The Habit of Using Hand Sanitizer among Teenagers and its Effectiveness Compared to

Washing Hands

ABSTRACT

The spread of infectious diseases occurs when disease-causing agents, such as bacteria, viruses, or germs, are transferred and
infected from one individual to another. Adolescents are a phase that is very vulnerable to contracting infectious diseases
because they are in a stage of physical development, emotional changes, and increasing social relationships. One practical
way to prevent infectious diseases is to kill disease-causing agents by washing hands. However, its use is often replaced with
a more practical hand sanitizer. For this reason, this research will discuss the effectiveness of washing hands and using hand
sanitizer. This research is a literature study that uses secondary data from publications published in 2020-2024 and is
relevant to the topic of discussion. Of the 16,800 articles according to keywords, 4 were found that met the criteria for
further discussion. The results of the five journals that were selected according to the criteria showed that 2 journals said that
there was no significant difference between hand sanitizer and hand washing. Meanwhile, 3 other journals stated that hand
washing was more effective than hand sanitizer. This is because there are remaining germs, bacteria, and viruses stuck to the
hands. After all, the hand sanitizer is not able to clean the deepest seams of the skin and long-term use also makes the skin
dry and irritated because the hand sanitizer contains quite a high amount of alcohol. For this reason, teenagers are expected
to prioritize washing their hands with soap and running water rather than using hand sanitizer.

KEYWORDS: Hand sanitizer, Teenagers, Washing hands

INTRODUCTION

Emerging Infectious Diseases (EID) or Infectious Diseases are diseases that have just emerged or that have
previously existed but become more rampant and pose new threats to human health in a relatively short period
(Spencer et al., 2020). Factors that can cause these diseases to emerge or develop include environmental
changes, changes in agricultural practices or drug use, migration of humans and animals, and mutations of
microorganisms.

The spread of infectious diseases occurs when disease-causing agents, such as bacteria, viruses, fungi, or
parasites, are transferred from one individual to another, or from other sources such as animals or the
environment, which then infect newly exposed individuals (Ergashevich, 2023). The spread of disease includes
direct contact, that is, transmission can occur through direct contact with infected individuals, either through
skin-to-skin contact, contact with body fluids such as saliva, blood, or mucus, or through contact with objects
contaminated by the agent. cause of disease. Airborne infectious diseases can also spread through the air when
infected individuals cough, sneeze, or talk, thereby spreading small particles containing disease-causing agents.
These particles can then be inhaled by other individuals, who then become infected. Through food or drink by
disease-causing agents. This can happen if food or drink is not cooked or stored properly, or if eating or
drinking utensils are contaminated and not cleaned properly. Furthermore, through vectors such as mosquitoes,
flies, or fleas. This vector acts as an intermediary between infected individuals and individuals who have not
been infected and spreads disease-causing agents when they bite or spread their feces. And finally through the
environment, such as through water or soil contaminated by infected human or animal feces.

Some infectious diseases that have emerged recently include SARS, MERS, Ebola, Zika, and COVID-19
(Esperanca et al., 2022). These diseases often attract global attention because of their potential to cause
disturbing outbreaks or pandemics. Therefore, monitoring, early detection, and rapid response to emerging
infectious diseases are essential to prevent wider spread and minimize their impact on public health (Destra et
al., 2023). Prevention of infectious diseases involves a series of measures aimed at reducing the risk of disease
transmission from one individual to another. Some ways to prevent this are vaccination, avoiding contact with
sick people, avoiding risky behavior, and practicing PHBS (Clean and Healthy Living Behavior).

One easy way to prevent infectious diseases for teenagers is to wash their hands with soap or use a hand
sanitizer. Washing your hands properly and correctly can be done using soap and running water. Washing your
hands with soap and running water effectively cleans your hands from dirt, germs, and microbes because your
hands often come into direct contact with your mouth, so you must maintain the cleanliness of your hands. This
is the best way to clean your hands, especially if your hands are visibly dirty or have been exposed to substances
that could cause disease. Washing hands using soap can reduce the incidence of diarrhea by 31% and reduce
respiratory tract infections by 21%. Washing hands not only reduces but also prevents the incidence of diarrhea
by up to 50% and upper respiratory tract infections by 45% (Ratmaja et al., 2023). Basic Health Research data
(2018) shows the proportion of correct hand-washing behavior among the population aged 10 years in Indonesia
is 49.8% and data in NTB Province is only 37.5% (Ayatullah, 2023).

