Irritancy of the skin disinfectant n-propanol

Hand disinfection with short-chain aliphatic alcohols, so-called "rub-ins" is the method of choice for cross-infection prevention in health care envir onments, but their irritant potential is not well known. Skin tolerance is a major compliance factor, and a high proportion of health care workers suf fer from low-grade irritant contact dermatitis. Therefore, assessment of th e irritancy of the skin disinfectant n-propanol 60%, and comparative 100% a nd 0% solutions, was performed in the setting of experimental low-grade ICD . ICD was induced by overnight patch exposure to H2O, and to 0.3% sodium do decyl sulfate (SDS), in 12 probands, followed by repeated open exposure to the test substances. Outcome variables were transepidermal water loss (TEWL ), and skin surface capacitance. On skin sites pre-irritated by SDS, all n- propanol concentrations (100%, 60%, 0%) increased TEWL. However, a clear di vergence appeared between pure n-propanol, and the lower concentrations. In contrast to pure n-propanol, n-propanol 60% and 0% had no significant effe ct on TEWL on H2O-pre-irritated skin sites. Capacitance of pre-irritated sk in sites was increased by exposure to H2O-containing n-propanol solutions ( 60% and 0%). These results show a clear difference between the irritant pot ential of n-propanol 100% on one side, and n-propanol 60% and 0% on the oth er side. The level of pre-existent skin irritation is a pertinent factor in susceptibility to irritation, as the irritant potential of n-propanol 60%, the concentration used in daily practice, and n-propanol 0% (water) became significant only on detergent-irritated skin. Thus, preventive skin care m ay be a constructive approach in increasing tolerance of modern hand disinf ection practices. (C) Munksgaard, 2001.