Institutional Presentation LOOKING FOR CHINA DISTRIBUTORS

2. Why are
Hand Sanitizers
SO
Important ?

8. Toilet Seat
Cafeteria Tray

13. Alcohol gels strip away the skin’s natural oils and severely dry the skin with
repeated use which actually increases the number of bacteria on the skin.
Note: Study conducted by independent researchers from the California College of Podiatric Medicine.

15. Apergillis niger
Brevibacterium
ammoniahenes
Candida albicans
Candida keyfr
Citrus canker disease
Clostridium difficile
Escherichia coli
( E. Coli )
Escherichia coli
pathogenic strain
Enterococcus faecalis
Enterococcus faecium
(VRE)
Klebsiella pneumonia
Listeria monocytogenes
( Listeria )
Microcoocus luteus
Pseudomonas aeruginosa
Proteus mirabilis
Salmonella cholerasuis
(Salmonella)
Salmonella enteritidis
Salmonella typhimurium
Serratia marcescens
Shigella sonnei
Staphylococcus aureus
(MRSA)
Staphylococcus aureus
( NARSA Strain )
Staphylococcus epidermidis
Staphylococcus haemolyticus
Staphylococcus
saprophyticus
Streptococcus pyogenes
Trichophyton mentagrophytes
Trichophyton rubrum
Vibrio cholera
Yersinia enterocolitica
Avian influenza virus
Canine distemper virus
Marek’s disease virus
Newcastle’s disease virus
Pseudorabies virus
Arkansas ’99 ( Infectious
Bronchitis virus )
HIV
Herpes simplex virus Type 1
Herpes simplex virus Type 2
Vaccinia ( Pox virus )
Human coronavirus
(related to SARS)
Hepatitis A and B
Rotavirus
Norwalk virus
Trichophyton
mentagrophytes
( Athletes Foot Fungus )
Dermatophytes
( cause of Ringworm )

16. •Education ( Schools, Daycares, Colleges )
•Food Service
•Corporate Health & Safety
•Banking ( Any employee that comes in contact
with Money or Credit & ATM cards. )
•Government
•Airlines
•Fitness / Spa’s
•EMS
•Corrections
•Retailers ( For use by employees and customers )

18. PRODUCT LISTING
Item #10009
Alcohol Free
Pocket Spray
0.27 ounce (8 mL)
75/case
Item #10005
Alcohol Free
Dispenser Cartridge
33.7 ounce (1 L)
8/case
Item #10002
Alcohol Free
Personal Size
2.5 ounce (75 mL)
12/case
Item #10010
Alcohol Free
Countertop Size
8.5 ounce (250 mL)
12/case
Item #10003
Alcohol Free
Institutional Size
33.7 ounce (1 L)
6/case
Item #10004
Alcohol Free
Refill
1.05 gallon (4 L)
2/case
Item #10080
Wall Dispenser
Manual
holds 33.7 ounces (1 L)
1/case
Item #10085
Wall Dispenser
Touchless
holds 33.7 ounces (1 L)
1/case
4 “AA” batteries required;
good for 15,000 applications.
Item #10090
Metal Wall Bracket
holds 1L institutional bottle
10/case
Mounting hardware included.
1L bottle sold separately.
Item #10070
Refillable Cartridge
Empty
33.7 ounce (1 L)
1/case
Item #10086
Wall Dispenser
Touchless
holds 33.7 ounces (1 L)
1/case (SPECIAL ORDER)
4 “AA” batteries required;
good for 15,000 applications.
Alcohol Free Hand Sanitizers
Dispensers and Wall Brackets

19. X3 labs inc. 35 Raglan Ave. Suite 106, Toronto, ON, M6C 2K7 Canada
Information contained in this literature is believed to be accurate and is offered in good faith for the benefit of the consumer. X3 Labs Inc.
does not assume any liability or risk involved in the use of its products since the conditions of use are beyond our control.
www.x3clean.com
MATERIAL SAFETY DATA SHEET / page 1
X3 Clean Foaming Hand Sanitizer
HAZARD RATING
HAZARD CODE
4- SEVERE
3- SERIOUS
2- MODERATE
1- SLIGHT
0- MINIMAL
FIRE HAZARD ( 0 )
HEALTH HAZARD ( 0 )
REACTIVITY ( 0 )
PERSONAL PROTECTION ( 0 )
SECTION I: PRODUCT IDENTIFICATION
TRADE NAME AND SYNONYMS CHEMICAL FORMULA MATERIAL USE
X3 Clean Foaming Hand Sanitizer Proprietary Liquid hand disinfectant
SECTION II: HAZARDOUS INGREDIENTS OF MATERIAL
HAZARDOUS
INGREDIENTS
APPROXIMATE
CONCENTRATION (%)
CAS. NA
OR UN NUMBERS
LD50 (SPECIFY SPECIES & ROUTE)
The ingredients are not hazardous.
SECTION III: PHYSICAL DATA OF MATERIAL
PHYSICAL STATE pH (as is) ODOUR AND APPEARANCE
Liquid 5.00±1.00 Mild – Colorless
% VOLATILE (BY VOL.) SPECIFIC GRAVITY VAPOUR PRESSURE (MM) VAPOUR DENSITY (AIR-1)
N/AV 1.000±0.050 N/AV N/AV
EVAPORATION RATE BOILING POINT (0C) FREEZING POINT (0C) SOLUBILITY IN WATER (200C)
N/AV N/AV N/AV Complete
N/A = Not Applicable N/AV = Not Available
SECTION IV: FIRE AND EXPLOSION HAZARD
MEANS OF EXTINCTION
Vaporised water, foam of carbon bioxide.
HAZARDOUS COMBUSTION PRODUCTS
•CO, CO2 products of combustion.
SPECIAL PROCEDURES N/A
FLAMMABILITY NO
IF YES UNDER WHAT CONDITIONS? N/A
FLASH POINT (°C) AND METHOD N/A
UPPER EXPLOSION LIMIT (% BY VOLUME) N/A
LOWER EXPLOSION LIMIT (% BY VOLUME) N/A