Hand sanitizer is used as a practical alternative to washing hands with soap and water when water and soap are
not available, or when washing hands is impractical (Sadino et al., 2022). It is an effective solution for cleaning
hands in public places such as public transportation, workplaces, or public events. Hand sanitizer is an antiseptic
made from 60-80% alcohol, so it can kill gram-positive and negative bacteria, fungi, viruses, and bacteria
(Ratmaja et al., 2023). However, according to (Singh et al., 2020) hand sanitizer is very useful in certain
situations, but cannot replace washing hands with soap and water when possible. Washing hands with soap and
water remains the most effective hand-cleaning method and is recommended by health experts.

There are still pros and cons regarding the effectiveness of hand sanitizer and washing hands with soap among
teenagers. Many people want to practically kill bacteria, germs, and viruses using a hand sanitizer. However, the
effectiveness of using hand sanitizer is still doubted by several studies. To determine the effectiveness of using
hand sanitizer and washing hands among teenagers to reduce the number of Emerging Infectious Diseases (EID)
in Indonesia, this research discusses "The habit of using hand sanitizer among teenagers and its effectiveness
compared to washing hands"

MATERIALS AND METHODS

This research is a literature study that uses secondary data from publications published in 2020-2024 and is
relevant to the topic of discussion. These articles come from a predetermined database, namely Google Scholar.
This research uses the search term "habit of using hand sanitizer among teenagers and its effectiveness
compared to washing hands". In selecting articles, inclusion criteria were determined to filter the results of the
articles found. The inclusion criteria for literature studies are studies that use quantitative and qualitative
studies, studies published in the last 5 year period (2020-2024), articles published in national and international
journals, studies conducted at home and abroad, articles that use Indonesian and English, as well as articles that
can be downloaded in full paper. The next stage, namely assessing the quality of the article, is carried out using
the Critical Appraisal instrument from the Joanna Briggs Institute in research with the Checklist for Qualitative
Research. The article will be declared unfit for synthesis if the assessment results show a value of ≤ 20, and the
article will be declared suitable for synthesis if the assessment results show a value of ˃ 20. The search strategy
for literature results is shown in the following flow diagram. Of the 16,800 articles according to keywords, 5
were found that met the criteria for further discussion.

RESULTS

No Title and Year Writer Research Contents

1 The difference in the Moh.Rivai Nakoe, Hand sanitizer is a gel containing a high percentage of
effectiveness of hand Nur Ayini S lalu, alcohol solution used to kill viruses without water in
 sanitizer by washing hands Yesintha Amelia less than 30 seconds. Washing hands is the process of
using soap as a COVID- Mohamad killing viruses with soap and a little water so it can be
19 preventive measure more effective because it can cover all corners of the
( 2020) hands.

2 Soap versus sanitizer for Tammy Hoffman, The research results show that there is no significant
preventing the Mina Bakhit, difference between the use of sanitizer and soap
transmission of acute Natalia Krzyzaniak, because both can kill bacteria.
respiratory infections in Chris Del Mar,
the community: a Anna Mae Scott,
systematic review with Paul Glasziou
meta-analysis and dose-
response analysis (2021)

3 Perbandingan Efektivitas Melisa Gustina Wash hands utilizing a sterile fluid cleanser is more
Cuci Tangan Dengan Hasibuan viable than washing your hands utilizing hand
Menggunakan Air, Sabun sanitizer in lessening the number of germs. The
Cair Antiseptik dan Hand adequacy of washing hands utilizing hand sanitizer in
Sanitizer (2020) diminishing the number of germs is 60% and 40.3%,
whereas the adequacy of washing hands utilizing
sterile fluid cleanser diminishes the number of germs
by 73% and 42,3%.

