Hand washing
Encyclopedia
Hand washing for hand hygiene is the act of cleaning the hand
s with or without the use of water
or another liquid
, or with the use of soap
, for the purpose of removing soil
, dirt
, and/or microorganism
s.
Medical hand hygiene
pertains to the hygiene practices related to the administration of medicine and medical care that prevents or minimizes disease and the spreading of disease. The main medical purpose of washing hands is to cleanse the hands of pathogen
s (including bacteria
or virus
es) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field, but it is also an important practice for the general public. People can become infected with respiratory illnesses such as influenza or the common cold, for example, if they don't wash their hands before touching their eyes, nose, or mouth. Indeed, the Centers for Disease Control and Prevention
(CDC) has stated: "It is well documented that one of the most important measures for preventing the spread of pathogens is effective hand washing." As a general rule, handwashing protects people poorly or not at all from droplet- and airborne disease
s, such as measles
, chickenpox
, influenza
, and tuberculosis
. It protects best against diseases transmitted
through fecal-oral route
s (such as many forms of stomach flu) and direct physical contact (such as impetigo
).
In addition to hand washing with soap and water, the use of alcohol gels is an effective form of killing some kinds of pathogens.
In symbolic hand washing, using water only to wash hands is a part of ritual handwashing
as a feature of many religions, including Bahá'í Faith
, Hinduism
, and tevilah and netilat yadayim
in Judaism
. Similar to these are the practices of Lavabo
in Christianity
, Wudu
in Islam
and Misogi
in Shintō
.
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.
, because of its reusable nature, may hold bacteria acquired from previous uses. Yet, it is unlikely that any bacteria are transferred to users of the soap, as the bacteria are rinsed off with the foam.
s 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 antibiotic resistant strains aren't selected for by antibacterial soaps, 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.
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 some 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.
Hand sanitizers are most effective against bacteria and less effective against some viruses. Alcohol-based hand sanitizers are almost entirely ineffective against norovirus or Norwalk type viruses, the most common cause of contagious gastroenteritis.
The CDC recommends hand washing over hand sanitzer rubs.
The increasing use of these agents is based on their ease of use and rapid killing activity against micro-organisms, however they should not serve as a replacement for proper hand washing unless soap and water are unavailable.
Frequent use of alcohol-based hand sanitizers can cause dry skin unless emollients and/or skin moisturizer
s 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 became an attraction as compared to soap and water hand washing.
Despite their effectiveness, non-water agents do not cleanse the hands of organic material, but simply disinfect them. It is for this reason that hand sanitizers are not as effective as soap and water at preventing the spread of pathogens, since the pathogens still remain on the hands.
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 formulation
s 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. Other alcohol-free hand sanitizer products that use benzalkonium chloride as the active ingredient include Hy5, Soapopular, DEBSBS and EcoHydra. A further aspect of efficacy
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. In a recent study, the effectiveness of alcohol was shown to decrease after repeated use. The study demonstrated that, unlike Benzalkonium Chloride, alcohol does not have persistent or cumulative antimicrobial activity after application. Purell has been 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 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.
is often recommended to keep the hands from drying out, should one's hands require washing more than a few times per day.
In 2008, a study was conducted by the University of Westminster, London and sponsored by the paper towel industry the European Tissue Symposium, 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:
The scientists also carried out tests to establish whether there was the potential for cross contamination of other washroom users and the washroom environment as a result of each type of drying method. They found that:
In 2005, in a study conducted by TUV Produkt und Umwelt, different hand drying methods were evaluated. The following changes in the bacterial count after drying the hands were observed:
Medical
hand washing is for a minimum of 15 seconds using generous amounts of soap and water or gel to lather and rub each part of the hands. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush may be used to remove it. Since germs may remain in the water on the hands it is important to rinse well and wipe dry with a clean towel. After drying, the paper towel should be used to turn off the water (and open any exit door if necessary). This avoids re-contaminating the hands from those surfaces.
The purpose of hand washing in the health care setting is to remove pathogenic microorganisms ("germs") and avoid transmitting them. The New England Journal of Medicine
reports that lack of hand washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients. One study showed that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.
The World Health Organization
has published a sheet demonstrating standard handwashing and handrubbing in health care sectors. The draft guidance of hand hygiene by the organization can also be found at its website for public comment. A relevant review was conducted by Whitby et al. Commercial devices can measure and validate hand hygiene, if demonstration of regulatory compliance is required.
The addition of antiseptic chemicals to soap ("medicated" or "antimicrobial" soaps) confers killing action to a hand washing agent. Such killing action may be desired prior to performing surgery or in settings in which antibiotic-resistant organisms are highly prevalent.
