Fire Alcohol gel can catch fire, producing a translucent blue flame. This is due to the flammable alcohol in the gel. Some<unk>  gels may not produce this effect due to a high concentration of water or moisturizing agents. There have been some rare instances where alcohol has been implicated in starting fires in the operating room, including a case where alcohol used as an antiseptic pooled under the surgical drapes in an operating room and caused a fire when a cautery instrument was used. Alcohol gel was not implicated. To minimize the risk of fire, alcohol rub users are instructed to rub their<unk> s until dry, which indicates that the flammable alcohol has evaporated. Igniting alcohol<unk>  rub while using it is rare, but the need for this is underlined by one case of a health care worker using<unk>  rub, removing a polyester isolation gown, and then touching a metal door while her<unk> s were still wet; static electricity produced an audible spark and ignited the<unk>  gel. Fire departments suggest refills for the alcohol-based<unk> s can be stored with cleaning supplies away from heat sources or open flames. Skin Research shows that alcohol<unk> s pose any risk by eliminating beneficial microorganisms that are naturally present on the skin. The body quickly replenishes the beneficial microbes on the<unk> s, often moving them in from just up the arms where there are fewer harmful microorganisms. However, alcohol may strip the skin of the outer layer of oil, which may have negative effects on barrier function of the skin. A study also shows that disinfecting<unk> s with an antimicrobial detergent results in a greater barrier disruption of skin compared to alcohol solutions, suggesting an increased loss of skin lipids. Frequent use of alcohol-based<unk> s can cause dry skin unless emollients and/or skin moisturizers are added to the formula. The drying effect of alcohol can be reduced or eliminated by adding glycerin and/or other emollients to the formula. In clinical trials, alcohol-based<unk> s containing emollients caused substantially less skin irritation and dryness than soaps or antimicrobial detergents. Allergic contact dermatitis, contact urticaria syndrome or hypersensitivity to alcohol or additives present in alcohol<unk>  rubs rarely occur. The lower tendency to induce irritant contact dermatitis became an attraction as compared to soap and water<unk>  washing. Ingestion In the United States, the U.S. Food and Drug Administration (FDA) controls antimicrobial<unk> soaps<unk> s as over-the-counter drugs (OTC) because they are intended for topical anti-microbial use to prevent disease in humans. The FDA requires strict labeling which informs consumers on proper use of this OTC drug and dangers to avoid, including warning adults not to ingest, not to use in the eyes, to keep out of the reach of children, and to allow use by children only under adult supervision. According to the American Association of Poison Control Centers, there were nearly 12,000 cases of<unk>  ingestion in 2006. If ingested, alcohol-based<unk> s can cause alcohol poisoning in small children. However, the U.S. Centers for Disease Control recommends using<unk>  with children to promote good hygiene, under supervision, and furthermore recommends parents pack<unk>  for their children when traveling, to avoid their contracting disease from dirty<unk> s. People suffering from alcoholism may attempt to consume<unk>  in desperation when traditional alcoholic beverages are unavailable, or personal access to them is restricted by force or law. There have been reported incidents of people drinking the gel in prisons and hospitals to become intoxicated. As a result, access to sanitizing liquids and gels is controlled and restricted in some facilities. For example, over a period of several weeks during the COVID-19 pandemic in New Mexico, seven people in that U.S. state who were alcoholic were severely injured by drinking<unk> : three died, three were in critical condition, and one was left permanently blind. In 2021, a dozen children were hospitalized in the state of Maharashtra, India, after they were mistakenly orally administered<unk>  instead of a polio vaccine. Absorption On 30 April 2015, the FDA announced that they were requesting more scientific data based on the safety of<unk> . Emerging science suggests that for at least some health care antiseptic active ingredients, systemic exposure (full body exposure as shown by detection of antiseptic ingredients in the blood or urine) is higher than