Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption

Stephan Gessner, Elke Below, Stephan Diedrich, Christian Wegner, Wiebke Gessner, Thomas Kohlmann, Claus Dieter Heidecke, Britta Bockholdt, Axel Kramer, Ojan Assadian, Harald Below

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase. Methods We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs. Results The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models. Conclusions The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary.

Original languageEnglish
Pages (from-to)999-1003
Number of pages5
JournalAmerican Journal of Infection Control
Volume44
Issue number9
DOIs
Publication statusPublished - 1 Sep 2016

Fingerprint

Antisepsis
Alcohol Drinking
Ethanol
Hand
Urine
Delivery of Health Care
Alcoholic Beverages
Alcohols
Aldehyde Dehydrogenase
ethyl glucuronide
Inhalation
Pregnant Women
Linear Models
Skin

Cite this

Gessner, Stephan ; Below, Elke ; Diedrich, Stephan ; Wegner, Christian ; Gessner, Wiebke ; Kohlmann, Thomas ; Heidecke, Claus Dieter ; Bockholdt, Britta ; Kramer, Axel ; Assadian, Ojan ; Below, Harald. / Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption. In: American Journal of Infection Control. 2016 ; Vol. 44, No. 9. pp. 999-1003.
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title = "Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption",
abstract = "Background During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase. Methods We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs. Results The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models. Conclusions The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary.",
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author = "Stephan Gessner and Elke Below and Stephan Diedrich and Christian Wegner and Wiebke Gessner and Thomas Kohlmann and Heidecke, {Claus Dieter} and Britta Bockholdt and Axel Kramer and Ojan Assadian and Harald Below",
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Gessner, S, Below, E, Diedrich, S, Wegner, C, Gessner, W, Kohlmann, T, Heidecke, CD, Bockholdt, B, Kramer, A, Assadian, O & Below, H 2016, 'Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption', American Journal of Infection Control, vol. 44, no. 9, pp. 999-1003. https://doi.org/10.1016/j.ajic.2016.02.021

Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption. / Gessner, Stephan; Below, Elke; Diedrich, Stephan; Wegner, Christian; Gessner, Wiebke; Kohlmann, Thomas; Heidecke, Claus Dieter; Bockholdt, Britta; Kramer, Axel; Assadian, Ojan; Below, Harald.

In: American Journal of Infection Control, Vol. 44, No. 9, 01.09.2016, p. 999-1003.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption

AU - Gessner, Stephan

AU - Below, Elke

AU - Diedrich, Stephan

AU - Wegner, Christian

AU - Gessner, Wiebke

AU - Kohlmann, Thomas

AU - Heidecke, Claus Dieter

AU - Bockholdt, Britta

AU - Kramer, Axel

AU - Assadian, Ojan

AU - Below, Harald

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase. Methods We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs. Results The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models. Conclusions The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary.

AB - Background During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase. Methods We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs. Results The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models. Conclusions The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary.

KW - Absorption

KW - Alcohol dehydrogenase

KW - Alcohol-based handrub

KW - Hand hygiene

KW - Pregnant

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U2 - 10.1016/j.ajic.2016.02.021

DO - 10.1016/j.ajic.2016.02.021

M3 - Article

VL - 44

SP - 999

EP - 1003

JO - American Journal of Infection Control

JF - American Journal of Infection Control

SN - 0196-6553

IS - 9

ER -