20. X3 labs inc. 35 Raglan Ave. Suite 106, Toronto, ON, M6C 2K7 Canada
Information contained in this literature is believed to be accurate and is offered in good faith for the benefit of the consumer. X3 Labs Inc.
does not assume any liability or risk involved in the use of its products since the conditions of use are beyond our control.
www.x3clean.com
MATERIAL SAFETY DATA SHEET / page 2
SECTION V: REACTIVITY DATA
CHEMICAL STABILITY YES
IF NO, UNDER WHAT CONDITIONS? N/A
INCOMPATIBILITY TO OTHER SUBSTANCES YES
IF SO, WHICH ONES?
Strong oxydizers, reducing agents, acids and alkalines agents.
REACTIVITY AND UNDER WHAT CONDITIONS?
•When in contact with strong oxydizers, reducing agents,
acids and alkalines agents.
HAZARDOUS DECOMPOSITION PRODUCTS
CO, CO2.
SECTION VI: TOXICOLOGICAL PROPERTIES
ROUTE OF ENTRY
Eye contact
Ingestion
EFFECTS OF ACUTE EXPOSURE TO MATERIAL
EYES: May cause irritation.
INGESTION: May cause irritation, abdominal pain, and diarrhea.
EXPOSURE LIMITS N.AV.
CARCINOGENICITY, REPRODUCTIVE EFFECTS,
TERATOGENICITY, MUTAGENICITY
None
SECTION VII: PREVENTIVE MESURES
PERSONAL PROTECTIVE EQUIPMENT
GLOVES (SPECIFY)
None
EYES (SPECIFY)
None
RESPIRATORY (SPECIFY)
None
OTHER (SPECIFY)
None
ENGINEERING CONTROLS (E.G. VENTILATION, ENCLOSED PROCESS
SPECIFY) N/A
LEAKS AND SPILLS PROCEDURE
Wash away with water.
WASTE DISPOSAL
Neutralize and then dispose according to local laws.
HANDLING PROCEDURES AND EQUIPMENT
N/A
STORAGE REQUIREMENTS
Steel or plastic. Store at 5°C to 30°C. Keep lid closed.
SPECIAL SHIPPING INFORMATION
Shipping temperature has to be between 5°C and 30°C.
SECTION VIII: FIRST AID MEASURES
EYES: Flush eyes with abundant water for 15 minutes. If irritation persists, seek medical attention.
INGESTION: Drink 3-4 glasses of water, do not induce vomiting. Consult physician.
SECTION IX: EMERGENCY NUMBER
PREPARED BY PHONE NUMBER DATE
Technical Department Tel: 877-977-0299 Aug. 15, 2008
SECTION X: W.H.M.I.S. Classe(s): D 2 B
SHIPPING : Not Regulated

21. FAQ’S Version #3: Jan. 23/08
WHY IS IT CALLED X3 CLEAN?
The name originates from the 2 main attributes:
a.) The 3 items NOT in our product - No Alcohol, Fragrance or Dye
b.) You get 3 times ( x ) the number of applications per ounce compared to
alcohol gels similar to Purell.
HOW DO I USE X3 CLEAN HAND SANITIZER?
Apply a thumbnail size amount on palms and rub hands thoroughly until dry. No
water or rinsing is necessary.
HOW CAN I TELL THAT THE X3 CLEAN HAND SANITIZER IS WORKING?
X3 CLEAN HAND SANITIZER works instantly to kill harmful, illness causing
germs as soon as it is applied.
DOES X3 CLEAN HAND SANITIZER CONTAIN ALCOHOL?
No, X3 CLEAN HAND SANITIZER is alcohol free. Unlike other alcohol based
hand sanitizers, X3 CLEAN HAND SANITIZER is not a skin irritant.
WHAT IS THE ACTIVE INGREDIENT IN X3 CLEAN HAND SANITIZER?
X3 CLEAN HAND SANITIZER contains the germ-killing ingredient
Benzalkonium Chloride or BAC. BAC has been widely used for over 40 years by
medical professionals and is approved for safety and effectiveness in many
antiseptic applications including skin treatments. BAC is also used extensively as
a preservative in cosmetics and many over-the-counter products, including
Contact Lens solution.
IS X3 CLEAN HAND SANITIZER FLAMMABLE?
No, X3 CLEAN HAND SANITIZER is not flammable because it contains no
alcohol.
IS X3 CLEAN HAND SANITIZER TOXIC?
No. X3 CLEAN is Non- Toxic
IS X3 CLEAN HAND SANITIZER BIODEGRADABLE?
Yes.
ARE THERE ANY “SIDE EFFECTS” TO USING X3 CLEAN HAND
SANITIZER?
There have been no reported side effects as a result of using X3 CLEAN HAND
SANITIZER. Use X3 CLEAN HAND SANITIZER only as directed.

