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Hand washing forhand hygiene is the act

ofcleaningoneshandswith or without the use ofwateror

anotherliquid, or with the use ofsoap, for the purpose of

removingsoil,dirt, and/ormicroorganisms.

HAND HYGIENEDEFINITIONS

Hand hygiene is a term that applies to the process of hand washing or hand

decontamination.

Hand washing involves mechanically removing transient organisms from hands

with soap and water.

Hand decontamination reduces the number of both transient and resident

micro-organisms on the hands. This is accomplished by either washing with

antimicrobial soap and water or application of an alcohol or alcohol/chlorhexidine

based hand rub.

The Benefits of Hand WashingText Font

Regular hand washing is important to

your health year-round because it

can keep you from getting sick or

from spreading germs to friends,

family or even an entire community.

Hand washing is especially important during the stretchbetween Thanksgiving and New Years Eve. Thats because

the holidays coincide with the height of the cold and flu

season as people congregate in close quarters and out-of-

town guests can come bearing new strains of bacteria,

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viruses and other microbes along with their big boxes of

presents.

Numerous illnesses can be spread by people who neglectbasic hand hygiene, either through hand-to-hand contact

or by leaving germs on commonly used surfaces. So its

essential to regularly wash your hands with soap and

running water or use a hand sanitizer containing at least 60

percent alcohol.

Your Mom was correct. You should always wash your handsbefore eating food. You also should always wash your

hands:

Before, during, and after preparing food.

After using the toilet.

After changing diapers or cleaning up a child

who has used the toilet.

Before and after caring for someone who is sick.

After blowing your nose, coughing, or sneezing.

After touching an animal or animal waste.

After touching garbage.

Before and after treating a cut or wound.

Before giving medicine.

Unfortunately, too many of us either ignore these basic

precautions or wash in such a perfunctory manner that we

walk away from the sink with our hands still crawling with

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germs.

Although not even the most thorough hand washing can

remove every germ, appropriate hand washing can removemost of them. Heres how to correctly wash your hands:

Wet your hands with clean, running water (warm

or cold) and apply soap.

Rub your palms together to make a lather and

scrub them well

Also scrub the backs of your hands, betweenyour fingers, and under your nails.

Continue rubbing your hands for at least 20

seconds. How long is that? If you cant keep your eye

on a watch, just hum The Happy Birthday Song twice

from beginning to end.

Rinse your hands well under running water.

Dry your hands using a clean towel or air dry

them.

Soap and running water are the best ways to remove

germs. But if theyre not available, an alcohol-based hand

sanitizer is a good alternative even though it cant

eliminate all types of germs and is ineffective when hands

are visibly dirty.

To correctly use a hand sanitizer:

Apply the product to the palm of one hand.

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Rub your hands together.

Rub the product over all surfaces of your hands

and fingers until your hands are dry.

Quick Quiz: True or False

1.Antibacterial soap is more effective at killing germs

than regular soap.

2.Using a towel to turn off the faucet can prevent the

spread of germs.

3.Antibacterial wipes or towelettes kill as many germs asalcohol-based sanitizers.

4.You can safely touch people or surfaces before your

hands are completely dry.

5.Children in care settings need to wash their hands at

least several times per day, not just before meals.

Answers

1.False. Research shows that regular liquid, bar, or

powder soap is just as effective.

2.True. This last little step can minimize exposure to

another common source of germs, especially in public

restrooms.

3.False. Although antibacterial wipes or towelettes are

better than nothing, alcohol-based sanitizers are

significantly more lethal to germs.

4.False. Moist hands are a germ-friendly environment.

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5.True. Children cared for in groups outside the home

are at high risk of respiratory and gastrointestinal

illnesses which they can spread to family members

and others.

A delicious mud pie, a good-luck rock, or a friendly frog are thetypes of goodies kids love to bring home. But these adorable giftscan also bring millions ofgerms with them.

Kids don't always listen when you tell them to wash their handsbefore eating, after using the bathroom, or when they comeinside from playing. But it's a message worth repeating handwashing is by far the best way to prevent germs from spreading

and to keep your kids from getting sick.

