HAND HYGIENE FOR WHO?
For many decades hand hygiene has been a practice targeted
at prevention of communicable diseases. Most people will ask, why practice hand
hygiene, what are the consequences of dirty hands, nails etc. Well most of the
pathogenic microorganisms we ingest are passed through contact by hands if not
for already stale foods. Hand hygiene focusses on reduction but not total
eradication of microbes. Hand hygiene basically ensures the microbial
levels/quantities are deemed safe for consumption.
Hand hygiene can be performed through hand washing or by use
of ABHR (Alcohol based hand rubs). Hand washing by water or soap and water
involves the mechanical removal of microbes from our hands. Soap adds some
value by lysing some of the potential pathogens. Disinfection may or may not be
achieved by some soaps depending on the level of soil and the nature of
microbes one is exposed to. For the soaps that claim anti-microbial efficacy,
they mainly target very basic bacteria, fungi but hardly viruses. One would
need a more efficient antimicrobial agent like povidone or chlorhexidine to be
able to achieve intense antimicrobial activity against pathogenic bacteria,
fungi and viruses. This in many cases is not necessary especially when you are
exposed to less pathogenic microbes.
The use of ABHR has a topic that has received various
discussions some supporting while others against the use of such. The best
recommendation for use of ABHR is when the hands are not visibly soiled.
Remember we cannot see pathogens with our naked eyes. This doesn’t mean they do
not exist! In fact, microbes are cosmopolitan and exist everywhere around us.
Some may be opportunistic causing infections during low immunity or when
exposed in great amounts more than the usual. As well we have microbes that are
considered as normal flora and interact and have mutual benefits with their
hosts – this is a wide discussion that can be expounded later. Thus we are
advised that when our hands are visibly soiled, we are required to wash them
with soap and water, dry the hands and then you can either continue with your
activities or if more precaution is to be observed you can use ABHR to
ABHR are considered as agents for hands antisepsis-
Disinfection is a term more used with inanimate objects but while antisepsis is
used when talking about disinfection of skin, always be sure not to confuse the
two terms- when no visible soil is present on the hands. These ABHR’s are rinse
free as most of them are based on Ethanol or Isopropyl which evaporates after
hand rubbing. The levels are safe enough not to get anyone drunk. Consider
this, apple juice contains alcohol, one can hardly get drunk by drinking 2 litres
of apple juice, thus the amount of alcohol used on the hands is very little and
cannot be absorbed into the human body.
ABHR vary in the type of alcohol used, emollients
(moisturizing agents) and log reduction (microbes killing power). ABHR used at
home, and sanitizers carried in the hand bags are usually having a low killing
power considering the microbes one is exposed to are not very pathogenic. Those
used in the hospitals are stronger and have a higher log reduction. When ABHR
claim a 99.9% killing of germs we consider this a log 3 reduction, ABHR used in
the hospitals should be able to meet at least a log 5 reduction which is
99.999% reduction. The 0.001% is very significant as far as killing microbes is
concerned. This will determine what kind of ABHR one should select for use.
Therefore, hand hygiene is for everyone! We can all control
communicable diseases by practicing hand hygiene.