I remember teaching my kids how to wash their hands.  No, not the ritual washing that we Jews do before meals- but they had to learn that process, too.  (Pour water from a pitcher- first on your left hand, then the right, the left, the right, and then say the blessing.)   Because that method certainly doesn’t remove the grime and dirt- or microbes- from our hands.  And, if you have young kids, you know that sometimes that grime is not just on the surface of the skin, but seems to have been imbued down to the stem cell layers of their skin.

But, it turns out that how and what we taught our kids needs to be updated.  Certainly, if our kids are going to enter the medical profession.  Because it is all too frequent that our physicians, our nurses, our health care staff are responsible for the infections that run rampant in our hospitals.

Not even the CDC (US Centers for Disease Control and Prevention) seems to have the process down pat.  Because WHO (World Health Organization) disagrees with them.

Here’s what the CDC recommends:

1. Wet your hands with running water.  (It can be cold or hot.)  Turn off the tap.  (This is not part of the cleanliness protocol- it’s to stop us from wasting water!)
2. Apply soap to your hands.
3. Lather your hands by rubbing them with soap- the fronts, the backs, between the fingers, and under our nails.
4. Scrub your hands for 20 seconds. (No, you don’t need a watch or timer.  Sing Happy Birthday to yourself- twice.)
5. Turn on the water and rinse your hands well.
6. Dry your hands. (Clean towel or air dry)

The World Health Organization (WHO) recommends this more elaborate process to wash one’s hands.  Note, however, that their process is based on sanitizer use.

1. Rub hands palm to palm.
2. Rub Right palm over back of left hand, interlacing fingers, and vice versa.
3. Rub hands palm to palm with interlaced fingers.
4. Rub the backs on one’s fingers to opposing palms with interlocked fingers.
5. Clasp right thumb in left palm for rotational rubbing and vice versa.
6. Using fingertips, do rotational rubbing in palm
7. Dry hands.

Now, there’s a new study published in Infection Control & Hospital Epidemiology that confronts these guidelines with the real practice in hospitals.  Drs. Jacqui Reilly, L. Prices, S. Lang, K. Skinner (all four from Glasgow Caledonian University)  C. Robertson (University of Strathclyde), F. Cheater(University of East Anglia), and A. Chow (Tan Tock Seng Hospital, Singapore) were the authors of the study: A Pragmatic Randomized Controlled Trial of 6-Step vs 3-Step Hand Hygiene Technique in Acute Hospital Care in the United Kingdom .

Because most health practitioners (both in the USA and the rest of the world) “wash” their hands with sanitizers and don’t use soap and water.  Because it is faster and need not be conducted in the bathrooms.  (I’ve warned you about the dangers of these hand sanitizers– they render your skin capable of transmitting all sorts of chemicals- like BPA-  right into your body. )

In a randomized, controlled study of 120 health practitioners, the authors  found that the CDC process failed to do the job.  Instead, the WHO process met the needs- according to the authors.  The researchers were hoping the results would indicate that the simpler CDC process would suffice.

But, even with the more rigorous WHO process- one that takes more than twice as long (42 seconds)- the practitioners still had significant microbial loads on their hands. The researchers felt the failure was compliance- only 65% of the subjects did the WHO process properly, while 100% of the test subjects accomplished the CDC process in full.

But, to my thinking, these findings simply mean that using these sanitizers are useless.  Soap and water is the only way to go.  And, that probably means the CDC process- using water and soap- will probably do the job- if we really use soap and water.

Because it’s absolutely clear that the sanitizers don’t.

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