First Line of Defense Against Germs

Germs can be transmitted many ways, including:

touching dirty hands

changing dirty diapers

through contaminated water and food through droplets released during a cough or a sneeze

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via contaminated surfaces

through contact with a sick person's body fluids

When kids come into contact with germs, they can unknowinglybecome infected simply by touching their eyes, nose, or mouth.And once they're infected, it's usually just a matter of time beforethe whole family comes down with the same illness.

Good hand washing is the first line of defense against the spreadof many illnesses, from the common cold to more seriousillnesses such as meningitis, bronchiolitis, influenza, hepatitis A,and most types of infectious diarrhea.

Washing Hands Correctly

Here's how to scrub those germs away. Demonstrate this routineto your kids or better yet, wash your hands together often sothey learn how important this good habit is:

1.Wash your hands in warm water. Make sure the water isn'ttoo hot for little hands.

2.Use soap and lather up for about 20 seconds (antibacterialsoap isn't necessary any soap will do). Make sure you get inbetween the fingers and under the nails where uninvitedgerms like to hang out. And don't forget the wrists!

3.Rinse and dry well with a clean towel.

To minimize the germs passed around your family, make frequenthand washing a rule for everyone, especially:

before eating and cooking

after using the bathroom

after cleaning around the house

after touching animals, including familypets before and after visiting or taking care of any sick friends or

relatives

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after blowing one's nose, coughing, or sneezing

after being outside (playing, gardening, walking the dog, etc.)

Don't underestimate the power of hand washing! The few secondsyou spend at the sink could save you trips to the doctor's office.

Reviewed by:Mary L. Gavin, MDDate reviewed: March 2011

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Summary

Washing hands properly after using the toilet, changing nappies, handling

animals and before and after handling food helps prevent the spread of

various forms of gastroenteritis, some of which can cause serious health

problems. Use soap and warm running water and wash hands for at least

10 seconds. Liquid soap is best.

A number of infectious diseases can be spread from one person to another

by contaminated hands, particularly gastrointestinal infections, influenza

and hepatitis A. Washing your hands properly can help prevent the spread

of the organisms that cause these diseases.

Some forms of gastroenteritis can cause serious complications, especially

for young children, the elderly, or those with a weakened immune system.

Drying your hands properly is as important as washing them.

When to wash your hands

You should wash your hands thoroughly:

Before preparing food

Before eating

Between handling raw and cooked or ready-to-eat food

After going to the toilet or changing nappies

After smoking

After using a tissue or handkerchief

After handling rubbish or working in the garden

After handling animals

After attending to sick children or other family members.

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How to wash your hands properly

To wash hands properly:

Wet your hands with warm water.

Apply one dose of liquid soap and lather (wash) well for 1520 seconds (or

longer if the dirt is ingrained).

Rub hands together rapidly across all surfaces of your hands and wrists to

help remove dirt and germs.

Dont forget the backs of your hands, your wrists, between your fingers and

under your fingernails.

If possible, remove rings and watches before you wash your hands, or ensureyou move the rings to wash under them, as microorganisms can exist under

them.

Rinse well under running water and make sure all traces of soap are

removed, as residues may cause irritation.

Pat your hands dry using paper towels (or single-use cloth towels). Make

sure your hands are thoroughly dry.

Dry under any rings you wear, as they can be a source of futurecontamination if they remain moist.

Hot air driers can be used but, again, you should ensure your hands are

thoroughly dry.

At home, give each family member their own towel and wash the towels

often.

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How to wash and dry hands with liquid soap and water (Click to open largerimage)

Use warm water

Cold water is better than no water at all for a one-off hand wash, but should

not be used for routine handwashing. Soap lathers (soaps up) better with

warm water. The active ingredients on the surface of the soap are released

more easily, making them more effective in cleaning your hands of dirt,

grease and oils, without stripping away the natural oils in your skin. Using

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cold or hot water can also damage the skins natural oils. Over time, this

can cause dermatitis.

