Talk:Hand washing

Baptism

I removed Baptism from examples for Hand Washing since it doesnt belong there. As can be seen from Baptism it can be:

• Aspersion - sprinkling water over the head,
• Affusion - pouring water over the head, or
• Immersion - lowering the entire body into a pool of water.

Hands are not even mentioned, and washing hands is not part of the ritual. To reiterate, Im not saying washing is not involved its just not hand washing, which is the title of this article. Shinhan 06:30, 16 July 2006 (UTC)

Personal hand washing

I haven't been able to find any decent studies showing rigorous hand washing linked to a decrease in illness incidence in a non-medical setting. If anyone can find anything (verfying or contradicting the claims in the article), we could remove the verify tag. The section currently reads well, but seems based on conventional wisdom rather than scientific fact. Scott5834 18:42, 24 October 2006 (UTC)

See http://www.cdc.gov/germstopper/home_work_school.htm they in turn cite a study at Am J Infect Control 2000;28:340-6. I don't think we need second guess the CDC. Also see the FDA's guidance at: http://www.cfsan.fda.gov/%7Edms/a2z-h.html#handwashing --agr 20:04, 24 October 2006 (UTC)

Here is a source on the scientific evidence for hand washing effectiveness in the community: http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=12726975&dopt=Abstract

Most of my questions arise from CDC studies, see the 2001 paper, Hygiene of the Skin: When Is Clean Too Clean?".

Specifically:

From the public health perspective, more frequent use of current hygiene practices may not necessarily be better (i.e., perhaps sometimes clean is "too clean"), and the same recommendations cannot be applied to all users or situations.

The trend in both the general public and among health-care professionals toward more frequent washing with detergents, soaps, and antimicrobial ingredients needs careful reassessment in light of the damage done to skin and resultant increased risk for harboring and transmitting infectious agents. More washing and scrubbing are unlikely to be better and may, in fact, be worse.

Scott5834 20:32, 24 October 2006 (UTC)

The CDC's recommendations are here: http://www.cdc.gov/nceh/vsp/cruiselines/hand_hygiene_general.htm. Presumably they have taken this paper and other research into account. I don't think Wikipedia is in a position to form an independent judgement on the matter. --agr 23:30, 24 October 2006 (UTC)

I'm not sure if the CDC Vessel Sanitation Program (the place you linked to) is as authoritative as a CDC research publication, especially considering the VSP information is undated, unsourced, and contradicts a foremost expert in the field (Larson). Scott5834 02:40, 25 October 2006 (UTC)

I think this is a source: S P Luby and others. Effect of handwashing on child health . Lancet 2005; 366: 225 193.174.133.20 16:09, 12 February 2007 (UTC)

I'm a bit concerned that the personal handwashing section may have been written by someone who is marginally OCD. "To maintain good hygiene, hands should always be washed..." is an assertion without verifiable/falsifiable claims. For example I only wash under my fingernails when they are visibly dirty, which is not very often - why is it that I "should" be washing under there? I concur with Scott5834 and think it would read better if it were to elaborate the outcomes of "good hygiene" and convert the "should" language to statements referring to actual scientific theory or statistical observation. Rhys Lewis 01:19, 13 November 2007 (UTC)

Pathogens aren't necessarily 'visibly dirty', that's why you should wash under your nails even when they don't look dirty. This is easily verifiable; luckily I don't have to propose some OR experiment be other people have done the studies. Perhaps the wording could be changed to say "Best Current Practice recommends [. . .]" with refs to those BCP docs. Dan Beale-Cocks 12:05, 4 December 2007 (UTC)

Medical Hand Washing

I think "hand washing" is the wrong rubric for this article because it is too narrow in scope. For example, this article discusses the topic of antiseptic hand rubs under hand washing, which is awkward. It would be better to have an article about "hand hygiene" that encompasses the subcategories of hand washing, antiseptic hand rubs, and surgical hand antisepsis.

