The year was 1846. Dr. Ignaz Semmelweis was working in the Vienna General Hospital when he noticed a perplexing problem. Women giving birth in the doctor-run maternity ward developed fever and died more often than women in the midwife-run maternity ward. Doctors tended to visit their wards after performing autopsies, while the midwives did not. Dr. Semmelweis wondered if “cadaverous particles” might remain on their hands. He imposed a new rule, urging doctors to wash their hands before entering the ward. Sure enough, fever and death in the doctor-run ward decreased significantly.
Today we know that bacteria and viruses cause fever and death. We also know the simple act of handwashing continues to be a powerful way to protect ourselves from infection. In fact, according to the Centers for Disease Control and Prevention, nearly two million young children die each year from illnesses that can be prevented by washing hands with soap and water.
When Are the Best Times to Wash Hands?
Before and after food preparation
Before and after caring for someone with vomiting or diarrhea
Before and after treating a cut or wound
After using the toilet
After changing diapers or cleaning a child who has used the toilet
After blowing your nose, coughing or sneezing
After touching an animal or animal waste
After handling pet food or treats
After touching garbage
Anytime hands appear dirty or greasy
Here Are Five Easy Steps for Washing Hands Correctly:
Wet hands with running water and apply soap. It doesn’t matter if the water is warm or cold.
Lather soap, spreading it to the palms, between fingers and back of hands.
Scrub hands for 20 seconds. Sing a song if you need a timer. The ABC Song or Happy Birthday (twice through) work well.
Rinse hands with running water.
Dry hands with a clean towel. Air drying is also acceptable.
What About Hand Sanitizer?
Washing hands with soap and water is best. However, hand sanitizer is a good alternative when soap and water are not available. Hand sanitizers should contain at least 60% alcohol. Hands should be rubbed together (including between fingers) until dry, which will take about 20 seconds. It is important to keep hand sanitizer away from young children because it can be toxic if swallowed.
Are There Any Downsides to Handwashing?
Washing hands frequently with soap and water may result in dry, cracked skin. This can be uncomfortable and increase the risk of skin infection. If dryness becomes a problem, apply a moisturizing cream after washing to lubricate the skin, lock in moisture and prevent further drying.
Unfortunately, hand washing did not stick after Dr. Semmelweis asked doctors at the Vienna General Hospital to wash their hands. They soon forgot, and handwashing failed to catch on elsewhere. A few years later, Florence Nightingale revived the practice of handwashing during the Crimean War, which greatly reduced the number of infections in field hospitals. But it wasn’t until the 1980’s, following a large outbreak of food-borne illness, that handwashing became a constant and important public health message.
It turns out “cadaverous particles” are not really dangerous. It’s bacteria and viruses on those particles… and on everyday things… that we have to worry about, and the best defense against those is washing our hands!
Dr Mike Patrick is an Assistant Professor of Pediatrics at the Ohio State University College of Medicine and Medical Director of Interactive Media for Nationwide Children's Hospital. Since 2006, he has hosted the award-winning PediaCast, a pediatric podcast for parents. Dr Mike also produces a national podcast for healthcare providers—PediaCast CME, which explores general pediatric and faculty development topics and offers free AMA PRA Category 1 Credit™ to listeners.
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