We assessed cutaneous ethanol (ETOH) and isopropanol (ISOP) absorption after intensive (30 times per h) use of alcohol-based hand-rub solutions by healthcare workers (HCWs). ETOH was detectable in the breath of 6/20 HCWs (0.001 to 0.0025%) at 1 to 2 min postexposure and in the serum of 2/20 HCWs at 5 to 7 min postexposure. Serum ISOP levels were unrecordable at all time points.Although hand hygiene culture-change programs using alcohol-based hand-rub solutions (ABHRS) have been associated with a reductions in nosocomial infections, some health care workers (HCWs) remain concerned about potential cutaneous absorption of alcohol from ABHRS (1,4,10,11,13 Consenting HCW volunteers completed a questionnaire recording their age, height, weight, gender, ethnicity, alcohol consumption during the 24 h prior to the study, and prescribed medication usage. Participants' heights and weights were used to calculate their body mass indexes (BMI). HCWs were excluded if they had a evidence of chronic dermatitis (e.g., eczema) or broken/damaged skin or a history of allergy to ABHRS or were currently pregnant.We assessed two commonly used ABHRS that contained 0.5% chlorhexidine gluconate, a skin emollient and either 70% ETOH (Avagard; 3M Healthcare, Pymble, Australia) or 70% ISOP (DeBug; Orion Laboratories Pty Ltd., Balcatta, Australia) (4, 13). To mimic intensive clinical conditions, HCWs used ABHRS 30 times during a 1-h period on two separate days, with a 1 day "washout" period between (day 1, Avagard use; day 2, washout; day 3, DeBug use). Supervisors coordinated, timed, and advised all participants when to reapply ABHRS and ensured compliance with the correct application (one squirt [1.2 to 1.5 ml] every 2 min) of ABHRS (13). Study room conditions were as follows: room temperature, 24 to 26°C; humidity, 39 to 42%; study room volume, 124 cubic meters.Breath and serum alcohol levels were assessed as follows. Preexposure (baseline), breath and serum alcohol levels were assessed. Postexposure (time after last application of ABHRS), at 1 to 2 min, breath levels only were tested; at 5 to 7 min, serum levels only were tested; and 10 to 13 min, breath levels only were tested. Breath alcohol levels were assessed by police from the Traffic Alcohol Section, Victoria Police, using a Drager Alcotest 7110 breathalyzer (lower limit of detection, 0.001%), as is used by Victoria Police for all evidential breath alcohol analysis, following preliminary roadside breath testing using a hand-held screening device. Results from this breathalyzer are sufficiently accurate to be legally admissible in court and obviate the need for serum ETOH assessment. The breathalyzer detects ETOH but not ISOP. All breathalyzer analyses were undertaken in a room distant from where ABHRS was in use to avoid potential vapor contamination of breath alcohol tests.Serum ETOH and ISOP levels were assessed by gas chromatography (lower limit of quantitation, 0.002 g/100 ml [%]; lower limit of detection: 0.0001 g/100 ml [%] for both alcohols) at the Victorian Institute of For...