External link

I would like to add the following link to the external links section. The article identifies and explains recent research in hand washing, soaps, alcohol-based hand antiseptics and hand-hygiene techniques. Wikipedia links to external pages that contain further research which is accurate and on-topic, and I believe this to be one. Comments? Wjjessen 13:46, 26 February 2007 (UTC)

Seems totally appropriate. See WP:RS " Wikipedia articles should rely on reliable, published secondary sources wherever possible." The problem with research articles is that Wikipedia has no way to assess various viewpoints in the research literature. --agr 17:16, 26 February 2007 (UTC)

Any other comments regarding the addition of the link above to the external links section? Wjjessen 17:27, 3 March 2007 (UTC)

Unless there are any objections, I'm going to add Hand Washing - A review of research findings at HighlightHEALTH.com to the external links section. Wjjessen 02:11, 13 March 2007 (UTC)

Hand hygiene merge suggestion

I suggest that the page hand hygiene be used to create a new section for this page; the one fully-formed section on that page may make a decent section on its own straight away, in fact. SamBC 02:37, 6 August 2007 (UTC)

The content of hand hygiene requires a complete re-write to be encyclopedic. The references may be useful. The article should be changed to a redirect. Axl 09:07, 6 August 2007 (UTC)

Further considering, I think which of those two actions to take depends on whether the references given document the fact that the statements are common beliefs or commonly stated. If so, then it can make a good section, if not, then some of the material can be re-used with the references (which is still a merge, really). If the author could clarify this, it would be good.

As to the amount of rewriting needed, it's not so much really, and I'm doing it bit by bit. I'm happy to do the merge once the consensus view of those who wish to make their feelings known is reasonably clear. SamBC 17:23, 7 August 2007 (UTC)

Proposed redirect hand washing to hand hygiene

I disagree with your editing of the hand hygiene article and your assertion that the article on hand hygiene be redirected to hand washing. It should be the other way around. Hand washing should be rediredted to hand hygiene. Washing your hands is one way to obtain hand hygiene. Hand hygiene includes hand washing and the use of other procedures to obtain good hand hygiene. I am reinstating the orginal revised article and would appreciate it if you did no further editing to the article until it is discussed on the hand hygiene talk page. Thank you very much for your cooperation--JSHibbard 19:32, 5 August 2007 (UTC) Retrieved from "http://en.wikipedia.org/wiki/User_talk:Axl"

Obsession with "encyclopedic"

I do not understand the terminology "encyclopedic". I was under the impression that an encyclopedia was a "reference work on many subjects". The hand hygiene article certainly is a "referenced work" on the truths, myths and misinformation of hand hygiene. The references are from the CDC, the CEC (as taken form the CDC), and peer reviewed scientific journals. The statements in the article are taken directly from those references. They are not not "based on conventional wisdom". The information contained in the hand hygiene article is very important for every person in the world concerned with the spread of germs. There is a lot of confusion surrounding good hand hygiene due to all of the myths and misinformation being circulated by "coventional wisdom". The hand hygiene article is based on scientific facts. Please consider keeping the article on hand hygiene and redirecting hand washing to hand hygiene. Thank you for your consideration of this matter.--JSHibbard 18:02, 6 August 2007 (UTC)

I refer to compliance with Wikipedia:Manual of Style and Wikipedia:Guide to layout. Antelan regarded the article as similar to a magazine article. I agree with that opinion. The article requires heavy copy-editing to fall in line with Wikipedia guidelines. While I tried to make a start on this, I note that JSHibbard reverted my edits. Axl 18:17, 6 August 2007 (UTC)

I reverted the first sentence since it made more sense to me. It is has now been re-reverted back to your original edit.--67.65.59.153 15:26, 7 August 2007 (UTC)

further explication of boiling temperatures' fatality

"It would take more than double that temperature to effectively kill germs (typically 100 °C (212 °F))"

---> It would take more than double that temperature to effectively kill germs (typically 100 °C (212 °F)), which would also effectively kill the skin.

I want to put that in there, but it seems too poetical for an encyclopedia :-(

—Isaac Dupree^(talk) 00:23, 28 November 2007 (UTC)

microorganisms' non-water-solubility

"The application of water alone is ineffective for cleaning skin because water is unable to remove fats, oils, and proteins, which are components of organic soil. Therefore, removal of microorganisms from skin requires the addition of soaps or detergents to water."

