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Charles H. Booras, MD.
Co-Founder and Editor
Jacksonville Medical Park Online

For the week of: 9/28/98

Question: "I have a real problem getting my children to wash their hands regularly. Since they both seem to trust the information they read more than what I tell them, could you please publish some good reasons to wash up?"

Answer: Glad to oblige since I personally feel that adequate handwashing is the key to reducing the spread of illness. The following information was taken from the University of California at Berkeley Wellness Letter and is a pretty comprehensive discussion of the best (and worst) ways to defend against germs

"Recently, possibly because of so much news about food poisoning, microorganisms have moved to the top of the national worry list. Half of all Americans, when buying soap and cleansers, choose antibacterial products. Dishwasher detergents and dozens of products to use on your hands contain disinfectants. Some people wonder if it's safe to ride a bus, use a pay phone, or touch an ATM machine. Feeding these concerns are a lot of busy marketers. Ads portray a dangerous world, seething with microbes. Lysol warns you that germs will move into your new home faster than you can. Toy companies impregnate products with germ-fighting chemicals. One ad assures you that black phones hide dangerous germs and offers to sell you a gaily colored "germ-guard" to fit over the pay phone, plus some "filters." You can buy antibacterial cloths, towels, sheets, and mops equipped for germ warfare.  

It's well known that bacteria, viruses, and other pathogens can sicken and even kill people. Yet when it comes to fighting germs at home or on your person, keep a cool head. "Germs," meaning microorganisms, are all around us and, in fact, in and on us. Billions of bacteria reside on our skin and in our mouths, noses, intestines, and mucous membranes-resident flora, as they are called. Ordinarily, they are not a problem. Some, like intestinal flora, even perform vital functions such as helping to manufacture certain vitamins. Other residents are not helpful. For example, mouth bacteria cause tooth decay. Fortunately, toothbrushes, toothpaste, and floss are effective in fighting them.  

Still other types of microbes, the transient flora, can indeed be classified as contaminants, but they are usually not troublesome either. Their life span on the skin is brief, and healthy immune systems have efficient ways of dealing with them. Microorganisms are here to stay, natural inhabitants of our habitat-or we of theirs (they got here first). An infant meets bacteria in its mother's birth canal before it even begins to breathe the air. Microbes are our lifelong companions, for better or worse.   

There are many ways to defend yourself against harmful microorganisms. A healthy immune system is the best defense. Having a government and a public health system that ensure safe drinking water and proper disposal of sewage is another. Clean habits are another: keeping the kitchen and bathroom clean, washing clothes, bathing or showering at reasonable intervals.  

But the single most important thing we can do to prevent the transmission of infectious organisms is to wash our hands often, according to the Centers for Disease Control and Prevention.  

When should you wash your hands?  

• Before and after eating; before and after handling food, particularly raw meat or fish;

• before and after having sex,

• or changing a tampon;

• before putting in contact lenses or treating a wound;

• after using the toilet;

• after sneezing, coughing, or blowing your nose (particularly when you have a cold);

• after changing a diaper;

• after playing with a pet (particularly chameleons or iguanas, which are highly contaminated)

• or changing a litter box;

• after gardening or any other task that leaves hands grimy.

It's largely common sense.

How and with what should you wash them?

Thoroughly, with soap and water. Any kind of soap is fine. Warm water cuts through grease faster, but cold water will do the job. Rub your hands with soap and water for at least 10 seconds to loosen germs and dirt, then rinse all soap away. If your hands are really dirty, clean around your fingernails and in the creases of your skin. Take off rings. Soap and water don't actually kill microorganisms, but they create a slippery environment so that the critters slide off. That's all you need. It is not necessary to nuke them. Even if you are caring for an infant or a sick person, plain soap and water is still fine.  

Do antiseptic and antibacterial products really help?

Soaps with triclosan and other antiseptics do kill or inhibit bacteria, presumably by breaking down their cell walls, but they probably don't affect viruses. The result is essentially the same as with regular soap, though, since you simply wash the germs off.   

Do antibacterials have any down side?

Yes. Besides being overkill, they are harsher and more likely to cause skin irritations than plain soap. Of course, frequent hand-washing with soap can also dry and irritate your skin. If your skin is dry, use a moisturizer after each wash. Some experts also worry that the widespread use of antibacterial products will lead to strains of resistant bacteria-"super-bugs." The FDA says that this trend bears watching.  

Are antibacterial sponges and cleansers and antibacterial cutting boards advisable for the
kitchen?

They aren't necessary. Nothing can take the place of cleanliness-frequent washing of kitchen counters and utensils, particularly any that have come in contact with raw meat, and particularly, washing and/or replacing sponges and dishcloths often. An antibacterial sponge will not disinfect a countertop, and the sponge will eventually get dirty. A cutting board impregnated with chemicals still has to be carefully washed. Plain soap or detergent is just as effective in the kitchen as an antibacterial product.  

What about alcohol wipes and hand washes?

Such products as Purell Instant Hand Sanitizers and Bath & Body Works Instant Antibacterial Hand Gel have been flying off the shelves. The alcohol in them kills bacteria. But they are not a substitute for soap and water, and alcohol is extremely drying to the skin. They don't remove dirt, but are okay to use when soap and water are not available.  

What about antibacterial toys, mops, and phone-guards?

These are designed to make money, and their health benefits are nil. Disinfectant chemicals are regulated by the EPA, along with pesticides and fungicides. It's strange that people who might worry about pesticide residues in food can at the same time be persuaded to buy antibacterial toys for their babies. Microban, the antiseptic built into toys and high chairs by companies like Playskool and Hasbro, is not harmful to kids, but the EPA has ordered these companies to stop making misleading claims about health benefits. If people imagine that products are "self-sanitizing," the danger is that they'll dispense with regular hygiene-that is, soap and water-to prevent the transmission of germs." 

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