Clean Hands saves Life!

 

Hand Washing – Clean Hands saves Life!

Alcohol hand sanitizer

Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water.

How germs get onto hands and make people sick

 

Feces (poop) from people or animals is an important source of germs like Salmonella, E. coli O157, and norovirus that cause diarrhea, and it can spread some respiratory infections like adenovirus and hand-foot-mouth disease. These kinds of germs can get onto hands after people use the toilet or change a diaper, but also in less obvious ways, like after handling raw meats that have invisible amounts of animal poop on them. A single gram of human feces—which is about the weight of a paper clip—can contain one trillion germs. Germs can also get onto hands if people touch any object that has germs on it because someone coughed or sneezed on it or was touched by some other contaminated object. When these germs get onto hands and are not washed off, they can be passed from person to person and make people sick.

Washing hands prevents illnesses and spread of infections to others

 

Handwashing with soap removes germs from hands. This helps prevent infections because:

 

  • People frequently touch their eyes, nose, and mouth without even realizing it. Germs can get into the body through the eyes, nose and mouth and make us
  • Germs from unwashed hands can get into foods and drinks while people prepare or consume them. Germs can multiply in some types of foods or drinks, under certain conditions, and make people
  • Germs from unwashed hands can be transferred to other objects, like handrails, table tops, or toys, and then transferred to another person’s
  • Removing germs through handwashing therefore helps prevent diarrhea and respiratory infections and may even help prevent skin and eye

 

Teaching people about handwashing helps them and their communities stay healthy. Handwashing education in the community:

  • Reduces the number of people who get sick with diarrhea by 31%
  • Reduces diarrheal illness in people with weakened immune systems by 58%
  • Reduces respiratory illnesses, like colds, in the general population by 21%

 

Not washing hands harms children around the world

 

About 2.2 million children under the age of 5 die each year from diarrheal diseases and pneumonia, the top two killers of young children around the world.

  • Handwashing with soap could protect about 1 out of every 3 young children who get sick with diarrhea and almost 1 out of 6 young children with respiratory infections like pneumonia.
  • Although people around the world clean their hands with water, very few use soap to wash their hands. Washing hands with soap removes germs much more
  • Handwashing education and access to soap in schools can help improve
  • Good handwashing early in life may help improve child development in some

 

References

 Azor-Martínez E, Cobos-Carrascosa E, Gimenez-Sanchez F, Martínez-López JM, Garrido- Fernández P, Santisteban-Martínez J, Seijas-Vazquez ML, Campos-Fernandez MA, Bonillo- Perales A. Effectiveness of a multifactorial handwashing program to reduce school absenteeism due to acute Pediatr Infect Dis J. 2013 Oct 3.

  1. Bowen A, Agboatwalla M, Luby S, Tobery T, Ayers T, Hoekstra RM. Association between intensive handwashing promotion and child development in Karachi, Pakistan: a cluster randomized controlled trial. Arch Pediatr Adolesc Med. 2012 Nov;166(11):1037-44.
  2. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since Lancet. 2012 Jun 9;379(9832):2151-61.
  3. Lau CH, Springston EE, Sohn MW, Mason I, Gadola E, Damitz M, Gupta RS. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort BMC Pediatr. 2012;12:52.
  4. Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of Int J Environ Res Public Health. 2011 Jan;8(1):97-104.
  5. Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008;1:CD004265.
  6. Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372-81.
  7. Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD004265.
  8. Huang DB, Zhou J. Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled J Med Microbiol. 2007;56(5):659- 63.
  9. Rabie T and Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic Trop Med Int Health. 2006 Mar;11(3):258-67.
  10. Franks AH, Harmsen HJM, Raangs GC, Jansen GJ, Schut F, Welling GW. Variations of bacterial populations in human feces measured by fluorescent in situ hybridization with group-specific 16S rRNA-targeted oligonucleotide Appl Environ Microbiol. 1998;64(9):3336-3345.
  11. Master D, Hess Longe SH, Dickson H. Scheduled hand washing in an elementary school Fam Med. 1997;29(5):336-9.

