The Medical Minute: National Hand Washing Week

By John Messmer

With two epidemics of novel H1N1 flu in 2009, hand washing has been in the news often, but there are many other reasons for keeping our hands clean besides colds and flu. Flu viruses are more likely to reach us through the air after someone with the flu coughs or sneezes, but viruses that cause the common cold are often found on surfaces that we touch, including other people’s hands. We pick up the virus on our hands, then if we touch our nose, eyes or mouth we can infect ourselves.

There are a number of infections that enter through the gastrointestinal tract from simple diarrhea to hepatitis. Clean hands are important for us and those who handle our food to reduce the chance of infection.

Viruses, bacteria and parasites are everywhere. Even doctors’ ties have been shown to harbor bacteria. For most of us who are generally healthy, these are not a problem -- as long as they stay outside our bodies. Unless the skin is broken, having pathologic organisms on our hands is not a big risk. Problems arise when these organisms get to where they should not be, such as our respiratory or gastrointestinal tracts or under the skin. But when we have germs on our hands, we leave them on other surfaces where other people can pick them up, or we might accidentally introduce them into our bodies by eating a snack or scratching an itch and breaking the skin.

So, keeping our hands clean is a good idea in general, but it is particularly important in certain situations of greater risk. Always wash your hands before eating or preparing food, treating cuts or scrapes, tending to others who are ill or injured, or inserting or removing contact lenses. Always wash your hands after handling uncooked food, particularly meat and fish, using the toilet or changing a diaper, handling or touching an animal of any kind, coughing or blowing your nose, treating wounds or otherwise ill people, or handling food waste or anything with bodily secretions or blood.

Washing with soap and water is time honored and effective if done properly. Cold or warm water is fine. Warm water does not kill germs; it dissolves soap better but is not essential. Soap and brisk rubbing loosen dirt and suspend it with bacteria so the water can wash it away. About 15-20 seconds of rubbing will increase the effectiveness of washing – about the time it takes to sing “Happy Birthday” twice. Since the sink, faucet and handles may harbor more bacteria, turning the water off with the towel is a good idea if possible. Antibacterial soap is not necessary. In order to kill bacteria, antibacterial soap must be in place for several minutes. Antibacterial soap is more useful for surgeons who scrub for 10 minutes. There is even some concern that it could lead to the development of resistant bacteria.

Alcohol gel sanitizers are a good option because soap and water are not always available. Small containers of alcohol gel can be taken along to be available quickly. The key points for alcohol sanitizers are to use enough and rub it over the entire surface of the hands until it evaporates. Alcohol gel can be used as long as visible dirt is not present.

Hand washing is a simple but effective way to reduce the spread of infection, but too often it is ignored or given superficial attention. This week during National Hand Washing Week, let’s focus on clean hands for ourselves, our families and the community.

John Messmer is associate professor of family and community medicine at Penn State College of Medicine and a staff physician at Penn State Hershey Medical Center.

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Last Updated December 03, 2009