Wash Your Damn Hands, Part I Can't Count That High (Again)

We're getting worse at washing our hands according to the Baltimore Sun. One thing I've said many times before, but it bears repeating: the best way to avoid getting sick is to limit contact with someone else who is sick. While that sounds obvious, one very good way to do that is handwashing. Handwashing breaks the 'transmission network' and essentially isolates the sick person. If you view preventing infectious disease as a question of how can I protect myself from disease, then we've already lost. The best measures (vaccination and handwashing) aren't just about protecting yourself, but protecting others from you.

Onto the article:

Men are much worse about it than women. Museum visitors do it more often than sports fans. And in general, we're all doing it less and less these days.

The practice of hand washing - at least in public restrooms - is on the decline and no one is sure why.

While Americans profess to wash their hands when questioned in surveys, they do it much less frequently in reality, according to observations of 6,000 people using public restrooms at six prominent venues in Atlanta, Chicago, New York and San Francisco.

Hand washing is a key tool in fending off germs, experts say. The U.S. Centers for Disease Control and Prevention considers it the single most effective step in preventing the spread of ailments ranging from colds and flu to a host of nasty gastrointestinal bugs.

"It's the number one public health tool around today," said Kellogg J. Schwab, an associate professor of environmental health at the Johns Hopkins Bloomberg School of Public Health.

Noroviruses alone, which cause nasty bouts of nausea, vomiting and stomach distress, infect 23 million people in the United States each year, and much of their damage could be prevented by hand washing.

Here's how it works:

Why is it so critical? If one person coughs or sneezes on his hands and touches a doorknob or other surface, the next person can pick up whatever bacteria and virus might be left there, Ristaino and others said.

If that person puts a hand to his mouth or eyes, he can be infected with a cold, flu or gastrointestinal infection.

"Anything you come into contact with - pens, doorknobs, countertops. They all will hold it," said Utah's Daly.

Viruses can be particularly hardy - surviving for weeks on doorknobs, countertops, telephones, light switches, elevator buttons and other surfaces, according to Bloomberg's Schwab.

And spreading infection doesn't require a sneeze or cough. Germs hide in a baby's diaper, a pet's fur or the cash in our wallets. The ASM recommends hand washing before we eat, as well as after we use a bathroom, sneeze, cough, or handle a dog, cat, cash or diaper.

And it's not just for viruses, but bacteria too:

Germs such methicillin-resistant staphylococcus aureus, a hard-to-kill staph infection better known as MRSA, can live for days and even weeks in someone's nose without producing symptoms. But the host can pass it on to others unknowingly by wiping his nose and touching a table that someone else touches, experts say.

MRSA causes deadly blood infections and pneumonias. Some say the rise of such drug-resistant superbugs is one of the nation's most alarming public-health threats.

More common infections are also spread by unwashed hands. Noroviruses that sicken cruise ship passengers, for instance, can be spread when someone touches a surface contaminated with it, according to the CDC.

Sounds good, but what's the reality of handwashing? Dunno, so let's do some science:

In a telephone poll of 1,001 people, about 92 percent professed to wash their hands whenever they used a public restroom. But when observers discreetly recorded the behavior of 6,076 men and women in high-volume washrooms around the country, only 77 percent actually did it. And that's down from 83 percent who washed up in 2005.

....The researchers sent observers into restrooms in New York's Grand Central Terminal and Penn Station, the San Francisco Ferry Terminal Farmers' Market, Chicago's Museum of Science and Industry and Shedd Aquarium, and Turner Field, the home of the Atlanta Braves.

Observers were instructed to appear occupied by grooming themselves - but not to wash their hands more than 10 percent of the time. They also rotated bathrooms every hour or so to avoid counting repeat users.

"If they were in there washing all the time, they might have thrown off the results," said Brian Sansoni, a spokesman for the Soap and Detergent Association - whose members would sell more soap if more Americans washed up. If someone was observed spending only five or 10 seconds just rinsing their fingers, that didn't count, Sansoni said.

Not encouraging results:

Men were worse slobs than women. Eighty-eight percent of women washed their hands this year, down only two points from2005. Only 66 percent of men washed up, down from 75 percent two years ago.

The gender differences were most pronounced at Turner Field, where 95 percent of the women but only 57 percent of the men washed their hands. "The women did a beautiful job there, and the guys did a horrible job," Daly said.

....Men performed best at Chicago's Shedd Aquarium, where 81 percent of men and women washed their hands.

