The #1 Infection Fighter
For: Wellness Made Easy, May 2002
It's a good guess that the simple act of handwashing has
prevented more illness and saved more lives than any other single measure
in the last century. Colds, flu, and food poisoning are only three of
the ills that can be passed hand to hand, or from hand to object to hand.
Washing your hands with soap and water after using the toilet is particularly
important. Yet while nearly everybody claims to do this, many actually
don't. They simply exit the bathroom or just rinse their fingertips. A
recent survey by the American Society for Microbiology found that only
49% of visitors to Penn Station and Grand Central Station in New York
City paused to wash up after using the toilet. Chicago was the cleanest
city—83% of those at the Navy Pier washed—followed by San Francisco,
with 80% at Golden Gate Park. Overall, just 67% of Americans washed with
soap and water after using public toilets. Who can say how many wash their
hands at home?
We'd all be healthier, maybe even wealthier, if we were
wise enough to wash our hands frequently with soap and warm water. Kids
wouldn't miss school as often, and grown-ups wouldn't have to call in
sick as often. We'd have fewer cases of stomach upsets, diarrhea, and
staph infections. As a way to ward off colds, hand-washing beats whole
carloads of echinacea and megadoses of vitamin C. It's easy, cheap, and
accessible to all.
You need not load up on special products. Antibacterial
soaps are not required. Hand-sanitizers are of limited usefulness. You
may have noticed that workers who handle food now wear plastic gloves,
and may have wondered if you should wear them in your own kitchen. But
plastic gloves, like hands, have to be clean. Here's what you need to
know about handwashing:
• Plain soap and warm water are the gold standard for handwashing. This does not kill bacteria, but it does remove them. They go down the drain. It takes 10 to 15 seconds to wash your hands well. Wash your palms and the back of your hands, then between your fingers and under your nails. (A lot of dirt hides under nails. It's a good idea to use a nail brush if your hands are very dirty or you've been handling raw meat and fish or diapers.) Cold water is okay, too. It's important to rinse and dry thoroughly with a paper towel, clean cloth towel, or a blower. All drying methods are equally effective.
• When to wash your hands: after using the toilet, before and after preparing food, before eating, after working in the garden or cleaning the basement or other heavy work, after working at a desk all day, after changing a diaper, after sex, and whenever your hands feel or look soiled. Common sense will no doubt dictate other handwashing opportunities. Frequent washing when you have a cold or are around people with colds is a good idea.
• Antibacterial soaps, lotions, and other hand-sanitizers with triclosan or other antiseptics are not superior to soap and water. There is no evidence they ward off infection. Although the FDA has decided not to take antibacterials off the market, many scientists fear that widespread use of them will give rise to resistant strains of bacteria. Attacked by antibiotics, bacteria have been known to fight back and flourish. In hospital settings, antiseptic soaps are needed, but not in your bathroom or kitchen.
• Alcohol gels and wipes kill microorganisms (without promoting resistant strains) but are not a substitute for soap and water. They are not effective when your hands are visibly soiled. But if you can't wash with soap and water, these sanitizers can be useful: for example, if you're traveling where facilities are scarce, or you're in a car and about to hand out snacks to fellow passengers. And at home, too, the added protection they provide may be a good idea if, for instance, your immune system is compromised, you are caring for an infant or a person who is seriously ill, or you've just handled raw meat or fish. Wash with soap and water first, then use the alcohol. If this dries or chaps your skin, stick with soap and water. (It may be hard to distinguish the antibacterials on the drugstore shelves from the alcohol gels. Both may say "antibacterial." Check the ingredients.)
Final thought: Handwashing
should be a matter of good sense. You needn't aim for a germ-free home.
Unless you're a surgeon about to enter the OR, you needn't try to sterilize
your hands. Bacteria are part of our natural environment, and not all
of them are harmful. Billions of them live peaceably on our skin. But
washing with soap and water will keep the bad bugs at bay.
UC Berkeley Wellness Letter, March 2001
