Purell and the Power of Marketing

In 1997, Purell was introduced to the marketplace and has swept the world with its claims of removing "99.9% of bacteria" from surfaces. Even politicians, it seems,are now getting into the act, using a spritz of the goo to clean their hands after shaking the hands of their constituents.

But what are the data here? You know, the REAL data. Is this goo as good as it's advertized? I decided to spend a minute looking for some data and review of what others have found. It's pretty interesting.

Take for instance, that most of the "99.9% bacterial free" studies were done on inanimate surfaces, not human hands. In fact, in one study, the number of bacterial colonies on neonatal nurses' hands after using the stuff was found to be "3.11 x log10" and was no different (statistically) than plain hand washing ("3.21 x log10"). Whoa there. Let's write out the numbers of bacteria on those alcohol gel hands:

31,100,000,000 colonies of bacteria were STILL THERE after the use of alcohol-based goo! Hardly sterile. No wonder I never use this stuff before surgery. But obsessive compulsives can rejoice! No need to rid yourself of your hand-washing compulsion, there's still tons of bacteria left over that NEED your attention!

And even the FDA has questioned the claims of "antibacterial" products as well:

In the documents released yesterday, the FDA said it found no medical studies that showed a link between a specific consumer antibacterial product and a decline in infection rates. Indeed, one major study found little difference between washing with soap and using an antimicrobial product. However, the agency said that the data about links to resistant strains of bacteria are "conflicting and unclear." The worries raised by researchers center largely on triclosan, an ingredient in a number of antibacterial products.

But Purell and its congeners are less irritating to our skin compared to repetitive handwashing, so health care providers might be more apt to use it. Fair enough.

The issues of what we're doing to our immune systems is now coming into question, especially with the high prevalence of asthma in kids these days. We have known about "super bugs" like methicillin-resistant staph. aureus, or c. difficile. One wonders if we're selecting out these critters using antimicrobial products and alcohol-based gels. This piece from Salon.com does a nice job on presenting the drawbacks that might be inherent to using all these products.

Some bacteria are good for us. They are part of what makes us tick. Take, for instance, folks taking the blood thinner, warfarin (Coumadin(R)). Warfarin blocks the production of Vitamin K which is integral to allowing our blood to clot. Vitamin K has several sources: some is produced in the liver, some exists in our diet, and some is produced by bacteria in our gut. Antibiotics administered to people on warfarin can kill many of the gut bacteria that make Vitamin K, causing the person's blood to become "too thin" if the dose of warfarin is not adjusted accordingly. So in this case, bacteria can be helpful to us, provided we do not disturb nature's careful homeostasis.

Maybe these politicians using this stuff should clean up their acts before cleaning their hands. Our health care system would be a great place to start.

-Wes