"Therefore"? That doesn't follow by itself. It didn't say that water is unable to remove microorganisms. Is it because microorganisms contain, or consist of, fats, oils and proteins? Or did it just neglect to mention that "water is unable to remove fats, oils, proteins, and microorganisms, which are components of organic soil." (I don't know why organic soil is relevant, but its certainly contains microorganisms - albeit maybe not the ones that are most likely to make you sick)

—Isaac Dupree^(talk) 00:32, 28 November 2007 (UTC)

Conflicting information

The article contains conflicting information. Part of the article says alcohols are ineffective against non-lipid-enveloped viruses (e.g., Noroviruses) and the spores of bacteria (e.g., Clostridium difficile) and protozoa (e.g., Giardia lamblia), the article then says Alcohol rub hand sanitizers do not kill germs - This is misinformation - Hand sanitizers containing a minimum of 60 to 95% alcohol are very efficient germ killers.. C.Diff is a significant cause of illness in UK hospitals, so correct information would be useful. Dan Beale-Cocks 18:41, 4 December 2007 (UTC)

replying to my own post: C.Diff causes about 3500 - 4000 deaths per year in UK hospitals. There's a big concentration on the use of alcohol gels in hospitals. But the refs seem clear. Alcohol gels are ineffective against c.diff. Dan Beale-Cocks 23:56, 4 December 2007 (UTC)

Washing Hands with Soap -- How does it actually work

Can someone explain what mechanism is at work, reducing the potential for infection when people wash their hands with soap. It seems clear that it's not killing germs. Nor does it seem clear that it's actually reducing the load of pathogens on the skin (happy to discover this is wrong -- but again I'd like to know the mechanism). Yet various studies do seem to show it reduces for example, diarrhoea. So what is happening?

Soap and water generally remove loose organic material from the hands (dead skin flakes, oils, dirt). The mechanism is that the hydrophobic center of soap micelles surround the hydrophobic organic material and the hydrophilic exterior of soap micelles flow away with the water and bring the material along for the ride. See the diagram at Surfactant. Plenty of pathogens are attached to this loose organic material, so, even though they aren't killed, they get swept away down the drain (or at least onto the sink surface) along with the material they are attached to. Detaching more material by rubbing/scrubbing will remove more pathogens. Maybe some microorganisms attached to dead-but-not-flaking Stratum corneum are removed too. I don't know. I have no sources to back me up on all of that, but it seems like common sense, and it should be in the article once sources are found. The current version of the article flirts with being self-contradictory by not explaining this mechanism.Flying Jazz (talk) 00:01, 31 July 2008 (UTC)

Article structure change

Hello, I would like to ask what are the odds I can change the structure of this article using {{in use}} tag? I like to split the article to become just handwashing with the structure sub title of handwashing (only, with water), hand washing with soap (in this is medical hand washing), hand washing using wet tissue, and hand washing with hand sanitizer and a second article of handwashing with soap . The reason I asked is because Wikipedia Bahasa Indonesia have three article about hand washing handwashing with soap (http://id.wikipedia.org/wiki/Mencuci_tangan_dengan_sabun), just handwashing with the above structure (http://id.wikipedia.org/wiki/Mencuci_tangan) and Global handwashing day with soap (http://id.wikipedia.org/wiki/Kampanye_Cuci_Tangan_Pakai_Sabun). If no one object, I'd like to start the article. (talk) 16:03, 2 October 2008 (UTC)

Undefined maths in "Hand Sanitizer" section

From the Hand Sanitizer section: "Alcohol rub sanitizers containing 70% alcohol kill 3.5 log₁₀ (99.9%) of the bacteria on hands 30 seconds after application and 4 to 5 log₁₀ (99.99 to 99.999%) of the bacteria on hands 1 minute after application."

"3.5 log₁₀" and "4 to 5 log₁₀" are nonsensical. log₁₀(x) is a function of x whereby the inverse function is 10^x. I'm not sure what the original writer meant here by simply writing "log₁₀". To express, for example, 99.9% in a similar format one would have to specify "1 - 10^-3". Doing so, however, adds no useful information to the simpler expression in its percentage form.

