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Effectiveness
This hygienic behavior has been shown to cut the number of child deaths from diarrhea (the second leading cause of child deaths) by almost half and from pneumonia (the leading cause of child deaths) by one-quarter. There are five critical times in washing hands with soap and/or using of a hand antiseptic related to fecal-oral transmission: after using a bathroom (private or public), after changing a diaper, before feeding a child, before eating and before preparing food or handling raw meat, fish, or poultry, or any other situation leading to potential contamination and see below. To reduce the spread of germs, it is also better to wash the hands and/or use a hand antiseptic before and after tending to a sick person. If your hands are not visibly dirty or soiled, washing one’s hands with a good hand antiseptic is the most effective overall way to prevent the spread of infectious disease. If your hands are dirty or soiled, washing your hands with soap and water followed by a good hand antiseptic is the most effective overall way to prevent the spread of infectious disease.
The Institue for Good Medicine at the Pennsylvania Medical Society recommends that you wash your hands and/or use a good hand antiseptic:
After touching an animal or items associated with animals
After blowing your nos , discount wall paper .
After coughing or sneezing into your hand , iron on transfer paper .
Before and after treating cuts and wounds
Before and after touching a sick or injured person
After contact with blood or body fluid
After handling garbage
Before inserting or removing contact lenses
And see above
Substances used
Soap and detergents
The application of water alone is inefficient for cleaning skin because water is often unable to remove fats, oils, and proteins, which are components of organic soil. To remove pathogens, two gallon of water per minute is needed in washing hands using flowing water.
Therefore, removal of microorganisms from skin requires the addition of soaps or detergents to water. Currently most products sold as “soaps” are actually detergents, so that is the substance most used to wash hands.
Water temperature
Hot water that is comfortable for washing hands is not hot enough to kill bacteria. However, warm, soapy water is more effective than cold, soapy water at removing the natural oils on your hands which hold soils and bacteria.
Solid soap
Solid soap, because of its reusable nature, may hold bacteria acquired from previous uses, so it’s important to wash the soap itself before and after use.
Hand washing with contaminated soap could colonize the hands with Gram-negative bacteria, which results in an increase in bacterial counts on the skin.
Hand washing with soap
Schoolchildren washing their hands before eating lunch.
Antibacterial soap
Antibacterial soaps have been heavily promoted to a health-conscious public. To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature. However, antibacterial soaps contain common antibacterial agents such as Triclosan, which has an extensive list of resistant strains of organisms. So, even if antibacterial soaps aren’t selected for antibiotic resistant strains, they might not be as effective as they are marketed to be.
A comprehensive analysis from the University of Oregon School of Public Health indicated that plain soaps are as effective as consumer-grade anti-bacterial soaps containing triclosan in preventing illness and removing bacteria from the hands.
Hand antiseptic
A hand sanitizer or hand antiseptic is a non-water-based hand hygiene agent. In the late 1990s and early part of the 21st century, Alcohol rub non-water-based hand hygiene agents (also known as alcohol-based hand rubs, antiseptic hand rubs, or hand sanitizers) began to gain popularity. Most are based on isopropyl alcohol or ethanol formulated together with a thickening agent such as Carbomer into a gel, or a humectant such as glycerin into a liquid, or foam for ease of use and to decrease the drying effect of the alcohol.
Hand sanitizers containing a minimum of 60 to 95% alcohol are efficient germ killers. Alcohol rub sanitizers kill bacteria, multi-drug resistant bacteria (MRSA and VRE), tuberculosis, and viruses (including HIV, herpes, RSV, rhinovirus, vaccinia, influenza, and hepatitis) and fungus. Alcohol rub sanitizers containing 70% alcohol kill 3.5 log10 (99.9%) of the bacteria on hands 30 seconds after application and 4 to 5 log10 (99.99 to 99.999%) of the bacteria on hands 1 minute after application. Alcohol rub sanitizers can prevent the transfer of health-care associated pathogens (Gram-negative bacteria) better than soap and water.
