M391-酒精消毒還是洗手比較好的資料查詢

13 min readMar 10, 2020

之前的疑問，找到英文資料就當作英文閱讀測驗看。資料來源是英文維基百科。

補充:

看到專家專文探討，轉貼給大家分享:

文中的大意看起來像是，雖然75%酒精可以殺死武漢肺炎病毒，但是我們手上碰到的不是單純的武漢肺炎病毒，而是躲在飛沫中的武漢肺炎病毒。因此這種躲在飛沫中的病毒用酒精乾洗手就日本的研究必須花四分鐘才可以殺死，直接用30秒的(濕)洗手洗掉飛沫反而比較有效果。所以建議使用濕洗手而不是只用酒精乾洗手。

抗菌洗手液可以消滅新冠病毒嗎？感染科醫師解析3個洗手的重要知識 #LINETODAY

https://today.line.me/TW/article/6711mv?utm_source=lineshare

疑問:不知道是否洗掉飛沫之後露出不在飛沫中的病毒，再使用酒精乾洗手可以達到預防感染的最佳效果?

還有每接觸一次可能的感染源-病人或是客人就洗30秒的手對手的傷害也不小，不知道是否戴手套加上洗手可以減少對手的傷害?

資料整理:

很多人都聽過酒精消毒，事實上酒精殺菌的濃度不是越高越好，比較有效的的是75%左右，因為如果濃度太高，譬如90%，會使得細菌產生一層保護膜而反而不會被殺死。

另外細菌和病毒也是不同的東西，由以下資料可以看出，大多數的病毒怕90%的酒精，德國研究的以前的冠狀病毒怕 62% ~71% 酒精或是 0.5% 雙氧水(Hydrogen peroxide)或是 0.1% 漂白水(bleach or sodium hypochlorite)，目前的武漢肺炎怕75%的酒精。

酒精為基礎的乾洗手清潔劑(Alcohol-based hand sanitizer)比起用肥皂和水洗手(hand washing with soap and water)在 healthcare setting的大多數情形是比較方便的。[3]他一般能更有效的殺死微生物而且比起肥皂和水有更好的容忍性[5]。但是如果說汙染物可以被看到或是使用完馬桶是仍然要洗手的。

在高油脂的環境或是蛋白質廢棄物(譬如食物處理)，只使用酒精和搓手液可能不夠確保合適的手部衛生。[5]

此外，如果手被液體或是其他可見的汙染物汙染、剛使用完馬桶或是酒精乾洗手後感覺手部不舒服，洗手是比較被青睞的[34]。

酒精搓手液乾洗手可以殺死大多數的細菌、黴菌(真菌)和停止某些病毒。酒精搓手液含有至少70%的酒精(大多數是乙醇)可以在30秒內殺死99.9%的手上細菌，99.99%的則可以在一分鐘內[23]殺死99.999%[note1]的細菌。

酒精搓手液可以殺死各式各樣的細菌，包含抗生素抗藥性細菌還有肺結核分枝桿菌。90%的酒精搓手液是高度可燃性的，但是他可以殺死各式各樣的病毒，譬如有外套模的病毒(enveloped viruses)中的流感病毒(flu virus)，一般感冒病毒(the common cold virus)和愛滋病病毒(HIV)，雖然他對狂犬病病毒( rabies virus)沒有效果。[19][20][21][22]

有些情況使用肥皂和水洗手比乾洗手好，這些情況包含去除Clostridioides difficile的細菌孢子、寄生蟲Cryptosporidium和譬如諾羅病毒(norovirus)一類的病毒(其實由酒精濃度決定，95%濃度的酒精可以殺死大多數的病毒)[33]。

此外，疾病管理局說乾洗手無法對殺蟲劑一類的化學物質有效果[35]。

90%的酒精搓手液比起其他大多數形式的洗手是比較有效果的。[23]異丙醇可以在不到30秒內就殺死99.99%甚至更多的非孢子生成性細菌，不但在實驗室或是人類皮膚上都是如此。

乾洗手液中的酒精可能不到10~15秒內的暴露時間就可以使得蛋白質變性或是溶解細胞(此處指細菌)，而且只需要0.3毫升或是60%的低濃度。[5]

至少有60%的酒精或是含有持續防腐劑的乾洗手清潔劑應該被使用。[17][18]

對於醫院或是診所一類的health care settings，最適合的酒精濃度是70%~95%[25][26]。

酒精乾洗手的方法:

