How have hygiene habits in Romania changed following the pandemic?
Disinfectants are chemical substances designed to inactivate or destroy microorganisms on various surfaces. They act by destroying the cell walls of microbes and viruses or by interfering with their metabolism. In the disinfection process, the spores of bacteria that cause various diseases can be destroyed if the recommended cleaning and disinfection steps are followed: first, contaminated or dirty surfaces are washed with water and detergent, then left to dry and disinfected properly with the right product. A disinfectant solution is a chemical substance used to destroy or inactivate pathogenic microorganisms on surfaces, equipment, or other objects.
Hand and skin disinfectants are available in various forms, such as hand disinfectant gel or hand and skin disinfectant spray.
What are hand disinfectants?
Hand disinfectants are usually available as foam, gel, or liquid. Their use is recommended when soap and water are not available for washing hands, or when repeated handwashing compromises the natural skin barrier (e.g., causing flaking or skin fissures).
Although the effectiveness of hand disinfectant varies, it is used as a simple infection control measure in a wide variety of settings, from kindergartens and schools to hospitals and healthcare clinics, and from supermarkets to public transport. In common areas, a disinfectant gel available in wall-mounted dispensers is most commonly used.
Types of hand disinfectants
Depending on the active ingredient used, hand disinfectants can be classified into two types: alcohol-based or alcohol-free. Alcohol-based products typically contain between 60% and 95% alcohol, usually in the form of ethanol, isopropanol, or n-propanol.
At these concentrations, alcohol immediately denatures proteins, effectively neutralizing certain types of microorganisms. Alcohol-free products are generally based on disinfectants such as benzalkonium chloride or antimicrobial agents such as triclosan.
The activity of disinfectants and antimicrobial agents is both immediate and persistent. Many types of hand disinfectant also contain emollients (e.g., glycerin) to soothe the skin, thickening agents, and fragrance, especially in disinfectant gel products.
How do hand disinfectants work?
Alcohol-based hand disinfectants break down the protein envelope surrounding the cells of bacteria, fungi, and viruses, including coronaviruses. This protein envelope is essential for the survival of germs and for them to be able to multiply and attack the human body.
The recommended percentage of alcohol for acceptable hand disinfectant efficacy is 60% to 95%. The formulation concentration refers to the amount of alcohol present in a gel or disinfectant spray compared to the total amount of product. For example, a specification for a 75% concentrated hand disinfectant means there are 75 milliliters of alcohol in 100 milliliters of liquid. The remaining volume consists of other additives to make the product suitable and safe for use.
Soap and water are the gold standard for effectively removing germs. If soap and water are not available, the use of hand disinfectants is recommended to destroy disease-causing germs. However, any disinfectant solution is only effective when there is no visible dirt on the skin.
It is also important to understand that although hand disinfectants kill germs on the skin, the effect is short-lived. According to guidelines based on research published by the World Health Organization (WHO), germs reappear shortly after the use of hand disinfectants. Thus, the product must be used at regular intervals to prevent an attack by disease-causing germs. (Source)
The effectiveness of hand disinfectants
The effectiveness of a hand disinfectant depends on several factors, including how the product is applied (e.g., amount used, exposure duration, frequency of use) and whether the specific infectious agents present on the person's hands are sensitive to the active ingredient in the product.
In general, an alcohol-based disinfectant spray for hands, if rubbed well into fingers and hands for 30 seconds followed by complete air drying, can effectively reduce populations of bacteria, fungi, and some enveloped viruses.
However, most hand disinfectants are relatively ineffective against bacterial spores, non-enveloped viruses (e.g., norovirus), and encysted parasites (e.g., Giardia). Also, a disinfectant solution does not completely clean or disinfect the skin when hands are visibly dirty before application.
Despite the variability in effectiveness, hand disinfectants can contribute to controlling the transmission of infectious diseases, especially in environments where handwashing compliance is poor. For example, among children in elementary schools, incorporating an alcohol-based or alcohol-free hand disinfectant into classroom hand hygiene programs has been associated with reductions in absenteeism related to infectious diseases.
