---
title: How big are your hands?
description: How big are your hands?
---

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## How big are your hands?

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568ac85fd63b5f2928762b/1498845350187//img.jpg.com/static/595689fc9de4bbc892200518/t/59568ac85fd63b5f2928762c/1498843848721/1000w/>

Having just returned from the National IPAC-Canada  
 Conference and seeing the excitement that Prof. Didier Pittet can bring during  
 his talk and book signings (as seen in the picture with my colleague Olivia  
 Lattimore being more than just a little star struck), coming across an article  
 that talks about hand size versus the amount of alcohol-based hand rub (ABHR)  
 that needs to be used seemed like fate.

I’m not that big – 5 feet 5 inches if I stand with my very  
 best posture and as one would assume, with a shorter frame I have fairly small  
 hands (at least I think a ring size of 4.5 is pretty small).  I’ve generally had more problems finding  
 gloves that fit than ever thinking about whether the amount of hand sanitizer I  
 use or is automatically dispensed is sufficient.  It’s funny, we know when a glove is too big  
 or too small and the problems that can occur with that, yet with hand  
 sanitizers we all think one size fits all.

The article published in [2015  
 by Bellissimo-Rodrgues et al](https://aricjournal.biomedcentral.com/articles/10.1186/2047-2994-4-S1-P302) concludes that healthcare professionals need  
 to consider the size of their hands when it comes to using ABHR products to  
 ensure that adequate coverage, and therefore efficacy of the product, can be  
 met. Their study investigated whether the volume of ABHR used by healthcare  
 workers affects the residual bacterial concentration on their hands according  
 to hand size, and found that bacterial reduction was significantly lower for  
 large hands compared with small hands. This highlights the need for customizing  
 the volume of alcohol-based hand rub for the most effective hand hygiene.

As the researchers acknowledged, *"Over the past 20 years, ABHRs have become the preferential tool  
 for hand hygiene in healthcare settings because of their high antimicrobial  
 efficacy, tolerability, and accessibility. There is common sense and  
 microbiologic evidence that the volume of ABHR used should be large enough to  
 cover the whole surface area of both hands, but there is no consensus on how  
 much is the minimum necessary, and whether healthcare worker hand size  
 influences it." *

*  
*

For the study prior to each contamination procedure,  
 participants washed their hands with 5mL of plain soap for 1 minute. Hands were  
 then contaminated artificially by inserting them into the bacterial suspension  
 5 seconds, and held up to dry for 3 minutes. After the first contamination  
 procedure, baseline bacterial recovery was obtained using the fingertip method.  
 As a next step, participants washed their hands, re-contaminated them in the  
 same way as before, and undertook a hand friction action with no ABHR and a  
 second baseline recovery of bacteria was performed. Next the study participants applied the ABHR varying every 0.5  
 mL from 0.5 to 3 mL.  The participants with  
 large hands were investigated further with the application of 4, 5, and 6 mL of  
 ABHR. The bacterial recovery step was  
 repeated with each application. 

The researchers found that overall there were no differences  
 between the hand size categories and the average level of contamination of  
 hands at baseline. As the volume of ABHR was increased, there was an associated  
 decrease in the mean bacterial count and they also found that bacterial  
 reduction was inversely and significantly associated with hand surface area. 

The study without a doubt demonstrates a strong relationship  
 between the reduction of bacterial count on hands and the amount of ABHR used  
 for hand hygiene.  The researchers  
 concluded that it is a matter of concern that HCWs with large hands could not  
 achieve a minimum of 2 log reduction of bacteria on their hands by the  
 application of 3 mL of ABHR, the volume recommended by most manufacturers. That  
 concern gets greater when we realize that the mean application volume of ABHR  
 in clinical practice may be lower than 1 mL.

So?  How big are your  
 hands?  If you have large hands, the next  
 time you use hand sanitizer you may want to consider using 2 pumps!

*Bugging Off!*

Nicole

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