrast, in a double-blind trial by Kampf and colleagues582 of 27 persons with atopic dermatitis, there were no significant differences in the tolerability of alcohol-based handrubs when compared with normal controls.
Allergic reactions to alcohol-based formulations may represent true allergy to the alcohol, or allergy to an impurity or aldehyde metabolite, or allergy to another product constituent.330 Allergic contact dermatitis or immediate contact urticarial reactions may be caused by ethanol or isopropanol.330 Allergic reactions may be caused by compounds that may be present as inactive ingredients in alcohol-based handrubs, including fragrances, benzyl alcohol, stearyl or isostearyl alcohol, phenoxyethanol, myristyl alcohol, propylene glycol, parabens, or benzalkonium chloride.330,491,588,603-606
https://www.ncbi.nlm.nih.gov/books/NBK144008/
We have several staff here who do not tolerate an alcohol hand gel we provide, but are quite able to use a alcohol foam formulation.I would recommend you seek more information on the nature of the ‘allergy’, including dermatology review if possible, and offer to supply some different formulations of alcohol hand sanitisers to see if any can be tolerated (with dermatologist approval, if possible).
I agree that only hand washing in a busy ICU would be potentially more detrimental to her skin over time, but this might be an interim measure whilst you sort out a suitable alcohol based product she can tolerate.
My thoughts, anyway.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Hi there
Hoping to get your advice on staff with an allergy to Alcohol in ABHR . ICU would like to employee a nurse form NZ who has an allergy to ABHR and Latex gloves. The gloves are no problem as we use latex free gloves however I am not aware of non alcohol hand rub that meets EN1500 testing standard. The person is currently using Alcohol Free Hand Sanitising Foam By Reynard Health Services which is TGA approved as a cosmetic product. It is not TGA approved as a hand hygiene product.
ICU are insistent on employing the nurse as they believe handwashing is a viable option for 5 moment of hand Hygiene which Infection Prevention and Control unit do not endorse , Alice Springs has very hard water and hand issues are a problem from time to time .
There has been no assessment by dermatologist or formal report provided regarding this sensitivity.
Can you if you have experience with clinical staff who are unable to use AHBR and what are the options?
RegardsCate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
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Hi Cate,
We recently had a similar situation with a staff member who was allergic to Alcohol in ABHR, Kathon’s & was advised to keep hands dry (could not perform hand washing more than 20 times per day), we tried to source alternatives & treatments but unfortunately they were unsuccessful.
I would suggest getting a thorough assessment from an occupational dermatologist.
Kind regardsKim Testi
Infection Control Coordinator
T: 8337 0488 | M: 0488 257 174 | E: ktesti@lhi.org.au | W: http://www.lhi.org.au
[LHI Retirement Services]
Hi there
Hoping to get your advice on staff with an allergy to Alcohol in ABHR . ICU would like to employee a nurse form NZ who has an allergy to ABHR and Latex gloves. The gloves are no problem as we use latex free gloves however I am not aware of non alcohol hand rub that meets EN1500 testing standard. The person is currently using Alcohol Free Hand Sanitising Foam By Reynard Health Services which is TGA approved as a cosmetic product. It is not TGA approved as a hand hygiene product.
ICU are insistent on employing the nurse as they believe handwashing is a viable option for 5 moment of hand Hygiene which Infection Prevention and Control unit do not endorse , Alice Springs has very hard water and hand issues are a problem from time to time .
There has been no assessment by dermatologist or formal report provided regarding this sensitivity.
Can you if you have experience with clinical staff who are unable to use AHBR and what are the options?
RegardsCate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
The information in this e-mail is intended solely for the addressee named. It may contain legally privileged or confidential information that is subject to copyright. If you are not the intended recipient you must not use, disclose copy or distribute this communication. If you have received this message in error, please delete the e-mail and notify the sender. No representation is made that this e-mail is free of viruses. Virus scanning is recommended and is the responsibility of the recipient.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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Hi Cate
We had a similar anecdotal allergy to a HH product that was resulting in a staff member unable to work clinically due to the state of her hands.