To 'scrub' one's hands for a surgical operation
, it is necessary to have a tap that can be turned on and off without touching with the hands, some chlorhexidine or iodine wash, sterile towels for drying the hands after washing, and a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewelry should be removed. This procedure requires washing the hands and forearms up to the elbow, usually 2–6 minutes. Long scrub times (10 minutes) are not necessary. When rinsing, water on the forearms must be prevented from running back to the hands. After hand washing is completed, the hands are dried with a sterile cloth and a surgical gown is donned.
Medical hand-washing became mandatory long after Hungarian physician Ignaz Semmelweis
discovered its effectiveness in preventing disease in a hospital environment.
Liquid hand antiseptics are much more effective germ killers than gel and foam hand sanitizers. To use in a medical or surgical setting a sterile stainless bowl is filled with antiseptic and both hands are dipped and rinsed in the liquid up to the elbows. The hands and lower arms are removed from the liquid, rubbed and allowed to dry. After, drying in approximately 30 to 60 seconds the healthcare provider is gloved and gowned.
Alcohol rubs and hand antiseptics (biocides) kill microorganisms. Current scientific evidence has not demonstrated a link between the use of topical antimicrobial formulations and antiseptic
or antibiotic
resistance. Antiseptics (biocides) have multiple (thousands) of nonspecific killing sites on and in the microbial cell which cannot easily mutate. Antibiotics and antibacterial soaps (triclosan
) have one very specific killing site on and in the microbial cell which can easily mutate. Antibiotic resistance has no effect on the effectiveness of antiseptics.
Alcohol rubs and combination hand sanitizers are effective at killing some germs on the hands. Many clinical studies have shown that alcohol rubs containing two germ killers (i.e. Alcohol and Chlorhexidine gluconate
or Benzalkonium chloride
) are significantly better germ killers than alcohol rubs containing alcohol alone.
However alcohol rub sanitizers are not appropriate for use when the hands are visibly dirty, soiled. Visible soiling of any sort on the hands must be washed with soap and water because alcohol-based hand rubs are less effective in the presence of organic material. In addition, alcohols may not be effective against non-lipid-enveloped viruses (e.g., Noroviruses) as enveloped viruses but they are still effective. Hand antiseptics and soap and water will not kill the endospores of bacteria (e.g., Clostridium difficile and Anthrax) and the spores of protozoa (e.g., Giardia lamblia) but soap and water may wash them down the drain. When such microorganisms are likely to be encountered, soap and water hand washing followed by use of a good hand antiseptic is preferable.
Hand washing with hand sanitizer (hand antiseptic) is effective in cleaning [killing] staph aureus and the bacteria that are causing these staph infections, but alcohol-based hand sanitizers and soap and water are not effective in killing spore forming organisms because alcohol or soap will not destroy bacterial spores. Washing hands with soap and water may wash the spores down the sink.
In the U.S. alcohol rubs have been banned from some schools because of flammability concern. The fire department allows Tallahassee Memorial Hospital to have a certain amount of hand sanitizer per smoke compartment, and supply it up to that limit.
(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.
For control of staphylococcal
infections in hospitals, it has been found that the greatest benefit from hand-cleansing came from the first 20% of washing, and that very little additional benefit was gained when hand cleansing frequency was increased beyond 35%. Washing with plain soap results in more than triple the rate of bacterial infectious disease
transmitted to food as compared to washing with antibacterial soap. Comparing hand-rubbing with alcohol-based solution with handwashing with antibacterial soap for a median time of 30 seconds each showed that the alcohol hand-rubbing reduced bacterial contamination 26% more than the antibacterial soap. But soap and water is the more effective than alcohol-based hand rubs for reducing H1N1 influenza A virus and Clostridium difficile
spore
s from hands.
In symbolic hand washing using water only to wash hands is a part of ritual handwashing
as a feature of many religions, including Bahá'í Faith
, Hinduism
and tevilah and netilat yadayim
in Judaism
. Similar to these are the practices of Lavabo
in Christianity
, Wudu
in Islam
and Misogi
in Shintō
.
, verse 27:24 gives an account of Pontius Pilate
washing his hands of the decision to crucify Jesus
: "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, 'I am innocent of the blood of this just person: see ye to it'." Also see .
In Shakespeare's Macbeth
, Lady Macbeth
begins to compulsively wash her hands in an attempt to cleanse an imagined stain, representing her guilty conscience regarding crimes she had committed and induced her husband to commit.
It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.
Excessive hand washing is commonly seen as a symptom of obsessive-compulsive disorder
(OCD).
Hand
A hand is a prehensile, multi-fingered extremity located at the end of an arm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs...
s with or without the use of water
Water
Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...
or another liquid
Liquid
Liquid is one of the three classical states of matter . Like a gas, a liquid is able to flow and take the shape of a container. Some liquids resist compression, while others can be compressed. Unlike a gas, a liquid does not disperse to fill every space of a container, and maintains a fairly...
