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Technical Guide Technical Information and Efficacy Data TABLE OF CONTENTS Hand Hygiene PURELL® Instant Hand Sanitizer PURELL Instant Hand Sanitizer with Aloe PURELL Instant Hand Sanitizer Lasting Care Formula PURELL Instant Hand Sanitizer with DERMAGLYCERIN SYSTEM™ PURELL Foaming Hand Sanitizer PURELL Instant Hand Sanitizer Food Code Compliant PROVON® Antimicrobial Skin Cleanser with 2% CHG PROVON Medicated Lotion Soap with Chloroxylenol PROVON Medicated Lotion Soap with Triclosan PROVON Antimicrobial Lotion Soap with 0.3% Chloroxylenol PROVON Gentle Lotion Soap PROVON Mild Lotion Soap PROVON Enriched Lotion Cleanser PROVON Foaming Handwash with Moisturizers PROVON Foaming Antimicrobial Handwash with Moisturizers and 0.3% Chloroxylenol PROVON Foaming Medicated Handwash with Moisturizers and 0.5% Triclosan 1 2 4 5 7 8 9 13 14 15 16 16 17 17 18 19 Bathing & Moisturizing PROVON PROVON PROVON PROVON PROVON PROVON PROVON PROVON Antibacterial Body Wash Moisturizing Bathing Cloths Conditioning Shampoo & Body Wash Tearless Shampoo & Body Wash Enriched Shampoo for Body & Hair Foaming Hair & Body Wash with Moisturizers Moisturizing Hand & Body Lotion Skin Moisturizer with Aloe & Vitamins 22 23 24 24 25 25 26 27 Perineal Skin Care PROVON PROVON PROVON PROVON PROVON PROVON Perineal Wash Antibacterial Perineal Wash Personal Wash Cloths Moisturizing Perineal Skin Protectant with Petrolatum Perineal Cream Perineal Ointment with Petrolatum 27 28 29 29 30 30 Glossary of Terms Glossary of Terms Inside Back Cover Hand Hygiene PURELL® Instant Hand Sanitizer Efficacy Data — In Vitro Dermatologist-tested, dye-free. Latex compatible. CHG compatible. Objective: These tests were designated to evaluate the antimicrobial effectiveness of product formulations when challenged with a broad spectrum of microorganisms. Description of Test: Fifteen (15) second exposure kill studies were performed utilizing thirtyfour (34) challenge microorganisms. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds). Standard plate counting techniques were used to enumerate viable challenge micro-organisms. Independent Laboratories: BioScience Laboratories, Bozeman, Montana; November 3, 1999; March 9, 1998. February 9, 2001. Stock No. 9651, 9652, 9654, 9656, 9657, 9659, 9661, 7187, 2256, 2156, 9605, 9606, 3020, 9584, 3005, 9650 Physical Characteristics Color: Clear Fragrance: Citrus Viscosity: 6,000-25,000 cps (gel) pH: 4.5-9.5 Irritancy Data and Allergy Test Results Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay. Method: The method is that summarized by Phillips et al. (Toxic and Applied Pharmacology 21:369-382, 1972). The fresh materials are applied five (5) days weekly for twenty-one (21) days to the same site. Patches are not reapplied on weekends (or holidays); they remain in place for these periods. There are fifteen (15) days of reading, even when holidays intervene. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: February 27, 1998 Results: Average score 0.05 (scale 0-4). Lower scores indicate lower potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Percent Reduction of Test Organisms After a 15-Second Exposure Human Repeated Insult Patch Test Objective: Determination of the dermal irritation and sensitization potential of the product. Description of Test: Human repeated patch test. Method: This study was conducted utilizing a standard protocol and a total of two hundred and fifteen (215) subjects. Prior to patch application, the test area was wiped with seventy percent (70%) ethanol and allowed to dry. The test material was applied under a semi-occlusive patch (Readi-Bandage®) to the upper back (between the scapulae) and allowed to remain in direct skin contact for twenty-four (24) hours. Patches were applied to the same site on Monday, Wednesday and Friday for a three (3)-week induction period. The sites were graded for dermal irritation and sensitization twenty-four (24) hours after removal of the patches on Tuesday and Thursday, and forty-eight (48) hours after patch removal on Saturday. Standard Dermal Scores (0-4+) were used to record dermal reactions. After two (2) weeks, the subjects were rechallenged and evaluated forty-eight (48) and seventy-two (72) hours after patch removal. Independent Laboratory: Clinical Research Laboratories, Inc., Piscataway, New Jersey. Date: April 30, 2002 Results: No dermal reactions were observed during the induction or challenge phases of the study. Conclusion: Test product did not demonstrate potential for eliciting a dermal irritation or sensitization. Microorganism ATCC No. % Reduction Acinetobacter baumannii Bacillus megaterium Citrobacter freundii Clostridium difficile Corynebacterium diphtheriae Enterobacter aerogenes Enterococcus faecalis Vancomycin resistant Enterococcus faecium Vancomycin resistant Escherichia coli Escherichia coli (O157; H7) Klebsiella ozaenae Klebsiella pneumoniae Lactobacillus plantarum Listeria monocytogenes Proteus mirabilis Proteus vulgaris Pseudomonas aeruginosa Salmonella enteritidis Salmonella typhimurium Serratia marcescens Shigella dysenteriae Shigella sonnei Staphylococcus aureus Methicillin resistant Staphylococcus aureus Vancomycin intermediate Methicillin resistant Staphylococcus epidermidis Streptococcus pneumoniae Streptococcus pyogenes 19606 14581 8090 9689 >99.999 >99.998 >99.999 99.998 11913 13048 >99.999 >99.999 51575 >99.999 51559 11229 >99.999 >99.999 35150 11296 13883 14917 15313 7002 13315 15442 13076 14028 14756 13313 11060 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 33591 >99.999 Clinical Isolate >99.999 12228 >99.999 33400 19615 99.994 >99.999 9643 9642 14053 13803 52063 9849 9533 >99.999 >99.998 >99.999 >99.999 >99.988 >99.999 >99.999 Yeasts and Fungi Aspergillus flavus Aspergillus niger Candida albicans Candida tropicalis Epidermophyton floccosum Penicillium citrinum Trichophyton metagropytes Conclusion: Very effective reduction of Gram-negative and Gram-positive bacteria, yeasts, and fungi was demonstrated. 1 PURELL® Instant Hand Sanitizer (continued) PURELL® Instant Hand Sanitizer with Aloe Efficacy Data — In Vitro Virus Test Description of Test: A suspension of challenge virus was exposed to product. An aliquot was removed and neutralized at the 30second exposure by serial dilution and then assayed for the presence of viable virus. The following controls were assayed in parallel: positive virus, cytotoxicity, and neutralization. Independent Test Laboratory: ViroMed Laboratories, Inc., Minneapolis, Minnesota; April 29, 1998; September 23, 1998, November 4, 1998. Dermatologist-tested. Latex compatible. CHG compatible. Percent Reduction of Test Organisms After a 30-Second Exposure Irritancy Data and Allergy Test Results Microorganism Adenovirus type 2 Coxsackievirus B3 Hepatitis A Virus Herpes Simplex Virus Type 1 HIV type 1 Influenza Virus Type A2 Parainfluenza Virus Type 2 Parainfluenza Virus Type 3 Rhinovirus Type 14 Rhinovirus Type 16 Rhinovirus Type 37 ** Variant 18F ATCC No. VR-846 VR-30 VR-1073** Stock No. 9637, 9631, 9639, 2237, 2137, 9682, 9641 Physical Characteristics Color: Clear, Green Fragrance: Pleasant Floral Viscosity: 6,000-25,000 cps (gel) pH: 4.5-9.5 Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Cumulative Irritancy. Method: The method is that summarized by Phillips et al. (Toxic and Applied Pharmacology 21:369-382, 1972). The fresh materials are applied five (5) days weekly for twenty-one (21) days to the same site. Patches are not reapplied on weekends (or holidays); they remain in place for these periods. There are fifteen (15) days of reading, even when holidays intervene. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: July 5, 2002 Results: Average scores 0.06 (Scale 0-4) Conclusion: Product has a very low potential for eliciting skin irritation and allergic contact dermatitis. % Reduction 95.195 99.822 94.377 VR-733 HTLV-IIIB ≥99.999 ≥99.993 VR-544 ≥99.999 VR-92 ≥99.996 VR-93 VR-284 VR-1126 VR-1147 ≥99.993 99.438 ≥99.994 99.822 Human Repeated Insult Patch Test Ingredients Active Ingredient Ethyl Alcohol 62% Also Contains: Water Carbomer Tocopheryl Acetate (Vitamin E) Glycerin Propylene Glycol Isopropyl Myristate Aminomethyl Propanol Fragrance Objective: Evaluation of skin irritation and sensitization potential in humans. Description of Test: Human repeated insult patch test. Method: This study was conducted utilizing a standard protocol and a total of one hundred and four (104) subjects. Prior to patch application, the test area was wiped with seventy percent (70%) ethanol and allowed to dry. The test material was applied under a semi-occlusive patch (Readi-Bandage®) to the upper back (between the scapulae) and allowed to remain in direct skin contact for twenty-four (24) hours. Patches were applied to the same site on Monday, Wednesday and Friday for a three (3)-week induction period. The sites were graded for dermal irritation and sensitization twenty-four (24) hours after removal of the patches on Tuesday and Thursday, and forty-eight (48) hours after patch removal on Saturday. Standard Dermal Scores (0-4+) were use to record dermal reactions. After two (2) weeks, the subjects were rechallenged and evaluated forty-eight (48) and seventy-two (72) hours after patch removal. Independent Laboratory: Clinical Research Laboratories, Inc., Piscataway, New Jersey. Date: September 10, 1997 Results: No observed dermal reactions. Conclusion: No demonstrated potential for eliciting dermal irritation or sensitization. Ingredient Class Antimicrobial Agent Diluent Thickener Skin Conditioning Agent Skin Conditioning Agent, Humectant Skin Conditioning Agent, Humectant Emollient pH Adjuster Fragrance 2 PURELL® Instant Hand Sanitizer with Aloe (continued) Efficacy Data — In Vitro Ingredients Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15) second exposure kill studies were performed utilizing twelve (12) challenge bacteria. