Do you wash your hands before meals and after using the toilet? With images of your mother hovering over your shoulder, you probably answered yes. But, do you really?
About 95 percent of subjects in an August 2003 survey said they washed their hands regularly after using a public restroom. An observational survey of 7,541 air travelers one month later found that only 70 percent of travelers in New York, Miami and Chicago actually did wash their hands before exiting the airport restroom.
Do you wash your hands after you sneeze or cough? Only 58 percent of respondents in the first survey answered yes; the actual percentage is unknown.
The Centers for Disease Control would like for 100 percent of Americans to wash their hands after:
• Using the toilet.
• Nose blowing.
• Handling pets.
• Returning home from work or the shopping center.
• Before eating or handling food.
Frequent and careful hand washing, according to the CDC, is the single most important thing you can do to protect yourself against infectious respiratory and food borne illnesses.
Kids carry home bugs
During the cold and flu season, families with children in school or day care can expect that the youngsters will be carrying home bugs nearly every day and depositing them on door knobs, telephone receivers, remote controls and refrigerator doors. According to one study, 60 percent of surfaces in the average American home are infected during the cold and flu season.
You can't disinfect every surface in your home, nor is it recommended since use of antibacterial products increases the risk of antibiotic resistance. The solution is to wash your hands frequently so you are less likely to pass germs to your mouth, nose or eyes.
In one Canadian study, subjects who washed their hands with soap and water more than seven times a day had less than one quarter the risk of getting a cold or flu infection compared to those who washed less frequently.
These results have been confirmed time and again among different populations. University freshmen living in dormitories who were provided educational materials about hand hygiene had 26 percent fewer cold and flu illnesses than other students.
A hand washing program in an elementary school resulted in a 21 percent decrease in absences for respiratory illness. A Naval training center that required recruits to wash their hands fives times a day witnessed a 45 percent reduction in outpatient visits for colds and flu.
With National Hand Washing Awareness Week scheduled for early December, it's time to spread the message that hand washing is good for your health.
From hand to mouth
When it comes to eating and food preparation, the importance of hand washing may be even more crucial than it is to the prevention of colds and flu. The diarrhea commonly known as the intestinal flu is nearly always a virus that is transferred from hand to mouth, usually a result of sloppy hygiene in food preparation or eating.
In developing countries, diarrhea and respiratory infections kill more than 3.5 million children under age 5 every year - deaths that could be prevented with proper attention to hand washing.
A CDC study in Pakistan found that distribution to families of soap and information about hand hygiene resulted in a 53 percent reduction in diarrhea and a 50 percent reduction in pneumonia among children. Daily bathing with soap lowered the incidence of impetigo.
Even though the water used for hand washing in this study was heavily contaminated with fecal organisms, soap provided necessary protection, and no significant differences were found between the use of regular and anti-bacterial soap.
If you're traveling in countries with sanitation that is suspect, hand washing with soap may be as important as avoiding the local drinking water. But even in your own kitchen, there are hidden dangers.
Meat, chicken and eggs often have salmonella, E. coli, shigella and other organisms that are killed with proper cooking. But, if you use your hands to pat seasonings onto raw meat, then touch salad vegetables, dishes or utensils that will not be cooked, you're spreading the contamination. Even when you break an egg into the frying pan, wash your hands before resuming other food preparation tasks.
Restaurant and other food handling operations usually have strict requirements. The bare minimum requires hand washing:
• After arrival on the job.
• Before and after break periods.
• After restroom use.
• Following any task change.
• Before and after putting on gloves.
• Any time the face or hair is touched.
• Following a sneeze or cough.
• After any customer contact.
In your own home, some of these requirements may be unnecessary, but it's important to be aware of where your hands have been and where they're going. If in doubt, wash them.
How to wash hands
The way your mother taught you to wash your hands may or may not be sufficient, but here's what most experts recommend:
• Wash vigorously for at least 20 seconds using warm, running water and soap.
• Lather every surface thoroughly, particularly around the nails and in any creases of the skin.
• If you've been handling food, be sure to scrub away fat and protein residue.
• Rinse thoroughly with warm, running water.
• Dry with a clean, dry towel or a paper towel.
Soap bars don't transmit germs, but many people prefer liquid soap anyway. Antibacterial soap is no more effective than regular soap.
Alcohol-based gels are effective for killing bacteria, but when hands are soiled by food, the protein and fatty substances can coat and protect the infectious organisms.
There's nothing controversial about hand washing. Everyone knows that it's a good thing. But because we're busy and because disease organisms are microscopic, it's easy to neglect this simple matter.
By remembering the image of your mother - and the Centers for Disease Control - hovering over your shoulder, you may be able to prevent a serious illness.