previously thought, and existing data raise potential concerns about the effects of repeated daily human exposure to some antiseptic active ingredients. This would include<unk>  antiseptic products containing alcohol and triclosan. Surgical<unk>  disinfection<unk> s must be disinfected before any surgical procedure by<unk>  washing with mild soap and then<unk> -rubbing with a<unk> . Surgical disinfection requires a larger dose of the<unk> -rub and a longer rubbing time than is ordinarily used. It is usually done in two applications according to specific<unk> -rubbing techniques, EN1499 (hygienic<unk> wash), and EN 1500 (hygienic<unk>  disinfection) to ensure that antiseptic is applied everywhere on the surface of the<unk> . Alcohol-free Some<unk>  products use agents other than alcohol to kill microorganisms, such as povidone-iodine, benzalkonium chloride or triclosan. The World Health Organization (WHO) and the CDC recommends "persistent" antiseptics for<unk> s. Persistent activity is defined as the prolonged or extended antimicrobial activity that prevents or inhibits the proliferation or survival of microorganisms after application of the product. This activity may be demonstrated by sampling a site several minutes or hours after application and demonstrating bacterial antimicrobial effectiveness when compared with a baseline level. This property also has been referred to as "residual activity." Both substantive and nonsubstantive active ingredients can show a persistent effect if they substantially lower the number of bacteria during the wash period. Laboratory studies have shown lingering benzalkonium chloride may be associated with antibiotic resistance in MRSA. Tolerance to alcohol<unk> s may develop in fecal bacteria. Where alcohol<unk> s utilize 62%, or higher, alcohol by weight, only 0.1 to 0.13% of benzalkonium chloride by weight provides equivalent antimicrobial effectiveness. Triclosan has been shown to accumulate in biosolids in the environment, one of the top seven organic contaminants in waste water according to the National Toxicology Program Triclosan leads to various problems with natural biological systems, and triclosan, when combined with chlorine e.g. from tap water, produces dioxins, a probable carcinogen in humans. However, 90–98% of triclosan in waste water biodegrades by both photolytic or natural biological processes or is removed due to sorption in waste water treatment plants. Numerous studies show that only very small traces are detectable in the effluent water that reaches rivers. A series of studies show that photodegradation of triclosan produced 2,4-dichlorophenol and 2,8-dichlorodibenzo-p-dioxin (2,8-DCDD). The 2,4-dichlorophenol itself is known to be biodegradable as well as photodegradable. For DCDD, one of the non-toxic compounds of the dioxin family, a conversion rate of 1% has been reported and estimated half-lives suggest that it is photolabile as well. The formation-decay kinetics of DCDD are also reported by Sanchez-Prado et al. (2006) who claim "transformation of triclosan to toxic dioxins has never been shown and is highly unlikely." Alcohol-free<unk> s may be effective immediately while on the skin, but the solutions themselves can become contaminated because alcohol is an in-solution preservative and without it, the alcohol-free solution itself is susceptible to contamination. However, even alcohol-containing<unk> s can become contaminated if the alcohol content is not properly controlled or the<unk>  is grossly contaminated with microorganisms during manufacture. In June 2009, alcohol-free Clarcon Antimicrobial<unk>  was pulled from the US market by the FDA, which found the product contained gross contamination of extremely high levels of various bacteria, including those which can "cause opportunistic infections of the skin and underlying tissues and could result in medical or surgical attention as well as permanent damage". Gross contamination of any<unk>  by bacteria during manufacture will result in the failure of the effectiveness of that<unk>  and possible infection of the treatment site with the contaminating organisms. File:Automat do dezynfekcji rąk w 60-tysięcznym Tomaszowie Mazowieckim, w województwie łódzkim.Automatic<unk>  File:COVID-19. Orlen, Płyn do higieniczniej dezynfekcji rąk o dzałaniu wirusobójczym, 5L.Hand<unk>  liquid in Poland File:Alcohol Free<unk> .Alcohol free<unk>
Hand sanitizer
Disinfectant
Insect repellent
Automatic soap dispenser
Tooth polishing
Topical medication
Mouthwash
Hand washing