Back in 18th century, there was a maternity clinic at the Vienna General Hospital in Austria that was divided into two identical sub-clinics which had very different mortality rates due to puerperal fever (a devastating disease that affected women within 3 days of childbirth)

The mortality rate at the first clinic was extremely high and it had such a bad reputation that many women preferred to give birth in the streets than to end up there.
During 1846, there were 460 deaths in first clinic and 105 in second clinic, from puerperal fevel alone.(Newton, 2010)

Dr. Ignaz Semmelweis, a Hungarian physician that was employed at the clinic, started an extensive research to find the underlying cause, and he noticed that the first clinic was used by medical students who were involved in autopsies before they enter the clinic. The second clinic was used exclusively by midwife students.

He suggested that medical students should wash their hands with calcium hypochlorite, before entering the first clinic. It was only 6 years earlier when a doctor in USA, Dr. Oliver Wendell Holmes, published an extensive research called ” The contagiousness of puerperal fever” in which he concluded that puerperal fever can go from patient to patient through the physician.

Dr. Semmelweises suggestion worked right away. The mortality rates of the first clinic were dropped to the same levels as the second clinic, but despite his success, his suggestions were mostly rejected or ignored by the medical community outside his clinic. Tragically at the last years of his life, Dr. Semmelweis become a drinker, suffered from depression and died in insane shelter possibly as a result of beating. On top of that, only a few people attended his funeral.

The importance of handwashing

A number of Infectious diseases can spread from one person to another by contaminated hands. (State Government of Victoria, n.d) Chlamydia, Hepatitis A, Influenza, Salmonella are only a few of the diseases and conditions that could be eliminated or reduced by a thorough handwashing.

Appropriate handwashing

A thorough handwashing should include rubbing hands, scrubbing all surfaces including hands, wrists, between the fingers and under the fingernails (WHO, n.d), Ideally it should last around 20 seconds but even only 15 seconds of soap and water hand washing, can reduce bacterial counts by approximately 90% (Harvard Health Publications, 2007). When finish handwashing in a public bathroom, it is a good idea to turn off the faucet with a disposable towel or tissue because it is likely to contain germs.

When to wash your hands

According to Centers for Disease Control and Prevention (n.d) we should wash our hands

• Before, during, and after preparing food
• Before eating food
• Before and after caring for someone who is sick
• Before and after treating a cut or wound
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• After blowing your nose, coughing, or sneezing
• After touching an animal (including pet, animal feed, or animal waste)
• After handling pet food or pet treats
• After touching garbage

Liquid soap vs bar soap

Liquid soap is superior to bar soap because it easier and safer to use. Germs can grow and spread from bar soap. Home use of bar soap can be safe if no one has skin infections. In contrast, liquid soap will not spread germs and it can be used in public places. In addition, liquid soaps may include a moisturizing agent. (Minnesota department of health, n.d)

Sanitizers

When soap and water is not available, a gel or wipe sanitizer containing at least 60% alcohol can be used. However Sanitizers do not eliminate all types of germs and their efficiency is based on the volume and the time on the hands (it is better left dried on than wiped) Sanitizers don’t remove pesticides, harmful chemicals and heavy metals (Centers for Disease Control, n.d)

Germs usually hide in:

• Work desk
• Kitchen sink which is usually worse than a bathroom sink
• Dishcloth, sponge
• Garbage can
• Refrigerator
• Bathroom doorknob
• Keyboards
• Escalator handrails
• Shopping cart handles
• Picnic tables
• Light switches
• Remote controls
• Toys
• Pens, pencils and crayons
• Pet cages

(source: Minnesota health department)

Conclusion

Handwashing is an important health-promoting practice that can reduce or eliminate harmful germs. A liquid soap is a better choice over a soap bar. A sanitizer plus some tissues in your bag, might be very useful in situations where there is no soap or water. Tissues can be used to hold dirty surfaces such as a faucet or a doorknob in a public toilet.