, or with the use of soap
Soap
In chemistry, soap is a salt of a fatty acid.IUPAC. "" Compendium of Chemical Terminology, 2nd ed. . Compiled by A. D. McNaught and A. Wilkinson. Blackwell Scientific Publications, Oxford . XML on-line corrected version: created by M. Nic, J. Jirat, B. Kosata; updates compiled by A. Jenkins. ISBN...
, for the purpose of removing soil
Soil
Soil is a natural body consisting of layers of mineral constituents of variable thicknesses, which differ from the parent materials in their morphological, physical, chemical, and mineralogical characteristics...
, dirt
Dirt
Dirt is unclean matter, especially when in contact with a person's clothes, skin or possessions when they are said to become dirty. Common types of dirt include:* dust — a general powder of organic or mineral matter...
, and/or microorganism
Microorganism
A microorganism or microbe is a microscopic organism that comprises either a single cell , cell clusters, or no cell at all...
s.
Medical hand hygiene
Hygiene
Hygiene refers to the set of practices perceived by a community to be associated with the preservation of health and healthy living. While in modern medical sciences there is a set of standards of hygiene recommended for different situations, what is considered hygienic or not can vary between...
pertains to the hygiene practices related to the administration of medicine and medical care that prevents or minimizes disease and the spreading of disease. The main medical purpose of washing hands is to cleanse the hands of pathogen
Pathogen
A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...
s (including bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
or virus
Virus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
es) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field, but it is also an important practice for the general public. People can become infected with respiratory illnesses such as influenza or the common cold, for example, if they don't wash their hands before touching their eyes, nose, or mouth. Indeed, the Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
(CDC) has stated: "It is well documented that one of the most important measures for preventing the spread of pathogens is effective hand washing." As a general rule, handwashing protects people poorly or not at all from droplet- and airborne disease
Airborne disease
Airborne diseases refers to any diseases which are caused by pathogenic microbial agents and transmitted through the air. These viruses and bacteria can be aerosolized through coughing, sneezing, laughing or through close personal contact...
s, such as measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...
, chickenpox
Chickenpox
Chickenpox or chicken pox is a highly contagious illness caused by primary infection with varicella zoster virus . It usually starts with vesicular skin rash mainly on the body and head rather than at the periphery and becomes itchy, raw pockmarks, which mostly heal without scarring...
, influenza
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...
, and tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. It protects best against diseases transmitted
Transmission (medicine)
In medicine and biology, transmission is the passing of a communicable disease from an infected host individual or group to a conspecific individual or group, regardless of whether the other individual was previously infected...
through fecal-oral route
Fecal-oral route
The fecal-oral route, or alternatively, the oral-fecal route or orofecal route is a route of transmission of diseases, in which they are passed when pathogens in fecal particles from one host are introduced into the oral cavity of another potential host.There are usually intermediate steps,...
s (such as many forms of stomach flu) and direct physical contact (such as impetigo
Impetigo
Impetigo is a highly contagious bacterial skin infection most common among pre-school children. People who play close contact sports such as rugby, American football and wrestling are also susceptible, regardless of age. Impetigo is not as common in adults. The name derives from the Latin impetere...
).
In addition to hand washing with soap and water, the use of alcohol gels is an effective form of killing some kinds of pathogens.
In symbolic hand washing, using water only to wash hands is a part of ritual handwashing
Ritual purification
Ritual purification is a feature of many religions. The aim of these rituals is to remove specifically defined uncleanliness prior to a particular type of activity, and especially prior to the worship of a deity...
as a feature of many religions, including Bahá'í Faith
Bahá'í Faith
The Bahá'í Faith is a monotheistic religion founded by Bahá'u'lláh in 19th-century Persia, emphasizing the spiritual unity of all humankind. There are an estimated five to six million Bahá'ís around the world in more than 200 countries and territories....
, Hinduism
Hinduism
Hinduism is the predominant and indigenous religious tradition of the Indian Subcontinent. Hinduism is known to its followers as , amongst many other expressions...
, and tevilah and netilat yadayim
Ablution in Judaism
Ritual washing in Judaism, or ablution, takes two main forms. A tevilah is a full body immersion in a mikveh, and a netilat yadayim which is the washing of the hands with a cup....
in Judaism
Judaism
Judaism ) is the "religion, philosophy, and way of life" of the Jewish people...
. Similar to these are the practices of Lavabo
Lavabo
A lavabo is a device used to provide water for the washing of hands. It consists normally of a ewer or container of some kind to pour water, and a bowl to catch the water as it falls off the hands. In ecclesiastical usage it refers to both the basin in which the priest washes his hands and the...
in Christianity
Christianity
Christianity is a monotheistic religion based on the life and teachings of Jesus as presented in canonical gospels and other New Testament writings...