22. IS X3 CLEAN HAND SANITIZER SAFE FOR CHILDREN?
X3 CLEAN HAND SANITIZER is safe for children 2 and older when used
according to the directions.
UNDER THE DRUG FACTS LISTING ON THE BACK OF THE PACKAGING IT
SAYS “ KEEP OUT OF REACH OF CHILDREN, IF SWALLOWED, GET
MEDICAL HELP OR CONTACT A POISON CONTROL CENTER
IMMEDIATELY “ WHY?
The wording on the Drug Facts panel is a requirement of the FDA for all hand
sanitizers, regardless if they are safe for kids ( non-toxic ) or not.
DOES X3 CLEAN HAND SANITIZER LEAVE A RESIDUE OR FRAGRANCE?
X3 CLEAN HAND SANITIZER leaves no sticky residue or any detectable
fragrance.
IS X3 CLEAN HAND SANITIZER BETTER THAN ANTIBACTERIAL SOAPS?
Laboratory tests show that X3 CLEAN HAND SANITIZER is more effective
against bacteria than other antibacterial active ingredients found in these soaps.
DOES X3 CLEAN HAND SANITIZER HAVE A LONG LASTING EFFECT TO
KILL GERMS?
Once an alcohol-based sanitizer has evaporated, its killing power is gone. X3
CLEAN HAND SANITIZER continues to work, with repeated use, even after it is
absorbed.
HOW DOES X3 CLEAN HAND SANITIZER PROTECT YOU?
Hand hygiene is recognized as the single most important means of preventing
the spread of germs. X3 CLEAN HAND SANITIZER kills 99.99% of the most
common germs that may cause illness. By using X3 CLEAN HAND SANITIZER
as part of a regular hand hygiene regimen, you can prevent illness.
HOW OFTEN CAN I USE X3 CLEAN HAND SANITIZER?
X3 CLEAN HAND SANITIZER can be used as often as you like. Use X3 CLEAN
HAND SANITIZER before eating meals, at work, before and after changing a
baby's diaper, during your daily travels, camping, or anytime soap and water are
unavailable.
WHAT IF A X3 CLEAN HAND SANITIZER IS INGESTED?
If ingested you should contact medical personnel or your local Poison Control
Center immediately.
WILL X3 CLEAN HAND SANITIZER STAIN FLOORS, CARPETS, OR OTHER
SURFACES?
Unlike alcohol-based sanitizers, X3 CLEAN HAND SANITIZER is not corrosive
and will not stain floors, carpets, or other surfaces. It does not stain or damage
clothing.

23. CAN X3 CLEAN HAND SANITIZER FREEZE?
X3 CLEAN HAND SANITIZER freezes below 28ºF; however, the effectiveness is
not diminished after thawing.
CAN X3 CLEAN HAND SANITIZER DAMAGE JEWELRY, LIKE GOLD
RINGS?
X3 CLEAN HAND SANITIZER does not damage jewelry.
THE CDC ( CENTERS FOR DISEASE CONTROL ) ONLY RECOMMEDS
ALCOHOL BASED SANITIZERS, WHY?
The CDC hand hygiene guidelines have not been updated since first being
published in 1996. Alcohol free products have only been on the market for the
last 7 years. Alcohol free products will be included in the next CDC update.
HOW DO I SPEC X3 CLEAN?
For the Best result use:
Alcohol Free, Fragrance Free & Dye Free, Foaming Hand Sanitizer.
2.5 oz / 8.5 oz / 1 L Bottle / 1 L Cartridge / 4 L Refill
HOW MANY APPLICATIONS DO YOU GET FROM A SET OF BATTERIES
FOR THE TOUCHLESS DISPENSER:
15,000 applications