Resat Alagiali

Bibliography and references

Betterhealth.vic.gov.au. (2017). Handwashing – why it’s important. [online] Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/handwashing-why-its-important [Accessed 28 Apr. 2017].

Center for Disease Control (2013) Handwashing: Clean Hands Save Lives, Centre for Disease Control. Available at: https://www.cdc.gov/handwashing/index.html (Accessed: 14 April 2017).

Center for Disease Control (2016) When and How to Wash Your Hands | Handwashing | CDC. Available at: https://www.cdc.gov/handwashing/when-how-handwashing.html (Accessed: 14 April 2017).

Dr. Semmelweis’ Biography at Semmelweis Society International (no date) Semmelweis Society International. Available at: http://semmelweis.org/about/dr-semmelweis-biography/ (Accessed: 14 April 2017).

Chlamydia – What You Need to Know (no date). Available at: https://www.drugs.com/cg/chlamydia.html (Accessed: 28 April 2017).

Dunn, P. M. (2007) ‘Oliver Wendell Holmes (1809-1894) and his essay on puerperal fever.’, Archives of disease in childhood. Fetal and neonatal edition. BMJ Publishing Group, 92(4), pp. F325-7. doi: 10.1136/adc.2005.077578.

Hallett, C. (2005) ‘The attempt to understand puerperal fever in the eighteenth and early nineteenth centuries: the influence of inflammation theory.’, Medical history. Cambridge University Press, 49(1), pp. 1–28. Available at: http://www.ncbi.nlm.nih.gov/pubmed/15730128 (Accessed: 26 April 2017).

Harvard Health Publications (2007) Proper hand washing technique: how to wash your hands properly – Harvard Health. Available at: http://www.health.harvard.edu/press_releases/proper-hand-washing (Accessed: 14 April 2017).

Health.state.mn.us. (No date). Which Soap is Best? – Minnesota Dept. of Health. [online] Available at: http://www.health.state.mn.us/handhygiene/how/bestsoap.html [Accessed 24 Apr. 2017].

Health.state.mn.us. (No date). Where do germs hide? – Minnesota Dept. of Health. [online] Available at: http://www.health.state.mn.us/handhygiene/why/hide.html [Accessed 24 Apr. 2017].

Ignaz Semmelweis (1818-65) (no date) Science Museum History of Medicine. Available at: http://www.sciencemuseum.org.uk/broughttolife/people/ignazsemmelweis (Accessed: 14 April 2017).

Mayo Clinic. (No date). Hand-washing: Do’s and don’ts – Mayo Clinic. [online] Available at: http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/hand-washing/art-20046253?pg=1 [Accessed 14 Apr. 2017].

Newton Richard Cole (1910) A brief study of the contribution of Ignaz Philip Semmelweis to modern medicine : Newton, Richard Cole : Free Download & Streaming : Internet Archive. Available at: https://archive.org/details/b28978250 (Accessed: 10 May 2017).

Show Me the Science – When & How to Use Hand Sanitizer | Handwashing | CDC (no date). Available at: https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html (Accessed: 14 April 2017).

WebMD (No date) Proper Hand-Washing: When to Wash Your Hands, How Long, and More (no date). Available at: http://www.webmd.com/cold-and-flu/tc/hand-washing-topic-overview (Accessed: 14 April 2017).

WHO (2016) ‘WHO | Hepatitis D’, WHO. World Health Organization. Available at: http://www.who.int/mediacentre/factsheets/fs328/en/ (Accessed: 28 April 2017).

‘WHO | Clean hands protect against infection’ (2011) WHO. World Health Organization. Available at: http://www.who.int/gpsc/clean_hands_protection/en/ (Accessed: 14 April 2017).

Zoltán, I. (2017). Ignaz Semmelweis | Biography & Facts. [online] Encyclopedia Britannica. Available at: https://www.britannica.com/biography/Ignaz-Semmelweis [Accessed 14 Apr. 2017].

 

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