Soap is important

Soap contains ingredients that will help to:

Loosen dirt on your hands.

Soften water, making it easier to lather the soap over your hands.

Rinse your hands, leaving no residues to irritate and dry your skin.

Soaps can have different pH they may be neutral, slightly alkaline orslightly acidic. Thats why some soaps irritate some people and not others.Perfumes in soap can be another reason why some people have skinreactions.

Liquid soap is best

Generally, it is better to use liquid soap than bar soap, particularly at work.

The benefits of liquid soap include:

Hygieneit is less likely to be contaminated.

Right amountliquid soap dispensers do not dispense more than required

(more is not better).

Less wasteits easier to use, with less wastage. Drop-in cassette

dispensers use all the soap.

Saves timeliquid soap dispensers are easy and efficient to use.

Disposable liquid soap cassettes are convenient, as you do not have towash and thoroughly dry the refillable container before refilling. If you wantto use refillable containers, they must not be topped up. When they areempty, they must be thoroughly cleaned and dried before they are refilledto avoid contamination.

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At home, refillable dispensers are more likely to be used rather than drop-incassettes, which are designed for commercial use.

The problems with bar soap

particularly in public places

There are many reasons why bar soap can be a problem, particularly if its

used by a lot of people. These problems include:

Bar soap can sit in pools of water and become contaminated with many

harmful germs.

People are less likely to use bar soap if it is messy from sitting in water.

Contaminated soap may spread germs and may be more harmful than not

washing your hands.

Bar soap can dry outpeople are less likely to use it to wash their hands

because it is difficult to lather.

Dried-out bar soap will develop cracks, which can harbour dirt and germs.

Again, you may be adding more harmful germs to your hands than you were

trying to remove.

Its fine to use bar soap at home, but it might help to keep it on a soap rack(so its not sitting in a pool of water) and change it if it becomes old andcracked.

Take care of your hands

Handwashing is only one part of hand hygiene. Looking after your skin

generally is important, as your skin is the perfect barrier against infection.

After your hands have been dried thoroughly, you can help to look after

your hands if you:

Apply a water-based absorbent hand cream three to four times a day, or

more frequently if your hands are constantly in water.

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Use gloves to wash dishes to protect your hands.

Use gloves when gardening to prevent a build-up of ingrained soil or

scratches.

Consult a doctor if a skin irritation develops or continues.Where to get help

Your doctor

Your local councils health departmentThings to remember

Proper handwashing can protect you and others from a range of diseases.

Liquid soap is better than bar soap, especially at work.

Wash and dry your hands carefully.

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Hand Washing: Reducing the Risk of

Common Infections

Is it important to wash your hands?Simply put, yes. Hand washing is the single most effectiveway to prevent the spread of infections. You can spreadcertain "germs" (a general term for microbes like viruses

and bacteria) casually by touching another person. You can

also catch germs when you touch contaminated objects or

surfaces and then you touch your face (mouth, eyes, and

nose).

"Good" hand washing techniques include using an adequate

amount of soap, rubbing the hands together to create

friction, and rinsing under running water. The use of gloves

is not a substitute for hand washing.

There is additional information in OSH Answers about how

the common cold is transmitted by contaminated hands.

Also see Influenza and Pandemic Influenza. Other stepsthat can be taken to reduce the spread of infections are

discussed in the OSH Answers document Good Hygiene

Practices - Reducing the Spread of Infections and Viruses.

Please note: In some workplaces, universal precautionsshould be followed when workers are exposed to blood and

certain other body fluids. Please see the OSH Answers

document Routine Practices for more complete information.

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When should I wash my hands?

