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Fire chiefs back alcohol hand rubs in hospitals
May lead to national code changes
Saying the risk of infection outweighs the risk of fire, a national fire marshals’ association has come out in support of the use of alcohol hand rubs in the health care facilities.
The Centers for Disease Control and Prevention (CDC) now recommends the routine use of alcohol-based hand rubs by health care workers, but the historic transition from soap and water has run afoul of fire codes because the products are flammable.
"We have taken the information given us by the CDC and [looked at] the lack of fire incidents that have been recorded," says Bob Shewbrooks, president of the Hospital Fire Marshals’ Association [HFMA]. "It seems a wise thing to do. The [CDC] didn’t hide the fact the less than 50% of physicians and nurses wash their hands."
The executive committee of HFMA recently voted unanimously to support the installation of alcohol-based hand-washing gels in corridors. HFMA compared the fire risk vs. the risk of infection and concluded the likelihood of a fire was minimal by comparison to the risk of spreading a life-threatening infection.
Indeed, the likelihood of alcohol hand hygiene products contributing to a fire appears to be exceedingly remote, a recent study found.1 Not one of 798 surveyed facilities using the hand hygiene products reported that "a fire attributed to [or involving]" an alcohol-based hand rub dispenser had ever occurred. Although a few facilities had been using alcohol-based hand rubs since the 1980s, 87% of respondents started using them routinely after January 2000.
The initial date of use of alcohol-based hand rubs was available for 766 (96%) of the facilities. These facilities had accrued an estimated combined total of 1,430 hospital-years of use of an alcohol-based hand rub.
In addition, the American Society of Healthcare Engineering reported that dispensers of gels not exceeding 1 liter could be safely installed in corridors as long as they were spaced intermittently and not in carpeted areas. Thus, HFMA recommended that national fire code officials revise the rules to allow installation of the hand hygiene products. The association recommended that facilities using the gels have automatic sprinklers.
"What we are hoping is that the National Fire Protection Association — the one that has the life safety code — will put an exemption in to make this a permissible thing," Shewbrooks tells Hospital Infection Control. "The life safety code itself is probably two years away [from periodic review]. They could always add an interim addendum until the new code comes out. I don’t know, but I feel that may happen because there is so many people in favor of this."
In lieu of that national change, the HFMA action remains a "vote of support" for groups seeking fire code exemptions at the local level, he says. "I just got off the phone with someone with the Philadelphia Fire Department, and what we are going to do [there] is ask for a variance from the city to permit this to be done. Hopefully, we will be successful."
1. Boyce JM, Pearson ML. Low frequency of fires from alcohol-based hand rub dispensers in health care facilities. Infect Control Hosp Epidemiol 2003; 24:618-619.