Wash your hands

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Wash your hands

Hand washing is the cleaning of the hands with water (and usually soap or soap-like substances) to remove or inactivate dirt and potential pathogens. It thus fulfills an aesthetic and a hygienic function.

Hygienic function

Coarse dirt that comes into contact with the skin and can be seen or felt, and residues of skin flakes, sebum and sweat form a breeding ground for pathogens, especially on the hands, which can be removed mechanically by washing the whole hand on a regular basis including the spaces between the fingers is cleaned for at least 20 seconds and then rinsed and dried thoroughly. Microbial contamination is reduced, for example bacteria by one to two log 10 levels (90–99%); Non-enveloped viruses are only removed mechanically, while enveloped viruses are partially inactivated by soap.

Hand washing is considered sufficient outside of medical areas, but is not an alternative to hygienic hand disinfection . An exception is contact with certain spore-forming pathogens (e.g. Clostridioides difficile ), in which only washing your hands reduces any spores that may stick, which cannot be inactivated by the usual alcohol-based skin disinfectants.

Washing your hands lowers the risk of fecal-oral smear infections , such as: B. contagious diarrhea . This is why hand washing is particularly important after using the toilet, before preparing meals and before eating. Some children learn the motto "After the toilet and before eating - don't forget to wash your hands".

Diseases that can be transmitted by droplet infections , such as respiratory infections or the flu, can also be transmitted through the hands when they come into contact with mucous membranes, which is why hand washing is recommended for prevention.

Equipment of hand washing stations

The Commission for Hospital Hygiene and Infection Prevention (KRINKO) recommends a large, deeply shaped washbasin and running hot and cold water for equipping hygienic hand-washing stations . The basin should not have an overflow due to possible colonization with pathogens. Adjacent work surfaces must be shielded with a splash guard so that they cannot be contaminated . Wall-mounted dispensers for hand disinfectants , hand washing preparations and disposable towels should be located at the hand washing station. In order to largely prevent an aerosol containing pathogens from spreading when washing hands, the water jet must not be aimed directly at the drain.

Hand-free operation of the fitting using an extended lever or foot or knee activation is recommended if employees have direct patient contact, for example. Disposable towels must be removed from the dispenser without the risk of contamination, used towels are disposed of in the waste container provided. So-called retractive dispensers with automatic feed of a textile towel can be used if the used towel is rolled up on a second roll without contact with the clean towel roll. Conventional hot air dryers, on the other hand, are unsuitable for healthcare facilities.

Suitable products

Wash basin in a private household

Different products are used depending on the application or field of work.

Washing hands in everyday life

For everyday hygiene in private households or in public areas without any particular risk of infection, soaps , syndets , washing lotions or emulsions and shower gels are sufficient to mechanically remove bacteria, fungi and viruses. So-called antibacterial or antimicrobial soaps or syndets can increase the effect in individual cases, but have no proven additional benefit compared to normal soaps; on the other hand, they may have irritative, allergic and environmentally harmful side effects. Some products contain triclosan , the use of which is not recommended by the Federal Institute for Risk Assessment (BfR) and the Institute for Hygiene and Public Health at the University of Bonn.

So-called hand washing pastes contain fine abrasive particles with which particularly stubborn dirt can be rubbed off the skin (e.g. engine oil).

Hand washing at work and hygienic hand washing

Mandatory sign M011: Wash your hands

Hand washing is required, for example, when starting work in food processing, in large kitchens, canteens, medical areas and in old people's and nursing homes as an infection prevention measure. It supplements hygienic hand disinfection . For "hygienic hand washing" (DIN EN 1499: 2013-07), products with the designation hygienic hand washing products are mainly used in the food sector . They are tested in accordance with a standardized test procedure in accordance with DIN or by the Association for Applied Hygiene (VAH) and are suitable for hygienic hand washing, as they are usually effective against all bacteria and yeasts or fungi. For this purpose, the product exposure time specified by the manufacturer must be strictly observed. In contrast, the use of products with so-called antimicrobial effectiveness is not required in any set of rules and is not significantly more effective than normal soap washing.

In Germany, the recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute (RKI) apply to the equipment of hand washing stations in medical areas : Solid washing products such as soap or syndet bars may not be used. Disposable paper or textile towels from a hand towel dispenser are used for drying; they remove significantly more residual flora and contaminate the environment less than hot air dryers.

Effect on the skin

Normally there is an acidic environment on the hand, as on the entire human skin, with a pH value between 4.8 and 5.3. Washing hands with alkaline soap temporarily shifts the natural pH value of the skin. With healthy, intact skin, the slightly acidic environment is restored after an hour. Manufacturers of "pH skin-neutral" syndets advertise that there is no pH shift in these products.

