The Impact of Effective Handwashing Against Infection

Analysis by Dr. Joseph Mercola Fact Checked

proper handwashing

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  • To effectively wash your hands, use soap and running water, lather up and scrub for at least 20 seconds, and be sure to wash your fingertips and between your fingers
  • Forget the hot air hand dryer or cloth towels and use a folded paper towel to increase absorbency
  • By washing your hands you can prevent the spread of viruses and bacteria, which may slow the spread of antibiotic resistance
  • Washing your hands too frequently may damage the skin barrier and trigger cracks in your skin that allow germs into your body
  • Build a strong immune system by avoiding processed foods and sugar, supporting your gut microbiome, eating foods high in vitamins and minerals and getting quality sleep

Drug resistant infections are on the rise, the novel coronavirus COVID-19 is spreading rapidly and research has demonstrated you may be participating in activities that exacerbate the issue. Preventing the spread of contagious disease is the best option as there is no cure for viral infections and COVID-19 isn't a simple virus.

However, the key to prevention is to be smart about it. One of the primary ways is using proper handwashing techniques with safe products. Unfortunately, many still work under the assumption that antibacterial soap or hand sanitizer will get the job done safely and correctly. Yet even the FDA acknowledges antibacterial soaps haven’t been proven effective and they have potentially negative health effects.1

The authors of one study2 suggested hospital-based health care providers had a hand hygiene compliance rate of 70% to 72%. This means that at least 28% of the health care providers were not practicing safe handwashing techniques.

Yet, proper handwashing is especially important in the hospital where close contact among patients is common. Critically ill patients are especially susceptible to the risks introduced in hospital environments. The results of one study suggested that using a patient hand hygiene protocol reduced infection rates.3

Washing your hands helps remove harmful bacteria that may contaminate your immediate surroundings. It also stops the spread of infection and reduces the chances that germs may be transferred to your internal systems when you touch your nose, mouth or eyes.4

By learning to use proper handwashing techniques you and others may reduce the number of people who get a diarrheal illness by at least 23% and you can contribute to reducing respiratory infections by up to 21%.

Immediate Disease Prevention Strategy — Proper Handwashing

In the past decade there's been a rapid emergence of resistant bacteria; this has rather quickly risen to the level of a crisis. The overuse and misuse of antibiotic medications has accelerated what is supposed to be a natural process.5

Antibiotic resistance has made it more difficult to treat diseases such as gonorrhea, tuberculosis and pneumonia — one of the secondary infections occurring in individuals with COVID-19. The World Health Organization says antibiotic resistance is one of the biggest threats to global health, food security, and development today. It can affect anyone and leads to higher medical costs and mortality rates.

Yet, the simple act of handwashing may help reduce the potential for infection. In a unique study designed by the U.S. military, the Navy studied incoming recruits to evaluate the rate of respiratory illnesses. By the early 2000s, respiratory illnesses had become the most common cause of lost duty time.6,7

In the past, the military used ultraviolet lights, vaccines and disinfectant vapors to help reduce the number of lost hours. In this study, recruits were ordered to wash their hands five times a day and drill instructors underwent monthly education on the importance of handwashing.

After just two years, recruits had a 45% reduced rate of respiratory illnesses than the recruits from the year before the program began. The simple act of washing their hands consistently and appropriately had nearly halved the number of recruits who developed a respiratory illness.

While recent news reports have said a review of multiple studies showed that handwashing can reduce respiratory illness risks by as much as 54%, none of the news agencies has linked directly to the source. According to a 2019 study, the reality of measuring implementation has challenges:8

“Most previous efficacy studies reporting the impact of intense implementation of hygiene behavior change on respiratory illness have been small, involving up to 6,000 people … however, the impact of implementing hygiene promotion programs on respiratory illness on a large scale is still unclear.”

The reason for this, the authors explain, is that:

“Accurately assessing handwashing behaviors is problematic. Direct observation of handwashing by trained staff is both highly resource intensive and also biased, as the presence of an observer alters the handwashing behavior.

Assessment of handwashing behavior through a low-cost proxy measure such as presence of soap and water in a designated handwashing station is a practical alternative and has been associated with lower rates of respiratory illness in some settings, but not in others.”

The bottom line is, research does show that diligently washing your hands helps stave off infections, including respiratory illnesses. So, the best thing to do is be sure to follow the CDC’s advice and make good handwashing a regular practice.

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Step-by-Step: How to Effectively Wash Your Hands

To enjoy the greatest benefit, handwashing must be done effectively and correctly as demonstrated in this short video. This probably sounds obvious! Yet, one study from the U.S. Department of Agriculture found 97% of the time consumers were not washing their hands correctly.9

Said another way, only 3% were using the correct handwashing technique to prevent the spread of bacteria and viruses. The following are times that are especially important to wash your hands:

When your hands are visibly soiled

After coming in from the outside

Often during cold and flu season

Before sitting down to eat

After coughing or sneezing

Before and after visiting or caring for sick people

After playing with children or handling children's toys

After handling garbage, using the phone or shaking hands

After touching your pet, animal waste, pet food or treats

After going to the bathroom or changing a diaper

Before and after handling food, being especially careful with raw eggs, meat, seafood and poultry

After coming home from the grocery store, school, mall or church

To be truly effective you must wash for at least 20 seconds, address all aspects of your hands, use soap and running water and dry your hands appropriately. Consider using these strategies in your approach to wash your hands:

Use warm, running water and a mild soap. You do NOT need antibacterial soap. The U.S. Food and Drug Administration has stated,10 “ … there isn’t enough science to show that over-the-counter (OTC) antibacterial soaps are better at preventing illness than washing with plain soap and water.

