Part III – a) Keeping My Home Germ Free & Effective Hand Washing

Avian flu, rhinovirus, SARS, norovirus, MRSA, e-coli, salmonella, malaria and cholera are names of diseases and conditions that are increasingly prevalent in our modern world. Health professionals all around the globe are constantly assessing the pandemic risk, issuing warnings and recommending steps to prevent those pathogens from spreading. Foodborne, airborne and Viral hemorrhagic fever (VHF) (1) illnesses are particularly contagious through direct contact with a contaminated surface and in presence of a sick individual. Cross-contamination usually passes from hands to eye, to mouth and to nose. The solution health professionals, from the CDC to your physician are promoting is simple: wash your hands and avoid contact with a contagious individual. Experts will often add to the usual list of recommendations the use of antimicrobial products. Despite these precautions, contagious diseases outbreaks are on the rise, and the environmental and social change will most likely cause a migration of “new” germs (2) and lead to an increase of outbreaks. The next three posts look at some solutions to prevent the spread of contagious illnesses.

Keeping your home germ free
The only environment in which germs will multiply to levels threatening our health is one that lacks hygiene. To some, “cleanliness is next to Godliness”. But when it comes to germs, there is the obvious and the much less obvious. When we enter a room and we see dust or mud stains, we understand it requires cleaning. When we touch a gas nozzle, a shopping cart handle or a doorknob, we do not always feel the need to clean our hands. Health agencies have published hygiene (including cleaning and maintenance) protocols to reduce the risk of cross-contamination in high-risk areas such as healthcare and food facilities. These protocols are enforced by infection control officers and food inspectors – two different professions that share one goal: health and safety of workers, patients and customers – who can swab a surface and analyze its content at a lab or assess employees’ compliance to hygiene protocols in a hospital, food facility or restaurant. Unfortunately, these are the two only industries that are strictly enforcing hygiene and hand hygiene in particular (which does not stop them to face serious disease outbreaks from time to time or to be helpless in eliminating resistant bugs).

Most public places are required to maintain a standard of cleanliness (guidelines), but nothing that can be effective in preventing a disease from spreading into a community. For instance, more and more teachers are asked to clean kids desks as schools budget keep shrinking (schools often have to share 1 janitor and 1 nurse – usually a 4 to 1 ratio but can be 8 to 1). Gas stations are not required to disinfect gas nozzle. Malls, train stations or airports do a once or twice a day cleaning maintenance on escalator handrails, which are completely ineffective to eliminate germs. It is not very reassuring, is it? The less these items are effectively cleaned and sanitized the higher the rate (chance) of cross-contamination is.
All this to say that we bear the responsibility to keep our sanctuary free of germs and to do so effectively, we need to recognize when to wash/ clean/ sanitize our hands. If there is one instance you should enforce is to wash your hands as soon as you enter your home. If you could get your family and guests to do so you will most likely keep pathogens from entering your home and spreading from one object to another as your hands touch them. The same can apply to your office, especially if you use public transportation, and to your car. And please, don’t feel you’re out of line when you ask your guests to go and wash their hands, especially if you have a newborn baby.

The list below describes events before or/and after which we should clean your hands, whether through hand washing, wiping, sanitizing or/ and a combination of each. This list is pretty exhaustive, and you might find it difficult to stick to it. Apply to it some common sense, such as where you are, what you touch, feeling whether or not your hands are sticky, oily or dirty, and so on.

When to wash, clean or/and sanitize your hands
Before and after
* Eating/preparing food
* Breastfeeding
* Feeding a child
* Giving medication to a child
* Touching/cuddling/holding a child
* Treating a cut or wound
* Visiting or taking care of any sick friends or relatives (at home or at any health care facilities)
* Having a physical intimate relationship.

After
* Shopping, especially if you have used a store cart or basket.
* Using public transportation
* Using the nozzle at the gas station
* Changing a nappy
* Helping a child use the toilet
* Using the toilet yourself
* Wiping your nose or your child’s nose
* After you use the bathroom
* Carrying objects from the floor/ ground
* Touching an animal
* Handling animal waste
* Handling garbage
* Handling toxic chemicals (bleach, phenols, ammonium)
* Touching any object that has been handled by someone else
* Any physical activity (especially at a health club or gym)

Note that cross-contamination have higher chance to occur in confined areas in which a high number of people will interact socially or professionally. They include: hospitals, schools, childcare, nursing homes, offices, event venues, health clubs, public transportation systems, shopping malls and stores, planes, cruise ships, (…).

Washing your hands with soap and water:
Washing your hands properly, you have understood, is the surest way to remove germs from your hands. The soap loosens the dirt and germs and the water rinses them off.
It entails to turn the water on until it reaches a warm temperature, to wet (or pre-wash) your hands, to apply the right amount of soap (better more than not enough) as to cover the entire surface of your hands (if you are skilled enough and for the sake of water conservation – about a gallon/ 30 sec, use your elbow to turn the water off), rub your hands vigorously, everywhere from wrist to nails. Turn the water back on and rinse your hands long enough so you have removed the soap. The whole process is called “washing your hands”.
The rubbing, friction part (which is the most important) is “recommended to last” 20 seconds (see previous post). This is of utmost importance because 5 seconds or 15 seconds is not long enough to remove germs to reach a safe standard studies have shown. The last part of the process is drying your hands. If left wet, your hands will be “re-colonized” quicker. That means every part of your hands should be dried up with a clean dry towel. Paper towel is usually recommended. However, I do use a microfiber cloth, I’ll explain why later in the next post I believe it to be more efficient.

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