Hand care (or hand washing) is the act of cleaning one’s hands with soap and water to remove viruses, bacteria, and microorganisms, as well as dirt, grease, and other toxic and unwanted substances attached to the hands. Wet and moist hands are more easily re-contaminated, so drying the washed hands is an important step.
Unless hands are clearly overly dirty or greasy, hand sanitizer that is at least 60% (v/v) alcohol in water (specifically, ethanol or isopropyl alcohol/isopropanol (trying to rub alcohol)) should be used instead of soap and water if soap and water are unavailable.
WHO Recommendations for Hand Washing
Hands should be washed for at least 20 seconds before and after the following activities, according to the World Health Organization (WHO).
- Before and after caring for any sick person
- Before, during, and after preparing food
- Before eating
- After using the toilet (for urination, defecation, and menstrual hygiene),
- After helping someone who just used the toilet
- After blowing one’s nose, or coughing or sneezing
- After touching an animal, animal feed or animal waste
- After touching garbage
- After coming from the hospital
- After work
- After any travel
CDC Recommendations For Hand Washing
The Centers for Disease Control and Prevention (CDC) in the United States recommends the following precautions when washing one’s hands to prevent disease transmission.
- Hands should be wet with warm or cold running water. Running water is recommended because standing basins may become polluted, and the temperature of the water does not seem to affect the outcome.
- Hands, including the backs of hands, between fingers, and under nails, should be lathered with a generous amount of soap. Soap eliminates germs from the skin, and studies indicate that when soap is used instead of only water, people wash their hands more thoroughly.
- Scrub for a minimum of 20 seconds. Scrubbing causes friction, which aids in the removal of germs from the skin, and scrubbing for longer periods of time removes even more germs.
- Rinse thoroughly with running water. Hands may be recontaminated by rinsing in a basin.
- Enable to air dry or dry with a clean towel. Hands that are wet or damp area more easily recontaminated.
- Scrub for a minimum of 20 seconds. Scrubbing causes friction, which aids in the removal of germs from the skin, and scrubbing for longer periods of time, removes even more germs.
- Rinse thoroughly with running water. Hands may be recontaminated by rinsing in a basin.
- Enable to air dry or dry with a clean towel. Hands that are wet or damp area more easily recontaminated.
- The palm, elbow, areas between the fingertips, and under the fingernails are the most frequently overlooked areas.
- Microorganisms can live on artificial nails and chipped nail polish. To prevent the hands from drying out, moisturizing lotion is often recommended; dry skin can lead to skin damage, which can increase the risk of infection transmission.
- If neither hand washing nor hand sanitizer is available, hands may be washed with uncontaminated ash and clean water, but the benefits and risks of this approach for preventing viral and bacterial infections are unknown.
- Hand washing on a regular basis, on the other hand, may cause skin damage due to drying.
Health benefits
Hand washing has many health benefits, including avoiding influenza, coronavirus, and other infectious diseases preventing infectious causes of diarrhea, reducing respiratory infections, and lowering infant mortality rates during home birth deliveries.
Improved hand washing activities can lead to small improvements in length growth in children under the age of five, according to a 2013 report. Basic lifestyle improvements, such as hand washing with soap, can minimize childhood mortality rates related to respiratory and diarrheal diseases in developing countries.
This simple intervention has the potential to minimize disease-related mortality by nearly half. Hand washing interventions may minimize diarrhea episodes by a third, which is equivalent to providing clean water in low-income areas.
Hand washing with soap is linked to a 48 percent reduction in diarrhea episodes. Hand washing with soap is the most efficient and affordable way to avoid diarrhea and acute respiratory infections (ARI), and it is an automatic behavior practiced in households, colleges, and communities all over the world.
Pneumonia, a major ARI, is the leading cause of death in children under the age of five, killing an estimated 1.8 million children per year.
Together, diarrhea and pneumonia account for almost 3.5 million child deaths annually. Hand washing with soap before eating and after using the toilet, according to UNICEF, will save more lives than any single vaccine or medical aid, reducing diarrhea deaths by nearly half and acute respiratory
infections deaths by a quarter. As part of the water, sanitation, and hygiene (WASH) program, hand washing is typically combined with other sanitation measures. Hand washing also helps to prevent impetigo, which is spread by direct physical contact.