Also, in the workplace, the use of alcohol-based hand disinfectant has been associated with reduced illness episodes and sick leave days. In hospitals and healthcare clinics, easy access to alcohol-based hand disinfectant has been associated with general improvements in hand hygiene.
How to choose a hand disinfectant?
Hand disinfectants are available in different concentrations and formulations, so it can be difficult to understand which is the right product. The COVID-19 epidemic has made it even more essential to purchase disinfection products with sufficient capacity to protect against germs.
Klintensiv Tip: We recommend only using products approved by the Ministry of Health through the Biocidal Products Commission, as these are the only ones that guarantee effectiveness in eliminating viruses and bacteria.
A research study published in the Emerging Infectious Diseases Journal states that most alcohol-based hand disinfectant brands in supermarkets and retail stores have a concentration of only about 40%. A product with a concentration lower than 60% only slows down germ growth but does not kill them. It is safe to purchase scientifically approved, medical-grade products to ensure better protection and, above all, peace of mind. (Source)
So, how do you choose an effective disinfectant solution?
Pure alcohol-based disinfectants are useful and sufficient for daily use at home or in places requiring minimal contact with crowds, such as a private office. However, if you or your family members travel or commute to work or other places with a high chance of coming into contact with many people, it is better to use a combined formula, such as ethanol and IPA, or ethanol and benzalkonium chloride.
In a mixture with ethanol, these additives help protect against a wider range of germs and are also known to have a longer-lasting effect than alcohol alone. It is important to check the alcohol percentage (by volume) present in a hand disinfectant before buying it. Most products approved to medical standards have the details marked on the packaging. It is always recommended to consult a doctor for advice and approval as an additional safety measure.
How have hygiene habits in Romania changed following the pandemic?
According to statistics, 46% of Romania's population lives in rural areas, where hygiene conditions are poor or completely absent. Beyond the lack of healthy hygiene habits, most localities and villages still lack water and sewage networks.
Another area where Romanians rank among the lowest in Europe is oral hygiene: on average, a Romanian uses one and a half tubes of toothpaste a year. This has led to 72% of Romanians having dental problems. (Source)
The population in cities is not much better compared to the European average, although the consumption of cleaning products among urban dwellers has increased slightly compared to previous years. Or at least that is what a national study carried out between May and June 2020 claims.
People in urban areas are saving and stocking up, with spending on personal care products decreasing for 16.71% of respondents. However, the largest increase in spending can be observed in the case of cleaning and household care products for over a third of the respondents of the same study. (Source)
Trends in hygiene habits
Another increase is seen in hand washing, with Romanians using over twice as much soap and disinfectant as before the pandemic; we practically wash our hands with different types of soap more than 8 times a day. A study conducted by Ipsos shows that during the pandemic, the frequency of using hand sanitizers increased by 110%, and two-thirds of respondents stated that they will continue to use a hand disinfectant gel even after the pandemic. (Source)
Klintensiv Tip: Hand hygiene is essential in preventing and reducing the risk of infection with viruses and bacteria. The Klintensiv product portfolio provides customers with Alchosept hand and skin disinfectants, based on 85% ethanol. These have certified virucidal and bactericidal action and protect the skin without leaving a sticky sensation after application.
Safety-related concerns
Recommendations from specialized agencies such as the World Health Organization and the U.S. Centers for Disease Control and Prevention support the use of alcohol-based hand sanitizers over those that are alcohol-free.
Limiting the use of alcohol-free products was determined, in part, by these organizations' focus on alcohol-based disinfectants and concerns regarding the safety of the chemicals used in alcohol-free products. Studies have highlighted potential adverse effects of certain antimicrobial compounds, such as triclosan, which can affect endocrine system function. (Source)
Disinfectants and antimicrobials can also contribute to the development of antimicrobial resistance. In 2014, growing concerns about triclosan led authorities in the European Union to restrict the use of this chemical in various consumer products in the EU.
In comparison, concerns regarding alcohol-based disinfectants are mainly focused on the risk of flammability and accidental or intentional ingestion. However, with proper storage and the implementation of strategies that limit access to alcohol-based disinfectants, the risk of fire or poisoning is considered to be low.
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