Am I missing something?

Feldhaus (talk) 21:58, 9 December 2008 (UTC)

Microbial growth on a culture plate picture and other confusions

The picture and caption of a culture plate which has been inoculated after no hand hygeine, hand washing then alcohol gel suggests that hand washing is not as effective at removing bacteria as alcohol. There is no evidence presented in the article that this is reproducable or scientifically proven, and its use is therefore misleading. —Preceding unsigned comment added by 62.49.1.101 (talk) 22:02, 20 January 2009 (UTC)

There is some confusion and misunderstanding in the article on this subject. First, to address the editor above, it may be that there is no evidence presented in the article - but that doesnt make it misleading, it's just unreferenced - this can be solved by better means than deletion of a good image. The article suggests that water flowing at high rates is as good as disinfection - this is absolultely CRAZY - and there is no support for it in the "reference" given. There are (at least) three purposes for handwashing: 1) your own comfort, 2) if you are dealing with foods etc that other people will eat (HACCP), 3) very, very clean hands used for surgery or medical procedures - the current article messes this up, hence the confusion about what is "acceptable levels" of cleaning. Regular good soap wash may be fine for 2) depending on actual HACCP requirements, but for 3) criteria are really demanding. Another confusion, soap itself is not a good disinfectant (meaing it is not good at killing microbes) - what it does is that it emulsifies the microbes, permitting them to be flushed away with the soap. There are also confusions in the article regarding the words effective and efficient - I will work on it Monday/Tuesday when I have more time. Power.corrupts (talk) 14:27, 1 February 2009 (UTC)

There is scientific evidence that alcohol is a better germ killer than soap and water in this article. Click on reference 7 in the article and you will see scientific proof that alcohol is a better germ killer than soap and water or antimicrobial soap and water.--JSHibbard (talk) 21:06, 9 June 2009 (UTC)

Hand washing temperature necessity discussion

http://www3.interscience.wiley.com/journal/120097609/abstract?CRETRY=1&SRETRY=0 seems to imply the hand washing temperature thing is false. Thoughts? --Kaddar (talk) 06:48, 17 February 2009 (UTC)

Broken link.-Nutriveg (talk) 16:07, 17 February 2009 (UTC)

Added a Sentence

I have added the following sentence and reference to the article to clarify important information concerning the effectiveness of alcohol hand rubs. "However in a more recent study, the effectiveness of alcohol did not decrease after repeated use. This study also demonstrated that alcohol does not have persistent antimicrobial activity after application. —Preceding unsigned comment added by JSHibbard (talk • contribs) 19:41, 4 April 2009 (UTC)

Changed Paragraph

Changed from

Hand washing is the act of cleansing the hands with water or another liquid, with or without the use of soap or other detergents, for the sanitary purpose of removing soil and/or microorganisms.

Changed to

Hand washing for Hand Hygiene is the act of cleansing the hands with water or another liquid, with or without the use of soap or other detergents or other substances, for the purpose of removing soil, dirt and/or microorganisms.JSHibbard (talk) 15:22, 10 June 2009 (UTC)

Changed Paragraph

Changed from

The main purpose of washing hands is to cleanse the hands of pathogens (including bacteria or viruses) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field. The Centers for Disease Control and Prevention (CDC) has stated: "It is well-documented that the most important measure for preventing the spread of pathogens is effective handwashing."

Changed to

Medical hand hygiene pertains to the hygiene practices related to the administration of medicine and medical care that prevents or minimizes disease and the spreading of disease. The main medical purpose of washing hands is to cleanse the hands of pathogens (including bacteria or viruses) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field. The Centers for Disease Control and Prevention (CDC) has stated: "It is well-documented that one of the most important measure for preventing the spread of pathogens is effective hand washing." In addition to hand washing with soap and water, the use of alcohol rubs is a much more efficient and safer way to kill germs than the use of soap and water or antibacterial soap and water.JSHibbard (talk) 15:37, 10 June 2009 (UTC)

