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Proper Handwashing

Quick Tips #285


What do Ignaz Semmelweis and mothers everywhere have in common? The knowledge that proper handwashing is an important means of preventing the spread of disease-causing germs. Dr. Semmelweis worked in a hospital in Vienna in the 1800s and was alarmed at the mortality rate in the maternity wards. The patients were dying at such an alarming rate that many of them were begging to be sent home. Patients in the ward died at a rate of 5 times greater then those who gave birth at home.

Most of those dying were treated by students who worked on cadavers during anatomy class, before beginning their rounds on the maternity ward. Students were not sterilizing properly, as handwashing was not recognized as a necessary hygienic practice, and thus pathogenic bacteria from the cadavers was inadvertently transferred to the expectant mothers via the students hands.

Dr. Semmelweis conducted an experiment in which the students were told to wash their hands after anatomy class before making their rounds in the maternity ward. The results of this experiment lead to a decrease of deaths fivefold.

This was the beginning of infection control, not just in hospital settings, but in public health in general. Today the value of proper handwashing is recognized in schools, child care settings, eating establishments, as well as throughout the general community.

According to the Center for Disease Control (CDC) each year Americans are sick more than 4 billion days, spending 950 billion dollars on direct medical expenses, and over 160,000 die from infectious diseases. Infectious diseases are caused by various types of microscopic germs such as: viruses, bacteria, parasites and fungi. These germs cause illnesses ranging from common ailments like the cold and flu, disabling diseases and deadly diseases like the Hantavirus and AIDS. The good news is that many of these diseases can be prevented through simple and inexpensive methods of personal hygiene.

According to the CDC, one of the most important steps you can take to avoid infection is to properly wash your hands. CDC cites three common household scenarios in which disease-causing germs can be transmitted by contaminated hands:

  1. Hand to food: Germs are transmitted from unclean hands to food, when a food preparer fails to adequately wash hands before food is served and ingested.
  2. Person to person: During a diaper change, germs are passed from an infant with diarrhea to the hands of a parent/child care provider. When that person handles other children without washing his/her hands, he/she passes that infection onto them.
  3. Nose, mouth, or eyes to hand to others: Germs that cause colds, eye infections and other illnesses can spread to the hands by sneezing, coughing or rubbing of eyes, then transfer to others through touching.

Follow these easy steps to help stop the spread of infectious diseases:

  • Clean your hands often
  • Clean and disinfect surfaces
  • Handle and prepare food safely
  • Use caution when handling animals specifically wild animals

To properly wash hands:

  1. Wet hands and apply liquid or clean bar soap.
  2. Rub hands vigorously together and scrub all surfaces of the hands. Continue 20 seconds or about the length of time it takes to sing "Happy Birthday to You". It is the soap, combined with the scrubbing action, which allows dislodging and removal of germs.
  3. Turn off faucet using a paper towel
  4. Rinse hands and dry well with a disposable towel. Do not wipe your hands on clothing.

When to wash your hands:

  • After using the restroom
  • After handling animals
  • Before eating
  • Before preparing foods
  • After removing soiled clothes or shoes

In the event handwashing facilities are not available an alcohol based hand sanitizer can be used. The FDA suggests using a sanitizer with an alcohol concentration of 60% or greater. It is important to note that hand sanitizers are effective against common diseases but they are ineffective against certain organisms such as bacterial spores. Also hand sanitizers are less effective if your hands are soiled. Removing any dirt or debris before using the sanitizer will increase the effectiveness.

Hand sanitizer should not be used in place of soap and water all of the time. Research has shown that with just three applications of an alcohol based sanitizer the effectiveness of the sanitizer decreases. The reason for the decreased effectiveness is alcohol in the sanitizers can remove natural oils from your hands, which will cause your hands to dry out and crack. Germs can remain trapped within in the cracks of your hands.

The Food and Drug Administration (FDA) and the CDC work together to control the transmission of pathogens that can result in foodborne illnesses. Transmission of pathogenic bacteria, viruses and parasites from raw food, or from infected workers to food by way of improperly washed hands, continues to be one of the major factors in the spread of foodborne illnesses. For more information read Quick Tips #335: Foodborne Illnesses.

The FDAs Food Code contains federal recommendations for the prevention of foodborne illnesses in restaurants, grocery stores, institutions and vending locations. This code is used by local, state and federal regulators as a model for their own safety rules. The Food Code contains specific hand hygiene guidelines for retail and food service workers, describing where, when and how to wash and sanitize hands. OSHAs bloodborne pathogen standard (29 CFR 1910.1030) demands that institutions require proper handwashing facilities. If they are not feasible, an antiseptic cleanser or antiseptic towelettes must be made available.

Commonly Asked Questions

Q.   When should you wash your hands?
A.   Hands should be washed before, during and after you prepare food, before you eat, after you use the bathroom, after handling animals or animal waste, when your hands are dirty and when someone is sick in your household.
Q.   Are alcohol-based hand gels accepted in place of washing with soap and water in retail or food service setting?
A.   Retail food and food service work involves a high potential for wet hands, and scientific research questions the efficacy of alcohol on moist hands. Alcohols do not adequately reduce important foodborne pathogens on the preparers hands, thus the alcohol based gels for retail or food service must be approved food additives and approved under the FDA monograph or as a New Drug Application. Proper handwashing with soap and water is still the preferred method.
Q.   Should disinfectants be used for washing hands?
A.   No, disinfectants are designed for objects and surfaces and may be too harsh for use on skin tissue. Soaps containing antiseptic should be used for proper handwashing.



CDC (Centers for Disease Control and Prevention)

FDA (Food and Drug Administration)

(Rev. 1/2012)

Find even more information you can use to help make informed decisions about the regulatory issues you face in your workplace every day. View all Quick Tips Technical Resources at

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The content in this newsletter is intended for general information purposes only. This publication is not a substitute for review of the applicable government regulations and standards, and should not be construed as legal advice or opinion. Readers with specific compliance questions should refer to the cited regulation or consult with an attorney.

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