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Infection Control For Everyone
By : Bruce Kaler, MD 

Good technique for hand washing and use of hand sanitizers is the most effective and fundamental way to prevent spread of infectious disease. A lot of emphasis is placed on nine million health care workers in the United States but this applies to everyone throughout our daily lives. Most of the problems that we incur are self-inflicted. That is, we simply get the germs on our hands and transfer contaminates when eating or touching areas of our face. Influenza, MRSA, and most important infections are not airborne. They require direct contact with the source or a pool of germs left behind on an object we touch. For example, the cashier at the grocery store who coughs into their hand proceeds to hand you a receipt or change. Similarly, a customer contaminates the grocery cart handle from a sneeze or cough into their hand. Only moments later, you take the same empty cart when your hand becomes contaminated. You inadvertently touch your face or try a food sample at the store. Covering a cough or sneeze into your elbow or arm will prevent transmission in close quarters. Washing or sanitizing the hands again is critical to preventing transmission. Ultimately the last link in transmission is our own hands the large majority of time.

We have seen how great an impact these common illnesses can have on our family and the workplace. Time loss for an individual can be financially devastating. If a large portion of an office or factory workforce is out with the flu, services and production have a negative impact that makes compensation temporarily impossible for the business. Simple education and planning for these circumstances can prevent and minimize the impact to both individuals and business.

Proper hand washing is both underrated and taken for granted. Washing hands for 15-20 seconds with soap and water can make a huge difference but requires good technique. Neither the soap nor the water is the important element. The mechanical rubbing of all surfaces of the hands is actually the element that removes the germs. Warm water and soap only serve to help release the grime and natural oils on the skin surface. The rubbing is able to loosen the offending elements followed by rinsing. All areas need this meticulous but brief attention including under the nails, back of the hands, wrists and possibly forearms. The antibacterial effect of most soap is not very effective or even necessary unless you are dealing with a particularly resistant infection. In such cases, a stronger anti-bacterial such as iodine or chlorhexidine may be useful. Hand sanitizers that require no water and use alcohol as the active ingredient can be a satisfactory substitute. Remember to use a sanitizer that is at least 65% alcohol. These products are best used on dry hands without adding water. It is a perfectly good alternative when soap and water are not available.

Hand washing should always be done before food preparation or eating. It should also be done before and after treating a cut or caring for any sick person. Any time one has contact with garbage, animal or human waste, thorough hand cleaning should be done promptly even if gloves were worn. If you cough, sneeze or blow your nose your hands should be cleaned afterwards to avoid spreading germs to your environment or immediate contacts. Soaps or sanitizers should be readily available at convenient locations at home and in the workplace to make it easy to do this. Antibacterial wipes may be useful to clean high traffic areas and frequently touched surfaces. Nonetheless, the final step in prevention is in our own hands. Be thoughtful and considerate about these simple things. You will be much happier and healthy.