4 Comparative Efficacy of Mahesh R Khairnar, The inquiry about comes about appears that there's no
Hand Disinfection Anitha G, Tanushri noteworthy distinction between the utilization of hand
Potential of Hand Sanitizer M Dalvi, sanitizer and fluid cleanser since both can murder
and Liquid Soap among Shrivardhan microscopic organisms.
Dental Students: A Kalghatgi, Uma V
Randomized Controlled Datar, Umesh
Trial(2020) Wadgave, Shrushti
Shah, and Lucky
Preet

5 Studi Literatur Perbedaan Abiyad Wisnu The use of antiseptic soap I n washing hands with
Efektifitas Cuci Tangan Wardana flowing ones is considered more effective in reducing
the number of germs or bacterial colonies on the hands
Dengan Hand Sanitizer and is still the main choice for maintaining hand
Dan Dengan Sabun Cair hygiene by reducing the percentage of germs when
Pada Masa washing hands while washing hands using hand
sanitizer effective in killing germs if the formulation
Pandemi (2021) of ingredients for making hand sanitizer is as
recommended

The results of the four journals that have been selected according to the criteria show that 2 journals say that
there is no significant difference between hand sanitizer and hand washing in killing germs, viruses, and
bacteria. Both are considered equally effective so they can be two choices for teenagers in maintaining hand
hygiene. Meanwhile, 3 other journals stated that washing hands is considered more effective in killing germs,
viruses, and bacteria because it can clean the hands more thoroughly, the ingredients are safer because it does
not use alcohol, and the ingredients used are more natural.
 DISCUSSION

Overall, the research results show that hand sanitizer is no more effective at killing germs, bacteria, or viruses
than washing hands with soap. This is by Hasibuan's (2022) statement which states that hand sanitizer is only
able to inhibit the growth of Staphylococcus aureus with antibacterial activity in the weak to very strong range.
In line with Adriani et al. (2021) who stated that although using hand sanitizer is very easy and practical, it is
not as good as washing hands with water and soap. Apart from that, according to research by Elisanti et al.
(2022) stated that using 70% alcohol cannot eliminate all bacteria on banknotes. According to Lusiana et al.
(2020), continuous use of alcohol as a hand sanitizer is less safe for skin health, because alcohol is flammable
and repeated use causes dryness and irritation of the skin.

The research results show that an effective way to kill germs, bacteria, and viruses in teenagers is to wash their
hands with soap. This is in line with Handayani et al., (2022) who stated that hand washing is one of the most
effective interventions in reducing the incidence of infectious diseases. Utami et al., (2018) too expressed that
washing hands with cleanser has been logically demonstrated to be successful in slaughtering microbes and
avoiding the spread of irresistible infections such as the run, Upper Respiratory Tract Diseases (ARI) and
slaughtering infection germs or microscopic organisms on the hands. Research by Adriani et al., (2021) proves
that proper hand-washing behavior is more effective in removing dirt and dust from the surface of the skin and
can reduce disease-causing microorganisms such as viruses, bacteria, germs, and parasites on the surface of the
skin, nails and fingers. fingers on hand. This is reinforced by Ayatullah's statement (2023) that washing hands
with water and cleanser can more viably evacuate soil and clean mechanically from the surface of the skin and
essentially decrease the number of disease-causing microorganisms such as infections, microbes, and other
parasites on both hands.

CONCLUSIONS

Hand sanitizer is a practical sanitizer that can be carried and used in all conditions to clean the hands of
teenagers. However, its use is no more effective than washing hands with soap. There are still remnants of
germs, bacteria, and viruses that stick to the hands because the hand sanitizer is unable to clean the deepest
seams of the skin. Apart from that, long-term use also makes the skin dry and irritated because hand sanitizer
contains quite a lot of alcohol. For this reason, teenagers are expected to prioritize washing their hands with
soap and running water rather than using hand sanitizer

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