Different situations where people can pick up "germs"

include:

when hands are visibly soiled

after using the washroom (includes changing diapers)

after blowing your nose or after sneezing in your hands

before and after eating, handling food, drinking or

smoking

after touching raw meat, poultry, or fish

after handling garbage

visiting or caring for sick people handling pets, animals or animal waste

Ensuring that employees wash their hands properly after

using the washroom is very important in reducing diseasetransmission of stomach "flus" (which really is not a "flu" or

influenza) and other gastrointestinal infections. Using soap

and lathering up is very important (rinsing hands in water

only is not as effective). Use comfortably warm, runningwater. Hands should be washed for a minimum of 15

seconds - longer if the hands are visibly soiled. To help

people (especially children) wash long enough, one optionmay be to sing a short song such as "Happy Birthday" or

"A, B, C" twice. The idea of surgeons scrubbing for an

operation (as on TV) is very similar.

How do I properly wash my hands?

For effective hand washing, follow these steps:

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remove any rings or other jewelry

use warm water and wet your hands thoroughly

use soap (1-3 mL) and lather very well

scrub your hands, between your fingers, wrists, and

forearms with soap for 15 seconds scrub under your nails

rinse thoroughly

turn off the taps/faucets with a paper towel

dry your hands with a single use towel or air dryer

protect your hands from touching dirty surfaces as you

leave the bathroom

Other tips include:

Cover cuts with bandages and wear gloves for added

protection (cuts are very vulnerable to infections).

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rinse, or on wipes or towelettes. They can be used by

paramedics, home care attendants, or other mobile

workers where hand washing facilities are not available.

However, these agents are not effective when the hands

are heavily contaminated with dirt, blood, or other organicmaterials. In addition, waterless hand scrubs may have a

drying effect on the skin and may have odours which may

be irritating to some users.

Document last updated on July 4, 2011

Handwashing: Clean Hands Save LivesKeeping hands clean through improved hand hygiene is one of

the most important steps we can take to avoid getting sick and

spreading germs to others. Many diseases and conditions are

spread by not washing hands with soap and clean, running water.

If clean, running water is not accessible, as is common in many

parts of the world, use soap and available water. If soap and

water are unavailable, use an alcohol-based hand sanitizer that

contains at least 60% alcohol to clean hands.

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When should you wash your hands?

Before, during, and after preparing food

Before eating food

Before and after caring for someone who is sick

Before and after treating a cut or wound After using the toilet

After changing diapers or cleaning up a child who has used thetoilet

After blowing your nose, coughing, or sneezing

After touching an animal or animal waste After handling pet food or pet treats

After touching garbage

What is the right way to wash your hands?

Wet your hands with clean, running water (warm or cold) andapply soap.

Rub your hands together to make a lather and scrub them well;be sure to scrub the backs of your hands, between your fingers,and under your nails.

Continue rubbing your hands for at least 20 seconds. Need a

timer? Hum the "Happy Birthday" song from beginning to endtwice.

Rinse your hands well under running water.

Dry your hands using a clean towel or air dry them.

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What if I dont have soap and clean, running water?

Washing hands with soap and water is the best way to reduce thenumber of germs on them. If soap and water are not available,use an alcohol-based hand sanitizer that contains at least 60%alcohol. Alcohol-based hand sanitizers can quickly reduce the

number of germs on hands in some situations, but sanitizersdo not eliminate all types of germs.Hand sanitizers are not as effective when hands are visiblydirty.How do you use hand sanitizers?

Apply the product to the palm of one hand.

Rub your hands together.

Rub the product over all surfaces of your hands and fingers untilyour hands are dry.

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HAND WASHING

Hand washing and hand sanitizers reduce the spread of

germs.

Hand washing is simple to do and is the best way to prevent

infection and its spread because your hands are constantly

coming into contact with germ-laden surfaces and

transferring those germs to your eyes, nose and mouth.

According to the Centers for Disease Control, heres when to

wash your hands: Before preparing or eating food

After going to the bathroom

After changing diapers or cleaning up a child who has

gone to the bathroom

Before and after tending to someone who is sick

After blowing your nose, coughing, or sneezing

After handling an animal or animal waste

After handling garbage

Before and after treating a cut or wound

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Those recommendations are pretty straightforward and

obvious. Less obvious, however, is that common surfaces

are loaded with germs and you come into contact with them

all day. Recent studies have shown that the worst offendersare things like refrigerator door handles, TV remotes,

doorknobs, telephones, light switches, faucets, even salt and

pepper shakers. With many people touching these things one

after another leaving their germs behind, its easy for you to

pick one up and infect yourself the next time your hands

unconsciously stray to your face. So frequent hand washing

throughout the day is critical.

