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Hand hygiene: A cleaning fundamental

Dr Denis Boulais goes back to basics and shares some important tips associated with hand washing.

With this issue of INCLEAN magazine focused on healthcare and hygiene – an article on the fundamental cleaning element of hand washing seemed quite fitting.

Hand washing programs in workplace settings have resulted in reduced sick days, according to some studies. Hand washing programs in the community have resulted in cold and flu reductions of up to 21 per cent, and gastrointestinal illness by as much as 58 per cent.

It is important cleaners understand the difference between cleaning, sanitising and disinfecting and how poor hygiene can compromise these processes.

Cleaning removes germs, dirt and other impurities from surfaces by using detergent (such as soap) and water to physically remove germs. It doesn’t necessarily kill the germs but lowers their numbers on the surface.

The terms ‘disinfectant’ and ‘sanitiser’ are regularly used interchangeably. Disinfection kills germs via the use of chemicals on surfaces. Disinfection doesn’t necessarily remove germs, but killing them certainly reduces their numbers. Sanitising significantly lowers germs on surfaces to a safe level with a fast kill.

In practicality the food industry may benefit primarily from sanitisers. For example; when cleaning dishes it is important to get an effective kill of germs fast so dishes can be reused as soon as required.

The medical industry, however, may prefer disinfectants because they aim to kill specific germs specified on their label. Both the food and hospital industries are prime examples of where correct hand washing and good hygiene can reduce the spread of germs.

Poor hand hygiene can comprise the level of cleaning we are aiming to achieve. For example, in handling rubbish a cleaner may come into contact with items such as tissues noting the flu virus can infect a person for up to eight hours after being deposited on a surface.

It is always important cleaners are trained to never put their hands where they cannot see them when handling rubbish and wash hands as required.

There are a number of reasons cleaners may not follow a strict regime of washing their hands which include:

  • Workload: If busy a cleaner may be less likely to hand wash.
  • Time: There may not be enough time to wash hands fully and properly.
  • Appearance: Hands may not appear dirty – but germs are too small to be seen.
  • Presence: A sink may be hard to get to – such as in a messy cleaning room. Hence it is important that cleaners are trained that hand washing is a priority for their own health benefits and that of the client.

Handwashing

Soap acts as a detergent with one side of its molecule liking water (hydrophilic) and the other side of its molecule liking oil (hydrophobic). Cell membranes are also made up of a dual sided hydrophilic and hydrophobic molecule. As such, soap solvates the hydrophobic parts of a cell membrane and hence kills the bacteria by dissolving the membrane. Furthermore, the hydrophilic part of the molecule then causes it to be easily washed away.

Soap isn’t as effective against viruses because viral membranes are more protein based than lipid based and hence the viral membrane isn’t as easily dissolved. That said, however, a soapy environment can still adversely affect protein structure and inactivate a virus. Of course, alcohol-based hand sanitisers and antibacterial soaps are likely to be more effective than soap.

It is normal to have germs living on the skin. While soap and water do a good job of removing germs from the hands it is important to ensure hands are properly dried. It is more likely that wet hands will spread germs more than dry ones. It takes around 20-30 seconds to dry the hands well with paper cloth towels and 30-45 seconds under an air dryer.

There are three important tips associated with washing hands:

  1. Don’t scrub hands as it can damage the skin and potentially provide small cuts for germs to enter.
  2. Try to keep your fingernails short as bacteria like the area under the nails and longer nails are harder to keep clean.
  3. Don’t be in a hurry as it takes around a minute to properly wash and dry the hands.

Alcohol-based cleansers kill germs by denaturing (changing the shape) of proteins essential to the survival of viruses and bacteria. Most cleansers have a high level of alcohol (around 60 per cent) mixed in with skin conditioners as alcohol itself would dry out the skin. Research has shown that alcohol based cleansers have reduced germ counts on hands better than soap.

Alcohol, however, does not kill everything such as bacterial spores and non-enveloped viruses. A non-enveloped virus is very virulent, can damage host cells significantly and is more resistant to harsh environments than an enveloped virus with its membrane of lipids and protein.

That’s why each environment needs to carefully assess its hand cleaning requirements. For example, many hospitals go back to soap and water cleansing during cold weather vomiting outbreaks that may be caused by non-enveloped more virulent viruses.

*Dr Denis Boulais is national risk manager at Broadlex Services

www.broadlex.com.au

This first appeared in the May/June issue of INCLEAN magazine. To subscribe, click here

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