24. EFFICACY SUMMARY
In Vitro Test Results
The following pathogens were killed within 30 seconds after exposure to X3 CLEAN hand sanitizer:
( Community Based MRSA )
Staphylococcus aureus aureus MRSA ( ATCC # 33593 ) 99.9999%
Staphylococcus aureus aureus MRSA ( ATCC # 700698 ) 99.9998%
Staphylococcus aureus NARSA Strain ( NRS123 – USA400 ) 99.9999%
Staphylococcus aureus NARSA Strain ( NRS22 – USA600 ) 99.9996%
Above are all Community Based MRSA
Enterococcus faecalis 99.9999%
Pseudomonas aeruginosa 99.9999%
Serratia marcescens 99.9999%
Staphylococcus aureus aureus 99.9999%
In vitro tests performed by Bioscience Labs Inc. Bozeman, MT
Virucidal Suspension Test Results
The following non-enveloped viruses were killed within 30 seconds after exposure to X3 CLEAN hand
sanitizer
Rotavirus 99.99999 %
Norwalk Virus* 99.99%
( *Surrogate Feline Calicivirus )
Virucidal Suspension Test performed by Microbiotest Labs, Inc. Washington, DC
In Vitro Test Results
The following pathogens were killed within 15 seconds after exposure to a .13% Benzalkonium Chloride
based Foam hand sanitizer:
Candida albicans Candida keyfr
Escherichia coli Enterococcus faecalis
Enterococcus faecium (VRE) Klebsiella pneumonia
Microcoocus luteus Pseudomonas aeruginosa
Proteus mirabilis Salmonella typhimurium
Serratia marcescens Staphylococcus aureus
Staphylococcus aureus (MRSA) Salmonella enteritidis
Staphylococcus epidermidis Staphylococcus haemolyticus
Staphylococcus saprophyticus Streptococcus pyogenes
Herpes simplex virus Type 1 Human Coronavirus (related to SARS)
Trichophyton mentagrophytes Trichophyton rubrum
Apergillis niger Hepatitis A and B
In vitro tests performed by SCI Laboratories, Inc.; revised protocol of CFR 333.470, Woodward
Laboratories, Inc.; revised protocol of CFR 333.470, Viromed Laboratories, Inc.; revised protocol of
ASTM E1052, and ATS Laboratories, Inc.; protocol of WLI01041603.COR

26. Absenteeism & Hand Sanitizers
Abstract Summary
Alcohol-free instant hand sanitizer reduces elementary school
illness absenteeism.
Fam Med. 2000 Oct;32(9):633-8
Dyer DL, Shinder A, Shinder F.
Research Division, Woodward Laboratories, Los Alamitos, Calif., USA.
BACKGROUND AND HYPOTHESES: A substantial percentage of school
absenteeism among children is related to transmissible infection. Rates of
transmission can be reduced by hand washing with soap and water, but such
washing occurs infrequently. This study tested whether an alcohol-free instant
hand sanitizer (CleanHands) could reduce illness absenteeism in school-age
children. METHODS: A 10-week, open-label, crossover study was performed on
420 elementary school-age children (ages 5-12). Students were given a brief
orientation immediately prior to the start of the study on the relationship of germs,
illness, and hand washing. Each student in the treatment group then received the
test product in individual bottles, with instructions to apply one to two sprays to
the hands after coming into the classroom, before eating, and after using the
restroom, in addition to their normal hand washing with soap and water. The
control group was instructed to continue hand washing as normal with non-
medicated soap. After 4 weeks of treatment and a 2-week wash-out period, the
control and experimental groups were reversed. Data gathered on absenteeism
were classified as gastrointestinal or respiratory related and normalized for
nonillness-related absenteeism and school holidays. RESULTS: Compared to
the hand washing-only control group, students using CleanHands were found to
have 41.9% fewer illness-related absence days, representing a 28.9% and a
49.7% drop in gastrointestinal- and respiratory-related illnesses,
respectively. Likewise, absence incidence decreased by 31.7%, consisting of a
44.2% and 50.2% decrease in incidence of gastrointestinal- and respiratory-
related illnesses, respectively. No adverse events were reported during the
study. CONCLUSIONS: Daily use of the instant hand sanitizer was
associated with significantly lower rates of illness-related absenteeism.