Heres the CDC advice on how to wash your hands:

Wet your hands with clean running water and apply

soap. Use warm water if it is available.

Rub hands together to make a lather and scrub all

surfaces.

Continue rubbing hands for 20 seconds. Need a timer?

Imagine singing Happy Birthday twice through to a friend!

Rinse hands well under running water

Dry your hands using a paper towel or air dryer. If possible,

use your paper towel to turn off the faucet. If soap andwater arent available, use alcohol-based hand sanitizers.

Some people wonder if overuse of alcohol sanitizers could be

a problem similar to the overuse of antibiotics, which isknown to promote bacterial resistance. The good news is

that alcohol sanitizers do not cause resistance, they work

differently than antibiotics and therefore can be used as

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often as your sensitive skin allows (some alcohol hand

sanitizers have skin-sparing ingredients like aloe built in).

Heres the CDC on how to use hand sanitizers:

Apply product to the palm of one hand

Rub hands together

Rub the product over all surfaces of hands and fingers

until hands are dry

In addition to keeping your hands clean, remember to cover

your coughs and sneezes. And dont cough or sneeze into

your hands (and if you do, wash them after). Rather, coughor sneeze into the crux of your elbow, keeping the germs

away from your hands and reducing the airborne spread of

germ-filled droplets. Or use a disposable tissue if one is

handy. It is not recommend repeatedly using a pocket

handkerchief, which are just germ reservoirs.

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In my line of work, you meet lots of people. You shake lots of hands. And those people have

shaken lots of hands, wiped noses and touched lots of different things, over and over. They

could have, well, dirty hands. Any of them, even the celebrities.

Did you know that 80 percent of all infectious diseases are passed by human contact, eitherdirect or indirect? That includes viruses like pneumonia, salmonella and the common cold.

But beyond the people I come in contact with every day, I got to thinking, what about

the things I come in contact with every day?

"Did you wash your hands?"

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How many times did you hear that today? Probably a lot. But whyare adults so hung up on hand washing? Why are they so in lovewith lather?

Washing your hands is the best way to stopgermsfromspreading. Think about all of the things that you touched today from the telephone to the toilet. Maybe you blew your nose in atissue and then went outside to dig around the dirt.

Whatever you did today, you came into contact with germs. It'seasy for a germ on your hand to end up in your mouth. Thinkabout how many foods you eat with your hands.

You can't wear rubber gloves all day long, but you can wash yourhands so those germs don't get a chance to make you orsomeone else sick. When germs go down the drain, they can'tmake anyone sick.

So when are the best times to wash your hands?

when your hands are dirty

before eating or touching food (like if you're helping cook or

bake, for example) after using the bathroom

after blowing your nose or coughing

after touching pets or otheranimals

after playing outside before and after visiting a sick relative or friend

Now you have the when and the why of hand washing. But didyou know that a lot of people don't know how to get their pawsperfectly clean? The next time you're told to step up to the sink

and scrub up, remember these handy hints:1.Use warm water (not cold or hot) when you wash your hands.

2.Use whatever soap you like. Some soaps come in cool shapesand colors or smell nice, but whatever kind gets you scrubbingis the kind you should use. Antibacterial soaps are OK to use,but regular soap works fine.

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3.Work up some lather on both sides of your hands, your wrists,and between your fingers. Don't forget to wash around yournails. This is one place germs like to hide. Wash for about 10to 15 seconds about how long it takes to sing "Happy

Birthday." (Sing it quickly two times or just once if you go niceand slow.)

4.Rinse and dry well with a clean towel.

Reviewed by:Mary L. Gavin, MDDate reviewed: March 2011