Without confirmed sensitivity testing it is really impossible to put in place a specific risk management plan.
Our staff member on expert testing was actually found to be sensitive to many chemical/product from her home and only one from the work place.
This testing and advise enabled us to work with her to reduce exposures both at home and at work leading to significant improvement in her hand condition and her ability to work with little time off.
Regards
CoralieCoralie Tyrrell | Manager Infection Prevention & Control | P: 03 56230625 | E: coralie.tyrrell@wghg.com.au
West Gippsland Healthcare Group | 41 Landsborough Street | Warragul Vic 3820 | http://www.wghg.com.au”WGHG strives to attract and retain a highly talented learning workforce that engages with a level of pride and passion in improving the health and wellbeing of its community”
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Hi there
Hoping to get your advice on staff with an allergy to Alcohol in ABHR . ICU would like to employee a nurse form NZ who has an allergy to ABHR and Latex gloves. The gloves are no problem as we use latex free gloves however I am not aware of non alcohol hand rub that meets EN1500 testing standard. The person is currently using Alcohol Free Hand Sanitising Foam By Reynard Health Services which is TGA approved as a cosmetic product. It is not TGA approved as a hand hygiene product.
ICU are insistent on employing the nurse as they believe handwashing is a viable option for 5 moment of hand Hygiene which Infection Prevention and Control unit do not endorse , Alice Springs has very hard water and hand issues are a problem from time to time .
There has been no assessment by dermatologist or formal report provided regarding this sensitivity.
Can you if you have experience with clinical staff who are unable to use AHBR and what are the options?
RegardsCate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
The information in this e-mail is intended solely for the addressee named. It may contain legally privileged or confidential information that is subject to copyright. If you are not the intended recipient you must not use, disclose copy or distribute this communication. If you have received this message in error, please delete the e-mail and notify the sender. No representation is made that this e-mail is free of viruses. Virus scanning is recommended and is the responsibility of the recipient.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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Hi Cate, I do have a backup product in these cases, which seems to be quite good in not aggravating damaged and inflamed hands.
I am by no means a fan of the active ingredient (benzalkonium chloride). but when needs must, it’s the best I have found. Needless to say we are a community based service not an ICU, so the risks are somewhat different.
Happy to share details so you can look into the product further, if you are interested.
Kind Regards,
Donna Schmidt
Clinical Nurse Consultant Infection Control – Primary & Community Health
Rosemeadow Community Health Centre
5 Thomas Rose Drive, Rosemeadow, NSW, 2560
Tel (02) 4633 4113 | Fax (02) 4633 4111 | Mob 0438 925 816
donnamarie.schmidt@health.nsw.gov.au[http://internal.health.nsw.gov.au/communications/e-signatures/images/NSW-Health-South-Western-Sydney-LHD.jpg]
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[cid:image004.jpg@01D2A16E.34EC46A0]Hi there
Hoping to get your advice on staff with an allergy to Alcohol in ABHR . ICU would like to employee a nurse form NZ who has an allergy to ABHR and Latex gloves. The gloves are no problem as we use latex free gloves however I am not aware of non alcohol hand rub that meets EN1500 testing standard. The person is currently using Alcohol Free Hand Sanitising Foam By Reynard Health Services which is TGA approved as a cosmetic product. It is not TGA approved as a hand hygiene product.
ICU are insistent on employing the nurse as they believe handwashing is a viable option for 5 moment of hand Hygiene which Infection Prevention and Control unit do not endorse , Alice Springs has very hard water and hand issues are a problem from time to time .
There has been no assessment by dermatologist or formal report provided regarding this sensitivity.
Can you if you have experience with clinical staff who are unable to use AHBR and what are the options?
RegardsCate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
The information in this e-mail is intended solely for the addressee named. It may contain legally privileged or confidential information that is subject to copyright. If you are not the intended recipient you must not use, disclose copy or distribute this communication. If you have received this message in error, please delete the e-mail and notify the sender. No representation is made that this e-mail is free of viruses. Virus scanning is recommended and is the responsibility of the recipient.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.
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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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