對於health care而言，最佳的消毒需要注意所有暴露的表面，譬如指甲附近、手指附近、大拇指的背面和手腕。手上的酒精必須完全的搓入手掌和前臂的下部，經過至少30秒的期間，並且使它自然風乾[28]。

20200307英文維基百科原文資料如所附:

Health care

Hand alcohol in a hospital

An automated hand sanitizer dispenser

Alcohol-based hand sanitizer is more convenient compared to hand washing with soap and water in most situations in the healthcare setting.[3] It is generally more effective at killing microorganisms and better tolerated than soap and water.[5] Hand washing should still be carried out if contamination can be seen or following the use of the toilet.[6]

Hand sanitizer that contains at least 60 % alcohol or contains a “persistent antiseptic(持續防腐)” should be used.[17][18] Alcohol rubs(酒精搓手液) kill many different kinds of bacteria, including antibiotic resistant bacteria and TB bacteria. 90% alcohol rubs are highly flammable, but kill many kinds of viruses, including enveloped viruses(有外套模的病毒) such as the flu virus, the common cold virus, and HIV, though is notably ineffective against the rabies virus.[19][20][21][22]

至少有60%的酒精或是含有持續防腐劑的乾洗手清潔劑應該被使用。[17][18]

90% alcohol rubs are more effective against viruses than most other forms of hand washing.[23] Isopropyl alcohol will kill 99.99 % or more of all non-spore forming bacteria in less than 30 seconds, both in the laboratory and on human skin.[17][24]

90%的酒精搓手液比起其他大多數形式的洗手是比較有效果的。[23]異丙醇可以在不到30秒內就殺死99.99%甚至更多的非包子生成性細菌，不但在實驗室或是人類皮膚上都是如此。

The alcohol in hand sanitizers may not have the 10–15 seconds exposure time required to denature proteins and lyse cells in too low quantities (0.3 ml) or concentrations (below 60%).[5] In environments with high lipids or protein waste (such as food processing), the use of alcohol hand rubs alone may not be sufficient to ensure proper hand hygiene.[5]

乾洗手液中的酒精可能不到10~15秒內的暴露時間就可以使得蛋白質變性或是溶解細胞(此處指細菌)，而且只需要0.3毫升或是60%的低濃度。[5]

在高油脂的環境或是蛋白質廢棄物(譬如食物處理)，只使用酒精和搓手液可能不夠確保合適的手部衛生。[5]

For health care settings like hospitals and clinics, optimum alcohol concentration to kill bacteria is 70% to 95%.[25][26] Products with alcohol concentrations as low as 40% are available in American stores, according to researchers at East Tennessee State University.[27]

對於醫院或是診所一類的health care settings，最適合的酒精濃度是70%~95%[25][26]。

Alcohol rub sanitizers kill most bacteria, and fungi, and stop some viruses. Alcohol rub sanitizers containing at least 70% alcohol (mainly ethyl alcohol) kill 99.9% of the bacteria on hands 30 seconds after application and 99.99% to 99.999%[note 1] in one minute.[23]

For health care, optimal disinfection requires attention to all exposed surfaces such as around the fingernails, between the fingers, on the back of the thumb, and around the wrist. Hand alcohol should be thoroughly rubbed into the hands and on the lower forearm for a duration of at least 30 seconds and then allowed to air dry.[28]

Use of alcohol-based hand gels dries skin less, leaving more moisture in the epidermis, than hand washing with antiseptic/antimicrobial soap and water.[29][30][31][32]

Drawbacks

There are certain situations during which hand washing with water and soap are preferred over hand sanitizer, these include: eliminating bacterial spores of Clostridioides difficile, parasites such as Cryptosporidium, and certain viruses like norovirus depending on the concentration of alcohol in the sanitizer (95% alcohol was seen to be most effective in eliminating most viruses).[33] In addition, if hands are contaminated with fluids or other visible contaminates, hand washing is preferred as well as after using the toilet and if discomfort develops from the residue of alcohol sanitizer use.[34] Furthermore, CDC states hand sanitizers are not effective in removing chemicals such as pesticides.[35]

缺點

此外，如果手被液體或是其他可見的汙染物汙染、剛使用完馬桶或是酒精乾洗手後感覺手部不舒服，洗手是比較被青睞的[34]。

此外，疾病管理局說乾洗手無法對殺蟲劑一類的化學物質有效果[35]。

基本知識:病毒和細菌不同

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