Hand hygiene

Bloomfield, S. F., Aiello, A. E., Cookson, B., O Boyle, C., and Larson, E. L. (2007). The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers. Am. 

Surgeoner, B. V., Chapman, B. J., and Powell, D. A. (2009). University students hand hygiene practice during a gastrointestinal outbreak in residence What they say they do and what they actually do. /. Environ. Health 72,24-28. 

Marketers are finding a positive role for anti-microbial compounds in areas which have not been seen before. Recent product introductions accompanied by major promotions by Savlon for First Aid-Hand Hygiene Liquid Gel with claims such as kills 99.99% of germs in 15 seconds . The main actives are ethanol, Triclosan and propylene glycol. Another major promotion from Dettol on Anti-septic properties is currently on our television screens, creating a positive image for use of these ingredients, which could only help this industry. 

The best means to decrease the morbidity and mortality associated with influenza is to prevent infection through vaccination. Appropriate infection control measures, such as hand hygiene, basic respiratory etiquette (cover your cough, throw tissues away), and contact avoidance, are also important in preventing the spread of influenza. 

The skin barrier properties and effect of hand hygiene practices are known to be important in protecting the body. The average adult has a skin area of about 1.75 m2. The superficial part of the skin, the epidermis, has five layers. The stratum corneum, the outermost layer, is composed of flattened dead cells (comeocytes or squames) attached to each other to form a tough, homy layer of keratin mixed with several lipids, which help maintain the hydration, pliability, and barrier effectiveness of the skin. This part of skin has been compared to a wall of bricks (comeocytes) and mortar (lipids) and serves as the primary protective barrier. Approximately 15 layers make up the stratum corneum, which is completely replaced every 2 weeks a new layer is formed almost daily. From healthy skin, approximately 107 particles are disseminated into the air each day, and 10% of these skin squames contain viable bacteria. This is a source of major dirt inside the house and contributes to many interactions. 

Some evidence indicates that long-term use of topical antimicrobial agents may alter skin flora. Water content, humidity, pH, intracellular lipids, and rates of shedding help retain the protective barrier properties of the skin. When the barrier is compromised (e.g., by hand hygiene practices such as scrubbing), skin dryness, irritation, cracking, and other problems may result. Although the palmar surface of the hand has twice as many cell layers and the cells are >30 times thicker than on the rest of the skin, palms are quite permeable to water. 

Constant monitoring of resistance patterns in a hospital or community (changing recommended antibiotics used for empirical treatment when the prevalence of resistance becomes high), and good infection control in hospitals (e.g. isolation of carriers, hand hygiene practices for ward staff) to prevent the spread of resistant bacteria... 

Requirements concerning personal hygiene, with emphasis on hand hygiene are outlined and followed by employees. 

In the course of regular check-up, special care shall be taken to ensure good hand hygiene. Open wounds, lesions, allergic symptoms or infections must not be allowed. 

In spite of the no bare-hand contact with ready-to-eat food policy in the Food Code, there is no direct information on the effectiveness of hand hygiene and gloving regimens in the food industry. All of the information available to date is anecdotal. Additionally, no clean epidemiology data have been found. The recent Idaho hepatitis case serves as a clear illustration. The food industry also lacks glove quality standards. Studies indicate that the gloves used in food... 

A total regimen for hand hygiene needs to be considered, and standards need to be established to ensure safe food handling. 

This literature review clearly demonstrates that there is insufficient scientific evidence to support the premise that the use of a physical barrier (gloves) on the hands of food-handling personnel prevents the transfer of pathogens to food and, consequently, to support the requirement for no-hand contact with ready-to-eat food. It is our recommendation that gloving studies be performed under food service conditions to establish data to support the most effective hand hygiene regimens for food protection and minimized risk of health hazards. 

JC deWit. The importance of hand hygiene in contamination of food. Antonie van Leeuwenhoek 51 523-527, 1985. 

AZ Sheena, ME Stiles. Comparison of barrier creams and germicides for hand hygiene. J Food Prot 46(ll) 943-946, 1983. 

The type of product form to be evaluated in the HCPHWT can affect the outcome of the test. The HCPHWT was specifically designed to evaluate traditional rinse-off products for healthcare workers. This method may not be appropriate for other types of hand cleaners. Alternative products to soap and water such as hand sanitizers and towelettes are being marketed to consumers. These product forms are generally used when soap and water are not available. The appropriate way to evaluate the efficacy of leave-on alternative hand hygiene products is being debated. The European community is recommending the CEN... 

Pittet, D., Hugonnet, S., Harbarth, S. et al. (2000) Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet, 356(9238), 1307-1312. 

Randle, J., Clarke, M. and Storr, J. (2006) Hand hygiene compliance in healthcare workers. Journal of Hospital Infection, 64(3), 205-209. 

Patients received an educational brochure, which provided information on hand hygiene. 

BOX 15.6 Patients experience of challenging staff on hand hygiene Surgical Patients... 

REPRINTED VKOM AMERICAN JOURNAL OF INFECTION CONTROL, MARYANNE MCGUCK-IN, ALEXIS TAYLOR, VERONICA MARTIN, LOIS PORTEN AND RICHARD SALCIDO. "EVALUATION OF A PATIENT EDUCATION MODEL FOR INCREASING HAND HYGIENE COMPLIANCE IN AN INPATIBNT REHABILITATION UNIT". 32, NO. 4, [235-238], 2004, WITH PERMISSION FROM ELSEVIER)... 

McGuckin, M., Taylor, A., Martin, V. et al. (2004) Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. American Journal of Infection Control, 32(4), 235-238. 

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