 

Keeping hands clean through improved hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water. If clean, running water is not accessible, as is common in many parts of the world, use soap and available water. If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands.

When should you wash your hands?

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage

How should you wash your hands?

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end
  • Rinse your hands well under clean, running
  • Dry your hands using a clean towel or air dry

Why? Read the science behind the recommendations.

 

What should you do if you don’t have soap and clean, running water?

Washing hands with soap and water is the best way to reduce the number of microbes on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.

Hand sanitizers are not as effective when hands are visibly dirty or greasy.

 

How do you use hand sanitizers?

 

  • Apply the product to the palm of one hand (read the label to learn the correct amount).
  • Rub your hands together.
  • Rub the product over all surfaces of your hands and fingers until your hands are

 

 

Washing hands with soap and water is the best way to reduce the number of microbes on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.

 

Why? Many studies have found that sanitizers with an alcohol concentration between 60–95% are more effective at killing germs than those with a lower alcohol concentration or non-alcohol-

based hand sanitizers 1,2. Non-alcohol-based hand sanitizers may 1) not work equally well for all classes of germs (for example, Gram-positive vs. Gram-negative bacteria, Cryptosporidium, norovirus); 2) cause germs to develop resistance to the sanitizing agent; 3) merely reduce the growth of germs rather than kill them outright, or 4) be more likely to irritate skin than alcohol- based hand sanitizers 1,2.

References

 

  1. Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and Clin Microbiol Rev. 2004 Oct;17(4):863-93.
  2. Todd EC, Michaels BS, Holah J, Smith D, Greig JD, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 10. Alcohol-based antiseptics for hand disinfection and a comparison of their effectiveness with J Food Prot. 2010 Nov;73(11):2128-40.

Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.

 

Why? Although alcohol-based hand sanitizers can inactivate many types of microbes very effectively when used correctly 1-10, people may not use a large enough volume of the sanitizers or may wipe it off before it has dried 10. Furthermore, soap and water are more effective than hand

sanitizers at removing or inactivating certain kinds of germs, like Cryptosporidium, norovirus, and

Clostridium difficile 11-15.

References

 Antimicrobial spectrum and characteristics of hand-hygiene antiseptic agents. MMWR Morb Mortal Wkly Rep. 2002;51(RR16):45.