Adverse effects
Hand washing has a minor negative effect in that it can dry out the skin and cause skin damage. Hand eczema or hand dermatitis, which is particularly common among healthcare workers, can be caused by excessive hand washing, according to a 2012 Danish report. One of the symptoms of obsessive-compulsive disorder is overly frequent hand washing.
When it is recommended
After using the toilet (for urination, defecation, or menstrual hygiene), after cleaning a child’s bottom (changing nappies), before feeding a child, before eating, and before/after preparing food or handling raw meat, fish, or poultry, there are five crucial times throughout the day when washing hands with soap is necessary to minimize fecal-oral transmission of disease.
Before and after treating a cut or wound; after sneezing, coughing, or blowing your nose; after touching animal waste or handling animals; and after touching garbage are all examples of when proper hand washing procedure should be used to avoid disease transmission.
Behavior change
Hand washing with soap is practiced infrequently in many countries. In 2015, a survey of hand washing in 54 countries showed that on average, 38.7% of households used soap to wash their hands.
Saudi Arabia had the highest rate of 97 percent, the United States was in the middle with 77 percent, and China had the lowest rate of 23 percent, according to a 2014 survey.
There are now many behavior modification methodologies available to improve the uptake of hand washing with soap at crucial times. In developed countries, community hand washing for school children at set times of the day is one choice for instilling hand washing in children’s behaviors.
The Philippine Department of Education’s “Critical Health Care Initiative” is an example of a large-scale intervention to support children’s health and education.
The center of this national program is deforming twice a year, followed by regular hand washing with soap and daily fluoride brushing. It has also been introduced successfully in Indonesia.
Substances used Soap and detergents
The addition of soaps or detergents to water improves the removal of microorganisms from the skin. Surfactants such as soap and detergents destroy bacteria by disorganizing their membrane lipid bilayer and denaturing their proteins. It also emulsifies oils, making it easier for them to be washed away by flowing water.
Solids soap
Since solid soap is reusable, bacteria from previous uses can remain on it. A limited number of studies have suggested that bacterial transfer from infected solid soap is impossible since the bacteria are rinsed away by the foam. Liquid soap with hands-free controls for dispensing is preferable the CDC continues.
Antibacterial soap and hand care
To a health-conscious public, antibacterial soaps have been highly marketed. There is no proof that using recommended antiseptics or disinfectants in nature selects for antibiotic-resistant bacteria.
Antibacterial soaps, on the other hand, contain popular antibacterial agents including triclosan, which has a long list of resistant species.
Antibacterial soaps cannot opt for antibiotic-resistant strains, so they may not be as effective as they are advertised to be. Aside from the surfactant and skin-protecting agent, advanced formulations can also include acids (acetic acid, ascorbic acid, lactic acid) as pH regulators, anti microbially active benzoic acid, and additional skin conditioners (aloe Vera, vitamins, menthol, plant extracts).
Plain soaps are as effective as consumer-grade antibacterial soaps containing triclosan in preventing illness and eliminating bacteria from the hands, according to a meta-analysis published in 2007 by the University Of Oregon School Of Public Health.
A 2011 meta-analysis published in the Journal of Food Safety argued that, when properly formulated, triclosan, as well as chlorhexidine gluconate, iodophor, and providence, can provide a limited yet measurable boost.
Warm water
Water that is hot enough to wash hands but not hot enough to kill bacteria is not hot enough to kill bacteria. Bacteria multiply even more quickly at body temperature (37 °C). Warm soapy water is more effective than cold soapy water at removing natural oils that retain soils and bacteria, according to the WHO. Warm water, on the other hand, causes more skin irritations and has a greater environmental effect, according to the CDC.
In terms of microbe elimination, water temperatures ranging from 4 to 40 °C do not vary significantly. Scrubbing properly is the most critical thing. Scientific studies have shown that using warm water has no impact on reducing the microbial load on hands, contrary to common belief.
Antiseptics
A hand sanitizer, also known as a hand antiseptic, is a hand care product that does not contain water. Hand sanitizers with a minimum alcohol content of 60 to 95 percent are effective germ killers.
Conclusion
The most efficient way to avoid pathogen transmission is to wash your hands. When soap and water are available, washing hands thoroughly with soap and water is the best way to protect one and others. When soap and water are not readily available, good hand hygiene can be achieved by using a hand sanitizer. The end aim of fostering a positive patient safety culture is to enhance hand hygiene practices.