Added the following sentences

If your hands are not visibly dirty or soiled, washing one's hands with a good hand antiseptic is the most effective overall way to prevent the spread of infectious disease. If your hands are dirty or soiled, washing your hands with soap and water followed by a good hand antiseptic is the most effective overall way to prevent the spread of infectious disease.JSHibbard (talk) 14:56, 12 June 2009 (UTC)

Moved Hand Sanitizer Paragraph

Moved the Hand Sanitizer (Hand Antiseptic) paragraph under "Substances".JSHibbard (talk) 15:07, 12 June 2009 (UTC)

Added the following section to Techniques

Hand Antiseptics

Enough Hand antiseptic or alcohol rub must be used to thoroughly wet or cover both hands. The front and back of both hands and between and the ends of all fingers are rubbed for approximately 30 seconds until the liquid, foam or gel is dry. The use of a hand antiseptic or alcohol rub is much quicker and more effective than hand washing with soap and water. Hand antiseptics and alcohol rubs with moisturizers will also not dry out the skin on hands as much as soap and water.JSHibbard (talk) 15:18, 12 June 2009 (UTC)

Can the second editor explain why his/her edition is more appropriate than the previous one....????

Original writing

• http://en.wikipedia.org/w/index.php?title=Hand_washing&diff=227174164&oldid=227173982

--124.78.208.136 (talk) 08:40, 16 February 2010 (UTC)

Current words

• Commercial devices can measure and validate hand hygiene, if demonstration of regulatory compliance is required

To me, the validating process include the step of the demonstration. That is why the original writing only use the word of validate. I guess that the second editor may not have the experience on validation works--124.78.208.136 (talk) 08:47, 16 February 2010 (UTC)

Red links in the See also section are based on the following ...

• http://scholar.google.com/scholar?as_q=hand+hygiene+compliance&num=10&btnG=Search+Scholar&as_epq=&as_oq=&as_eq=&as_occt=title&as_sauthors=&as_publication=&as_ylo=&as_yhi=&as_sdt=1.&as_sdtp=on&as_sdts=5&hl=en

--124.78.208.136 (talk) 09:11, 16 February 2010 (UTC)

The following FDA guidances only address the implementing issue of hand hygiene but have not mentioned the validation issue.....

• http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/ProduceandPlanProducts/ucm173902.htm

• http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/ProduceandPlanProducts/ucm174200.htm

--124.78.208.136 (talk) 09:25, 16 February 2010 (UTC)

• http://www.fda.gov/food/guidancecomplianceregulatoryinformation/guidancedocuments/produceandplanproducts/ucm064458.htm--124.78.208.136 (talk) 09:38, 16 February 2010 (UTC)

• http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm

--124.78.208.136 (talk) 09:42, 16 February 2010 (UTC)

info about validation

• http://www.google.com/search?hl=en&q=guidance+for+industry+hand+hygiene+compliance+validate+site%3Awww.who.int&btnG=Search&aq=f&aqi=&oq=

• http://www.google.com/search?hl=en&q=guidance+for+industry+hand+hygiene+compliance+validation+site%3Awww.who.int&btnG=Search&aq=f&aqi=&oq=

--124.78.208.136 (talk) 09:48, 16 February 2010 (UTC)

• http://scholar.google.com/scholar?as_q=hand+hygiene+validation&num=10&btnG=Search+Scholar&as_epq=&as_oq=&as_eq=&as_occt=title&as_sauthors=&as_publication=&as_ylo=&as_yhi=&as_sdt=1.&as_sdtp=on&as_sdts=5&hl=en

--124.78.208.136 (talk) 09:27, 16 February 2010 (UTC)

• http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W9M-4XWWJ6K-6&_user=10&_coverDate=12%2F31%2F2009&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1208411065&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=00e2594ed70917946494504f3e5a39fb

--124.78.208.136 (talk) 09:30, 16 February 2010 (UTC)

List of the products for hand hygiene validation...???

in addition to the following and the one mentioned in the article....???

• http://www.amazon.com/Medline-Hand-Hygiene-Validation-Kit/dp/B0021ZTVSE

--124.78.208.136 (talk) 10:10, 16 February 2010 (UTC)