, Wudu
Wudu
Wuḍhu is the Islamic procedure for washing parts of the body using water often in preparation for formal prayers...
in Islam
Islam
Islam . The most common are and . : Arabic pronunciation varies regionally. The first vowel ranges from ~~. The second vowel ranges from ~~~...
and Misogi
Misogi
is a Japanese mountain ascetic practice of ritual purification. This may be undertaken through exhaustive activities such as extended periods without sleep, breath training, standing under waterfalls, or other methods...
in Shintō
Shinto
or Shintoism, also kami-no-michi, is the indigenous spirituality of Japan and the Japanese people. It is a set of practices, to be carried out diligently, to establish a connection between present day Japan and its ancient past. Shinto practices were first recorded and codified in the written...
.
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. However, since pathogens removed from the skin have to be rinsed away, there must be a resonable flow of 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. Bacteria grows much faster at body temperature (37 C). However, warm, soapy water is more effective than cold, soapy water at removing the natural oils on your hands which hold soils and bacteria. Contrary to popular belief however, scientific studies have shown that using warm water has no effect on reducing the microbial load on hands.Solid soap
Solid soapSoap
In chemistry, soap is a salt of a fatty acid.IUPAC. "" Compendium of Chemical Terminology, 2nd ed. . Compiled by A. D. McNaught and A. Wilkinson. Blackwell Scientific Publications, Oxford . XML on-line corrected version: created by M. Nic, J. Jirat, B. Kosata; updates compiled by A. Jenkins. ISBN...
, because of its reusable nature, may hold bacteria acquired from previous uses. Yet, it is unlikely that any bacteria are transferred to users of the soap, as the bacteria are rinsed off with the foam.
Antibacterial soap
Antibacterial soapAntibacterial soap
Antibacterial soap is any cleaning product to which active antibacterial ingredients have been added. These chemicals kill bacteria and microbes, but are no more effective at deactivating viruses than any other kind of soap or detergent, and they also kill nonpathogenic bacteria.-Ingredients:Most...
s 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
Triclosan
Triclosan is an antibacterial and antifungal agent. It is a polychloro phenoxy phenol. Despite being used in many consumer products, beyond its use in toothpaste to prevent gingivitis, there is no evidence according to the American Food and Drug Administration that triclosan provides an extra...
, which has an extensive list of resistant strains of organisms. So, even if antibiotic resistant strains aren't selected for by antibacterial soaps, 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 handHand
A hand is a prehensile, multi-fingered extremity located at the end of an arm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs...
antiseptic
Antiseptic
Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction...
is a non-water-based hand hygiene agent. In the late 1990s and early part of the 21st century, Alcohol rub
Rubbing alcohol
Rubbing alcohol, USP / B.P. is a liquid prepared and used primarily for topical application. It is prepared from a special denatured alcohol solution and contains 97.5-100% by volume of pure, concentrated ethanol or isopropyl alcohol...
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
Isopropyl alcohol
Isopropyl alcohol is a common name for a chemical compound with the molecular formula C3H8O. It is a colorless, flammable chemical compound with a strong odor...
or ethanol
Ethanol
Ethanol, also called ethyl alcohol, pure alcohol, grain alcohol, or drinking alcohol, is a volatile, flammable, colorless liquid. It is a psychoactive drug and one of the oldest recreational drugs. Best known as the type of alcohol found in alcoholic beverages, it is also used in thermometers, as a...
formulated together with a thickening agent
Thickening agent
Thickening agents, or thickeners, is the term applied to substances which increase the viscosity of a solution or liquid/solid mixture without substantially modifying its other properties; although most frequently applied to foods where the target property is taste, the term also is applicable to...
such as Carbomer
Carbomer
In organic chemistry, a carbomer is an expanded molecule obtained by insertion of a C2 unit in a given molecule. Carbomers differ from their templates in size but not in symmetry when each C–C single bond is replaced by at least one alkyne bond, and when a double bond is replaced by an allene bond...
into a gel, or a humectant
Humectant
A humectant is a hygroscopic substance. It is often a molecule with several hydrophilic groups, most often hydroxyl groups, but amines and carboxyl groups, sometimes esterified, can be encountered as well; the affinity to form hydrogen bonds with molecules of water is crucial here.Since...
such as glycerin into a liquid, or foam for ease of use and to decrease the drying effect of the alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
.
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
Vancomycin-Resistant Enterococcus
Vancomycin-resistant Enterococcus, or vancomycin-resistant enterococci , are bacterial strains of the genus Enterococcus that are resistant to the antibiotic vancomycin. To become VRE, vancomycin-sensitive enterococci typically obtain new DNA in the form of plasmids or transposons which encode...
), tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
, and some viruses (including HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
, herpes, RSV, rhinovirus
Rhinovirus
Human rhinoviruses are the most common viral infective agents in humans and are the predominant cause of the common cold. Rhinovirus infection proliferates in temperatures between 33–35 °C , and this may be why it occurs primarily in the nose...
