Hygiene or health care measures are intended to prevent diseases and maintain and consolidate health.
Definitions and aspects of hygiene
Hygiene in the broader sense is the "totality of all efforts and measures to prevent diseases and damage to health". In this sense, the term hygiene covers various areas that partially overlap, such as aspects of infection protection (such as food safety , water hygiene - especially drinking water hygiene and wastewater disposal ), waste disposal , environmental hygiene (such as avoiding environmental toxins in the air and in the ground), occupational safety , building and residential hygiene as well as social and psychological hygiene .
According to Max Rubner (1911), hygiene means "the conscious avoidance of all health-threatening dangers and the performance of health-enhancing actions". Also, according to the World Health Organization (WHO), hygiene refers to conditions and actions that serve to maintain health and prevent the spread of disease.
Medical hygiene includes numerous specific preventive measures that serve to protect against infection and thus to maintain health. So z. B. clinical hygiene , keeping the environment clean, sterilization of devices, drinking water and bathing water controls as well as safe disposal of medical waste.
The German Society for Hygiene and Microbiology reduces the term to "detection, treatment and prevention of infectious diseases."
The subject of hygiene represents the “doctrine of the prevention of diseases and the maintenance, promotion and consolidation of health”. Hygiene specialists are generally referred to as hygienists; In Germany, there are further training courses to become a hygiene officer and a hygiene specialist .
The word hygiene comes from the Greek : ὑγιεινή [τέχνη] hygieinḗ [téchnē] means “[art] serving health”. It is derived from ὑγίεια hygíeia "health" - the word with which the Greek goddess of health , Hygieia , is also referred to.
Until the end of the 19th century the spelling “Hygieine” was predominant. The simplification to “hygiene” only caught on in the last quarter of the century.
Hygiene in the narrow sense refers to the measures for prevention against infectious diseases , in particular cleaning , disinfection and sterilization . In everyday language, the word hygiene is also incorrectly used in place of cleanliness, but it only covers a small part of the task area of hygiene.
Hygienic measures, including religious commands and prohibitions, as well as technical efforts to provide clean drinking water, have been demonstrable worldwide and have been for the most ancient times.
Life situation in the Middle Ages
In the Middle Ages , it was still common in Europe to defecate on the street, chamber pots were emptied on the streets, market waste (plant residues, slaughterhouse waste, slaughter blood) was left on the streets and squares, domestic rubbish and manure from the stalls of the city Animal husbandry was stored on the streets, pigs, chickens and other domestic animals roamed freely on the streets, rainwater moistened and distributed everything, all of which led to street dirt and the associated odor nuisance and disease spreading in the cities, while police regulations were issued . In the later Middle Ages, in addition to city ordinances to combat epidemics (especially after the Black Death had spread in 1348), ordinances were also issued to keep streets clean (e.g. in Regensburg in 1366) or to kill animals in slaughterhouses (Augsburg, 1276). Only the introduction of the sewer system, municipal slaughterhouses and paving were able to contain the dirt and related epidemics.
Hygiene in medicine
Hygiene in medicine relates to the behavior of specialists in outpatient use as well as in clinical hygiene to ward off new diseases. In 1979 Thomas McKeown attributed the decline in infectious diseases over the past 200 years to hygiene, better human nutrition , immunity and other non-specific measures. Apart from the industrialized countries , the pattern of diseases has not changed significantly, despite the introduction of some medicinal treatment methods. So it can be assumed that without financial and material support from the “ Third World ” and without better living conditions for the majority of humanity, the danger of epidemics will be increased.
The hygiene in the Roman Empire was relatively well developed. The Roman politician and polymath Marcus Terentius Varro suspected that diseases are caused by "small animals that are invisible to the eye" (from today's perspective, microorganisms). It was known that quarantine could prevent the spread of infectious diseases.
Until the first half of the 19th century, cleanliness and disinfection were not considered necessary in medicine . So were operation aprons of the surgeons never washed practical. Medical instruments were not cleaned prior to use. It is also not uncommon for hospitals to clean the wounds of different patients one after the other with the same sponge .
In the 1840s, Ignaz Semmelweis first succeeded in proving that disinfection can curb the transmission of diseases. As an assistant doctor in the Clinic for Obstetrics in Vienna , he investigated why the death rate from puerperal fever in one department in which medical students worked was significantly higher than in the second department in which midwifery students were trained. He found the explanation when one of his colleagues was injured with a scalpel by a student during a dissection and died a few days later of blood poisoning , a disease with a similar course to puerperal fever. Semmelweis found that the doctors involved in the autopsy run the risk of infecting the mothers during the subsequent obstetrics. Since student midwives do not perform dissections, this type of infection was less common in the second hospital ward. That explained the lower mortality there. Semmelweis therefore instructed his students to disinfect their hands with chlorinated lime before examining their mothers . This effective measure reduced the death rate from 12.3% to 1.3%. The procedure met with resistance from doctors and students alike. They didn't want to admit that they themselves transmitted the infections instead of curing them.
Joseph Lister , a Scottish surgeon , successfully used carbole to disinfect wounds before surgery. He was initially of the opinion that infections are caused by pathogens in the air. For a while, a fine carbolic mist was sprayed over the patient during the operation, which was abandoned when it was discovered that infections originated mainly from hands and objects that came into contact with the wounds.