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Lab: BioScience Laboratories, Inc., Bozeman, Montana Independent Test Labortory, Minneapolis, Minn. Date: September 8, 1997 Active Ingredient Ethyl Alcohol 62% Also Contains: Water Glycerin Carbomer Fragrance Aloe Barbadensis Leaf Juice Aminomethyl Propanol Propylene Glycol Isopropyl Myristate Tocopheryl Acetate Yellow No. 5 Blue No. 1 Percent Reduction of Test Organisms after a 15-Second Exposure Microorganism ATCC No. Clostridium difficile Enterococcus faecalis Vancomycin resistant Enterococcus faecium Vancomycin resistant Escherichia coli Listeria monocytogenes Pseudomonas aeruginosa Salmonella typhimurium Serratia marcescens Shigella dysenteriae Shigella sonnei Staphylococcus aureus Streptococcus pyogenes 9689 % Reduction 99.99 51575 >99.99 51559 11229 7644 >99.99 >99.99 >99.99 15442 14028 14756 13313 11060 6538 19615 >99.99 >99.99 >99.99 >99.99 >99.99 >99.99 >99.99 Conclusion: Very effective reduction of Gram-negative and Gram-positive bacteria was demonstrated. 3 Ingredient Class Antimicrobial Agent Diluent Skin Conditioning Agent, Humectant Thickener Fragrance Botanical Additive, Skin Conditioning Agent pH Adjuster Skin Conditioning Agent, Humectant Emollient Skin Conditioning Agent Colorant Colorant Human Repeated Insult Patch Test (continued) PURELL® Instant Hand Sanitizer Lasting Care Formula Dermatologist-tested. Latex compatible. Independent Laboratory: Clinical Research Laboratories, Inc. Piscataway, New Jersey. Date: October, 1999. Results: No dermal reactions were observed during the induction or challenge phases of the study. Conclusion: Test product demonstrated no clinically significant potential for eliciting either dermal irritation or sensitization. Stock No. 9671, 9672, 2176 Physical Characteristics Color: Clear Fragrance: Citrus Viscosity: 6,000-25,000 cps pH: 4.5 - 9.5 Irritancy Data and Allergy Test Results Efficacy Data-- In Vitro Objective: Evaluation of skin irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Method: The method is that summarized by Phillips et al. (Toxic and Applied Pharmacology 21:369-382, 1972). The fresh materials are applied five (5) days weekly for twenty-one (21) days to the same site. Patches are not reapplied on weekends (or holidays); they remain in place for these periods. There are fifteen (15) days of reading, even when holidays intervene. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: November 12, 1998 Results: No dermal reactions were observed during the induction or challenge phases of the study. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15)-second exposure kill studies were performed using twenty-five (25) challenge microorganisms. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: September, 1999. Percent Reduction of Test Organisms After a 15-Second Exposure Human Repeated Insult Patch Test Objective: Determination of the dermal irritation and sensitization potential of the product. Description of Test: Human repeated insult patch test. Method: This study was conducted utilizing a total of two hundred twenty one (221) subjects. The test material was applied under a semi-occlusive patch to the upper back and allowed to remain in direct skin contact for twenty-four (24) hours. Patches were applied to the same site on Monday, Wednesday, and Friday for a three (3)-week induction period. The `sites were graded for dermal irritation and sensitiza tion twenty-four (24) hours after removal of the patches on Tuesday and Thursday, and forty-eight (48) hours after patch removal on Saturday. Standard Dermal Scores (0-4+) were used to record dermal reactions. Microorganism ATCC No. % Reduction Acinetobacter baumannii Bacillus megaterium Citrobacter freundii Clostridium difficile Corynebacterium diphtheriae Enterobacter aerogenes Enterococcus faecalis Vancomycin resistant Enterococcus faecium Vancomycin resistant Escherichia coli Escherichia coli (O157; H7) Klebsiella ozaenae Klebsiella pneumoniae Lactobacillus plantarum Listeria monocytogenes Proteus mirabilis Proteus vulgaris Pseudomonas aeruginosa Salmonella enteritidis Salmonella typhimurium Serratia marcescens Shigella dysenteriae Shigella sonnei Staphylococcus aureus Methicillin resistant Staphylococcus epidermidis Streptococcus pyogenes 19606 14581 8090 9689 >99.999 >99.996 >99.999 >99.999 11913 13048 >99.999 >99.999 51575 >99.999 51559 11229 >99.999 >99.999 35150 11296 13883 14917 15313 7002 13315 15442 13076 14028 14756 13313 11060 >99.999 >99.999 >99.999 >99.996 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 33591 >99.999 12228 19615 >99.999 >99.999 Conclusion: Very effective reduction of Gram-negative and Gram-positive bacteria was demonstrated. 4 PURELL® Instant Hand Sanitizer Lasting Care Formula (continued) PURELL® Instant Hand Sanitizer with DERMAGLYCERIN SYSTEM™ Persistence Data Dermatologist-tested. Latex compatible. Vinyl compatible. Nitrile compatible. CHG compatible. Objective: Evaluate the persistent antibacterial efficacy of the product on the skin. Description of Test: Persistent antimicrobial efficacy of the product was performed by measuring the inhibition of a marker microorganism (Staphylococcus aureus ATCC #6538) on an agar plate following exposure to forearm skin. Twelve subjects were randomly assigned to the control group in which no product was applied to the forearm skin. Ten subjects each were randomly assigned to one of the two post-application intervals (4-hour and 6-hour). The marker organism plates were applied to the volar forearms of the subjects for a total of 30 minutes. The agar plates were incubated at 30°C for 24-48 hours. Independent Laboratory: BioScience Laboratory Inc., Bozeman, MT Date: September 27, 1999. Conclusion: The product resulted in significant inhibition of the marker microorganism after 4-hour and 6-hour post product application. Stock No. 9648, 9691, 9646, 2151 Physical Characteristics Active Ingredient: 62% Ethyl Alcohol Color: White opaque solution Fragrance: Mild alcohol odor with herbal fragrance Form: Liquid pH: 4.5-9.5 Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Method: Phillips et al (Toxic and Applied Pharmacology 21: 369-382) summarizes the method utilized for this evaluation. Fresh materials are applied daily, 5 days per week, for 21 days to the same site (patches were not moved or reapplied on the weekends). Independent Laboratory: Dermatologic Research Laboratory, San Francisco, CA Date: 26 July 2004 Results: Average Score = 0.06 (scale 0-4); No sensitization occurred. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Efficacy Data — In Vivo Objective: This study evaluated the antimicrobial effectiveness of one (1) test products and one (1) reference product using a Healthcare Personnel Handwash Procedure, as per methodology specified by the Food and Drug Administration (FR 59:116, 17 June 94, pp. 31448-31450). Description of Test: The antimicrobial effectiveness of one (1) test product and one (1) reference product for use as Health Care Personnel Handwashes was determined using ten (10) consecutive hand contamination/product application procedures. Serratia marcescens (ATCC #14756) was the marker organism used for hand contaminations. Eighteen (18) human subjects were utilized for the test and referenced product, for a total of thirty-six (36) subjects. Microbial samples were taken at baseline and after washes one (1), three (3), seven (7), and ten (10). All sampling of the hands was performed using the Glove Juice Sampling Procedure. The testing methods were based on the Food and Drug Administration Tentative Final Monograph (TFM) for Effectiveness Testing of an Antiseptic Handwash or Health Care Personnel Handwash (FR 59:116, 17 June 94, pp. 3144831450). Independent Laboratory: BioScience Laboratories, Inc., Bozeman, MT Date: June 24, 2004 Results: Wash Reduction from Number Baseline Log10 Ingredients Active Ingredient Ingredient Class Ethyl Alcohol 62% Antimicrobial Agent Also Contains: Water (Aqua) Glycerin Isopropyl Myristate Propylene Glycol Retinyl Palmitate Tocopheryl Acetate Zea Mays (Corn Oil) Acrylates/C10-30 Alkyl Acrylate Crosspolymer Aminomethyl Propanol Fragrance (Parfum) Triclosan Diluent Skin Conditioning Agent, Humectant Emollient Skin Conditioning Agent, Humectant Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent Thickener 1 3 7 10 pH Adjuster Fragrance Preservative 5 3.33 3.75 3.59 3.17 PURELL® Instant Hand Sanitizer with DERMAGLYCERIN SYSTEM (continued) Challenge Microbe Conclusions: Test product produced statistically significant (p < 0.05) Log10 reductions in bacterial populations from baseline populations of 3.33 after Wash 1 and 3.17 after Wash 10. The critical indices of this study were a two (2) Log10 reduction after Wash 1 and a three (3) Log10 reduction after Wash 10. The test product met these criteria. ATCC No. Staphylococcus aureus Staphylococcus aureus (MRSA) Staphylococcus aureus (VIMRSA) Staphylococcus epidermidis Staphylococcus haemolyticus Staphylococcus hominis Staphylococcus saprophyticus Streptococcus pneumoniae Streptococcus pyogenes Efficacy Data-- In Vitro Objective: Evaluate the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15) second exposure kill evaluations were performed utilizing forty two (42) challenge bacterial strains. