How the Pandemic has Impacted Public Health Hand Hygiene: Product Demand and Product Safety

Author: Holly Montejano, MS, CIC, CPHQ, VA-BC

Categories: General Infection Prevention & Hand Hygiene April 13, 2022
person washing hands

While hand hygiene has been a mainstay in healthcare infection prevention, the focus on this practice has been heightened in communities across the globe due to the COVID-19 pandemic.

It is no longer just the healthcare frontline workers who diligently perform hand hygiene, but also parents, children, office workers, travelers, and the list goes on and on. Hand hygiene, alongside social distancing, mask use, and vaccination (which is now broadly available), are all critical efforts in the community to maintain public health and reduce the transmission of the SARS-CoV-2 virus.

A Drastic Increase in Demand

The spread of COVID-19 in our communities over the past year has increased both the public’s understanding of infectious disease transmission AND the demand for hand hygiene products.

Alcohol-based hand rubs (ABHR) have always been a convenient option for on-the-go use as alcohol offers a broad-spectrum efficacy.

The Centers for Disease Control and Prevention (CDC) recommends that people use a hand-sanitizing product with at least a 60% alcohol, when soap and water are not an option, to prevent the spread of COVID-191. The CDC also suggests that the public check the Food and Drug Administration (FDA) Do-Not-Use list to ensure a safe product is being used. This excellent resource is available here.

A Growing Emphasis on Safe Product Use

Why do we need to be informed about safe product use? The pandemic sharply increased product demand. Survey results published online in April 2020 reported that ninety percent of Americans were washing their hands more frequently2, and it would be safe to assume the use of ABHR increased similarly. This increase resulted in supply chain disruptions, a global shortage of ABHR products and raw materials.

Ultimately, the FDA relaxed quality guidelines regarding production using ethanol which has allowed non-traditional manufacturers to enter this marketplace, producing “technical grade” alcohol to backfill the increased demand and increase the potential for toxic process contaminants in the formulations3. Dermal absorption, inhalation, and ingestion exposures have been documented- with ingestion being the primary exposure amongst children4 per one report, and dermal irritation was common in adults5, as reported during dermatology telemedicine visits in India.

A Focus on Ingredients

Aside from the potential for process contaminants, color and fragrance additives have the potential for contact allergies. Some manufacturers have included non-approved dyes and fragrances to mask the undesirable smells and colors associated with technical grade ethanols3. These colorful dyes and attractive scents may increase the appeal to children4– these very additives may contribute to the aforementioned findings in children regarding ingestion.

The pandemic has created interim changes in government regulations for critical hygiene items3. The public must be aware of the risks these changes may cause in the quality of non-traditional manufacturing of ABHR products, considering the frequency hand hygiene is performed in our new “normal.” Ensuring the safety of hand hygiene products being used so frequently within our daily routines is an essential caveat as we celebrate Hand Hygiene Day this year!

If you are looking for a hand hygiene product that meets CDC recommendations, PDI offers Sani-Hands® Instant Hand Sanitizing Wipes, an ideal hand hygiene solution for staff, visitors, and patients available in multiple formats to meet your facility’s needs.

  1. https:// Accessed April 29, 2021.
  2. Accessed April 29, 2021.
  3. Timothy, J. Tse, et al. “Toxicology of alcohol-based hand rubs formulated with technical-grade ethanol.” Toxicology Reports(2021).
  4. McCulley, Lynda, et al. “Alcohol-based hand sanitizer exposures and effects on young children in the US during the COVID-19 pandemic.” Clinical Toxicology4 (2021): 355-356.
  5. Singh, Mehak, et al. “Overzealous hand hygiene during the COVID 19 pandemic causing an increased incidence of hand eczema among general population.” Journal of the American Academy of Dermatology1 (2020): e37-e41.


Holly Montejano MS, CIC, CPHQ, VA-BC
holly Clinical Science Liaison, PDI Gulf Coast


Holly’s passion for infectious disease epidemiology developed during her undergraduate studies at University of Connecticut, where she studied biology and anthropology – and the profound impact of disease on people, public health and within healthcare systems.

Learn more about Holly here.


Phone: 321.439.7923


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