The increasing use of these agents is based on their ease of use and rapid killing activity against micro-organisms.
However frequent use of alcohol-based formulations for hand sanitizers can cause dry skin unless emollients and/or skin moisturizers are added to the formula. The drying effect of alcohol can be reduced or eliminated by adding glycerin and/or other emollients to the formula. In clinical trials, alcohol based hand sanitizers containing emollients caused substantially less skin irritation and dryness than soaps or antimicrobial detergents. Allergic contact dermatitis, contact urticaria syndrome or hypersensitivity to alcohol or additives present in alcohol hand rubs rarely occurs. The lower tendency to induce irritant contact dermatitis also become an attraction as compared to soap and water hand washing.
Despite their effectiveness, the non-water agents do not clean hands of organic material, they simply disinfect them. However, disinfection does prevent transmission of infectious microorganisms. The commercial products of those include the brands of Aqium, Germ Warfare, Cuticura et cetera, GermOut and Rochon-Edouard et al. has provided a good review of those products.
The efficacy of alcohol-free hand sanitizers is heavily dependent on their ingredients and formulation. In the past, alcohol-free hand sanitizers tended to significantly under-perform alcohol or alcohol rubs as germ killers in clinical studies using standard protocols such as EN1500. More recently, advanced formulations have been developed, some of which have been shown to out-perform alcohol. An example of this is HandClens, with a patented SAB (Surfactant, Allantoin and Benzalkonium Chloride) formulation. A further aspect of efficacy that is sometimes overlooked is the effect of repeated use. The efficacy of alcohol as a hand disinfectant has been shown to decrease after repeated use, probably due to progressive adverse skin reactions, whereas the efficacy of an alcohol-free hand sanitizer based on Benzalkonium Chloride as its active ingredient has been shown to increase with repeated use. However, in a more recent study, the effectiveness of alcohol did not decrease after repeated use. This study also demonstrated that, unlike Benzalkonium Chloride, alcohol does not have persistent or cumulative antimicrobial activity after application. However, Purell has been previously shown to fail to meet the FDA 21 CFR 333.470 performance standards for health-care personnel antiseptic hand washes not just as a consequence of the decrease in effectiveness with repeated use, but also due to a lack of persistence in antimicrobial activity after application and the decrease in effectiveness with heavy soil loads. In the same study, HandClens was shown to meet and exceed the FDA performance standards.
Techniques
Soap and water
Conventionally, the use of soap and warm running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 20 seconds, before rinsing thoroughly and then drying with a clean or disposable towel. It has been shown[citation needed] that the use of a towel is a necessary part of effective contaminant removal, since the washing action separates the contaminants from the skin but does not completely flush them from the skin - removing the excess water (with the towel) also removes the suspended contaminants. After drying, a dry paper towel should be used to turn off the water (and open the exit door if one is in a restroom or other separate room). Moisturizing lotion is often recommended to keep the hands from drying out, should one’s hands require washing more than a few times per day.
Hand antiseptics
Enough hand antiseptic or alcohol rub must be used to thoroughly wet or cover both hands. The front and back of both hands and between and the ends of all fingers are rubbed for approximately 30 seconds until the liquid, foam or gel is dry. The use of a hand antiseptic or alcohol rub is much quicker and more effective than hand washing with soap and water. Hand antiseptics and alcohol rubs with moisturizers will also not dry out the skin on hands as much as soap and water.
Drying
Effective drying of the hands is an essential part if the hand hygiene process. But there is some debate over the most effective form of drying in washrooms. A growing volume of research suggests paper towels are much more hygienic than the electric hand dryers found in many washrooms.
In 2008, a study was conducted by the University of Westminster, London, to compare the levels of hygiene offered by paper towels, warm air hand dryers and the more modern jet-air hand dryers . The key findings were:
after washing and drying hands with the warm air dryer, the total number of bacteria was found to…