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: June 23, 2004. Yeasts and Fungi 29213 33591 >99.9999 >99.9999 042800VISA* >99.9999 12228 43253 29885 49453 >99.9999 >99.9999 >99.9999 >99.9999 33400 19615 >99.9993 >99.9999 ATCC No. Aspergillus flavus Aspergillus niger Candida albicans Candida tropicalis Epidermophyton floccosum Penicillium citrinum Trichophyton mentagrophytes % Reduction 9643 9642 14053 13803 52063 9849 9533 % Reduction >99.9999 >99.3984 >99.9999 >99.9999 >99.9895 >99.9995 >99.9997 VISA - Vanncomycin-Intermediate Staphylococcus aureus MRSA - Methicillin-Resistant Staphylococcus aureus *=BSLI Clinical Isolate number Conclusion: Very effective reduction of Gram-negative and Gram-positive bacteria, yeasts and fungi was demonstrated. Percent Reduction of Test Organisms after a 15-Second Exposure Challenge Microbe ATCC No. % Reduction Ingredients Acinetobacter baumannii Bacillus megaterium Bacteroides fragilis Campylobacter jejuni Citrobacter freundii Clostridium difficile (vegetative cells) Clostridium perfringens (vegetative cells) Corynebacterium diphtheriae Enterobacter aerogenes Enterococcus faecalis (VRE) Enterococcus faecalis Enterococcus faecium (VRE) Escherichia coli Escherichia coli Escherichia coli (O157:H7) Haemophilus influenzae Klebsiella pneumoniae Subsp.ozaenae Klebsiella pneumoniae Subsp.pneumoniae Lactobacillus plantarum Listeria monocytogenes Listeria monocytogenes Micrococcus luteus Proteus mirabilis Proteus vulgaris Pseudomonas aeruginosa Pseudomonas aeruginosa Salmonella choleraesuis Serotype Choleraesuis Salmonella choleraesuis Serotype Enteritidis Salmonella choleraesuis Serotype Typhimurium Serratia marcescens Shigella dysenteriae Shigella sonnei Staphylococcus aureus 19606 14581 29762 29428 8090 9689 >99.9999 >99.9985 >99.9999 >99.9999 >99.9998 >99.9999 Active: 13124 >99.9912 11913 13048 51575 29212 51559 11229 25922 35150 33930 11296 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9998 >99.9998 >99.9999 >99.9999 13883 >99.9999 14917 7644 15313 7468 7002 13315 15442 27853 10708 >99.9999 >99.9999 >99.9999 >99.9997 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 13076 >99.9999 14028 >99.9999 14756 13313 11060 6538 >99.9999 >99.9999 >99.9999 >99.9999 INCI Name* Ingredient Class Ethyl Alcohol 62% Antimicrobial Agent Also Contains: Water (Aqua) Cyclomethicone Cetearyl Isononanoate Propylene Glycol Carbomer Styrene/Acrylates Copolymer Glycerin Cetyl Lactate Diazolidinyl Urea Aminomethyl Propanol C12-15 Alkyl Benzoate Methylparaben Fragrance (Parfum) PEG-4 Propylparaben Iodopropynyl Butylcarbamate Tocopheryl Acetate Cacamidopropyl PGDimonium Chloride Phosphate Carrier Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent Viscosity Increasing Agent Viscosity Increasing Agent Skin Conditioning Agent Skin Conditioning Agent Preservative pH adjuster Skin Conditioning Agent Preservative Fragrance Solvent Preservative Preservative Skin Conditioning Agent Conditioning Agent *International Nomenclature Cosmetic Ingredient 6 Efficacy Data — In Vivo PURELL® Foaming Hand Sanitizer Dermatologist-tested. Product meets the Protocol for Healthcare Personnel Handwash. Latex compatible. CHG compatible. Healthcare Personnel Handwash Data Objective: This study evaluated the antimicrobial effectiveness of one (1) test product and one (1) reference product using a Healthcare Personnel Handwash Procedure, as per methodology specified by the Food and Drug Administration (FR 59:116, 17 June 94, pp. 31448-31450). Description of Test: The antimicrobial effectiveness of one (1) test product and one (1) reference product for use as Health Care Personnel Handwashes was determined using ten (10) consecutive hand contamination/product application procedures. Serratia marcescens (ATCC #14756) was the marker organism used for hand contaminations. Eighteen (18) human subjects were utilized for the test and referenced product, for a total of thirty-six (36) subjects. Microbial samples were taken at baseline and after washes one (1), three (3), seven (7), and ten (10). All sampling of the hands was performed using the Glove Juice Sampling Procedure. The testing methods were based on the Food and Drug Administration Tentative Final Monograph (TFM) for Effectiveness Testing of an Antiseptic Handwash or Health Care Personnel Handwash (FR 59:116, 17 June 94, pp. 3144831450). Independent Laboratory: BioScience Laboratories, Inc., Bozeman, MT Date: January 22, 2003 Results: Wash Reduction from Number Baseline Log10 Stock No. 9698 Physical Characteristics Active Ingredient: 62% Ethyl Alcohol Color: White foam Fragrance: Mild alcohol odor Form: Foam pH: 7.0-8.0 Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: 21 Day Cumulative Irritancy Assay with Challenge. Fresh materials are applied daily, 6 days per week, for 21 days to the same site (patches were not moved or reapplied on Sunday). Independent Laboratory: RCTS, Inc., Irving, TX Date: January 3, 2003 Results: Average Score = 0.02 (scale 0 – 4); No sensitization occurred. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Human Repeated Insult Patch Test 1 3 7 10 Objective: Determination of the dermal irritation and sensitization potential of the product. Description of Test: Human repeated insult patch test. Independent Laboratory: Clinical Research Laboratories, Inc., Piscataway, New Jersey. Date: February 25, 2003 Results: No visible skin reactions were observed during the induction or challenge phases of the study. Conclusion: Test product demonstrated no potential for eliciting either dermal irritation or sensitization. Conclusions: Test product produced statistically significant (p < 0.05) Log10 reductions in bacterial populations from baseline populations of 3.29 after Wash 1 and 3.12 after Wash 10. The critical indices of this study were a two (2) Log10 reduction after Wash 1 and a three (3) Log10 reduction after Wash 10. The test product met these criteria. Ingredients INCI Name* Ingredient Class Ethyl Alcohol 62% Antimicrobial Agent Active: Also Contains: Water (Aqua) Hydrofluorocarbon 152a Isobutane Emulsifying Wax NF Cetyl Lactate Steareth-2 Propane Sodium Benzoate Sodium Sesquicarbonate Fragrance (Parfum) 3.29 2.82 2.95 3.12 Carrier Propellant Propellant Stabilizer Emollient Emulsifying Agent Propellant Fragrance Ingredient pH adjuster Fragrance *International Nomenclature Cosmetic Ingredient 7 PURELL® Foaming Hand Sanitizer (continued) PURELL® Instant Hand Sanitizer Food Code Compliant Efficacy Data — In Vitro Dermatologist-tested. Latex compatible. Timed-Exposure Kill Tests Objective: Evaluate the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15) or thirty (30) second exposure kill evaluations were performed utilizing twenty-seven (27) challenge bacterial strains. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 or 30 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: January 28, 2003. Stock No. 2166, 9666, 2006, 9660 Physical Characteristics Active Ingredient: 62% Ethyl Alcohol Color: Clear to hazy solution Fragrance: Mild alcohol odor with lemon fragrance Form: Liquid pH: 4.5-9.5 Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Method: Phillips et al (Toxic and Applied Pharmacology 21: 369-382) summarizes the method utilized for this evaluation. Fresh materials are applied daily, 5 days per week, for 21 days to the same site (patches were not moved or reap plied on the weekends). Independent Laboratory: RCTS, Inc. Irving, Texas Date: January 3, 2003 Results: Average Score = 0.05 (scale 0-4); No sensitization occurred. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Results: Percent Reduction of Test Organisms After a 15-Second Exposure Challenge Microbe ATCC No. Acinetobacter 19606 baumannii Campylobacter jejuni 29428 Citrobacter freundii 8090 Clostridium difficile 9689 Corynebacterium 11913 diphtheriae Enterobacter aerogenes 13048 Enterococcus faecalis 51575 (VRE) Enterococcus faecium 51559 (VRE) Escherichia coli 11229 Escherichia coli (O157:H7) 35150 Klebsiella pneumoniae 11296 Subsp.ozaenae Klebsiella pneumoniae 13883 Subsp.pneumoniae Lactobacillus plantarum 14917 Listeria monocytogenes 15313 Proteus mirabilis 7002 Proteus vulgaris 13315 Pseudomonas aeruginosa 15442 Salmonella choleraesuis 13076 Serotype Enteritidis Salmonella choleraesuis 14028 Serotype Typhimurium Serratia marcescens 14756 Shigella dysenteriae 13313 Shigella sonnei 11060 Staphylococcus aureus 33591 (MRSA) Staphylococcus aureus 03230 (MRSA) 1MMRSa4* Staphylococcus 12228 epidermidis Streptococcus pneumoniae 33400 Streptococcus pyogenes 19615 % Reduction >99.9999 >99.9995 >99.9999 >99.9999 >99.9998 >99.9993 >99.9999 Efficacy Data-- In Vitro >99.9999 Objective: Evaluate the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15)-second exposure kill evaluations were performed utilizing twelve (12) challenge bacterial strains. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (30 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: January 9, 2003. >99.9999 >99.9998 >99.9999 >99.9999 >99.9998 >99.9999 >99.9999 >99.9983 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 >99.9999 *Clinical Isolate MRSA - Methicillin-Resistant Staphylococcus aureus 8 PURELL® Instant Hand Sanitizer Food Code Compliant (continued) Percent Reduction of Test Organisms After a 30-Second Exposure Microorganism ATCC No. % Reduction Acinetobacter baumannii Candida albicans Enterobacter cloacae Enterococcus faecium Escherichia coli Klebsiella pneumoniae Micrococcus luteus Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens Staphylococcus aureus Staphylococcus epidermidis 19606 10231 13047 51559 25922 11296 7468 7002 27853 14756 29213 12228 PROVON® Antimicrobial Skin Cleanser with 2% CHG Dermatologist-tested. Meets protocol for Healthcare Personnel Handwash, Surgical Scrub, Pre-Operative Skin Prep, PreInjection Skin Prep & Wound Cleanser. Latex Compatible. >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 Stock No. 4106, 4104 Physical Characteristics Color: Clear Colorless to Clear Pink Fragrance: Floral Viscosity: 1,000-4,000 cps pH: 4.50-6.80 Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: October 17, 1997 Results: Average score 0.06 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Ingredients Active Ingredient Ethyl Alcohol 62% Also Contains: Water (Aqua) Carbomer Glycerin Fragrance (Parfum) Sodium Hydroxide Propylene Glycol Trocopheryl Acetate Ingredient Class Antimicrobial Agent Carrier Viscosity Increasing Agent Skin Conditioning Agent Fragrance pH Adjuster Skin Conditioning Agent Skin Conditioning Agent Efficacy Data — In Vitro Timed-Exposure Kill Tests Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen(15)-second-exposure kill studies were performed utilizing eighteen (18) challenge bacterial strains. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds). Standard plate counting techniques were used to enumerate viable challenge micro-organisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: September 23, 1997 9 PROVON® Antimicrobial Skin Cleanser with 2% CHG (continued) Efficacy Data — In Vitro (continued) Percent Reduction of Test Organisms After a 15-Second Exposure Microorganism ATCC No. % Reduction Clostridium difficile Enterococcus faecalis Enterococcus faecalis Vancomycin resistant Enterococcus faecium Enterococcus faecium Vancomycin resistant Escherichia coli Escherichia coli (O157; H7) Klebsiella ozaenae Listeria monocytogenes Proteus mirabilis Pseudomonas aeruginosa Salmonella typhimurium Serratia marcescens Shigella sonnei Staphylococcus aureus Staphylococcus aureus Methicillin resistant Staphylococcus epidermidis Streptococcus pyogenes 9689 19433 >99.999 >99.999 51575 19434 >99.999 >99.999 51559 11229 >99.999 >99.999 35150 11296 7644 7002 15442 14028 14756 11060 6538 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 >99.999 33591 >99.999 14990 19615 >99.999 >99.999 Efficacy Data — MICs Minimum Inhibitory Concentrations (MICs) Objective: Demonstration of the broad spectrum of antimicrobial activity. Description of Test: Bacterial tests run with agar to determine the concentration of chlorhexidine gluconate required to inhibit growth. Reference: Graham W. Denton, Disinfection, Sterilization and Preservation, Lea & Febiger, Malver, Pennsylvania, 1991, Chapter 16, “Chlorhexidene,” p. 278-279. Results: The minimum inhibitory concentrations (MICs) of chlorhexidine gluconate are listed in parts per million (ppm). Numbers in parentheses refer to the number of strains evaluated. Conclusion: Very effective reduction of Gram- negative and Gram-positive bacteria by the product was demonstrated. Efficacy Data — In Vivo Microorganism Bacteria (Number of Strains) Micrococcus flavus (1) Micrococcus lutea (1) Staphylococcus aureus (16) Staphylococcus epidermidis (41) Streptococcus faecalis (5) Streptococcus mutans (2) Streptococcus pneumoniae (5) Streptococcus pyogenes (9) Streptococcus sanguis (3) Streptococcus viridans (5) Bacillus cereus (1) Bacillus subtilis (2) Clostridium difficile (7) Clostridium welchii (5) Corynebacterium sp. (8) Lactobacillus casei (1) Listeria monocytogenes (1) Propionibacterium acne (2) Acinetobacter anitratus (3) Acinetobacter lwoffi (2) Alcaligenes faecalis (1) Bacteroides disastonis (4) Bacteroides fragilis (11) Campylobacter pyloridis (5) Citrobacter freundii (10) Enterobacter cloacae (12) Escherichia coli (14) Gardnerella vaginalis (1) Haemophilus influenza (10) Klebsiella aerogenes (5) Klebsiella oxytoca (2) Klebsiella pneumoniae (5) Proteus mirabilis (5) Proteus morganii (5) Healthcare Personnel Handwash Data Objective: Evaluation of the antimicrobial effectiveness of the product on hands. Description of Test: This study evaluated both the immediate and persistent antimicrobial effects of the product over the course of ten (10) consecutive microbial contamination/product application cycles. The study utilized six (6) subjects for the product and six (6) subjects for the control. The protocol used was a modification of the ASTM Standard Method and the methods described in the “Tentative Final Monograph for Health-Care Antiseptic Drug Products, Proposed Rule,” Federal Register, 59, No. 116, 31448-31450, 1994. This procedure involves determination of the reduction in transient bacteria on the hands determined by the Glove Juice Technique after Serratia marcescens contamination. Independent Laboratory: North American Science Associates, Inc., Northwood, Ohio. Date: February 28, 1986 Results: Reductions in recoverable Serratia marcescens counts. Summary: Both products demonstrated a good rate of kill and good residual activity throughout the course of this study. 10 MICs (ppm) 0.5 0.5 1-4 0.25-8 32-64 2.5 8-16 1-8 4-16 2-32 8 1 8-32 4-32 0.5-8 128 4 8 16-64 0.5 64 16 8-64 8-32 4-32 16-64 2-32 8 2-8 16-64 32 32-128 64->128 16-128 PROVON® Antimicrobial Skin Cleanser with 2% CHG (continued) Efficacy Data — MICs (continued) Surgical Scrub Evaluation Microorganism Bacteria (Number of Strains) Proteus vulgaris (5) Providencia stuartii (5) Pseudomonas aeruginosa (15) Pseudomonas cepacia (1) Pseudomonas fluorescens (1) Salmonella bredeney (1) Salmonella dublin (1) Salmonella galinarum (1) Salmonella montevideo (1) Salmonella typhmurium (4) Salmonella virchow (1) Serratia marcescens (10) MICs (ppm) Yeasts and Fungi Aspergillus flavus (1) Aspergillus fumigatus (1) Aspergillus niger (1) Penicillium notatum (1) Rhizopus sp. (1) Scopulariopsis sp. (1) Candida albicans (2) Candida guillermondii (1) Candida parapsilosis (2) Candida pseudotropicalis (1) Cryptococcus neoformans (1) Prototheca zopfii (1) Saccharomyces cerevissia (1) Torulopsis glabrata (1) Epidermophyton floccosum (1) Microsporum canis (2) Microsporum fulvum (1) Microsporum gypseum (1) Trichophyton equinum (1) Trichophyton interdigitale (2) Trichophyton mentagrophytes (1) Trichophyton quinkeanum (1) Trichophyton rubrum (2) Trichophyton tonsurans (1) MIC (ppm) 64 32 16 16 8 8 9 4 4 3 1 6 1 6 4 4 6 6 4 3 3 3 3 3 Objective: This evaluation measures the immediate and persistent antimicrobial effectiveness of the product and a reference product. Description of Test: Thirty-six (36) subjects were recruited and completed this evaluation. Baseline counts of the microbial skin flora of the hands of the subjects were performed utilizing a glove juice protocol. A standard surgical scrub wash was performed at least once by each of the subjects each day for five (5) days. A glove juice sampling procedure was performed at five (5) minutes post wash, three (3) hours post wash and six (6) hours post wash on days one (1), two (2) and five (5) after the first wash of the day. Additional scrubs without glove juice sampling occurred on days two (2), three (3) and four (4). Reference “OTC TopicalAntimicrobial Products Tentative Final Monograph,” Federal Register, Volume 43 (4): 1242-1243, 1978. Independent Laboratory: Skyland Scientific Services, Inc., Belgrade, MT. Conclusion: The results show good immediate and persistent antimicrobial effects of the product on the skin micro flora of the hands, in which the product was equivalent to or better than the reference product. 32-128 64-128 16-32 16 4 16 4 8 8 8-16 8 16 Conclusion Chlorhexidine gluconate is very effective against both Gram-positive and Gramnegative bacteria, yeast and fungal microorganisms. Ingredients Active Ingredient Chlorhexidine Gluconate (2% wt) Also Contains: Water Isopropyl Alcohol Surfactants Ingredient Class Antimicrobial Agent Carrier Carrier Surfactant, Cleaning Agent 11 PROVON® Antimicrobial Skin Cleanser with 2% CHG (continued) Results: Percent Reduction of Skin Micro Flora on the Hands 12 PROVON® Medicated Lotion Soap with Chloroxylenol (PCMX) Efficacy Data — In Vitro (continued) Microorganism Dermatologist-tested. Escherichia coli (O157; H7) Klebsiella pneumoniae Listeria monocytogenes Pseudomonas aeruginosa Salmonella enteritidis Salmonella typhimurium Shigella dysenteriae Shigella sonnei Staphylococcus aureus (MRSA) Streptococcus pyogenes Stock No. 4201, 4202, 4203, 4206, 4208, 4520, 2102, 2202 Physical Characteristics Color: Clear, Light Amber Fragrance: Fresh, Clean Balsam Viscosity: 3,000-7,000 cps pH: 8.6-9.2 Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: October 17, 1997 Results: Average score 0.09 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. ATCC No. % Reduction 35150 11296 >99.999 >99.999 7644 >99.999 15442 13076 14028 * 11060 >99.999 >99.999 99.997 99.993 >99.999 33591 19615 99.014 >99.999 * Clinical isolate Conclusion: Very effective reduction of Gram-negative and Gram-positive bacteria was demonstrated. Ingredients Efficacy Data — In Vitro Active Ingredient Chloroxylenol 0.3% Also Contains: Water (Aqua) Coconut Acid Oleic Acid Sodium Sulfate Time-Exposure Kill Tests Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15)- or thirty (30)- second exposure kill studies were performed utilizing nineteen (19) challenge microorganisms. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: October 13, 1998 Ethanolamine Coco-Betaine Aloe Barbadensis Leaf Juice Cocamide MEA Hydrolyzed Vegetable Protein Hydroxypropyl Methylcellulose Propylene Glycol Percent Reduction of Test Organisms After a 15-Second Exposure Retinyl Palmitate Microorganism ATCC No. % Reduction Acinetobacter baumannii Campylobacter jejuni Citrobacter freundii Clostridium difficile Clostridium perfringens Enterococcus faecalis Vancomycin resistant Enterococcus faecium Vancomycin resistant Escherichia coli 19606 29428 8090 9689 13124 >99.999 >99.999 >98.554 >99.999 >99.999 Tetrasodium EDTA Tocopheryl Acetate 51575 99.866 51559 11229 99.954 >99.999 Zea Mays (Corn) Oil Fragrance (Parfum) 13 Ingredient Class Antimicrobial Agent Carrier Cleansing Agent Cleansing Agent Viscosity Increasing Agent pH Adjuster Cleansing Agent Botanical Additive, Skin Conditioning Agent Foam Booster, Viscositiy Increasing Agent Skin Conditioning Agent Viscosity Increasing Agent Skin Conditioning Agent, Humectant Skin Conditioning Agent Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Fragrance PROVON® Medicated Lotion Soap with Triclosan Efficacy Data — In Vitro (continued) Dermatologist-tested. Microorganism ATCC No. % Reduction Stock No. 4152, 4153, 2258, 2158 Salmonella typhimurium Shigella dysenteriae Shigella sonnei Staphylococcus aureus Methicillin resistsant Streptococcus pyogenes 14028 ** 11060 >99.998 99.996 99.999 33591 19615 99.702 >99.999 Physical Characteristics Color: Clear, Light Amber Fragrance: Fresh, Clean Balsam Viscosity: 2,700-15,300 cps pH: 7.0-10.0 * 30-Second Exposure ** Clinical isolate Conclusion: Very effective reduction of Gramnegative and Gram-positive bacteria by the product was demonstrated. Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: June 19, 1998 Results: Average score 0.12 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Ingredients Active Ingredient Triclosan 0.3% Also Contains: Water (Aqua) Coconut Acid Sodium Sulfate Oleic Acid Ethanolamine Coco-Betaine Efficacy Data — In Vitro Timed-Exposure Kill Tests Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15) or thirty (30)second-exposure kill studies were performed utilizing nineteen (19) challenge bacteria. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds or 30 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: October 13, 1998 Aloe Barbadensis Leaf Juice Cocamide MEA Hydrolyzed Vegetable Protein Hydroxypropyl Methylcellulose Propylene Glycol Retinyl Palmitate Tetrasodium EDTA Tocopheryl Acetate Zea Mays (Corn) Oil Fragrance (Parfum) Methylchloroisothiazolinone Methylisothiazolinone Percent Reduction of Test Organisms After a 15-Second Exposure Microorganism ATCC No. % Reduction Acinetobacter baumannii Campylobacter jejuni Citrobacter freundii Clostridium difficile Clostridium perfringens Enterococcus faecalis Vancomycin resistant Enterococcus faecium Vancomycin resistant Escherichia coli Escherichia coli (O157; H7) Klebsiella pneumoniae Listeria monocytogenes Proteus mirabilis Pseudomonas aeruginosa Salmonella enteritidis 19606 29428 8090 9689 13124 >99.999 >99.999 >96.436* >99.999 >99.999 51575 >99.988 51559 11229 >99.987 >99.999 35150 11296 7644 7002 15442 13076 >99.97 >99.999 >99.999 >95.640* >99.999 >99.999 14 Ingredient Class Antimicrobial Agent Carrier Cleansing Agent Viscosity Increasing Agent Cleansing Agent pH Adjuster Cleansing Agent, Skin Conditioning Agent, Foam Booster Botanical Additive, Skin Conditioning Agent Foam Booster, Viscositiy Increasing Agent Skin Conditioning Agent Viscosity Increasing Agent Skin Conditioning Agent, Humectant Skin Conditioning Agent Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Fragrance Preservative Preservative Ingredients PROVON® Antimicrobial Lotion Soap with 0.3% Chloroxylenol Active Ingredient Chloroxylenol 0.3% Also Contains: Water (Aqua) Coconut Acid Oleic Acid Sodium Sulfate Ethanolamine Cocamide DEA Dermatologist-tested. Stock No. 4212, 4213, 4216, 4218, 4555, 2218, 2118 Physical Characteristics Color: Clear Amber Fragrance: Fresh Citrus Viscosity: 2,700 - 15,300 cps pH: 7.0-10.0 Sodium Laureth Sulfate Sodium Lauryl Sulfate Aloe Barbadensis Leaf Juice Propylene Glycol Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: 21-Day Cumulative Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: October 17, 1997 Results: Average score 0.28 (scale 0 – 4); no sensitization occured. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Soyamidopropyl Betaine Tetrasodium EDTA Tocopheryl Acetate Hydroxypropyl Methylcellulose Sodium Chloride Fragrance (Parfum) Triclosan Blue No. 1 (CI 42090) Red No. 4 (CI 14700) Red No. 33 (CI 17200) Yellow No. 5 (CI 19140) Efficacy Data — In Vitro Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Thirty (30)-second-exposure kill studies were performed utilizing eighteen(18) challenge bacterial strains. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (30 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana Date: April, 2001 Percent Reduction of Test Organisms After a 30-Second Exposure Microorganism ATCC No. % Reduction Citrobacter freundii Enterococcus faecalis Multi-drug resistant Enterococcus faecium Multi-drug resistant 8090 >99.999 51575 >99.991 51559 >99.992 33591 >97.576 >98.253 Staphylococcus aureus Methicillin resistant Staphylococcus epidermidis 12228 * 30-Second Exposure Conclusion: Effective reduction of Gram-negative and Gram-positive bacteria was demonstrated 15 Ingredient Class Antimicrobial Agent Carrier Cleansing Agent Cleansing Agent Viscosity Increasing Agent pH Adjuster Surfactant, Foam Booster Viscosity Increasing Agent Surfactant, Cleansing Agent Surfactant, Cleansing Agent Botanical Additive, Skin Conditioning Agent Skin Conditioning Agent, Humectant Cleansing Agent, Viscosity Increasing Agent Chelating Agent Skin Conditioning Agent Viscosity Increasing Agent Viscosity Increasing Agent Fragrance Preservative Colorant Colorant Colorant Colorant PROVON® Gentle Lotion Soap PROVON® Mild Lotion Soap Dermatologist-tested. Dermatologist-tested. Stock No. 4222, 4223, 4226, 4228, 2219, 2119 Stock No. 4008, 4019, 2208, 2108, 4508 Physical Characteristics Physical Characteristics Color: Light Yellow Fragrance: Fresh, Clean Viscosity: 2,700 - 15,300 cps pH: 7.0-10.0 Irritancy Data and Allergy Test Results Color: Blue Pearl Fragrance: Fresh, Clean Viscosity: 2,700-15,300 cps pH: 7.0-10.0 Irritancy Data and Allergy Test Results Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: July 18, 1997 Results: Average score 0.09 (scale 0-4). Lower scores indicate lower potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Ingredients Contents Water Cocamidopropyl Betaine Coconut Acid Oleic Acid Sodium Sulfate Ethanolamine Aloe Barbadensis Leaf Juice Cocamide DEA Hydrolyzed Vegetable Protein Polystyrene Propylene glycol Retinyl Palmitate Tetrasodium EDTA Tocopheryl Acetate Zea Mays (Corn) Oil Hydroxypropyl Methylcellulose Fragrance (Parfum) Chloroxylenol Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: May 7, 1993 Results: Average score 0.23 (scale 0-4). Lower scores indicate lower potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Ingredients Ingredient Class Carrier Cleansing Agent, Skin Conditioning Agent Cleansing Agent Cleansing Agent Viscosity Increasing Agent pH Adjuster Botanical Additive, Skin Conditioning Agent Surfactant, Foam Booster Skin Conditioning Agent Contents Water (Aqua) Coconut Acid Oleic Acid Sodium Sulfate Ethanolamine Cocamide DEA Cocamidopropyl Betaine Glycol Distearate Lauramide DEA Propylene Glycol Sodium Laureth Sulfate Tetrasodium EDTA Fragrance (Parfum) Chloroxylenol Blue No. 1 (CI 42090) Opacifier Skin Conditioning Agent, Humectant Skin Conditioning Agent Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Viscosity Increasing Agent Fragrance Preservative 16 Ingredient Class Carrier Cleansing Agent Cleansing Agent Viscosity Increasing Agent pH Adjuster Surfactant, Foam Booster Cleansing Agent Pearlizing Agent, Emollient Viscosity Increasing Agent Skin Conditioning Agent, Humectant Surfactant, Cleansing Agent Chelating Agent Fragrance Preservative Colorant PROVON® Enriched Lotion Cleanser PROVON® Foaming Handwash with Moisturizers Dermatologist-tested. Dermatologist-tested. Stock No.2213, 2113, 4013, 4017 Stock No. 5285, 5185, 5985 Physical Characteristics Physical Characteristics Color: Clear Pink Fragrance: Cranberry Form: Liquid pH: 4.5-9.5 Color: Pink, pearled Fragrance: Floral Viscosity: 3,700- 20,000 cps pH: 4.5- 9.5 Irritancy Data and Allergy Test Results Irritancy Data and Allergy Test Results Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: November 9, 2001 Results: Average score 0.14 (scale 0-4). Lower scores indicate lower potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Objective: Evaluation of skin irritation potential in humans. Description of Test: Phillips et al (Toxic and Applied Pharmacology 21: 369-382) summarizes the method utilized for this evaluation. Fresh materials are applied daily, 5 days per week, for 21 days to the same site (patches were not moved or reapplied on the weekends). Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: July 5, 2002 Results: Average score = 0.16 (scale 0-4); No sensitization occurred. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Ingredients Contents Water (Aqua) Sodium Laureth Sulfate Cocamide DEA Sodium Lauryl Sulfate Ammonium Chloride Disodium Laureth Sulfosuccinate Aloe Barbadensis Leaf Juice Cocamide MEA Cocamidopropyl PG-Dimonium Chloride Phosphate Glycerin Glycol Distearate Lactic Acid Laureth-7 Retinyl Palmitate Simmondsia Chinensis (Jojoba) Seed Oil Sodium C14-16 Olefin Sulfonate Soyamidopropyl Betaine Tocopheryl Acetate Zea Mays (Corn) Oil Sodium Chloride Fragrance (Parfum) DMDM Hydantoin Red 33 (CI 17200) Ingredient Class Carrier Surfactant, Cleansing Agent Surfactant, Foam Booster, Viscosity Increasing Agent Surfactant, Cleansing Agent Viscosity Increasing Agent Surfactant, Cleansing Agent, Foam Booster Botanical Additive, Skin Conditioning Agent Foam Booster, Viscosity Increasing Agent Skin Conditioning Agent Human Repeated Insult Patch Test Objective: Determination of the dermal irritation and sensitization potential of the product. Description of Test: Human repeated insult patch test. Independent Laboratory: Clinical Research Laboratories, Inc., Piscataway, N.J. Date: February 25, 2003 Results: No visible skin reactions were observed during the induction or challenge phases of the study. Conclusions: Test product demonstrated no potential for eliciting either dermal irritation or sensitization. Skin Conditioning Agent, Humectant Pearlizing Agent, Emollient pH Adjuster Surfactant Skin Conditioning Agent Skin Conditioning Agent Surfactant, Cleansing Agent Cleansing Agent, Viscosity Increasing Agent Skin Conditioning Agent Skin Conditioning Agent Viscosity Increasing Agent Fragrance Preservative Colorant 17 PROVON® Foaming Handwash with Moisturizers (continued) Ingredients INCI Name* Water (Aqua) Ammonium Laureth Sulfate Ammonium Lauryl Sulfate Algae Extract Aloe Barbadensis Leaf Juice Ammonium Xylenesulfonate Citric Acid Cocamide MEA Disodium Soyamphodiacetate Glycerin PEG-.80 Glyceryl Cocoate Retinyl Palmitate Simmondsia Chinensis (Jojoba) Seed Oil Tetrasodium EDTA Trocopheryl Acetate Zea Mays (Corn) Oil Ammonium Sulfate Fragrance (Parfum) Quaternium-15 Red 40 (Cl 16035) PROVON® Foaming Antimicrobial Handwash with Moisturizers and 0.3% Chloroxylenol Ingredient Class Carrier Surfactant, Cleansing Agent Surfactant, Cleansing Agent Skin Conditioning Agent Botanical Additive, Skin Conditioning Agent Surfactant, Cleansing Agent pH Adjuster Surfactant, Foam Booster, Viscosity Increasing Agent Cleansing Agent Skin Conditioning Agent, Humectant Surfactant, Cleansing Agent Skin Conditioning Agent Skin Conditioning Agent Dermatologist-tested. Stock No. 5286, 5186, 5986 Physical Characteristics Active Ingredient: 0.3% Chloroxylenol Color: Clear Amber Orange Fragrance: Floral Form: Liquid pH: 4.5-8.5 Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: 21 Day Cummulative Irritancy Assay with Challenge. Fresh materials are applied daily, 6 days per week, for 21 days to the same site (patches were not moved or reapplied on Sunday). Independent Laboratory: RDTS, Inc., Irving, TX Date: January 3, 2003 Results: Average score = 0.41 (scale 0-4); No sensitization occurred. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Thickener Fragrance Preservative Colorant *International Nomenclature Cosmetic Ingredient Human Repeated Insult Patch Test Objective: Determination of the dermal irritation and sensitization potential of the product. Description of Test: Human repeated insult patch test. Independent Laboratory: Clinical Research Laboratories, Inc., Piscataway, N.J. Date: February 25, 2003 Results: No visible skin reactions were observed during the induction or challenge phases of the study. Conclusions: Test product demonstrated no potential for eliciting either dermal irritation or sensitization. 