27. Reduction of illness absenteeism in elementary schools using
an alcohol-free instant hand sanitizer.
J Sch Nurs. 2001 Oct;17(5):258-65
White CG, Shinder FS, Shinder AL, Dyer DL.
Los Alamitos Unified School District, Los Alamitos, CA, USA.
Hand washing is the most effective way to prevent the spread of communicable
disease. The purpose of this double-blind, placebo-controlled study was to
assess whether an alcohol-free, instant hand sanitizer containing surfactants,
allantoin, and benzalkonium chloride could reduce illness absenteeism in a
population of 769 elementary school children and serve as an effective
alternative when regular soap and water hand washing was not readily available.
Prior to the study, students were educated about proper hand washing
technique, the importance of hand washing to prevent transmission of germs,
and the relationship between germs and illnesses. Children in kindergarten
through the 6th grade (ages 5-12) were assigned to the active or placebo hand-
sanitizer product and instructed to use the product at scheduled times during the
day and as needed after coughing or sneezing. Data on illness absenteeism
were tracked. After 5 weeks, students using the active product were 33% less
likely to have been absent because of illness when compared with the
placebo group.
Effect of hand sanitizer use on elementary school absenteeism.
Am J Infect Control. 2000 Oct;28(5):340-6
Hammond B, Ali Y, Fendler E, Dolan M, Donovan S.
GOJO Industries, Inc, Akron, OH 44309, USA.
BACKGROUND: Several studies have indicated a connection between
handwashing and illness-related absenteeism in school settings. The difficulty of
ensuring consistent and effective handwashing among student populations has
also been noted. The purpose of this study was to assess the effectiveness of
the use of an alcohol gel hand sanitizer in the classroom to help decrease the
illness-related absentee rate for elementary school students. METHODS: This
study involved 5 individual school districts, 16 individual schools, and more than
6000 students in Delaware, Ohio, Tennessee, and California. Individual schools
in each district were paired into product and control groups. In the product group
schools, an alcohol gel hand sanitizer was used by the students and staff when
entering and leaving the classroom. Absenteeism due to infection was recorded,
and the data were statistically analyzed. RESULTS: The overall reduction in
absenteeism due to infection in the schools included in this study was
19.8% for schools that used an alcohol gel hand sanitizer compared with
the control schools (P <.05). Data from the school system with the largest
teacher population (n = 246) showed that teacher absenteeism decreased 10.1%
(trend) in the schools where sanitizer was used. CONCLUSION: Elementary
school absenteeism due to infection is significantly reduced when an alcohol gel
hand sanitizer is used in the classroom as part of a hand hygiene program.

28. A randomized, controlled trial of a multifaceted intervention
including alcohol-based hand sanitizer and hand-hygiene
education to reduce illness transmission in the home.
Pediatrics. 2005 Sep;116(3):587-94
Sandora TJ, Taveras EM, Shih MC, Resnick EA, Lee GM, Ross-Degnan D,
Goldmann DA.
Division of Infectious Diseases, Children's Hospital Boston, Harvard Medical
School, Boston, MA, USA. thomas.sandora@childrens.harvard.edu
OBJECTIVE: Good hand hygiene may reduce the spread of infections in families
with children who are in out-of-home child care. Alcohol-based hand sanitizers
rapidly kill viruses that are commonly associated with respiratory and
gastrointestinal (GI) infections. The objective of this study was to determine
whether a multifactorial campaign centered on increasing alcohol-based hand
sanitizer use and hand-hygiene education reduces illness transmission in the
home. METHODS: A cluster randomized, controlled trial was conducted of
homes of 292 families with children who were enrolled in out-of-home child care
in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5
years of age and in child care for > or =10 hours/week. Intervention families
received a supply of hand sanitizer and biweekly hand-hygiene educational
materials for 5 months; control families received only materials promoting good
nutrition. Primary caregivers were phoned biweekly and reported respiratory and
GI illnesses in family members. Respiratory and GI-illness-transmission rates
(measured as secondary illnesses per susceptible person-month) were
compared between groups, adjusting for demographic variables, hand-hygiene
practices, and previous experience using hand sanitizers. RESULTS: Baseline
demographics were similar in the 2 groups. A total of 1802 respiratory illnesses
occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI
illnesses occurred during the study; 28 (11%) were secondary illnesses. The
secondary GI-illness rate was significantly lower in intervention families
compared with control families (incidence rate ratio [IRR]: 0.41; 95%
confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory
illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-
1.30). However, families with higher sanitizer usage had a marginally lower
secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI:
0.65-1.09). CONCLUSIONS: A multifactorial intervention emphasizing alcohol-
based hand sanitizer use in the home reduced transmission of GI illnesses within
families with children in child care. Hand sanitizers and multifaceted educational
messages may have a role in improving hand-hygiene practices within the home
setting.

29. Evaluating Effects of an Alcohol Hand Sanitizer Program on
Employee Absenteeism:
Pilot Results
James W. Arbogast, Ph.D.*Cristina Ferrazzano Yaussy, MPH*, Todd Cartner*
*Skin Care Science and Technology Research and Development, GOJO
Industries, Inc. Akron, Ohio
Background:
It is well recognized that hands are the primary mode of transmission of many
infectious diseases. Most workplace environments share key predisposing
factors that contribute to infection transmission, such as close working
environments, shared bathrooms, and break rooms for eating or cafeterias.
Absenteeism caused by transmissible diseases is a major contributor to lost
productivity in the workplace and to most companies. The objective of this pilot
study was to examine the effectiveness of an alcohol-based hand sanitizer
program on reducing employee absenteeism due to transmissible infections.
Concurrently, the feasibility of executing a workplace study was also examined.
Design:
34-week prospective intervention study.
Setting/Participants:
FedEx Custom Critical Custom Critical, in Green, OH. The study populations
were created using two different floors in the same building, with approximately
250 employees on each floor. The sample populations were composed of similar
“white-collar” jobs including customer service, sales/marketing, and operation
managers. The employees in each group did not interact with each other on a
regular basis.
Intervention:
Alcohol-based instant hand sanitizer and educational program.
Conclusions:
This study demonstrates that using an alcohol-based instant hand sanitizer in
conjunction with a simple educational program in a workplace setting could
produce a positive effect on absenteeism. The absenteeism rate observed in
the intervention population was 21% lower than the non-intervention
population, indicating this addition to a workplace wellness program could gain
an employer several employee work days per year. Additionally, it appears the
program is most effective during winter months when transmissible diseases are
most prevalent.