, vaccinia
Vaccinia
Vaccinia virus is a large, complex, enveloped virus belonging to the poxvirus family. It has a linear, double-stranded DNA genome approximately 190 kbp in length, and which encodes for approximately 250 genes. The dimensions of the virion are roughly 360 × 270 × 250 nm, with a mass of...
, influenza
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...
, and hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
) and fungus
Fungus
A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...
. 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.
Hand sanitizers are most effective against bacteria and less effective against some viruses. Alcohol-based hand sanitizers are almost entirely ineffective against norovirus or Norwalk type viruses, the most common cause of contagious gastroenteritis.
The CDC recommends hand washing over hand sanitzer rubs.
The increasing use of these agents is based on their ease of use and rapid killing activity against micro-organisms, however they should not serve as a replacement for proper hand washing unless soap and water are unavailable.
Frequent use of alcohol-based hand sanitizers can cause dry skin unless emollients and/or skin moisturizer
Moisturizer
Moisturizers or emollients are complex mixtures of chemical agents specially designed to make the external layers of the skin softer and more pliable, by increasing its hydration by reducing evaporation. Naturally occurring skin lipids and sterols as well as artificial or natural oils,...
s 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
Allergic contact dermatitis
Allergic contact dermatitis is a form of contact dermatitis that is the manifestation of an allergic response caused by contact with a substance....
, contact urticaria
Urticaria
Urticaria is a kind of skin rash notable for pale red, raised, itchy bumps. Hives is frequently caused by allergic reactions; however, there are many non-allergic causes...
syndrome or hypersensitivity to alcohol or additives present in alcohol hand rubs rarely occurs. The lower tendency to induce irritant contact dermatitis became an attraction as compared to soap and water hand washing.
Despite their effectiveness, non-water agents do not cleanse the hands of organic material, but simply disinfect them. It is for this reason that hand sanitizers are not as effective as soap and water at preventing the spread of pathogens, since the pathogens still remain on the hands.
The efficacy
Efficacy
Efficacy is the capacity to produce an effect. It has different specific meanings in different fields. In medicine, it is the ability of an intervention or drug to reproduce a desired effect in expert hands and under ideal circumstances.- Healthcare :...
of alcohol-free hand sanitizers is heavily dependent on their ingredients and formulation
Formulation
Formulation may refer to:* Clinical formulation* Formulations * Formulation science* Pharmaceutical formulation:** Galenic formulation* Pesticide 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 formulation
Formulation
Formulation may refer to:* Clinical formulation* Formulations * Formulation science* Pharmaceutical formulation:** Galenic formulation* Pesticide formulation...
s 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. Other alcohol-free hand sanitizer products that use benzalkonium chloride as the active ingredient include Hy5, Soapopular, DEBSBS and EcoHydra. A further aspect of efficacy
Efficacy
Efficacy is the capacity to produce an effect. It has different specific meanings in different fields. In medicine, it is the ability of an intervention or drug to reproduce a desired effect in expert hands and under ideal circumstances.- Healthcare :...
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
Benzalkonium chloride
Benzalkonium chloride, also known as alkyldimethylbenzylammonium chloride and ADBAC, is a mixture of alkylbenzyldimethylammonium chlorides of various even-numbered alkyl chain lengths. This product is a nitrogenous cationic surface-acting agent belonging to the quaternary ammonium group...
as its active ingredient
Active ingredient
An active ingredient is the substance of a pharmaceutical drug or a pharmaceutical ingredient and bulk active in medicine; in pesticide formulations active substance may be used. Some medications and pesticide products may contain more than one active ingredient...
has been shown to increase with repeated use. In a recent study, the effectiveness of alcohol was shown to decrease after repeated use. The study demonstrated that, unlike Benzalkonium Chloride, alcohol does not have persistent or cumulative antimicrobial activity after application. Purell has been 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 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.
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 towel, disposable or otherwise. It has been shown 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). Moisturizing lotionLotion
A lotion is a low- to medium-viscosity, topical preparation intended for application to unbroken skin. By contrast, creams and gels have higher viscosity.Lotions are usually applied to external skin with bare hands, a clean cloth, cotton wool or gauze...
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.Drying
Effective drying of the hands is an essential part of 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 and sponsored by the paper towel industry the European Tissue Symposium, 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 increase on average on the finger pads by 194% and on the palms by 254%
- drying with the jet air dryer resulted in an increase on average of the total number of bacteria on the finger pads by 42% and on the palms by 15%
- after washing and drying hands with a paper towel, the total number of bacteria was reduced on average on the finger pads by up to 76% and on the palms by up to 77%.
The scientists also carried out tests to establish whether there was the potential for cross contamination of other washroom users and the washroom environment as a result of each type of drying method. They found that:
- the jet air dryer, which blows air out of the unit at claimed speeds of 400 mph, was capable of blowing micro-organisms from the hands and the unit and potentially contaminating other washroom users and the washroom environment up to 2 metres away.