18 PROVON® Foaming Antimicrobial Handwash with Moisturizers and 0.3% Chloroxylenol (continued) Ingredients PROVON® Foaming Medicated Handwash with Moisturizers and 0.5% Triclosan INCI Name* Ingredient Class Dermatologist-tested. Active: Chloroxylenol Also Contains: Water (Aqua) Alcohol Denat. Ammonium Laureth Sulfate Ammonium Lauryl Sulfate Propylene Glycol Algae Extract Aloe Barbadensis Leaf Juice Ammonium Xylenesulfonate Cocamide MEA Glycerin Lactic Acid Retinyl Palmitate Simmondsia Chinensis (Jojoba) Seed Oil Tetrasodium EDTA Trocopheryl Acetate Zea Mays (Corn) Oil Ammonium Sulfate Fragrance (Parfum) Methylchloroisothiazolinone Methylisothiazolinone Red 40 (Cl 16035) Yellow 5 (Cl 19140) Yellow 6 (Cl 15985) Antiseptic Agent Stock No. 5288, 5188, 5986, 5788 Carrier Diluent, Solvent Surfactant, Cleansing Agent Surfactant, Cleansing Agent Skin Conditioning Agent, Humectant Skin Conditioning Agent Botanical Additive, Skin Conditioning Agent Surfactant, Cleansing Agent Surfactant, Foam Booster, Viscosity Increasing Agent Skin Conditioning Agent, Humectant pH Adjuster Skin Conditioning Agent Skin Conditioning Agent Physical Characteristics Active Ingredient: 0.5% Triclosan Color: Clear Blue Fragrance: Floral Form: Liquid pH: 4.5-8.0 Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: Phillips et al (Toxic and Applied Pharmacology 21: 369-382) summarizes the method utilized for this evaluation. Fresh materials are applied daily, 5 days per week, for 21 days to the same site (patches were not moved or reapplied on the weekends). Independent Laboratory: Dermatologic Research Laboratory, San Francisco, CA Date: July 5, 2002 Results: Average score = 0.07 (scale 0-4); No sensitization occurred. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Thickener Fragrance Preservative Preservative Colorant Colorant Colorant *International Nomenclature Cosmetic Ingredient Human Repeated Insult Patch Test Efficacy Data — In Vitro Objective: Determination of the dermal irritation and sensitization potential of the product. Description of Test: Human repeated insult patch test. Independent Laboratory: Clinical Research Laboratories, Inc., Piscataway, N.J. Date: February 25, 2003 Results: No visible skin reactions were observed during the induction or challenge phases of the study. Conclusions: Test product demonstrated no potential for eliciting either dermal irritation or sensitization. Objective: Evaluate the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen(15) or thirty (30)-secondexposure kill evaluations were performed utilizing ten(10) challenge bacterial strains. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 or 30 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana Dates: February 14, 2003 Percent Reduction of Test Organisms After a 15-Second Exposure Challenge Microbe ATCC No. % Reduction Acinetobacter baumannii Bacillus megaterium Clostridium difficile Corynebacterium diphtheriae Enterococcus faecalis (VRE) Enterococcus Faecium (VRE) Listeria monocytogenes Proteus vulgaris Streptococcus pneumonie Streptococcus pyogenes 19606 14581 9689 11913 >99.999 >99.999 >99.999 >99.997 51575 >98.938* 51599 >99.796 15313 13315 33400 19615 >98.757* >99.935 >99.996 >99.999 * 30 Second Exposure 19 PROVON® Foaming Medicated Handwash with Moisturizers and 0.5% Triclosan (continued) Ingredients INCI Name* Efficacy Data — In Vitro Ingredient Class Timed-Exposure Kill Tests Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15) or thirty (30)second-exposure kill evaluations were performed utilizing twenty-seven (27) challenge bacterial strains. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 seconds or 30 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: February 14, 2003 Active: Triclosan Also Contains: Water (Aqua) Lauramidopropylamine Oxide Propylene Glycol Didecyldimonium Chloride Alcohol Denat. Aloe Barbadensis Leaf Juice Glycerin Lactic Acid Retinyl Palmitate Simmondsia Chinensis (Jojoba) Seed Oil Tetrasodium EDTA Trocopheryl Acetate Zea Mays (Corn) Oil Fragrance (Parfum) Chloroxylenol Diazolidinyl Urea Methylparaben Propylparaben Blue 1 (Cl 42090) Antiseptic Agent Carrier Surfactant, Cleansing Agent Skin Conditioning Agent, Humectant Conditioning Agent Diluent, Solvent Botanical Additive, Skin Conditioning Agent Skin Conditioning Agent, Humectant pH Adjuster Skin Conditioning Agent Skin Conditioning Agent Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Fragrance Preservative Preservative Preservative Preservative Colorant Percent Reduction of Test Organisms After a 15-Second Exposure *International Nomenclature Cosmetic Ingredient Challenge Microbe ATCC No. % Reduction Acinetobacter baumannii Bacillus megaterium Campylobacter jejuni Citrobacter freundii Clostridium difficile Corynebacterium diphtheriae Enterobacter aerogenes Enterococcus faecalis (VRE) Enterococcus faecium (VRE) Escherichia coli Escherichia coli (O157; H7) Klebsiella pneumoniae Subsp. Ozaenae Klebsiella pneumoniae Subsp. Pneumoniae Lactobacillus plantarum Listeria monocytogenes Proteus vulgaris Pseudomonas aeruginosa Salmonella choleraesuis Serotype Enteritidis Salmonella choleraesuis Serotype Typhimurium Shigella dysenteriae Shigella sonnei Staphylococcus aureus (MRSA) Staphylococcus aureus (MRSA) Staphylococcus aureus (VISA) Staphylococcus epidermidis Staphylococcus pneumonia Staphylococcus pyogenes 19606 14581 29428 8090 9689 11913 13048 51575 >99.999 >99.999 >99.982 >99.999 >99.999 >99.997 >99.858 >99.999 51559 >99.999 11229 35150 >99.999 >99.999 11296 >99.999 13883 >99.999 14917 15313 13315 15442 13076 >99.999 >99.999 >99.999 >99.999 >99.999 14028 >99.999 13313 11060 33591 >99.999 >99.999 >99.999 080599MRSA* >99.999 042800VISA* >93.781** 12228 33400 19615 >99.999 >99.996 >99.999 *Clinical Isolate **30 Second Exposure 20 PROVON® Foaming Medicated Handwash with Moisturizers and 0.5% Triclosan (continued) Efficacy Data — In Vivo Healthcare Personnel Handwash Data Objective: This study evaluated the antimicrobial effectiveness of three (3) test products and on (1) reference product using a Healthcare Personnel Handwash Procedure, as per methodology specified by the Food and Drug Administration (FR 43:4, 06 Jan 78, pp. 1210-1248). Description of Test: The antimicrobial effectiveness and irritation potential of three (3) test products and one (1) reference product for use as Health Care Personnel Handwashes were determined using ten (10) consecutive hand contamination/product application procedures, followed by an additional fifteen (15) applications of product. Serratia marcescens (ATCC #14756) was the marker organism used for hand contaminations. Seventy-two (72) human subjects were utilized for the test. Microbial samples were taken at baseline and after product applications one (1), three (3), seven (7), and ten (10), followed by fifteen (15) additional washes with irritation evaluations performed after wash fifteen (15), twenty (20), and twenty-five (25). All sampling of the hands was performed using the Glove Juice Sampling Procedure. The testing methods were based on the Food and Drug Administration 1978 Tentative Final Monograph (TFM) (FR 45:1210, 6 Jan 78, pp. 1210-1248). Independent Laboratory: BioScience Laboratories, Inc., Bozeman, MT Date: January 31, 2003 Results: Wash Antibacterial Reference Number Reduction Reduction Log10 Log10 1 3 7 10 2.10 2.32 2.77 3.00 2.60 3.48 3.94 4.08 Conclusion: Product meets the protocol for a Healthcare Personnel Handwash. 21 Bathing & Moisturizing PROVON® Antibacterial Body Wash Efficacy Data — In Vitro (continued) Dermatologist-tested. Stock No. 4026, 4029 Microorganism Escherichia coli Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens Staphylococcus aureus Staphylococcus aureus Methicillin resistant Physical Characteristics Color: Dye-free, Colorless Fragrance: Floral Musk pH: 4.5-7.0 Irritancy Data and Allergy Test Results Active Ingredient Triclosan 0.15% Also Contains: Water (Aqua) Sodium Lactate Coco-Betaine Disodium EDTA Lactic Acid Lauramine Oxide PEG-4 Fragrance (Parfum) Iodopropynyl Butylcarbamate Percent Reduction of Test Organisms After a 15Second Exposure 8090 9869 >99.999 >99.999* 51575 19434 >99.999 >99.999* 51559 >99.999 >99.999 Ingredients Timed-Exposure Kill Tests Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15)- or thirty (30)second-exposure kill studies were performed utilizing thirteen (13) challenge bacteria. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time (15 or 30 seconds). Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Date: July 19, 1994, October 20, 1994, September 11,1995, and December 2, 1997. % Reduction >99.999 33591 Conclusion: Very effective reduction of Gramnegative and Gram-positive bacteria by the product was demonstrated. Efficacy Data — In Vitro ATCC No. 19606 % Reduction >99.999* >99.999 >99.999* >99.999 >99.999* >99.999* * 30-Second Exposure Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: August 17, 1999 Results: Average score 0.00 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Microorganism Acinetobacter baumannii Citrobacter freundii Clostridium difficile Enterococcus faecalis Vancomycin resistant Enterococcus faecium Enterococcus faecium Vancomycin resistant ATCC No. 8739 11296 7002 15442 14756 6538 22 Ingredient Class Antimicrobial Agent Carrier Skin Conditioning Agent, Humectant Surfactant, Cleansing Agent Chelating Agent pH Adjuster Surfactant, Cleansing Agent Humectant Fragrance Preservative PROVON® Moisturizing Bathing Cloths Dermatologist-tested. Stock No. 4475 Physical Characteristics Appearance: Soft white cloth Fragrance: Light fresh scent Form: Towel pH: 5.0-6.0 Irritancy Data and Allergy Test Results Objective: Determination of sensitizing properties of one (1) product by Draize repeated insult patch test in human volunteers. Description of Test: Patch with test article was applied to its designated contact site on 50 panelists and remained in place for 24 hours at which time it was removed and examined for dermal response. This procedure was repeated on Mondays, Wednesdays, and Fridays until a series of nine applications were made. A challenge phase occurred 2 weeks after the ninth application. Independent Laboratory: The Institute for Skin Research, Tel Aviv Israel. Date: November 27, 1996 Results: No reaction was observed in any of the volunteers. Conclusion: Low potential for irritation or sensitization with this product. Ingredients Contents Water Polysorbate 20 Propylene Glycol Ingredient Class Carrier Surfactant-emulsifying agent Skin conditioning agenthumectant Aloe Barbadensis Leaf Juice Skin conditioning agent Citric Acid pH adjuster Disodium Cocoamphodiacetate Surfactant-cleansing agent Sodium Citrate pH adjuster Sodium Laureth Sulfate Surfactant-cleansing agent Tetrasodium EDTA Chelating agent Fragrance (Parfum) Fragrance 2-Bromo-2-Nitropropane-1,3-Diol Preservative Benzalkonium Chloride Cosmetic biocide Benzyl Alcohol Preservative Methylchloroisothiazolinone Preservative Methylisothiazolinone Preservative Methylparaben Preservative *International Nomenclature Cosmetic Ingredient 23 PROVON® Conditioning Shampoo & Body Wash PROVON® Tearless Shampoo & Body Wash Dermatologist-tested. Dermatologist-tested. Stock No. 2127, 2227, 4127, 4446, 4037 Stock No. 4032, 4034, 4402, 4403, 4405, 4406, 4408, 2234, 2134 Physical Characteristics Physical Characteristics Color: Peach colored pearled viscous liquid Fragrance: Fruity Form: Liquid pH: 5.0-8.0 Color: Clear, Blue Fragrance: Floral Fruity Viscosity: 4,000- 10,000 cps pH: 5.5- 6.5 Irritancy Data and Allergy Test Results Irritancy Data and Allergy Test Results Objective: Evaluation of skin irritation potential in humans. Description of Test: Phillips et al (Toxic and Applied Pharmacology 21: 369-382) summarizes the method utilized for this evaluation. Fresh materials are applied daily, 5 days per week, for 21 days to the same site (patches were not moved or reapplied on the weekends). Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: July 5, 2002 Results: Average score = 0.18 (scale 0-4); No sensitization occured. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: July 5, 2000. Results: Average score 0.00 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Tearless Test Results Description of Test: Comparative human eye irritation / Sting potential study. Independent Laboratory: Essex Testing Clinic, Inc. Date: May 19, 2000. Conclusion: Tearless shampoo is considered to be “tear-free” Ingredients INCI Name* Water (Aqua) Cocamide DEA Sodium Laureth Sulfate Sodium Lauryl Sulfate Disodium Laureth Sulfosuccinate Cocamidopropyl Betaine Ammonium Chloride Soyamidopropyl Betaine Ingredient Class Carrier Surfactant, Foam Booster Surfactant, Foam Booster Surfactant, Cleansing Agent Surfactant Surfactant, Foam Booster Viscosity Increasing Agent Cleansing Agent, Skin Conditioning Agent, Foam Booster Glycol Distearate Emollient Pearlizing Agent Lactic Acid pH Adjuster DMDM Hydantoin Preservative Fragrance (Parfum) Fragrance Lauramide DEA Surfactant, Foam Booster, Viscosity Increasing Agent Glycerin Skin Conditioning Agent, Humectant Tetrasodium EDTA Chelating Agent Polyquaternium-10 Conditioning Agent Sodium Chloride Viscosity Increasing Agent Linoleamidopropyl PG-Dimonium Hair Conditioning Agent Chloride Phosphate Dimethicone Cocamidopropyl PG-Dimonium Conditioning Agent Chloride Phosphate Aloe Barbadensis Leaf Juice Botanical Additive, Skin Conditioning Agent Simmondsia Chinensis (Jojoba) Skin Conditioning Agent Seed Oil Tocopheryl Acetate Skin Conditioning Agent Red 40 (CI 16035) Colorant Retinyl Palmitate Skin Conditioning Agent Yellow 5 (CI 19140) Colorant Zea Mays (Corn) Oil Skin Conditioning Agent Ingredients Contents Water (Aqua) PEG-80 Sorbitan Laurate Cocamidopropyl Betaine Sodium Trideceth Sulfate PEG-150 Distearate Sodium Lauroamphoacetate Aloe Barbadensis Leaf Juice Citric Acid Glycerin Polyquaternium-10 Retinyl Palmitate Sodium Laureth13 Carboxylate Tetrasodium EDTA Tocopheryl Acetate Zea Mays (Corn) Oil Fragrance (Parfum) Quaternium-15 Blue No. 1 (CI 42090) *International Nomenclature Cosmetic Ingredient 24 Ingredient Class Carrier Surfactant, Cleansing Agent Surfactant, Foam Booster, Viscosity Increasing Agent Surfactant, Cleansing Agent Surfactant, Cleansing Agent Hair Conditioning Agent, Surfactant, Cleansing Agent, Foam Booster Botanical Additive, Skin Conditioning Agent pH Adjuster Humectant Antistatic Agent Skin Conditioning Agent Surfactant, Cleansing Agent Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Fragrance Preservative Colorant PROVON® Enriched Shampoo for Body & Hair PROVON® Foaming Hair & Body Wash with Moisturizers Dermatologist-tested. Dermatologist-tested. Stock No. 4012, 4014, 4015, 4016, 4018, 4033, 4035, 2133, 2233 Stock No. 5287, 5187, 5987, 5787 Physical Characteristics Physical Characteristics Color: Clear Yellow Fragrance: Herbal Viscosity: 5,700-18,300 cps pH: 4.5-8.0 Color: Clear Green Fragrance: Cucumber Melon Form: Liquid pH: 4.5-9.5 Irritancy Data and Allergy Test Results Irritancy Data and Allergy Test Results Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: November 10, 1992 Results: Average score 0.28 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Objective: Evaluation of skin irritation potential in humans. Description of Test: Phillips et al (Toxic and Applied Pharmacology 21: 369-382) summarizes the method utilized for this evaluation. Fresh materials are applied daily, 5 days per week, for 21 days to the same site (patches were not moved or reapplied on the weekends). Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: July 5, 2002 Results: Average score = 0.18 (scale 0-4); No sensitization occured. Conclusion: The product has a low potential for skin irritation and allergic contact dermatitis. Ingredients Contents Water (Aqua) Sodium Laureth Sulfate Cocamide DEA Sodium Lauryl Sulfate Soyamidopropyl Betaine Aloe Barbadensis Leaf Juice Ammonium Chloride Citric Acid Sodium Chloride Tocopheryl Acetate Fragrance (Parfum) DMDM Hydantoin Red No. 40 (CI 16035) Yellow No. 5 (CI 19140) Yellow No. 6 (CI 15985) Ingredient Class Carrier Surfactant, Cleansing Agent Surfactant, Foam Booster Surfactant, Cleansing Agent Cleansing Agent, Skin Conditioning Agent, Foam Booster Botanical Additive, Skin Conditioning Agent Viscosity Increasing Agent pH Adjuster, Chelating Agent Viscosity Increasing Agent Skin Conditioning Agent Fragrance Preservative Colorant Colorant Colorant Human Repeated Insult Patch Test Objective: Determination of the dermal irritation and sensitization potential of the product. Description of Test: Human repeated insult patch test. Independent Laboratory: Clinical Research Laboratories, Inc., Piscataway, New Jersey. Date: February 25, 2003 Results: No visible skin reactions were observed during the induction or challenge phases of the study. Conclusion: Test product demonstrated no potential for eliciting either dermal irritation or sensitization. 25 PROVON® Foaming Hair & Body Wash with Moisturizers (continued) PROVON® Moisturizing Hand & Body Lotion Ingredients INCI Name* Water (Aqua) Ammonium Laureth Sulfate Ammonium Lauryl Sulfate Cocamide MEA Aloe Barbadensis Leaf Juice Ammonium Xylenesulfonate Citric Acid Disodium Soyamphodiacetate Glycerin PEG-80 Glyceryl Cocoate Quaternium-52 Retinyl Palmitate Simmondsia Chinensis (Jojoba) Seed Oil Tetrasodium EDTA Tocopheryl Acetate Wheat Amino Acids Zea Mays (Corn) Oil Ammonium Sulfate Fragrance (Parfum) Quaternium-15 Blue 1 (Cl 42090) Yellow 10 (Cl 47005) Dermatologist-tested. CHG compatible. Latex compatible. Ingredient Class Carrier Surfactant, Cleansing Agent Surfactant, Cleansing Agent Surfactant, Foam Booster Viscosity Increasing Agent Botanical Additive, Skin Conditioning Agent Surfactant, Cleansing Agent pH Adjuster Cleansing Agent Skin Conditioning Agent, Humectant Surfectant, Cleansing Agent Cleansing Agent, Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent Stock No. 4231, 4232, 4233, 4236, 4238, 2533 Physical Characteristics Color: Creamy Opaque Fragrance: No Cosmetic Fragrance Viscosity: 10,000-22,000 cps Irritancy Data and Allergy Test Results Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: August 17, 1999 Results: Average score 0.23 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent Thickener Fragrance Preservative Colorant Colorant Ingredients *International Nomenclature Cosmetic Ingredient Contents Water (Aqua) Petrolatum Distearyldimonium Chloride Glycerin Isopropyl Myristate Cetyl Alcohol Dimethicone Fragrance (Parfum) Butylparaben Isobutylparaben Isopropylparaben Quaternium-15 26 Ingredient Class Carrier Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent, Humectant Skin Conditioning Agent, Emollient Skin Conditioning Agent, Emollient Skin Conditioning Agent Fragrance Preservative Preservative Preservative Preservative Perineal Skin Care PROVON® Skin Moisturizer with Aloe & Vitamins PROVON® Perineal Wash Dermatologist-tested. Dermatologist-tested. Stock No. 4251, 4252 Stock No. 4422, 4424, 4426 Physical Characteristics Physical Characteristics Color: Green Fragrance: Citrus Oriental pH: 5.0-8.5 Color: Creamy Opaque Fragrance: Floral Viscosity: 5,000-33,000 cps pH: 4.5-8.5 Irritancy Data and Allergy Test Results Irritancy Data and Allergy Test Results Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: June 11, 1999 Results: Average score 0.01 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: November 24, 1992 Results: Average score 0.03 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Ingredients Ingredients Contents Water (Aqua) Glycerin Stearic Acid Cetyl Alcohol Aloe Barbadensis Leaf Juice Dimethicone Mineral Oil (Paraffinum Liquidum) Retinyl Palmitate Tocopheryl Acetate Zea Mays (Corn) Oil Triethanolamine Fragrance (Parfum) Phenoxyethanol DMDM Hydantoin Iodopropynyl Butylcarbamate Contents Water (Aqua) Aloe Barbadensis Leaf Juice Ingredient Class Carrier Skin Conditioning Agent, Humectant Viscosity Increasing, Skin Conditioning Agent Skin Conditioning Agent, Emollient Botanical Additive, Skin Conditioning Agent Skin Conditioning Agent Emollient, Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent pH Adjuster Fragrance Preservative Preservative Preservative Citric Acid Cocamidopropyl PG-Dimonium Chloride Phosphate Coco-Betaine Lauramine Oxide Retinyl Palmitate Tetrasodium EDTA Tocopheryl Acetate Zea Mays (Corn) Oil Fragrance (Parfum) DMDM Hydantoin Iodopropynyl Butylcarbamate Blue 1 (CI 42090) Yellow 5 (CI 19140) 27 Ingredient Class Carrier Botanical Additive, Skin Conditioning Agent pH Adjuster Skin Conditioning Agent Surfactant, Cleansing Agent Surfactant, Cleansing Agent Skin Conditioning Agent Chelating Agent Skin Conditioning Agent Skin Conditioning Agent Fragrance Preservative Preservative Colorant Colorant Efficacy Data — In Vitro (continued) PROVON® Antibacterial Perineal Wash Dermatologist-tested, dye-free. U.S. Pat. 5,635,462. Microorganism Stock No. 4432, 4436, 4434 Staphylococcus aureus Staphylococcus aureus Methicillin resistant Physical Characteristics Color: Colorless (dye-free) Fragrance: Fresh and Light Viscosity: 100 cps pH: 5.8-6.2 >99.999 33591 >99.999 Ingredients Active Ingredient Triclosan 0.15% Also Contains: Water (Aqua) Sodium Lactate Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: August 17, 1999 Results: Average score 0.00 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Coco-Betaine Disodium EDTA Lactic Acid Lauramine Oxide PEG-4 Humectant Fragrance (Parfum) Iodopropynyl Butylcarbamate Efficacy Data — In Vitro Timed-Exposure Kill Tests Objective: Evaluation of the antimicrobial effectiveness of the