It is estimated that 80 percent of communicable illnesses are spread through touch but only about 30 percent of adults wash their hands after using the toilet and still fewer wash thoroughly. The very people who ought to know better are among the worst offenders. Nosocomial infections, or those occurring as the result of hospital caregivers not washing properly, kill 30,000 people each year and sicken another 70,000. In fact, the CDC estimates that as many as 15% of all hospital patients catch some type of nosocomial infection. The vast majority of these illnesses and deaths could easily be prevented by careful, deliberate handwashing with plain soap and clean water.
As early as the 1840s a few doctors were championing handwashing to limit disease transmission. In 1843 American physician Dr. Oliver Wendell Holmes created a scandal in his workplace by requiring handwashing as a means to prevent childbed fever. Dr Holmes believed that this disease, which killed up to 25% of women delivering in hospitals, was transmitted to women by their physicians. Dr. Holmes wasn’t alone in his crusade. A few years later an Austrian, Dr. Ignaz Semmelweis, observed delivery room death rates of women assisted by medical students to be up to 3 times higher than the death rates of women assisted by midwives. Dr. Semmelweis correctly guess that the medical students were carrying germs from the autopsy rooms right into the delivery rooms. His program of using chlorinated water to wash his medical students’ hands brought the mortality rate down to less than 1%. Unfortunately his colleagues were enraged by his actions and ordered the handwashing to stop.
Though handwashing was important in years past, it is equally vital today. Sixty percent of America’s children are under six years of age and many of them spend a great deal of time in day care or preschool where they are at increased risk for diarrhea illnesses such as rotavirus. According to the FDA, diarrhea is 30 percent more common in day-care children than preschoolers cared for at home. In America the diarrhea from rotavirus is usually short lived but in other parts of the world it is major cause of death in children under five, killing an estimated 5 million children a year.
Diarrhea-borne diseases aren’t the only issues that a well designed handwashing campaign could help. According to the CDC 22 million schools days are lost each year just to the common cold. Not surprisingly, children who exercise proper handwashing habits miss less school than those who don’t. Elementary school children practicing good handwashing technique miss 2.42 days a year while children the same age practicing inadequate handwashing habits miss 3.02 days per school year.
In 2004 the Karachi Health Soap Study studied the effects of handwashing education in 36 Pakistani neighborhoods. Researchers found that children who received plain soap along with handwashing instructions had a 53% lower incidence of diarrhea (and a shorter duration of diarrhea when it occurred) than children in the control group. The study also showed antibacterial soaps to be no more effective at reducing diarrhea episodes than plain soap.
The Karachi Health Soap Study confirmed the suspicions of many in the natural health industry. Diligent handwashing programs clearly lower the risk of diarrhea illnesses but antibacterial soaps and bath products are unnecessary for most families. Some in the natural products industry have even feared that the every-day use of germ killing products may eventually lead to the development of resistant strains of bacteria. A study by Tufts University looked at the effect of Triclosan, the chemical that makes products antibacterial, on E. coli bacterium. Researchers discovered that Triclosan kills by acting upon a specific bacterial gene. This discovery seems to prove that the threat of future resistance is very real.
Unlike antibacterial soaps, which actually kill germs, traditional soaps work mainly by removing germs. The mechanical action of rubbing your hands together dislodges germs so that running water can flush them away.
Concerns about creating resistant strains of bacteria have led some disease experts to recommend plain soap and clean water as a disease transmission preventative. Whether those fears are well founded or not it seems indisputable that deliberate, frequent handwashing with plain soap and water is an effective way to protect against person-to-person transmission of some of the most common communicable diseases.