You count on your hands to do your dirty, as well as your clean, work. You comfort a baby with your hands...and change his diaper. You wash dishes with your hands...and empty the garbage. You prepare raw chicken for cooking with your hands...and put the finishing touches on a birthday cake.
In between the dirty and the clean, it’s important, of course, to wash your hands...and to do it thoroughly enough to avoid infecting yourself and others.
A recent study published in Nature [June, 2012] reported that about 100 trillion bacteria–three or four pounds worth–live on the human body, and they are more than just passive travelers. Most of these germs do good rather than bad things for your health, but your bacteria are not the same as mine. And any touching with the hands can clearly spread the germs.
We all learned about hand washing in grade school, and it should have become a lifelong habit. It’s the best way to avoid getting or passing along infectious diseases such as colds, the flu or even more serious diseases. Unfortunately, most Americans are more lax about it than they want to admit. One study using video cameras found that one of every three women and two of every three men neglected to wash their hands after using a public toilet. Yet when questioned, more than 90 percent of Americans claim they do wash their hands after going to the toilet.
Another study found that 16 percent of the bacteria on subjects’ hands were E. coli, associated with fecal wastes and severe gastrointestinal illness.
WHY SHOULD YOU WASH? You have thousands, if not millions, of bacteria swarming all over your hands every minute, as the Nature article indicates. But they are friendly bacteria who enjoy a good relationship with your own immune system. And if the person whose hand you shake has an infectious disease, your own bacteria are likely to fight them off. But even if these bacteria don’t harm you, you could pass them on to someone whose immune system is not as healthy as yours. And that’s where problems begin.
Hand washing became recognized as a major tool of infection control when a 19th century Hungarian physician, Ignaz Semmelweis noted that mothers who delivered babies at his hospital were dying at a rate five times greater than those who delivered at home. Most, he discovered, had been treated by student physicians who had been working on cadavers during an anatomy class just before making their maternity rounds.
As an experiment, Dr. Semmelweis started requiring that his students wash their hands before treating the new mothers. A novel idea at the time, strict hand washing resulted in a prompt reduction of maternity ward deaths.
WHEN TO WASH: During cold and flu season or any time you’re sick or have been around sick persons, it’s important to wash your hands frequently.
Hospitals and doctors’ offices usually have strict rules about hand washing. So should you when you’re caring for a sick child or adult.
Other times you should wash your hands include:
• Before eating.
• After using the toilet, when the number of germs on your finger tips doubles.
• Before preparing food.
• After touching raw meat, poultry or fish and especially before you touch any fresh food, such as lettuce, that does not require cooking.
• When you’ve changed a baby’s diaper.
• When you’ve coughed or sneezed.
• After you’ve petted or cared for pets.
• When you’ve been working outside in the garden.
• After handling garbage.
• After you’ve taken medication or treated a sore on your skin.
• Before inserting or removing a contact lens.
HOW TO WASH: Just placing your hands under running water for a few minutes will do very little if anything to get rid of harmful bacteria.
• Use warm water and soap, lathering up all over the hands, in between the fingers, under the nails and up the wrists. Remember that millions of bacteria can hide under a ring, watch band or bracelet.
• Take at least 20 seconds–or the time it takes to sing the Happy Birthday song twice–to wash, rubbing the hands vigorously together before rinsing.
• Then dry the hands thoroughly with a clean towel or paper towel. Damp hands spread twice as many germs as dry hands.
Don’t worry about bacteria that might remain on the soap from a previous user. It washes away quickly with the lather.
And antibiotic soap is not required. A comprehensive University of Oregon study found that regular soaps are just as effective as consumer-grade antibacterial soaps containing triclosan in preventing illness and removing bacteria.
One worry is that antibacterial soaps may interfere with or destroy some of your beneficial germs and, over the long term, lead to antibiotic resistance.
If you have sensitive skin, don’t skip the soap; rather, try washing your hands in cold water. Warm or even hot water adds very little to hand washing. Water hot enough to kill bacteria would be hot enough to destroy your hands as well.
Alcohol-based hand cleaners may be less likely to irritate the skin. They are also handy when soap and water aren’t readily available. Simply apply an ample amount of the product to the palm of your hand, then rub your hands together until your hands are dry. Be sure to cover all surfaces of your hands. These cleaners, however, are believed to be less effective for viruses than for bacteria, and they can dry the skin.
If you’re concerned about the time it takes to wash your hands properly, think about the time it takes to recover from an infectious illness. One study found that Detroit school children who washed their hands four times a day had significantly fewer sick days because of respiratory or stomach illnesses. That’s a plus for parents and teachers as well as children.
REFERENCES:
Brenda Goodman, “Study finds bacteria in unused paper towels,” Medscape Health News, December 28, 2011.
“Hand washing how to,” Project WET, 2011.
“Hand washing: why and how we really should wash our hands,” Wellescent.com, May 17, 2012.
Jim Kling, “Electronic reminder improves hand washing,” Medscape Medical News, May 6, 2011.
Gina Kolata, “In good health? Thank your 100 trillion bacteria,” New York Times, June 13, 2012.
Minnesota Department of Health, “Hand hygiene,” updated November 22, 2010.
Nancy A. Melville, ‘WHO hand-hygiene initiative largely ignored,” Medscape Medical News, May 20, 2011.
“Soap and water hand washing superior to alcohol-based rubs in reducing presence of influenza A,” Medscape Medical News, February 13, 2009.
Trobey, M.D., Emergency Medicine, “Hand washing 101,” The Differential (blog), July 4, 2009.
“Washing your hands–how and why it is important for your health,” Environment, Health and Safety Online.
“Why is hand washing so important?” KidsHealth, reviewed by Mary L. Gavin, M.D., March, 2011.
08/08/2012
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