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1.1 This test method is designed to determine the activity of healthcare personnel hand rubs, (also known as hand rubs, hygienic hand rubs, hand sanitizers, or hand antiseptics) against transient microbial skin flora on the hands after a single application and after repeated applications.

1.2 Performance of this procedure requires the knowledge of regulations pertaining to the protection of human subjects (see 21 CFR Parts 50 and 56).

1.3 This test method should be performed by persons with training in microbiology, in facilities designed and equipped for work with potentially infectious agents at biosafety level 2.2^,3

1.4 Units—The values stated in SI units are to be regarded as standard. No other units of measurement are included in this standard.

1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use. For more specific precautionary statements, see 8.2.

1.6 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

5.1 Hand hygiene is considered one of the most important measures for preventing the spread of infectious microorganisms. Hand rubs reduce the microbial load on the hands without the use of soap and water, and are thus an important tool in the practice of good hand hygiene. Alcohol-based hand rubs are recommended in healthcare settings for use on hands that are not visibly soiled. They are formulated to be applied full strength to dry hands, “rubbed in” until dry, and are not rinsed off.

5.2 This test method is designed specifically to evaluate hand rubs for efficacy in eliminating bacteria from experimentally-contaminated hands. It is designed as an alternative to Test Method E1174, which was intended primarily to evaluate antimicrobial handwashing agents that are lathered with the aid of water and then rinsed off. When using Test Method E1174 to evaluate hand rubs, inadequate drying of the hands after contamination dilutes the test material and can compromise activity, to result in an underestimation of effectiveness. Additionally, because hand rubs are not rinsed after product use, activity can be further degraded by build-up of soil from the contaminating broth and inactivated challenge bacteria on the hands.

5.3 A reference control is evaluated for each subject prior to evaluation of the test material. Data from the reference control helps to control for inter-subject variability, inter-experimental variability, and inter-laboratory variability; and enables improved statistical comparison of test materials evaluated in the same experiment.

5.4 This test method can be used to test any form of hand rubs, including gels, rinses, sprays, foams, and wipes when used according to label directions at typical “in-use” doses.

5.5 Susceptibility to biocides can vary among different species of bacteria and major differences have been noted between gram-negative and gram-positive organisms. This test method provides the option to use either a gram-negative bacterium (Serratia marcescens) or a gram-positive bacterium (Staphylococcus aureus) as the test organism. S. marcescens is used as a test organism in both Test Method E1174 and Test Method E2276. S. aureus is a highly relevant pathogen in healthcare, institutional, and community settings. Moreover, hands are an important vehicle in the transfer of S. aureus between people and the environment, and in the transfer between individuals.

5.6 This test method may be used as an alternative to Test Method E2276, which limits the test bacteria to the fingerpads and does not incorporate actual use conditions such as friction during hand rubbing.

5.7 The investigator should be aware of potential health risks associated with the use of these organisms and precautions similar to those referenced in Section 8 should be taken.