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Research Article| Volume 102, ISSUE 4, P419-424, August 2019

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Ozonized water as an alternative to alcohol-based hand disinfection

Published:February 04, 2019DOI:https://doi.org/10.1016/j.jhin.2019.01.026

      Summary

      Background

      Hand hygiene plays a vital role in the prevention of transmission of micro-organisms. Ozone (O3) is a highly reactive gas with a broad spectrum of antimicrobial effects on bacteria, viruses, and protozoa. It can easily be produced locally in small generators, and dissolved in tap water, and quickly transmits into ordinary O2 in the surrounding air.

      Aim

      To compare ozonized tap water and alcohol rub in decontamination of bacterially contaminated hands.

      Methods

      A cross-over study among 30 nursing students. Hands were artificially contaminated with Escherichia coli (ATCC 25922), then sanitized with ozonized tap water (0.8 or 4 ppm) or 3 mL standard alcohol-based rub (Antibac 85%). The transient microbes from fingers were cultivated and colony-forming units (cfu)/mL were counted. The test procedure was modified from European Standard EN 1500:2013.

      Findings

      All contaminated hands before disinfection showed cfu >30,000/mL. The mean (SD) bacterial counts in (cfu/mL) on both hands combined were 1017 (1391) after using ozonized water, and 2337 (4664) after alcohol hand disinfection. The median (range) values were 500 (0–6700) and 250 (0–16,000) respectively (non-significant difference). Twenty per cent of participants reported adverse skin effects (burning/dryness) from alcohol disinfection compared with no adverse sensations with ozone.

      Conclusion

      Ozonized tap water is an effective decontaminant of E. coli, and it could be an alternative to traditional alcohol-fluid hand disinfectants both in healthcare institutions and public places. Ozonized water may be especially valuable for individuals with skin problems.

      Keywords

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      References

        • Wensaas K.A.
        • Langeland N.
        • Rortveit G.
        Prevalence of recurring symptoms after infection with Giardia lamblia in a non-endemic area.
        Scand J Prim Health Care. 2009; 27 (12–17)
        • World Health Organization
        WHO global strategy for containment of antimicrobial resistance.
        (Available at:) ([last accessed February 2019])
        • Rubin M.B.
        The history of ozone. The Schönbein period, 1839–1868.
        Bull Hist Chem. 2001; 26: 40-56
        • Schönbein C.F.
        On the odour accompanying electricity and on the probability of its dependence on the presence of a new substance.
        Phil Mag. 1840; 17: 293-294
        • Scott D.B.
        • Lesher E.C.
        Effect of ozone on survival and permeability of Escherichia coli.
        J Bacteriol. 1963; 85: 567-576
        • Azarpazhooh A.
        • Limeback H.
        The application of ozone in dentistry: a systematic review of literature.
        J Dent. 2008; 36: 104-116
        • Bocci V.
        Autohaemotherapy after treatment of blood with ozone.
        J Int Med Res. 1994; 22: 131-144
        • Bocci V.
        A reasonable approach for the treatment of HIV infection in the early phase with ozonetherapy (autohaemotherapy). How ‘inflammatory’ cytokines may have a therapeutic role.
        Mediators Inflamm. 1994; 3: 315-321
        • Solutions Ozone
        Ozone effects on specific bacteria, viruses and molds. 451 Black Forest Rd, Hull, IA 51239.
        Ozone Solutions, USA2014 (Available at:) ([last accessed February 2019])
        • Norwegian Labour Inspection Authority
        The Working Environment Act 704-ENG Regulations concerning action and limit values.
        2016 (Oslo)
        • Aiello A.E.
        • Coulborn R.M.
        • Perez V.
        • Larson E.L.
        Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis.
        Am J Public Health. 2008; 98: 1372-1381
        • Pittet D.
        • Allegranzi B.
        • Boyce J.
        The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations.
        Infect Control Hosp Epidemiol. 2009; 30: 611-622
        • Erasmus V.
        • Daha T.J.
        • Brug H.
        • Richardus J.H.
        • Behrendt M.D.
        • Vos M.C.
        • et al.
        Systematic review of studies on compliance with hand hygiene guidelines in hospital care.
        Infect Control Hosp Epidemiol. 2010; 31: 283-294
        • Fagernes M.
        • Sorknes N.
        Hand hygiene, National recommendations.
        Norwegian Institute of Public Health, Oslo2017
        • Banks M.
        National hand hygiene initiative Australia (HNA).
        3rd ed. 2012 (des. Available at:) ([last accessed February 2019])
        • Hudson J.B.
        • Sharma M.
        • Petric M.
        Inactivation of norovirus by ozone gas in conditions relevant to healthcare.
        J Hosp Infect. 2007; 66: 40-45
        • Martinelli M.
        • Giovannangeli F.
        • Rotunno S.
        • Trombetta C.M.
        • Montomoli E.
        Water and air ozone treatment as an alternative sanitizing technology.
        J Prev Med Hyg. 2017; 58: 48-52
        • Appelgrein C.
        • Hosgood G.
        • Dunn A.L.
        • Schaaf O.
        Ozonated water is inferior to propanol-based hand rubs for disinfecting hands.
        J Hosp Infect. 2016; 92: 340-343
        • Isosu T.
        • Kan K.
        • Hayashi T.
        • Fujii M.
        The effectiveness of ozonated water for hand washing before surgery.
        Masui. 2001; 50: 672-675
        • Liceaga A.
        • Mercado E.
        • Narcaroti M.
        • Liceaga L.
        Hand hygiene skin ATP study: hand washing with tap water and soap vs. ozonated water and soap vs. antiseptic and ozonated water vs. antiseptic and tap water.
        2017 (Unpublished results. Available at:) ([last accessed February 2019])
        • Nakamura K.
        • Saito K.
        • Kashiwazaki J.
        • Aoyagi T.
        • Arai K.
        • Hara Y.
        • et al.
        Evaluation of ozonated water using ASTM E1174 for standardized testing of handwash formulations for healthcare personnel.
        J Hosp Infect. 2018; 100: 211-213
        • National Standard Norway. NS-EN 1500: 2013
        Chemical disinfectants and antiseptics – hygienic handrub – test method and requirements (phase 2/step 2).
        2013 (Oslo; Available at:) ([last accessed February 2019])
        • Førde Municipality
        Information about domestic water supply. Førde.
        2018 (Available at:) ([last accessed February 2019])
        • Westerhoff P.
        • Aiken G.
        • Amy G.
        • Debroux J.
        Relationships between the structure of natural organic matter and its reactivity towards molecular ozone and hydroxyl radicals.
        Water Res. 1999; 33: 2265-2276
        • Fierer N.
        • Hamady M.
        • Lauber L.
        • Knight R.
        The influence of sex, headedness, and washing on the diversity of hand surface bacteria.
        Proc Natl Acad Sci USA. 2008; 46: 17994-17999
        • Kampf G.
        • Marschall S.
        • Eggerstedt S.
        • Ostermeyer C.
        Efficacy of ethanol-based hand foams using clinically relevant amounts: a cross-over controlled study among healthy volunteers.
        BMC Infect Dis. 2010; 10: 78