Handwashing Important Ideas and Key Basic Facts
Handwashing a Task for All Ages, Times and Places-How to and Why
Mar 6, 2009
The sign is displayed in restrooms of all restaurants: “ALL EMPLOYEES MUST WASH THEIR HANDS”. That sign is both a comforting thought, and an unsettling reminder, that for some it is an all too easily-forgotten or ignored habit.
Modern Surveys and Studies Are Revealing
The CDC in Atlanta reported observational studies that included a Men’s Restroom at a sports stadium. An astounding 46% of the male users left without ever handwashing while women at the same facility washed at 89% rate.
On the average 15-45% of all people routinely are not washing their hands.
Whether global or local, it is likely that some people almost never wash their hands- unless they are obviously dirty or stained. Unfortunately, what you do not see can often harm or kill. A short trip back in time is worthwhile.
Dr. Semmelweiss and Pueperal Fever
In Vienna, Austria around 1845, Dr. Semmelweiss noted that mothers who had their babies in one area of the hospital contracted puerperal fever, a deadly blood-borne (septicemic) disease caused by Streptococcus pyogenes, at an average rate of 12%. Mothers delivering in another area died at an average alarming rate 2%. The reason was discovered fairly soon. Interns often did not wash their hands and the doctors and interns in the most deadly area frequently did autopsies and then went out to help deliver babies. Semmelweiss connected the events and corrected the problem by requiring all the doctors to remove dirty autopsy aprons or gowns and to always handwash with chloride of lime before attending patients.The results were great- the whole hospital infection rate fell to 1.2%! Problem ended, right? No! A more recent story now follows.
Staphylococcus aureus Epidemic and Nosocomial Infection at The Royal Melbourne Hospital
In the 1980s, an epidemic of Staphylococcus aureus developed at a hospital in Melbourne, Australia. Many patients were getting hospital-acquired (nosocomial) infections with multiple-resistant strains of S. aureus known as MRSA.
A nurse epidmiologist (disease transmission expert) and Dr Ken Harvey, Microbiology Director,recalled two major problems relating to the epidemic:
- Antibiotic overuse and misuse by doctors
- Hand washing omission among hospital personnel throughout the ranks
The hospital posted simple signs throughout the hospital to remind doctors to prescribe antibiotics with greater thought and care and for everyone to wash their hands before and after attending to each patient. The incidence of S. aureus infections and disease in patients and personnel dropped dramatically.
One doctor came to the nurse epidemiologist and asked how he should wash his hands. She told him in no uncertain terms “If I have to tell you how to wash your hands, then you do not belong here”.
All need to recognize the importance handwashing and DO IT!.
Respiratory and digestive infectious diseases are reduced dramatically and lives are saved when handwashing is done correctly. When to do it and how are both important.
When to Handwash
Before eating, preparing a meal, after using a bathroom, changing a diaper, and touching any obvious or potentially-contaminated objects or surfaces. Many human infections are acquired by a person's own contaminated hands touching their eyes or mouth. As a rule: Avoid touching fingers to mouth or eyes.
How to Handwashing Essentials
- Wet your hands thoroughly with clean (preferably warm) water
- Add plenty of soap
- Rub both hands together for at least 15-20 seconds and rotate and wash one hand with the other
- Rinse thoroughly
- Dry by towel or forced air
- Gel or foam ethanol (62%) is most useful when water and soap are not available. Place 1 inch or 2.5 cm amount on your one palm and rub and rotate the hands together covering the top and bottom of hands in all areas until there is no more. It works!
Hand washing is an old and necessary ritual. Science and medicine have provided a clear understanding of what goes wrong when good handwashing routines are omitted. Now, more than ever, thorough and frequent hand washing is imperative for living a good and healthy life. Keep it that way!
Resources and References
Timmreck, Thomas C.1994.The Epidemiology of Childbed Fever in a Lying-In Hospital pp.68-70 in An Introduction to Epidemiology. Jones and Bartlett Publishers, Boston. 484 pp
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