Tag Archives: hygiene

A December 2019 study described the best way to fight a pandemic: wash your hands

In December 2019, just days before Christmas, an interesting study came out. The coronavirus cases were just starting to emerge, and the study mostly flew under the radar.

But the timing is remarkable considering the study’s conclusions: if you want to prevent or mitigate a pandemic, wash your hands — especially at airports.

Image credits: Curology.

30% don’t wash hands, and 35% don’t do it right

There’s a reason why the “wash your hands” advice gets thrown around so much in the time of the coronavirus outbreak. Well, there are two reasons, actually. The first one is that it works.

Our skin is essentially a protective armor, defending us from the endless stream of pathogens we encounter in our day to day life. Unless you cut yourself, viruses can’t really break through your skin. But there’s a chink in our armor (several, actually) — and they’re mostly on our face.

Our mouth, nose, and eyes, are excellent gateways pathways for pathogens to enter our body. The problem isn’t just that they can be exposed to pathogens directly, but we often bring pathogens there ourselves. Remember how we said your skin is effective at keeping stuff outside of you? Well, it keeps them outside, but it doesn’t really kick them out. The pathogens may not be able to enter your body, but they stay on your skin for a while. Every time you touch your face, you increase the chance of infection.

A 2015 study found that on average, we touch our face an average once every 2-3 minutes, and 44% of that touching involves contact with eyes, nose or mouth. Washing your hands is by far the best way to make sure we don’t push pathogens towards our vulnerable areas.

The second reason why health professionals keep telling us to wash our hands is that, well, we don’t really do it enough.

Previous research has found that up to 30% of airport travelers don’t wash their hands after going to the bathroom — and that’s an optimistic figure overall because some airport travelers might not go to the toilet at all (and not wash their hands).

Then, out of the 70% who do wash their hands, “50% don’t do it right”, says Prof. Christos Nicolaides, who has published the above mentioned 2003 study on hand washing in airports.

Why airports?

We started with a 2019 and don’t worry — we’re getting to it.

Air travel is particularly important in any outbreak. It’s how the disease spreads from one community to the other, which makes it extremely difficult to track and contain the disease. This is exactly what has happened to Covid-19: hopes that the disease would be contained in China were disproved and now, several countries are having their own disease clusters in different geographical areas (Italy, South Korea, Iran).

As if that wasn’t enough, airports themselves are hotspots for diseases. They’re full of crowded people from all around the world and are often surprisingly unhygienic.

The 2019 study starts thusly:

“The risk for a global transmission of flu‐type viruses is strengthened by the physical contact between humans and accelerated through individual mobility patterns. The Air Transportation System plays a critical role in such transmissions because it is responsible for fast and long‐range human travel, while its building components—the airports—are crowded, confined areas with usually poor hygiene.”

So far, nothing new. But what the study found is that by increasing air travelers engagement with hand washing, a potential pandemic “can be inhibited by 24% to 69%” — that’s right, the lion’s share of a global pandemic can be cut down if we’d simply wash our hands at airports.

“Our results provide evidence for the effectiveness of hand hygiene in airports on the global spread of infections that could shape the way public‐health policy is implemented with respect to the overall objective of mitigating potential population health crises,” the study concluded. Just imagine what we could achieve if we’d wash our hands everywhere — even when there’s not a pandemic.

Particularly good against the novel coronavirus

Coronaviruses are particularly vulnerable to washing hands.

The study doesn’t mention the coronavirus in any way (it came out before the outbreak took shape), but its findings apply excellently to the current situation.

In the case of Covid-19, perhaps it’s even more effective than in other pathogens.

Coronaviruses in general (not just the novel one) are enveloped viruses, which means that they have an outer lipid membrane layer. Simply put, coronaviruses are surrounded and protected by a layer of fat.

This makes them one of the easiest viruses to kill with the appropriate disinfectant product. Furthermore, even washing your hands with soap — which usually doesn’t kill pathogens as much as it gets them away from your skin — can kill coronaviruses. The soap can dissolve the fatty layer and kill the virus. You just need to wash your hands long enough (20 seconds), and you’re good to go.

The 20 seconds part is important. To make sure you wash your hands for the right amount of time, 20 seconds is the amount of time it takes to sing “Happy Birthday” twice — or just think of any chorus that’s stuck in your head, singing it twice should be a good timekeeper.

Of course, in our day to day life, we can spend hours without having access to a place to wash our hands. Fret not — sanitizers also work. Just make sure they have an alcohol content of 60% or over, and that will also do the job (as long as you cover your hands thoroughly).

