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Hand Sanitizer Use Can Affect Alcohol Breath Analyzer Tests in Emergency Departments

NEW HAVEN, CT – Are your emergency department’s hand hygiene protocols affecting the outcomes of point-of-care alcohol breath analysis?

A new study published in the American Journal of Infection Control suggests they might be.

The study, led by researchers at the Yale School of Medicine, sought to investigate the effects of alcohol-based hand hygiene solution (ABHS) use by care providers on point-of-care alcohol breath analyzer interpretation under different clinically relevant conditions.

Previous studies have explored the possible connection between ABHS and false alcohol readings, but this investigation expanded the research by testing different types of sanitizer application and using timing as a crucial experimental variable.

Foam vehicles with immediate testing, gel vehicles with immediate testing, allowing hands to dry after the use of ABHS, and donning gloves after the use of ABHS all were tested and had the same result: Alcohol was detected in breath at one minute after use of ABHS even if the study subject had not been drinking.

That led the study team to conclude, “The use of hand sanitizer by staff may result in errant alcohol detection.”

The investigation found that the effects occurred despite allowing time for hands to dry or donning gloves. “Because the use of ABHS by individuals administering breath alcohol detection may result in false-positive detection of alcohol, staff using these devices should consider traditional hand hygiene with soap and water,” the researchers conclude.

While the study provided additional information, it wasn’t the first to warn of those consequences of ABHS use. A 2013 article in Academic Emergency Medicine also reported concerns about a link between hand sanitizers and inaccurate breath alcohol tests in participants who had not ingested alcohol.

That study involved three broader situations: hand sanitizer applied according to manufacturer's recommendations; hand sanitizer applied improperly at standard doses; or hand sanitizer applied improperly at high doses.

“The use of common alcohol-based hand sanitizer may cause false-positive readings with a standard hospital Breathalyzer when the operator uses the hand sanitizer correctly,” the UCLA researchers wrote in the earlier report. “The Breathalyzer readings are further elevated if more sanitizer is used or if it is not allowed to dry appropriately.”