Old Habits Die Hard—It's Time to Form New Ones!
The spread of many illnesses can be prevented by breaking germ-carrying habits.
The Centers for Disease Control (CDC) tells us that proper hand washing is the single most important action each of us can perform to help stop the spread of diseases.1 Hand washing instructions populate many Web sites, such as www.flu.gov. The Internet boasts videos on "how to wash." The media in general keep the H1N1 pandemic in the forefront of local, state, and national press. After countless messages reminding us to wash our hands, you might think that all of us have finally been educated in the importance of hand washing in the fight against the transmission of diseases. Unfortunately, too many recent studies prove otherwise.
In a recent hand washing survey conducted by Bradley Corporation, participants were asked whether the threat of H1N1 had changed the frequency of their hand washing. Surprisingly, the majority of those surveyed had not altered their hand washing habits, even during this time of H1N1 pandemic! In fact, 54 percent of the 1,020 participants indicated they did not wash their hands more frequently, nor did they wash less frequently, in public restroom facilities as a result of the virus threat.2
In another report, more than 400 British commuters were part of a study of microbiological contamination on the hands of the general adult public. The study's author, Gaby Judah of the department of infectious and tropical diseases at the London School of Hygiene and Tropical Medicine, found the results astonishing: 28 percent of the 404 people tested were found to have fecal bacteria on their hands.3 Not only a disgusting scenario; failure to wash hands after using the bathroom constitutes a huge health risk. Hepatitis A, a foodborne illness, is transmitted when human sewage comes into contact with uncooked food.
The fifth annual Clean Hands Report Card® issued by the Soap and Detergent Association (SDA) in September 2009 gives America a hand hygiene grade of a B-minus versus the 2008 grade of C-minus. Positive results from the survey: 50 percent say they wash their hands more than 10 times per day. This is up from 26 percent in 2008. More Americans claim to wash their hands after coughing, sneezing, using the bathroom, and before eating lunch. Negative results: Women are still washing their hands more than men (62 percent of women wash more than 10 times per day versus only 37 percent of men). A disturbing 39 percent of survey participants seldom or never wash their hands after coughing or sneezing.
The survey also shows that nearly half (46 percent) of participants do not wash their hands the recommended amount of time for proper cleansing. The CDC and SDA recommend washing with soap and warm water for at least 15 to 20 seconds. Wash between the fingers, around cuticles and beneath nails, the backs of the hands, and the wrists. Friction during the hand washing process helps remove germs from the skin. Rinse thoroughly. Use a clean disposable towel to turn off the faucet and a second towel to completely dry the hands. Use a final paper towel to open the restroom door, preventing your hands (at least for a few moments) from becoming recontaminated. Finally, this survey shows that only one-third of the 888 participants said they had changed their overall hygiene habits in response to H1N1 concerns.4
Good Hand Hygiene Practices
Poor hand hygiene is but one habit that needs to be broken to help decrease the spread of disease-causing bacteria. Some additional habits include:
1. Touching the "T-Zone" of the face. The mucus membranes of the eyes, nose, and mouth provide warm and moist entryways in which bacteria thrive. How often do we touch the "T-Zone"? In a study by the University of California at Berkeley, the average contact rate was 15.7 touches per hour.5 During an eight-hour workday, that represents more than 125 times the average person touches his eyes, nose, or mouth. These 125 T-Zone touches then transferred to other items within our environment: workplace tools and equipment, desktops, keyboards, telephones, door handles, etc.
While we're on the topic of mucus, an Aug. 4 news release from ICBC (Insurance Corporation of British Columbia) cited its survey results on "dirty driving." Thirty percent of the persons surveyed picked their nose while driving. This habit not only transfers mucus to the steering wheel, it creates a point of contamination at the disposal site for the mucus. When the survey also stated that 73 percent of drivers admitted to eating or drinking while behind the wheel,6 the cross contamination of germs from nose to hands to mouth leads one to wonder why we all are not sick constantly. This same contamination transfer would exist in the home and workplace, where similar bad habits were practiced.
2. Shaking hands. Although the handshake is the traditional form of warm personal greeting we are all used to, one of the recommendations in pandemic plans is that of social distancing. Recently, the Association of Corporate Travel Executives called for the temporary suspension of handshaking until the H1N1 threat "has been reduced to the status of the common cold." 7
3. Sneezing/coughing into hands. Remember being taught to use your hands to cover your nose and mouth if you cough or sneeze? The CDC now teaches children (and adults!) to sneeze or cough into the bend of the elbow instead. Public service announcements, featuring characters from children's television programs, demonstrate this elbow-bend method and are often seen during prime-time hours so adults can change their unsanitary habits. Health and Human Services Secretary Kathleen Sebelius demonstrated this elbow-bend method during a press conference on Sept. 17, 2009, when a reporter sneezed into his hand rather than his arm.8
When you must blow your nose, use a facial tissue and immediately dispose of it, then wash your hands (or use an alcoholbased hand sanitizer if hand washing facilities are unavailable). If you are among the few men and women still carrying a cloth pocket handkerchief, break the habit and use disposable facial tissues. Imagine the contamination on your hands and clothing when reusing a cloth handkerchief soiled with mucus!
Changing for the Better
While it is challenging to change old habits, it is apparent from the studies cited above that it is indeed time for "old dogs to learn new tricks." Practicing proper hand hygiene, avoiding touching the "T-Zone" of the face, practicing social distancing with handshaking alternatives, and learning to sneeze/cough into the bend of an elbow are positive habits that will reduce the transmission of illnesses, both at home and in the workplace.
This article originally appeared in the February 2010 issue of Occupational Health & Safety.