30. The effect of a comprehensive handwashing program on
absenteeism in elementary schools.
Am J Infect Control. 2002 Jun;30(4):217-20
Guinan M, McGuckin M, Ali Y.
Agnes Irwin School, Rosemont, PA, USA.
Handwashing is one of the most important factors in controlling the spread of
micro-organisms and in preventing the development of infections. The objective
of this study was to determine the effectiveness of a comprehensive
handwashing program on absenteeism in elementary grades. Two hundred
ninety students from 5 independent schools were enrolled in the study. Each test
classroom had a control classroom, and only the test classroom received the
intervention (education program and hand sanitizer). Absenteeism data were
collected for 3 months. The number of absences was 50.6% lower in the test
group (P <.001). The data strongly suggest that a hand hygiene program that
combines education and use of a hand sanitizer in the classroom can lower
absenteeism and be cost-effective.

31. X3 Partners with Advil ( Canada )

32. Schools shun alcohol-based hand
cleanser
JOSH WINGROVE
From Saturday's Globe and Mail
August 30, 2008 at 7:36 PM EDT
The Winnipeg School Division is sticking to basics with
old-fashioned handwashing, deciding to avoid alcohol-
based hand sanitizer because it is potentially
flammable and toxic, a division nurse says.
The policy, reported this week, means the division's 77
schools will not be provided with, and cannot order,
alcohol-based hand sanitizer. Parents, staff and
students will be allowed to bring their own, but
students will be encouraged to use soap and water.
"We're simply not placing the [alcohol-based] product
in our schools," said school division nurse educator
Kerry Heather, a former pediatric-care and Health
Canada nurse. She was asked to investigate the issue,
and could not find any national recommendations on the
use of alcohol-based hand sanitizer in schools. So,
citing a recommendation by the Canadian Paediatric
Society to emphasize handwashing with soap and water,
the division developed the policy.
The cleansers are typically about 60-per-cent alcohol.
"You don't see that even in a liquor mart," Ms. Heather
said. They can be toxic or flammable. Instead, the
school board will encourage hand washing at schools and
non-alcoholic wipes for field trips.
Edmonton Public Schools is making a similar move in its
schools, said spokeswoman Jane Farrell. "We are moving
to the non-alcohol-based sanitizers."
The Vancouver School Board does not allow alcohol-based
cleansers, either.
In 2006, the pediatric society recommended washing a
child's hands with soap and water as the safest form of
germ and infection control, and that "antimicrobials,"

33. such as alcohol-based hand sanitizer, are "not
necessary."
"Handwashing, using plain soap and water, is still the
most important way to reduce the spread of germs,"
Joanne Embree, a pediatric society infectious-disease
specialist, said in a news release.
The Winnipeg school division's Ms. Heather said that
while alcohol-based cleanser is a good germ killer, it
is an unnecessary risk in schools where sinks and soap
are available.
"In an acute-care hospital, I would never make a
recommendation like this. But a school isn't an acute-
care facility. Even our curriculum speaks to the fact
we should teach our students hygiene, including proper
handwashing."

34. Addicts find a cheap high at shelters
February 14, 2008
ANDREA FREEDMAN
Recently, I found myself in the hospital emergency department for stitches after cutting
my finger in a careless slicing mishap.
Along with many others with far more urgent cases than mine, I waited for hours to be
seen by a doctor.
In order to pass the time while spending my entire evening at the hospital waiting room,
I found myself trying to pick up – all right, eavesdrop – on bits and pieces of
conversation among the medical staff.
I was hoping that I might satisfy my curiosity about one female patient in particular who
had caught my attention, so irate was her behaviour, yelling at the staff and other
patients in the waiting room, pacing back and forth unstably.
Perhaps the woman picked up on my inquisitiveness or perhaps this lonely, pathetic
creature simply needed someone to talk to while she waited for someone to take care of
her. Whatever the reason, she struck up a conversation with me.
Through slurred words, the woman explained to me that she had been in and out of the
hospital six times in the last two-and-a-half months, purely as a result of the effects of
her drinking hand sanitizer.
Sadly, this poor woman was an addict. She informed me that she had been living in
homeless shelters for the past two years and of all the 14 different shelters she has
resided at, hand sanitizer is readily available in all of them. For many, this provides a
proverbial open bar; the substance is free and there for the taking.
Since the SARS outbreak, we have been forced to become an overly cautious society.
But while hand sanitizer may be appropriate in hospitals and other highly populated
places in the city where people face a high exposure to germs, it is not necessarily so in
an atmosphere such as a homeless shelter, which is supposed to be safe and substance-
free, and where many of the inhabitants are addicts, desperate to find a cheap high.
The ethanol and alcohol content in most hand purifiers are of dangerous proportions
when ingested and these poisonous chemicals surge through the human bloodstream at
an alarmingly fast rate. Their use over time can cause, among other things, blindness
and liver damage.
Unfortunately, I am told, the word is spreading among addicts and many of the people