product in vitro. Description of Test: Fifteen (15) or thirty (30)-secondexposure kill studies were performed utilizing thirteen (13) challenge bacteria. The challenge inoculum was introduced to the test product at time zero; a portion of the sample was removed and placed in neutralizing media at the appropriate time. Standard plate counting techniques were used to enumerate viable challenge microorganisms. Independent Laboratory: BioScience Laboratories, Inc., Bozeman, Montana. Dates: July 19, 1994; October 20, 1994; September 11, 1995; December 2, 1997. Percent Reduction of Test Organisms After a 30-Second Exposure Acinetobacter baumannii Citrobacter freundii Clostridium difficile Enterococcus faecalis Vancomycin resistant Enterococcus faecium Enterococcus faecium Vancomycin resistant Escherichia coli Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens 6538 Conclusion: Very effective reduction of Gramnegative and Gram-positive bacteria by the product was demonstrated. Irritancy Data and Allergy Test Results Microorganism ATCC No. % Reduction ATCC No. % Reduction 19606 8090 9869 >99.999 >99.999 >99.999 51575 19434 >99.999 >99.999 51559 8739 11296 7002 >99.999 >99.999 >99.999 >99.999 15442 14756 >99.999 >99.999 28 Ingredient Class Antimicrobial Agent Carrier Skin Conditioning Agent, Humectant Surfactant, Cleansing Agent Chelating Agent pH Adjuster Surfactant, Cleansing Agent Fragrance Preservative PROVON® Moisturizing Perineal Skin Protectant with Petrolatum PROVON® Personal Wash Cloths Dermatologist-tested. Dermatologist-tested. Stock No. 4471, 4472, 4470 Stock No. 4441 Physical Characteristics Physical Characteristics Appearance: Soft white cloth Fragrance: Light fresh scent Form: Towel pH: 5.0-6.0 Color: Dye-free, Creamy White Fragrance: Fresh and Light Viscosity: Nongreasy, Semisolid Irritancy Data and Allergy Test Results Irritancy Data and Allergy Test Results Objective: Determine whether any of a series of test materials produces primary irritation under a single Patch test on selected persons. Description of Test: A test is conducted using a specific solution to identify individuals with sensitive skin. A minimum of 10 participants with sensitive skin are required. Following the pretest, the test product is applied for 48 hours to all subjects and evaluated at 1 hour, 24 hours and after removal of the patch. The site is ranked on a 0-4 scale. Independent Laboratory: The Institute for Skin Research, Tel Aviv Israel. Date: February 18, 2001 Results: There were 50 panelist with 16 classified as having sensitive skin. No reaction was observed in any of the volunteers in the irritation patch test. Conclusion: The product is not irritating on sensitive skin. Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: November 24, 1992 Results: Average score 0 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Lower potential for skin irritation and allergic contact dermatitis as indicated by a score of zero (0). Ingredients Active Ingredient Petrolatum, 60% Also Contains: Aluminum Starch Octenylsuccinate Fragrance (Parfum) Methyldibromo Glutaronitrile Phenoxyethanol Ingredients Contents Water Mineral Oil Trilaureth-4-phophate Cocamidopropyl Betaine Iodopropynyl Butylcarbomate Fragrance (Parfum) Disodium EDTA Allantoin 2-Bromo-2-nitropropane-1,3-diol Panthenol Chamomilla Recutita (Matricaria) Extract Sodium Citrate Citric Acid Dimethicone Ingredient Class Carrier Skin Conditioning Agent Surfactant Skin Conditioning Agent Preservative Fragrance Chelating Agent Skin Conditioning Agent Preservative Conditioning Agent Cosmetic Biocide pH Adjuster pH Adjuster Skin Conditioning Agent *International Nomenclature Cosmetic Ingredient 29 Ingredient Class Skin Protectant Texture Enhancer Fragrance Preservative Preservative PROVON® Perineal Cream PROVON® Perineal Ointment with Petrolatum Dermatologist-tested. Dermatologist-tested. Stock No. 4421 Stock No. 4428, 4429 Physical Characteristics Physical Characteristics Color: White Opaque Fragrance: Floral Viscosity: 5,000-33,000 cps minimum (cream) Color: Blue Opaque Fragrance: Oriental Citrus Viscosity: Semisolid Irritancy Data and Allergy Test Results Irritancy Data and Allergy Test Results Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: November 24, 1992 Results: Average score 0.10 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Product has a low potential for skin irritation and allergic contact dermatitis. Objective: Evaluation of irritation potential in humans. Description of Test: 21-Day Human Irritancy Assay with Delayed Challenge. Independent Laboratory: Dermatologic Research Laboratory, San Francisco, California. Date: August 17, 1999 Results: Average score 0 (scale 0-4). Lower scores indicate low potential for skin irritation and allergic contact dermatitis. Conclusion: Lower potential for skin irritation and allergic contact dermatitis as indicated by a score of zero (0). Ingredients Contents: Water (Aqua) Lanolin Oil Glycerin Cetyl Alcohol Sodium Lauryl Sulfate Beeswax (Cera Alba) Allantoin Aloe Barbadensis Leaf Juice Antioxidant Conditioning Agent Agent Skin Conditioning Agent Conditioning Agent Conditioning Agent Viscosity Increasing Crosspolymer Xanthan Gum Agent (Parfum) Methylparaben Propylparaben Quaternium-15 Ingredients Carrier Skin Conditioning Agent, Emollient Skin Conditioning Agent, Humectant Skin Conditioning Agent, Emollient Surfactant, Emulsifier Skin Conditioning Agent Skin Conditioning Agent Botanical Additive, Skin Conditioning AgentBHT Cholecalciferol Skin Panthenol Skin Conditioning Retinyl Palmitate Tocopheryl Acetate Skin Zea Mays (Corn) Oil Skin Acrylates/C10-30 Alkyl Acrylate Agent Viscosity Increasing Fragrance Fragrance Preservative Preservative Preservative 30 Active Ingredient Petrolatum 99% Inactive Ingredients: Cholecalciferol Lanolin Retinyl Palmitate Sodium Caseinate Sorbitan Oleate Tocopheryl Acetate Zea Mays (Corn) Oil Fragrance (Parfum) Methyldibromo Glutaronitrile Phenoxyethanol Green 6 (CI 61565) Ingredient Class Skin Protectant Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent Skin Conditioning Agent Surfactant, Emulsifying Agent Skin Conditioning Agent Skin Conditioning Agent Fragrance Preservative Preservative Colorant NOTES 31 NOTES 32 GLOSSARY OF TERMS 21-Day Human Irritancy Assay with Delayed Challenge A standard patch test method used to determine the irritancy and allergic (sensitization) potential of a product applied to human skin. Antibacterial A substance that kills or inhibits the growth of bacteria. Antimicrobial A substance that kills or inhibits the growth of microorganisms. Antiseptic A substance that kills or inhibits the growth of disease-causing microorganisms. ASTM American Society for Testing and Materials CHG Compatible Products that have no inhibitory effect on the antimicrobial efficacy of products containing CHG (see Chlorhexidine Gluconate (CHG)). Chlorhexidine Gluconate (CHG) A topical antimicrobial active ingredient. Chloroxylenol A topical antimicrobial active ingredient. Also known as PCMX. Glove Juice Technique An in vivo technique used to enumerate microbial flora on the hands. (see In vivo). Gram-negative bacteria A primary characteristic of bacteria that possesses a thin cell wall. Used as a general classification of bacteria. Gram-positive bacteria A primary characteristic of bacteria that possesses a thick cell wall. Used as a general classification of bacteria. Healthcare Personnel Handwash Test A standard test method developed by the American Society for Testing and Materials (ASTM) that is designed to determine the ability of an antimicrobial handwashing agent to give reduction of transient microbial flora when used in a handwashing procedure (see In vivo). Human Repeated Insult Patch Test A repeated insult patch test procedure for determining irritancy and allergic potential of a product on the skin using human subjects. In vitro Latin term that means “in glass.” This term is used in reference to scientific tests that are conducted in glass beakers, Petri dishes, etc. In vivo Latin term that means “in a living body.” This term is used in reference to scientific tests that are conducted on humans. Latex Compatible Products that will not adversely affect the physical properties of latex gloves. Log Kill A measurement of the reduction in bacteria, virus, or fungi challenge numbers as measured in log base 10. Petrolatum Also known as petroleum jelly. A grade of hydrocarbon waxes known to be a skin moisturizer. At higher concentrations, this chemical can be used as a skin protectant. pH Level A measure of the acidity or alkalinity of a solution. Equal to 7 for neutral solutions and increasing with increased alkalinity, decreasing with increased acidity. Retinyl Palmitate Vitamin A. Surgical Scrub Test An in vivo procedure which measures the antimicrobial efficacy of a surgical scrub product (see In vivo). Tocopheryl Acetate Vitamin E. Triclosan A topical antimicrobial active ingredient. PURELL and PROVON . ® ® Cost-effective solutions for preventing the spread of infection and maintaining healthy skin. PROVEN SKIN CARE REGIMENS • PURELL® Instant Hand Sanitizer -- America’s number one brand, should be used frequently to disinfect hands. Kills 99.99% of most common germs that may cause disease in as little as 15 seconds. • PROVON® hand hygiene products -- Effective ways of preventing the spread of germs in healthcare settings. • PROVON bathing & moisturizing products -- Bathing products to help clean, and control odors. Moisturizing products help restore and protect dry, irritated skin. • PROVON perineal care products -- Help maintain healthy skin and leaves skin smelling clean and fresh. RELIABLE DISPENSING SYSTEMS • Removes the obstacles that can affect Healthcare Worker’s compliance. • A variety of practical, reliable and alternative dispensing options. • Easy-to-clean dispensers engineered for durability. • Refilling systems help staff service dispensers quickly and efficiently. • Guaranteed for life. EFFECTIVE TRAINING • Comprehensive skin care inservice programs for healthcare personnel. • Continuing education to support ongoing training needs. • Self study (1.5 CE) course for nurses on hand hygiene. GOJO Industries, Inc. Professional Markets Group P.O. Box 991, Akron, OH 44309-0991 800-321-9647 • 800-FAX-GOJO www.GOJO.com ©2004. GOJO Industries, Inc. All rights reserved. LIT-PRV-TIB (12/03)