Here's what you can do:

The CDC and the American Society for Microbiology recommend washing for at least 15 to 20 seconds, about the amount it takes to sing "Happy Birthday" twice.

Happy Birthday! Now wash your damn hands...

And guys, your penis is a loaded weapon--in a bad way. Wash your hands, after you pee...

More like this

Gack. I've developed the habit of taking the paper towel I use to dry my hands in public bathrooms along with me, using it to turn the doorknob and pocketing it, folded to the inside, to throw away. Remembering not to blow my nose in it no matter what.

I recall the "hot air" dryers turned out to be quite effective at aerosolizing bacteria, blowing them off the drying skin without killing them. Don't see them so much any more.

Too bad the little 61-percent alcohol dispensers are considered potential terrorist firebombs, that's limited their widespread distribution.

Can an epidemiologist give us an idea whether, with an assumed background rate of infection with any particular organism in the population, these handwashing rates are adequate to keep transmission below epidemic levels?

Has anyone who's studied history of epidemiology commented on whether the old habit of wearing gloves in public all the time made a difference in transmission?

You know that funny little compartment at the front of your horseless carriage called a "glove compartment" or "glove box"? That's what they were for. Of course their hands probably risked getting noticeably more dirty riding behind the horses.

By Hank Roberts (not verified) on 01 Oct 2007 #permalink

Notice how in 'restrooms' you usually have to pull on a handle to enter or exit, picking up whatever filth was on the handle (and depositing whatever was on your hand).

Try grasping a door handle and immediately smelling your hand. Gross.

By Watt de Fawke (not verified) on 01 Oct 2007 #permalink

I saw a story on one of those nightly news shows where they went around and measured the cleanliness of different spots in people's houses. Toilet seats were surprisingly clean. The dirtiest spots: doorknobs. I try not to be OCD about it, but I still wash my hands about 10-12 times a day.

OK, I will wash my hands more often when they get that GD stinking soap replaced. I have allergies and the artificial perfumes they use to stink the stuff up stay with me and give me asthma and/or runny nose and painful sinuses all day -- not a good tradeoff.
And don't get me started on "air fresheners" aka asthma inducers in public places.
Anybody else out there want to join me in an anti-perfume campaign?

Try grasping a door handle and immediately smelling your hand.

I'm no health expert, but I'm guessing that's not highly recommended.

Okay, I'll ask, since no one else is asking. Why are penises a problem with regard to handwashing, since they presumably stay tucked away most of the time?

http://www.pedorthicnewswire.com/pdf/Copper%20as%20%20Biocidal%20Tool.p…

"Small strips of stainless steel, brass, aluminum, and copper, were inoculated with broths of Escherichia coli,
Staphylococcus aureus, Streptococcus group D, and pseudomonas species. The broths contained approximately 107 bacteria/ml, a very heavy inoculum. The strips were then air-dried for 24 hours at room temperature, inoculated onto blood agar plates, and incubated for 24 hours at 37C. The results were striking. The copper and brass strips showed little or no growth, while the aluminum and stainless steel strips produced a heavy growth of all microbes. The test was repeated at drying intervals of 15 minutes, 1, 5, 7, 20 and 24 hours. Brass disinfected itself in seven hours or less, depending on the inoculum size and the condition of the surface of the metal. Freshly scoured brass disinfected itself in one hour. Copper disinfected itself of some microbes within 15 minutes. Aluminum and stainless steel produced heavy growths of all isolates after eight days and growths of most isolates after three weeks.

By Hank Roberts (not verified) on 01 Oct 2007 #permalink

I'm a lot more thorough about washing my hands now that I work in a school of public health and there's a little sign in the bathroom reminding us to wash for 30 seconds.

As a counterpoint (though I agree with you in every way), my mother-in-law used to say you have to eat a peck of dirt before you die. There is altogether too much microbial alarmism, and we don't want to turn into immune-deficient bubble children. The Arlo and Janis strip from last week is funny alluding to this: http://www.youtube.com/watch?v=fAYnc_-ddlw

As one of the pesky science journalists who bemoan the negative opinion of science journalism on Science Blogs, was this a well-reasoned article? Did it present the science accurately? With all the negative coverage, I think it would be nice if you could highlight instances of science journalism done right.

Occam's Trowel: folds of warm, moist skin (ideal breeding conditions for many bacteria) which are not particularly distant from the the anus. Do we really need to go into detail?

-- victoria, I'm with you.

By Luna_the_cat (not verified) on 03 Oct 2007 #permalink

check this out nursey