Max von Pettenkofer held the first German chair for hygiene from September 1865 and is considered the father of hygiene as a medical subject. As a sub-area, hygiene was part of medical training at the Vienna Medical Faculty from 1805 and the subject was also taught at the Medical Faculty of Würzburg by the doctor and chemist Joseph von Scherer before it was appointed as a nominal subject . Other well-known researchers in the field of hygiene were Johann Peter Frank , Robert Koch and Louis Pasteur . Franz Ballner was a pioneer of hygiene in the military sector .
Public hygiene in the 19th century
The 19th century was marked by new discoveries in disease prevention and the emergence of public health care. From the mid-19th century onwards, governments recognized the need to systematically develop public health care. While the measures for this in Western Europe were initially limited to quarantine regulations in ports for the control and exclusion of sick or potentially sick people, new measures were aimed at expanding infrastructural facilities, whereby diseases should be deprived of the breeding ground. Public health care became the responsibility of the state, while until then it was left to private and religious initiative. Starting in Great Britain, the new priorities from the 1830s were the removal of rubbish and sewage in cities and the supply of harmless drinking water. The side effects of early industrialization were recognized and gradually, albeit with resistance, tackled. First of all, water had to be recognized as a public good. Only on this basis could a water policy with comprehensive legal provisions for the ownership and use of water emerge. Private ownership claims had to be revoked, a lengthy and complicated process that in Western Europe sometimes dragged on into the 20th century, for example in France. Adequate technologies in the form of modern water supply had to be added. In 1842, New York was the first city to have an extensive pipe system, aqueducts, reservoirs and connected public fountains.
The value of technical water purification has been impressively confirmed since it was known in 1849 that cholera is transmitted through water. Nevertheless, it took decades, for example in London until 1868 and in Munich even until 1881, until the new knowledge prevailed against the often radical market liberalism and suitable measures could be taken. In London around 1800 salmon could still be fished and swam in the Thames , while around 1858 the stench rose from the river so strong that the House of Commons put sheets on its covers and the meetings there had to be broken off because of the stench. It was only this event that led to the commissioning of the construction of an underground sewer system to improve urban hygiene.
Outside of Western Europe, cities had in some cases taken action to improve urban hygiene much earlier. Persian Isfahan was praised for its water supply in reports prior to the Afghan destruction in 1722. In Damascus , a city with then 15,000 inhabitants, every street, every mosque, every public and private house was supplied in abundance with canals and fountains in 1872. A public organized water supply was set up in Bombay as early as 1859. A sewage system was built in Calcutta in 1865 and a water filter system in 1869. The same thing happened in Shanghai in 1883, but there by private investors and only for a few rich Chinese and Europeans living there. The Chinese have been cautious about the renewals.
Hygiene measures are individual methods and procedures that are based on experience, tradition or scientific research. If a hygiene measure is documented as a procedural instruction, it is considered a binding regulation in the respective area.
In the economic sector in particular, food , drinking water and laundry hygiene are regulated by law. This also includes pest control . Of these are z. B. Commercial kitchens and communal facilities or accommodation are affected. These regulations do not apply to private households.
Health care institutions
Medical measures are sterilization , disinfection , isolation and quarantine . The basic clinical hygiene measures are mandatory in most health care facilities. They include regulations on hand hygiene and aseptic activities such as wound care to prevent infectious agents from being transmitted. In areas with an increased risk of infection, z. B. According to the German accident prevention regulations, watches and jewelry are not worn on hands and forearms.
For cleaning in private households, the Federal Environment Agency , Federal Institute for Consumer Health Protection and Veterinary Medicine and Robert Koch Institute considered conventional cleaning agents to be sufficient to ensure hygiene; the use of products with a bactericidal, antibacterial and antimicrobial effect is unnecessary (status: 2000).
Criticism of modern hygiene
Modern hygiene and medicine focus on the danger or virulence of pathogens. The conclusion of 40 years of research by the French physician and physiologist Claude Bernard was: Le germe n'est rien, le terrain est tout! ( "The germ is nothing, the milieu is everything!") With seed ( germ ) here is a microbial pathogens meant as still in medicine, the term seed is needed. With this statement, Bernard expressed that regardless of the virulence of a pathogen, the metabolic , wound and immune situation of the individual (human) organism in each case always determines the danger posed by the pathogen, either as a breeding ground for the multiplication of the pathogen ( see infection ), or makes it impossible to multiply. In the latter case, either only the criteria for contamination , not infection, would be met (criterion for pathogen multiplication in the organism), or an infectious disease would be prevented despite the occurrence of an infection (see Silent Feiung ). Both the individual performance of the organism as well as the medical help given to it, including medical help (see e.g. debridement , tetanus ) play a role here.
Scientific studies indicate a connection between excessive cleanliness in the home environment and the occurrence of allergies . Due to the reduced contact with pathogens , especially during early childhood , the immune system tends to react to actually harmless substances such as pollen or house dust .
Evolutionary researchers assume that the human body depends on certain bacteria and also worms living in it or its environment.
Euphemistic use of the term
The suggestive , euphemistic term “ racial hygiene ” ( eugenics ) suggests that a (human) “ race ” or a “ national body ” is kept “pure” (or “cleaned up”) by whatever “hygienic” measures. The term determined the population policy in the time of National Socialism (see National Socialist Racial Hygiene ).
- personal hygiene
- Monthly hygiene
- Hospital hygiene
- Sleep hygiene
- Mental hygiene
- Social medicine
- Public health
- Sanitary Movement
- German Hygiene Museum
- International Hygiene Exhibition Dresden 1911
- Regimen sanitatis
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