- use of a warm air hand dryer spread micro-organisms up to 0.25 metres from the dryer
- paper towels showed no significant spread of micro-organisms.
In 2005, in a study conducted by TUV Produkt und Umwelt, different hand drying methods were evaluated. The following changes in the bacterial count after drying the hands were observed:
| Drying method | Effect on Bacterial Count |
|---|---|
| Paper towel Paper towel A paper towel is an absorbent textile made from paper instead of cloth. Unlike cloth towels, paper towels are disposable and intended to be used only once. Paper towels soak up water because they are loosely woven which enables water to travel between them, even against gravity... s and roll |
Decrease of 24% |
| Hot-air dryer Hand dryer Hand dryers are electric devices found in public washrooms that are used to dry hands. They may either operate with a button or automatically using an infrared sensor.- Costs :... |
Increase of 12% |
Medical use
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
hand washing is for a minimum of 15 seconds using generous amounts of soap and water or gel to lather and rub each part of the hands. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush may be used to remove it. Since germs may remain in the water on the hands it is important to rinse well and wipe dry with a clean towel. After drying, the paper towel should be used to turn off the water (and open any exit door if necessary). This avoids re-contaminating the hands from those surfaces.
The purpose of hand washing in the health care setting is to remove pathogenic microorganisms ("germs") and avoid transmitting them. The New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
reports that lack of hand washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients. One study showed that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.
The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
has published a sheet demonstrating standard handwashing and handrubbing in health care sectors. The draft guidance of hand hygiene by the organization can also be found at its website for public comment. A relevant review was conducted by Whitby et al. Commercial devices can measure and validate hand hygiene, if demonstration of regulatory compliance is required.
The addition of antiseptic chemicals to soap ("medicated" or "antimicrobial" soaps) confers killing action to a hand washing agent. Such killing action may be desired prior to performing surgery or in settings in which antibiotic-resistant organisms are highly prevalent.
To 'scrub' one's hands for a surgical operation
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, it is necessary to have a tap that can be turned on and off without touching with the hands, some chlorhexidine or iodine wash, sterile towels for drying the hands after washing, and a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewelry should be removed. This procedure requires washing the hands and forearms up to the elbow, usually 2–6 minutes. Long scrub times (10 minutes) are not necessary. When rinsing, water on the forearms must be prevented from running back to the hands. After hand washing is completed, the hands are dried with a sterile cloth and a surgical gown is donned.
Medical hand-washing became mandatory long after Hungarian physician Ignaz Semmelweis
Ignaz Semmelweis
Ignaz Philipp Semmelweis was a Hungarian physician now known as an early pioneer of antiseptic procedures. Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics...
discovered its effectiveness in preventing disease in a hospital environment.
Hand antiseptics
Alcohol rubs and hand antiseptics (biocides) kill microorganisms. Current scientific evidence has not demonstrated a link between the use of topical antimicrobial formulations and antiseptic
Antiseptic
Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction...
or antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
resistance. Antiseptics (biocides) have multiple (thousands) of nonspecific killing sites on and in the microbial cell which cannot easily mutate. Antibiotics and antibacterial soaps (triclosan
Triclosan
Triclosan is an antibacterial and antifungal agent. It is a polychloro phenoxy phenol. Despite being used in many consumer products, beyond its use in toothpaste to prevent gingivitis, there is no evidence according to the American Food and Drug Administration that triclosan provides an extra...
) have one very specific killing site on and in the microbial cell which can easily mutate. Antibiotic resistance has no effect on the effectiveness of antiseptics.
Alcohol rubs and combination hand sanitizers are effective at killing some germs on the hands. Many clinical studies have shown that alcohol rubs containing two germ killers (i.e. Alcohol and Chlorhexidine gluconate
Chlorhexidine gluconate
Chlorhexidine is a chemical antiseptic. It is effective on both Gram-positive and Gram-negative bacteria, although it is less effective with some Gram-negative bacteria. It has both bactericidal and bacteriostatic mechanisms of action, the mechanism of action being membrane disruption, not ATPase...
or Benzalkonium chloride
Benzalkonium chloride
Benzalkonium chloride, also known as alkyldimethylbenzylammonium chloride and ADBAC, is a mixture of alkylbenzyldimethylammonium chlorides of various even-numbered alkyl chain lengths. This product is a nitrogenous cationic surface-acting agent belonging to the quaternary ammonium group...
) are significantly better germ killers than alcohol rubs containing alcohol alone.
