False alarm? No fire found in hubbub on hand rubs

Survey finds no alcohol-fueled fires

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.

Despite an ongoing flap between fire safety and infection control, the likelihood of alcohol hand hygiene products contributing to a fire appears to be exceedingly remote, the authors report.

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.

"We believe that the potential benefits of having these products available in easily accessible areas of health care facilities (e.g., hallways) far outweigh the apparent low (and undocumented) potential fire hazard that may occur with their use," the authors emphasized. Health care workers in some parts of Europe have used alcohol-based hand rubs routinely for decades. Compared with soap and water hand washing, the products require less time to use; can be more accessible than sinks; cause less skin irritation and dryness; are more effective in reducing the bacterial count on hands; and when made widely available within an institution, have been shown to improve hand hygiene practices among workers. In view of these advantages, the Centers for Disease Control and Prevention now recommends the routine use of alcohol-based hand rubs by health care workers, as long as their hands are not visibly soiled. However, the implementation of alcohol-based hand rubs, particularly the placement of the dispensers in hallways, has been impeded in health care facilities in several states because of the concerns of local fire marshals that they may pose a fire hazard.

To obtain data on the frequency of fires related to alcohol-based hand rub dispensers, in March 2003, the authors administered a web-based questionnaire to members of the Society for Healthcare Epidemiology of America, the Association of Professionals in Infection Control and Epidemiology, and the Emerging Infections Network of the Infectious Diseases Society of America. Out of 840 responses representing all 50 states, 798 respondents (95%) reported alcohol-based hand rubs were being used in their facilities. Dispensers were located in patient rooms in 80% of facilities, in treatment rooms in 89% of facilities, and in hallways in 61% of facilities. The authors conceded that the fact that 95% of respondents reported using alcohol-based hand rubs suggests that personnel working in facilities using these products were more likely to complete the questionnaire than those working in institutions where such products had not yet been adopted. "Nonetheless, the data provided by the survey, when combined with decades of experience with alcohol-based hand rubs in Europe, suggest that the incidence of fires associated with the use of these products in health care settings is extremely low," they concluded.