As our company is about to start a new contract which involves peripatetic working -ie constantly moving from site to site with no base - normal standards for site-based welfare facilities cannot be adhered to. As part of a number of different precautions, Antibacterial wipes are to be used when running water is not available. Being aware that in hospitals most antibacterial wipes are alcohol based, why does there appear to be a preference for non-alcohol based wipes in the H&S community? Is there a scientific/hygiene reason for so doing?

Alcohol is often rejected for reasons of safety - mainly when there is a risk of accidental or deliberate ingestion, so not common, not used and/or restricted for staff use only and behind a permanently locked door in secure psychiatric units and in prisons. In the former, ever liquid soap and non-alcohol based hand rubs might be ingested so these too are inaccessible to patients except under direct supervision. Alcohol products are withdrawn sometimes because of requests by those with religious objection, but more often by those getting twitchy about possible religious objections. There are some high level religious leaders who have come out to say that it is a) externally applied and b) for healthcare purposes so is perfectly acceptable, but there are many more who maintain their objection. neither alcohol not alcohol-free products are going to work on soiled hands. Use one or several LARGE FRESH tough hand wipe clothes to clean hands and finish off with a proprietary hand rub product. Chose a professional one and not a high street supermarket brand as the product will be far better, often by a factor of 10 or more. Having cleaned hands, use enough hand rub to cover the hands and wrists, forearms if necessary. How much to use? Well, not one cutesy little squirt on dinner plate sized hands of some hoary old construction worker because her hands won't be adequately sanitised by that inadequate dose. The few studies that have been done point to a rule of thumb that you should use enough to fill one cupped hand! Some hand wipe cloths are antibacterial, so there may be no need to use both products. Choose a quality product, make sure that they are in-date, and in stock sizes that do not dry out long before the pack has been consumed. Close the lid after use. Why are you concerned about 'contaminated hands'? What bugs are you trying to eliminate, and why? Are these just dirty hands, in which case the tuff-wipes should surely suffice if soap and water are unavailable. But if contamination and the need to sanitise soiled hands really is an issue, wear suitable gloves. Learn when to put them on and how; learn also when to take them off, how, and how to dispose of them. Then wash hands or use a tuff-wipe of two. Use an additional hand rub type product if you want, but don't get hung up on it. And if you represent a larger company that is under scrutiny from the Environment Agency with regard to waste disposal, take care with empty hand rub containers. They do seem to enjoy making mischief and expect that these are classified as hazardous waste. Concern may be raised due to the alcohol residues they may contain even when 'empty', the siloxane additives of some products, and if they really want to be troublesome - other more earthy adjectives are available - the biocide residues that are present in some formulations, especially those without alcohol.

Do not rely on any "evidence" from the Clinical Services Journal. This widely read commercial publication does NOT publish peer-reviewed scientific or clinical evaluations. It might be of some passing interest but the information in its pages, often quite basic and written at a low level, does not provide evidence for anything. It is not written with and is certainly not published with the same rigour of a scientific journal - though it might sound good! The authors might be experienced in their field, but the publications are never more than a very simplistic overview. Some publications are paid - I've written a few for sister publications - or sponsored by manufacturers. Clinical Services Journal is a trade- or commercial publication in which any article is there solely to give substance to an array of advertisements. If you want evidence, go to an authoritative textbook, medical or scientific journal. It's often a good read, and provides a useful listing of suppliers etc, but do not rely on the Clinical Services Journal any more than you would rely on a newspaper publication.

There are a number of waterless cleansers on the market that are simply wiped off with paper towel so I would choose these rather than skin wipes.. In general I prefer to avoid alcohol based materials simply on the basis of skin drying. Alcohol is a long established conservative skin cleanser in the NHS hence its continued use, I believe. Bob