However alcohol rub sanitizers are not appropriate for use when the hands are visibly dirty, soiled. Visible soiling of any sort on the hands must be washed with soap and water because alcohol-based hand rubs are less effective in the presence of organic material. In addition, alcohols may not be effective against non-lipid-enveloped viruses (e.g., Noroviruses) as enveloped viruses but they are still effective. Hand antiseptics and soap and water will not kill the endospores of bacteria (e.g., Clostridium difficile and Anthrax) and the spores of protozoa (e.g., Giardia lamblia) but soap and water may wash them down the drain. When such microorganisms are likely to be encountered, soap and water hand washing followed by use of a good hand antiseptic is preferable.
Hand washing with hand sanitizer (hand antiseptic) is effective in cleaning [killing] staph aureus and the bacteria that are causing these staph infections, but alcohol-based hand sanitizers and soap and water are not effective in killing spore forming organisms because alcohol or soap will not destroy bacterial spores. Washing hands with soap and water may wash the spores down the sink.
In the U.S. alcohol rubs have been banned from some schools because of flammability concern. The fire department allows Tallahassee Memorial Hospital to have a certain amount of hand sanitizer per smoke compartment, and supply it up to that limit.
Hand washing with wipes
Hand washing using hand sanitizing wipes is also recommended by CDC as a convenient alternative during traveling in the absence of soap and water in nonacute health care settings.Effectiveness
This hygienic behavior has been shown to cut the number of child deaths from diarrheaDiarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
(the second leading cause of child deaths) by almost half and from pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...
(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.
For control of staphylococcal
Staphylococcus
Staphylococcus is a genus of Gram-positive bacteria. Under the microscope they appear round , and form in grape-like clusters....
infections in hospitals, it has been found that the greatest benefit from hand-cleansing came from the first 20% of washing, and that very little additional benefit was gained when hand cleansing frequency was increased beyond 35%. Washing with plain soap results in more than triple the rate of bacterial infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
transmitted to food as compared to washing with antibacterial soap. Comparing hand-rubbing with alcohol-based solution with handwashing with antibacterial soap for a median time of 30 seconds each showed that the alcohol hand-rubbing reduced bacterial contamination 26% more than the antibacterial soap. But soap and water is the more effective than alcohol-based hand rubs for reducing H1N1 influenza A virus and Clostridium difficile
Clostridium difficile
Clostridium difficile , also known as "CDF/cdf", or "C...
spore
Spore
In biology, a spore is a reproductive structure that is adapted for dispersal and surviving for extended periods of time in unfavorable conditions. Spores form part of the life cycles of many bacteria, plants, algae, fungi and some protozoa. According to scientist Dr...
s from hands.
Religion
Ritual purification
Ritual purification is a feature of many religions. The aim of these rituals is to remove specifically defined uncleanliness prior to a particular type of activity, and especially prior to the worship of a deity...
as a feature of many religions, including Bahá'í Faith
Bahá'í Faith
The Bahá'í Faith is a monotheistic religion founded by Bahá'u'lláh in 19th-century Persia, emphasizing the spiritual unity of all humankind. There are an estimated five to six million Bahá'ís around the world in more than 200 countries and territories....
, Hinduism
Hinduism
Hinduism is the predominant and indigenous religious tradition of the Indian Subcontinent. Hinduism is known to its followers as , amongst many other expressions...
and tevilah and netilat yadayim
Ablution in Judaism
Ritual washing in Judaism, or ablution, takes two main forms. A tevilah is a full body immersion in a mikveh, and a netilat yadayim which is the washing of the hands with a cup....
in Judaism
Judaism
Judaism ) is the "religion, philosophy, and way of life" of the Jewish people...
. Similar to these are the practices of Lavabo
Lavabo
A lavabo is a device used to provide water for the washing of hands. It consists normally of a ewer or container of some kind to pour water, and a bowl to catch the water as it falls off the hands. In ecclesiastical usage it refers to both the basin in which the priest washes his hands and the...
in Christianity
Christianity
Christianity is a monotheistic religion based on the life and teachings of Jesus as presented in canonical gospels and other New Testament writings...
, Wudu
Wudu
Wuḍhu is the Islamic procedure for washing parts of the body using water often in preparation for formal prayers...
in Islam
Islam
Islam . The most common are and . : Arabic pronunciation varies regionally. The first vowel ranges from ~~. The second vowel ranges from ~~~...
and Misogi
Misogi
is a Japanese mountain ascetic practice of ritual purification. This may be undertaken through exhaustive activities such as extended periods without sleep, breath training, standing under waterfalls, or other methods...
in Shintō
Shinto
or Shintoism, also kami-no-michi, is the indigenous spirituality of Japan and the Japanese people. It is a set of practices, to be carried out diligently, to establish a connection between present day Japan and its ancient past. Shinto practices were first recorded and codified in the written...
.