  1. Edmonds SL, Mann J, McCormack RR, Macinga DR, Fricker CM, Arbogast JW, Dolan MJ. SaniTwice: a novel approach to hand hygiene for reducing bacterial contamination on hands when soap and water are J Food Prot. 2010 Dec;73(12):2296-300.
  2. Grayson ML, Melvani S, Druce J, Barr IG, Ballard SA, Johnson PD, Mastorakos T, Birch C. Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human Clin Infect Dis. 2009 Feb 1;48(3):285-91.
  3. Hammond B, Ali Y, Fendler E, Dolan M, Donovan S. Effect of hand sanitizer use on elementary school Am J Infect Control. 2000 Oct;28(5):340-6.
  4. Hübner NO, Hübner C, Wodny M, Kampf G, Kramer A. Effectiveness of alcohol-based hand disinfectants in a public administration: Impact on health and work performance related to acute respiratory symptoms and diarrhoea. BMC Infect Dis. 2010;10:250.
  5. Kramer A, Galabov AS, Sattar SA, Döhner L, Pivert A, Payan C, Wolff MH, Yilmaz A, Steinmann
  6. Virucidal activity of a new hand disinfectant with reduced ethanol content: comparison with other alcohol-based formulations. J Hosp Infect. 2006 Jan;62(1):98-106.
  7. Lee GM, Salomon JA, Friedman JF, Hibberd PL, Ross-Degnan D, Zasloff E, Bediako S, Goldmann DA. Illness transmission in the home: a possible role for alcohol-based hand gels. 2005 Apr;115(4):852-60.
  8. Sandora TJ, Taveras EM, Shih MC, Resnick EA, Lee GM, Ross-Degnan D, Goldmann DA. A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the Pediatrics. 2005 Sep;116(3):587-94.
  9. Stebbins S, Cummings DA, Stark JH, Vukotich C, Mitruka K, Thompson W, Rinaldo C, Roth L, Wagner M, Wisniewski SR, Dato V, Eng H, Burke DS. Reduction in the incidence of influenza A but not influenza B associated with use of hand sanitizer and cough hygiene in schools: a randomized controlled Pediatr Infect Dis J. 2011 Nov;30(11):921-6.
  10. Kampf G, Marschall S, Eggerstedt S, Ostermeyer C. Efficacy of ethanol-based hand foams using clinically relevant amounts: a cross-over controlled study among healthy volunteers. BMC Infect Dis. 2010 Mar 26;10:78.
  11. Barbee SL, Weber DJ, Sobsey MD, Rutala WA. Inactivation of Cryptosporidium parvum oocyst infectivity by disinfection and sterilization Gastrointest Endosc. 1999 May;49(5):605-11.
  12. Blaney DD, Daly ER, Kirkland KB, Tongren JE, Kelso PT, Talbot EA. Use of alcohol-based hand sanitizers as a risk factor for norovirus outbreaks in long-term care facilities in northern New England: December 2006 to March Am J Infect Control. 2011 May;39(4):296-301.
  13. Charbonneau DL, Ponte JM, Kochanowski BA. A method of assessing the efficacy of hand sanitizers: use of real soil encountered in the food service J Food Prot. 2000 Apr;63(4):495-501.

 

  1. Grayson ML, Melvani S, Druce J, Barr IG, Ballard SA, Johnson PD, Mastorakos T, Birch C. Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human Clin Infect Dis. 2009 Feb 1;48(3):285-91.
  2. Oughton MT, Loo VG, Dendukuri N, Fenn S, Libman MD. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile. Infect Control Hosp Epidemiol. 2009 Oct;30(10):939-44.

Hand sanitizers may not be as effective when hands are visibly dirty or greasy.

 

Why? Many studies show that hand sanitizers work well in clinical settings like hospitals, where hands come into contact with germs but generally are not heavily soiled or greasy 1. Some data also show that hand sanitizers may work well against certain types of germs on slightly soiled hands 2,3. However, hands may become very greasy or soiled in community settings, such as after people handle food, play sports, work in the garden, or go camping or fishing. When hands are

heavily soiled or greasy, hand sanitizers may not work well 1,4,5 Handwashing with soap and water is recommended in such circumstances.

References

 

  1. Todd ECD, Michaels BS, Holah J, Smith D, Grieg JD, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 10. Alcohol-based antiseptics for hand disinfection and a comparison of their effectiveness with J Food Prot. 2010 Nov;73(11):2128-40.
  2. Pickering AJ, Davis J, Boehm AB. Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking J Water Health. 2011 Sep;9(3):429-33.
  3. Pickering AJ, Boehm AB, Mwanjali M, Davis J. Efficacy of waterless hand hygiene compared with handwashing with soap: a field study in Dar es Salaam, Am J Trop Med Hyg. 2010 Feb;82(2):270-8.
  4. Charbonneau DL, Ponte JM, Kochanowski BA. A method of assessing the efficacy of hand sanitizers: use of real soil encountered in the food service J Food Prot. 2000 Apr;63(4):495-501.
  5. Edmonds SL, Mann J, McCormack RR, Macinga DR, Fricker CM, Arbogast JW, Dolan MJ. SaniTwice: a novel approach to hand hygiene for reducing bacterial contamination on hands when soap and water are J Food Prot. 2010 Dec;73(12):2296-300.

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