The problem with skin cleansing is a disturbance of the physiological skin flora : Frequent washing of the hands dissolves lipids from the skin and also leads to excessive storage of water in the upper layers of the stratum corneum. This overhydration causes the horny layer to swell; the missing lipid connection creates gaps between the cell layers. The protective skin barrier can only be built up again with a delay, which favors the development of skin irritations, especially in combination with hand disinfection. Hand washing is therefore unsuitable as a regular preventive measure and should be reduced to the necessary minimum. After washing, it is necessary to dry the spaces between the fingers carefully with a soft disposable towel.

Investigations related to hand washing

According to a study by the University of Regensburg, the temperature of the water when washing hands is insignificant. Only the use of cleaning agents helps against pathogens that are closely related to the skin. After washing hands with soap for at least 20 seconds, 99% of the germs would be removed or inactivated. A study by the University of Helsinki on behalf of the European Textile Services Association showed that drying hands by rubbing them with disposable paper towels is more hygienic than air drying. Damp hands harbor up to 1000 times more germs than dry hands. Women wash their hands more often than men.

Action days

In 2008, the WHO launched the International Hand Washing Day (for children and adults), which takes place on October 15th. World Hand Hygiene Day (for medical staff) has been taking place on May 5th since 2009 .

For cultural history see also

literature

Web links

Commons : washing hands  - collection of pictures, videos and audio files

Remarks

  1. ↑ a b c Hand hygiene measures - A contribution to the International Hand Hygiene Day on May 5th. Epidemiological Bulletin No. 17 of April 30, 2012 ; accessed on March 3, 2019
  2. ↑ KRINKO recommendation: hygiene measures for Clostridioides difficile infection (CDI). 2019, p. 912. Retrieved September 26, 2019.
  3. ↑ "Before eating, after the toilet I wash my hands anyway!" A project on health education in day-care centers , Bavarian Community Accident Insurance Association , Bavarian State Accident Fund
  4. ↑ G. Meilicke, A. Weißenborn, W. Biederbick, C. Bartels: With water and soap against the flu. Hand washing as an infection protection recommendation for the population - 7 hypotheses from a qualitative study on hygiene, flu and pandemics , Federal Health Gazette - Health Research - Health Protection, Volume 51, Issue 11, 2008, pp. 1273-1279, doi: 10.1007 / s00103-008 -0701-8
  5. ↑ Maren Eggers, Elena Terletskaia-Ladwig, Martin Enders: How effective is hand washing against influenza viruses? , Hygiene & Medizin, 2009, Volume 34, Issue 12, pp. 492–498.
  6. ↑ a b KRINKO recommendation for hand hygiene in health care facilities. Bundesgesundheitsblatt 2016, 59: 1189-1220 doi : 10.1007 / s00103-016-2416-6 , p. 1198; accessed on September 26, 2019.
  7. ^ A b c Institute for Hygiene and Public Health at the University of Bonn: Hygiene tips for kids. Hand hygiene information. March 2015 ; accessed on March 5, 2019
  8. ↑ SA Kim, H. Moon, K. Lee, MS Rhee: Bactericidal effects of triclosan in soap both in vitro and in vivo , Journal of Antimicrob. Chemother. (2015), doi: 10.1093 / jac / dkv275
  9. ^ Andreas Schwarzkopf: Practical knowledge for hygiene officers , Verlag W. Kohlhammer, Stuttgart 2008, ISBN 978-3-17-019849-4 , p. 124.
  10. ↑ Equipment of the hand washing area in medical practices , Hyg Med 2015; 40-3, S121-22.
  11. ↑ Hand hygiene in health care facilities. Bundesgesundheitsblatt 2016, 59: 1189–1220, DOI 10.1007 / s00103-016-2416-6.
  12. ↑ How good is soap for the skin? ndr.de, October 26, 2017 ; accessed on March 5, 2019.
  13. ↑ a b Wolfgang Raab: Structure of the skin. In: Wolfgang Raab, Ursula Kindl: Care Cosmetics: A Guide. Wissenschaftliche Verlagsgesellschaft, Stuttgart 2012, ISBN 978-3-8047-2761-8 , p. 10.
  14. ↑ Aspects of skin tolerance, skin protection and skin care , Epidemiological Bulletin No. 18, Robert Koch Institute, May 4, 2015.
  15. ↑ S2 guideline hospital hygiene: hand disinfection and hand hygiene. Retrieved March 3, 2019.
  16. ^ Uni Regensburg: Wash hands only with soap , Mittelbayerische, October 20, 2010
  17. ↑ Hygienic hand drying. A comparative study on four systems: cotton towel, paper towel, hot air dryer, air flow dryer  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. , European Textile Services Association, 2014@1@ 2Template: Dead Link / www.salesianer.at  
  18. ↑ a b Katrin Collmar: Tips on hygiene - "In Germany, hand washing could be improved". sueddeutsche.de, May 5, 2018 ; accessed on March 4, 2019
  19. ↑ “When it comes to hand washing, the man is a piglet!” Zeitmagazin! 53/2014, February 23, 2015.