To date, the benefits of using antibacterial hand soap haven’t been proven. In addition, the wide use of these products over a long time has raised the question of potential negative effects on your health.”

Start with wet hands, add soap and work up a good lather, all the way up to your wrists, scrubbing for at least 20 seconds (most people only wash for about six seconds). A good way to time this is to sing the "Happy Birthday" song twice.

Make sure you cover all surfaces, including the insides and backs of your hands, your wrists, your fingers and the areas between them and in around and below your fingernails. Wash your fingertips by clasping your hands, fingers to fingers and twisting your hands back and forth. This places friction against your fingertips. Next, scrub your fingertips over the palm of your hands to get the ends of your fingers.

Rinse thoroughly under running water.

Thoroughly dry your hands, ideally using a paper towel. Use a paper towel to shut off the sink and open the door at home when someone is ill to prevent the spread of germs. Do this regularly in public places.

How You Dry Your Hands Is Also Important

The next step is to dry your hands. If you're depositing more germs by using the wrong tool, you may not be as protected as you think. In one study11 researchers demonstrated how hot air hand dryers in public restrooms spread bacteria; this was supported by previous research with similar findings.12

It turns out the warm moist air inside hot air dryers is the perfect place for bacteria and germs to grow. Researchers from Connecticut theorized the appliance intake brings in bacteria where colonies grow and are then dispersed when the appliances are used. The team concluded that:13

“ … potentially pathogenic bacteria, including bacterial spores, may travel between rooms, and subsequent bacterial/spore deposition by hand dryers is a possible mechanism for spread of infectious bacteria, including spores of potential pathogens if present.”

A bathroom towel is also not a great option since you transfer bacteria onto the surface each time you use it.14 A warm, damp bathroom is the perfect environment for bacteria and other microorganisms to thrive. Experts recommend if you keep towels in the kitchen or bathroom, they should be washed every two days.

Using a paper towel may be the best cleanliness option, but also has an impact on the environment. Each year the global market for paper towels reaches $12 billion, of which Americans spend $5.7 billion.15

Joe Smith of Oregon has a solution, as outlined in a TED Talk (link below). By using his system it's apparent we can reduce the amount of paper towels we use while still getting our hands dry.

There are two points to this. The first is to shake your hands in order to eliminate as much free water as possible. The second is the method he uses to fold a towel to increase absorbency by increasing interstitial spaces while reducing the amount of paper towel used.

Too Much Hand Washing Can Be Harmful

It’s important to find a balance between keeping hands clean and scrubbing so much you damage the skin barrier. Of course, you don't want to unnecessarily open yourself to disease-carrying germs, but exposure is inevitable.

Without proper hygiene you can't achieve optimal health, yet over-washing can irritate your skin and take away protective oils. This causes your skin to crack, potentially bleed and sometimes invite trouble.

Consider adding coconut oil as a moisturizer for your hands. Lauric acid makes up 40% of the fat in coconut oil, best known for its antibacterial, antimicrobial and antiviral properties. Coconut oil offers several additional benefits to your health and home.

Your First Line of Defense Resides in Your Gut

While handwashing is important to help prevent the spread of disease, your first line of defense against COVID-19 and other viral and bacterial pathogens is a strong immune system.

There are several steps you can take to support this and create a strong foundation to help your body fight off pathogens and reduce your risk for chronic diseases. The first step is to cut out sugar and avoid processed foods.

Nutrition — Your body needs healthy amounts of protein found in lean meats, bone broth, fish, eggs, nuts and seeds to repair tissue and fight infection. Antioxidants in chaga tea can help with immunity because it's also packed with Beta D Glucan, a compound that increases macrophage killer cell efficiency.

Vitamins and minerals — Eating foods rich in vitamins, including vitamins K1 and K2, zinc, selenium, quercetin and B vitamins support your immune system. Vitamin D plays a large part and may be found in limited quantities in raw grass fed milk, wild-caught Alaskan salmon and organic pastured eggs. The ideal way to optimize your Vitamin D level is through sensible sun exposure.

Vitamin C-rich foods include leafy greens, bell peppers, broccoli and citrus fruits. Vitamin A can help lower your risk of infection and support wound healing. Foods high in vitamin A include sweet potatoes, dark leafy greens, carrots, squash, sweet potatoes, wild-caught Alaskan salmon, organic pastured eggs and grass fed beef.

Support your gut microbiome — One of the easiest and quickest ways to provide your gut with a diverse source of probiotic bacteria is to eat fermented vegetables. Other beneficial fermented foods include natto, kimchi, pickles, sauerkraut and raw yogurt made from the milk of grass fed cows.

Be sure to steer clear of yogurt with added sugar; this is found in most commercial varieties. Fiber-rich foods also help by promoting bowel movements, which keeps waste moving smoothly through your intestinal tract.

Sleep — A lack of sleep will quickly impact your immune function and leave you vulnerable to environmental threats, including viruses and bacteria. Consistently sleeping less than six hours increases your risk for psychological and physical effects. For suggestions on improving your sleep hygiene, see “Top 33 Tips to Optimize Your Sleep Routine.”