Handwashing behavior
The phrase "washing one's hands of" something, means declaring one's unwillingness to take responsibility for the thing or share complicity in it. In the New Testament book of MatthewGospel of Matthew
The Gospel According to Matthew is one of the four canonical gospels, one of the three synoptic gospels, and the first book of the New Testament. It tells of the life, ministry, death, and resurrection of Jesus of Nazareth...
, verse 27:24 gives an account of Pontius Pilate
Pontius Pilate
Pontius Pilatus , known in the English-speaking world as Pontius Pilate , was the fifth Prefect of the Roman province of Judaea, from AD 26–36. He is best known as the judge at Jesus' trial and the man who authorized the crucifixion of Jesus...
washing his hands of the decision to crucify Jesus
Jesus
Jesus of Nazareth , commonly referred to as Jesus Christ or simply as Jesus or Christ, is the central figure of Christianity...
: "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, 'I am innocent of the blood of this just person: see ye to it'." Also see .
In Shakespeare's Macbeth
Macbeth
The Tragedy of Macbeth is a play by William Shakespeare about a regicide and its aftermath. It is Shakespeare's shortest tragedy and is believed to have been written sometime between 1603 and 1607...
, Lady Macbeth
Lady Macbeth (Shakespeare)
Lady Macbeth is a fictional character in Shakespeare's Macbeth . She is the wife to the play's protagonist, Macbeth, a Scottish nobleman. After goading him into committing regicide, she becomes Queen of Scotland, but later suffers pangs of guilt for her part in the crime...
begins to compulsively wash her hands in an attempt to cleanse an imagined stain, representing her guilty conscience regarding crimes she had committed and induced her husband to commit.
It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.
Excessive hand washing is commonly seen as a symptom of obsessive-compulsive disorder
Obsessive-compulsive disorder
Obsessive–compulsive disorder is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing the associated anxiety, or by a combination of such obsessions and compulsions...
(OCD).
Pros
- helps minimize the spread of influenza
- diarrhea prevention
- avoiding respiratory infections
- a preventive measure for infant deaths at their home-birth-deliveries
See also
- Antibacterial soapAntibacterial soapAntibacterial soap is any cleaning product to which active antibacterial ingredients have been added. These chemicals kill bacteria and microbes, but are no more effective at deactivating viruses than any other kind of soap or detergent, and they also kill nonpathogenic bacteria.-Ingredients:Most...
- E. coli O157:H7Escherichia coli O157:H7Escherichia coli O157:H7 is an enterohemorrhagic strain of the bacterium Escherichia coli and a cause of foodborne illness. Infection often leads to hemorrhagic diarrhea, and occasionally to kidney failure, especially in young children and elderly persons...
- Antibiotic resistanceAntibiotic resistanceAntibiotic resistance is a type of drug resistance where a microorganism is able to survive exposure to an antibiotic. While a spontaneous or induced genetic mutation in bacteria may confer resistance to antimicrobial drugs, genes that confer resistance can be transferred between bacteria in a...
- Hand sanitizer
- Ignaz SemmelweisIgnaz SemmelweisIgnaz Philipp Semmelweis was a Hungarian physician now known as an early pioneer of antiseptic procedures. Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics...
- Soap dispenserSoap dispenserA soap dispenser is a device that, when manipulated or triggered appropriately, yields soap . It can be manually operated by means of a handle, or can be automatic...
- Methicillin-resistant Staphylococcus aureusMethicillin-resistant Staphylococcus aureusMethicillin-resistant Staphylococcus aureus is a bacterium responsible for several difficult-to-treat infections in humans. It is also called multidrug-resistant Staphylococcus aureus and oxacillin-resistant Staphylococcus aureus...
- Nosocomial infectionNosocomial infectionA nosocomial infection , also known as a hospital-acquired infection or HAI, is an infection whose development is favoured by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff...
- Rubbing alcoholRubbing alcoholRubbing alcohol, USP / B.P. is a liquid prepared and used primarily for topical application. It is prepared from a special denatured alcohol solution and contains 97.5-100% by volume of pure, concentrated ethanol or isopropyl alcohol...
- Shigella dysenteriaeShigella dysenteriaeShigella dysenteriae is a species of the rod-shaped bacterial genus Shigella. Shigella can cause shigellosis . Shigellae are Gram-negative, non-spore-forming, facultatively anaerobic, non-motile bacteria.S...
- Patient safetyPatient safetyPatient safety is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse healthcare events. The frequency and magnitude of avoidable adverse patient events was not well known until the 1990s, when multiple countries reported...
- Occupational biosafetyBiosafetyBiosafety: prevention of large-scale loss of biological integrity, focusing both on ecology and human health .Biosafety is related to several fields:*In ecology ,...
- Stainless steel soapStainless steel soapA stainless steel soap is a piece of stainless steel, usually in the shape of a soap bar. Its advertised purpose is to neutralize or reduce strong odors from the hands, present from handling odorous ingredients such as garlic, onion or fish....