35. who have been left homeless because of their addictions.
As unbelievable as it may seem, for many unfortunate people, hand sanitizer has actually
become the new, fashionable drug of choice.
Toronto's homeless need to get their lives back together and in order to do that, they
need to somehow try to remain clear-headed.
In a world where keeping one's hands clean in the figurative sense is often more
important than doing so in the literal sense, people living in homeless shelters in our city
have a lot more to worry about than sanitizing their hands.
One of the most helpful things the people who run the homeless shelters can do is to rip
every last one of those hand sanitizer dispensers off the walls of all the shelters and give
the people there a fighting chance to avoid a temptation that may have brought them
there in the first place.
In the meantime, soap and water works just fine.
Andrea Freedman is a freelance writer living in Toronto.

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Home --> Medical --> Toxin du jour --> Booze Ooze
Booze Ooze
Claim: Ingestion of hand sanitizer by children can result in alcohol poisoning.
Status: True.
Examples:
[Collected via e-mail, January 2007]
Hi All-
Just wanted to send you a quick email and warn you about using hand sanitizers
wtih your young kids. We have been using that with Sydney in place of hand
washing for convience sake. Today she told me she was going up to her room to
get a toy, while I was downstairs feeding Griffin, and after taking longer then it
should I called for her. When she didn't answer I knew she was up to something
and the bathroom door was closed. She got into the hand sanitizer and had
ingested some of it. There wasn't a large amount missing from the bottle but I
could smell it on her breath.
Within approx. 10 min. she was all glassy eyed and wobbly in her feet. As the
minutes passed, she continued to get worse and got to the point where she
couldn't even stand up or walk, it was awful!!
I called poison control immediately and they told me to take her to the ER right
away due to the alcohol level in hand sanitizers. As we were driving there her
speech became slurred and harder to understand and her eyes looked awful.
They admitted her and did urine and blood tests and it turns out that her blood
alcohol level was .10 — which is legally drunk. It turns out that the hand
sanitizers (Purell) have 62% alcohol in them and the dr. compared it to her
drinking something that is 120 proof.
We had a VERY scary afternoon but thankfully she is ok. We were in the ER until
this evening, after spending the whole afternoon there, so they could monitor her
and make sure her blood sugars were stable. They said that someone her size
would only need to have 3 squirts of it to get to the point of being .10 blood
level.
She has always wanted to lick her hands after we use it and we have warned her
that it is dangerous and something that kids can't do or they will end up in the
hospital. Needless to say, we are going to go back to washing hands with soap
and water because it is way to risky and scary to use this stuff seeing how little
a child needs to be affected by it. We asked about long term affected with the
liver, brain, etc and the dr. said we have nothing to worry about but we need to
get rid of all the hand sanitizer in the house.
Just wanted to let you all know so you can learn from our lesson and not have to
go through something as scary as this...
[Collected via e-mail, May 2007]
Ok. I don't know where to begin because the last 2 days of my life have been
such a blur. Yesterday, My youngest daughter Halle who is 4, was rushed to the
emergancy room by her father for being severely lethargic and incoherent. He
was called to her school by the school secretary for being "very VERY sick." He
told me that when he arrived that Halle was barely sitting in the chair. She
couldn't hold her own head up and when he looked into her eyes, she couldn't
focus them.
He immediately called me after he scooped her up and rushed her to the ER.

37. When we got there, they ran blood test after blood test and did x-rays, every
test imaginable. Her white blood cell count was normal, nothing was out of the
ordinary. The ER doctor told us that he had done everything that he could do so
he was sending her to Saint Francis for further test. Right when we were leaving
in the ambulance, her teacher had come to the ER and after questioning Halle's
classmates, we found out that she had licked hand sanitizer off her hand. Hand
sanitizer, of all things.
But it makes sense. These days they have all kinds of differents scents and when
you have a curious child, they are going to put all kinds of things in their
mouths. When we arrived at Saint Francis, we told the ER doctor there to check
her blood alcohol level, which, yes we did get weird looks from it but they did it.
The results were her blood alcohol level was 85% and this was 6 hours after we
first took her. Theres no telling what it would have been if we would have tested
it at the first ER. Since then, her school and a few surrounding schools have
taken this out of the classrooms of all the lower grade classes but whats to stop
middle and high schoolers too? After doing research off the internet, we have
found out that it only takes 3 squirts of the stuff to be fatal in a toddler. For her
blood alcohol level to be so high was to compare someone her size to drinking
something 120 proof. So please PLEASE don't disregard this because I don't ever
want anyone to go thru what my family and I have gone thru. Today was a little
better but not much. Please send this to everyone you know that has children or
are having children. It doesn't matter what age. I just want people to know the
dangers of this.
Thank you Lacey Butler and family
Origins: The first alert quoted above (which began circulating via e-mail in mid-
January 2007)
was written by Jennifer Moe, the mother of a 2-year-old girl who had
ingested some hand sanitizer. The second example (May 2007) was written
by Lacey Butler, the mother of a 4-year-old girl who had done the same;
although it contains some errors of fact or transcription (e.g., a "blood
alcohol level [measured at] 85%"), it is a true tale in the sense that 4-year-
old Halle Butler, a pre-kindergarten student at Okmulgee Primary School in
Okmulgee, Oklahoma, was treated at an area hospital after eating a small amount of
hand sanitizer squirted into her palm by a teacher.
While the stories as related in the e-mailed accounts fortunately did not result in death
or serious injury, they are cautionary tales worth heeding because they present a
scenario that can all too easily be repeated in other households, schools, or daycare
centers with small children. Hand sanitizer gels and wipes include a surprising amount of
alcohol (e.g., Purell and Germ-X contain 62% Ethyl Alcohol), and a child who swallowed
enough of such products could experience what 2-year-old Sydney and 4-year-old Halle
went through: intoxication, possibly even alcohol poisoning. "Ingesting as little as an
ounce or two of this product could be fatal to a toddler," says Heidi Kuhl, a health
educator at the Central New York Poison Control Center. (Other medical technicians
maintain that a child would have to ingest considerably more sanitizer than is typically
used in a single application in order for alcohol toxicity to be a likely result.)
Bottles of topical anti-bacterials do carry explicit warnings about the danger they pose
(e.g., bottles of Purell hand sanitizer caution: "Keep out of reach of children. If
swallowed, get medical help or contact a Poison Control Center right away.") However,
unlike cleaning supplies and numerous other products commonly used in the home,
hand sanitizer isn't generally thought of as
something that presents a poisoning danger
to children — folks unthinkingly tend to
regard it the way they do hand lotion, as
something that can be safely left on a
counter or nightstand. Yet such products
shouldn't be left within easy reach, not if
one has a small child about. While one
might think the taste of the product (which
in Purell's case is akin to a slightly flowery
version of vodka) would keep children from
swallowing too much of it, kids can and do
get into the darnest things.
More than half the calls received by most
poison centers across the country involve children under the age of six. Usually the
reported poisoning incidents result in mild or no symptoms, but many carry the potential
for severe injury or even death. Parents and caregivers therefore have to be vigilant
about reading product labels to determine what items need to be kept well out of reach
of tiny hands.
Youngsters are especially at risk of ingesting poisons from ordinary household products
due to four factors, notes a 1992 Clinical Pediatrics article:

38. Children are naturally curious about most everything, including the taste, smell,
and texture of products.
Children learn about the world through smelling, touching, and tasting. Brightly
colored liquids, spray containers, pills, and leafy or flowering plants are all
attractive lures to children, who may attempt to learn more about them through
spraying, smelling, or swallowing. The mechanics of spray containers are of
particular interest to many curious children.
Children lack the experience and knowledge to distinguish poisons and other non-
potables from harmless substances. Children can think that fuels, cough syrup, and
shampoo are safe to drink because they resemble beverages such as fruit punch or
soft drinks. Children may also find the appearance, taste, or odor of a dangerous
substance similar to that of a consumable product: medicine tablets look and taste
like candy, anti-freeze tastes sweet, red mouthwash looks like fruit punch, etc.
Children imitate the behavior of adults and frequently mimic what they see their
parents or grandparents do, such as taking medication, drinking colored liquids,
cleaning house, and spraying chemicals.
Although the warning's author argues for the outright ban of hand sanitizer from any
home where small children reside, it needs be kept in mind that a 2005 study of
292 families by Children's Hospital Boston (in which one-half of the subjects got hand
sanitizers, while the other half received literature advising them to wash their hands
frequently) found that those who used hand sanitizer gels experienced a 59% reduction in
gastrointestinal illnesses, and that increased use of sanitizers corresponded with a
decreased spread of contagions (including those resulting in respiratory illnesses).
Barbara "germ warfare" Mikkelson
Last updated: 30 May 2007
The URL for this page is http://www.snopes.com/medical/toxins/sanitizer.asp
Urban Legends Reference Pages © 1995-2007
by Barbara and David P. Mikkelson
This material may not be reproduced without permission.
Sources:
Brayden, R.M. "Behavioral Antecedents of Pediatric Poisonings."
Clinical Pediatrics. January 1993 (pp. 30-35).
Mulkins, Phil. "Do Hand Sanitizers Beat Soap and Water?"
Tulsa World. 2 November 2004 (p. A2).
Nishikawa, Maya. "Hand Sanitizer Hazards."
WCCO-TV [Minneapolis]. 20 January 2007.
Smith, Amber. "Is This Goo for You?"
The [Syracuse] Post-Standard. 12 October 1998 (p. C1).
Verhoeven, Jace. "Hand Sanitizer Makes Girl Drunk."
FOX 23 [Tulsa]. 14 May 2007.
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