In addition to ensuring you wash your hands for 20 seconds, here’s what you need to do for a proper handwashing:

  • make sure you use enough soap to cover your hands on both sides;
  • rub your hands together, using one hand to clean the other;
  • clean between your fingers, on both sides;
  • pay attention to your thumb, clean it carefully;
  • rub the tips of your fingers on the palm of your other hand. Do the same with the other hand;
  • rinse your hands thoroughly;
  • dry your hands (preferably with a disposable towel).

There you have it, the most powerful weapon against a pandemic. All it takes is 20 seconds, several times a day.

E. coli superbugs linked to poor hygiene and not contaminated food

Despite it has usually been associated with undercooked chicken or other food, antibiotic-resistant E. coli is actually more likely to be spread through poor toilet hygiene, according to new research.

Credit Wikipedia Commons

Millions of bacteria naturally populate the guts of humans and animals alike, with different species coexisting in a fine balance that ensures a state of health. Some strands of E. coli form part of the natural gut microbiome and are usually harmless.

However, sometimes, a person may come into contact with strains of this bacterium that have developed antibiotic resistance. When this happens, E. coli may cause food poisoning, urinary tract infections, or intestinal infections.

Two possible sources of E. coli infections are contaminated food items and poor personal hygiene. But it remains unclear which one of these sources is most likely to lead to infection, and that is what researchers set out to learn.

In their study, published in The Lancet, the researchers collected antibiotic-resistant E. coli strains from meat (chicken, pork, and beef), animal slurry, salad, and fruit, on the one hand, and human bloodstream infections, feces, and sewage, on the other. The samples came from the National Health Service (NHS) laboratories.

Typically, antibiotic-resistant strains of this bacterium feature extended-spectrum beta-lactamases (ESBLs), enzymes that neutralize the action of antibiotics that people use to fight E. coli, such as penicillin and cephalosporin. Scientists refer to such strains of E. coli as “ESBLs-E. coli.

The researchers’ analysis revealed that resistant E. coli strains present in the samples of human blood, feces, and sewage had lots of similarities. The dominant strain present in samples of human origin was ST131. In samples of food, however, the researchers found barely any traces of ST131. Instead, they noticed the presence of other ESBL-E. coli strains.

The almost complete lack of a crossover of E. coli strains between samples of human origin and those taken from contaminated foods suggested to the study authors that most infections with antibiotic-resistant E. coli are, most likely, transmitted from human to human as a result of poor hygiene practices.

“Critically — there’s a little crossover between strains from humans, chickens, and cattle. The great majority of strains of ESBL-E. coli causing human infections aren’t coming from eating chicken, or anything else in the food chain,” notes Prof. Livermore. “Rather — and unpalatably — the likeliest route of transmission for ESBL-E. coli is directly from human to human.”

Still, researchers noted that the findings do not mean people should stop being careful about how they handle foods, as food remains a source of infection.

“We need to carry on cooking chicken well and never to alternately handle raw meat and salad,” the lead author says. “There are plenty of important food-poisoning bacteria, including other strains of E. coli, that do go down the food chain.”

Menstrual cups are cheap, effective, and just as reliable as tampons, large-scale study shows

Ladies, rest assured: menstrual cups are as leakproof as tampons and pads, according to the first large scientific review of these sanitary products.

Image credits: Kaitilyn Nicole.

Period taboo

Unfortunately, menstruation is still a taboo. Periods can be very difficult and unpleasant for women, especially young girls, and not talking about it isn’t doing anyone any favors. Menstrual products are also rarely discussed and many women have difficulties in choosing the right product — or even worse, can’t afford the proper menstruation products. Even in the US, poor women often can’t afford tampons or pads.

“Girls and women need effective, safe, and affordable menstrual products. Globally, an estimated 1·9 billion women—around 26% of the population—were of menstruating age in 2017, spending on average 65 days in the year dealing with menstrual blood flow,” the researchers write in the study.

In recent times, menstrual cups have emerged as a potential alternative to traditional products. The cup is inserted into the vagina during menstruation with the purpose of collecting menstrual blood and prevent it from leaking. They collect the blood rather than absorbing it and should be emptied and rinsed every 4-12 hours. They are also reusable, with most products being usable for up to 5 years. Menstrual cups are made of soft and flexible materials such as rubber or silicone which also make for easy cleaning.

However, most women fear complications from these products, or are simply unaware of their existence. A new report, the first large review of this type, concluded that these fears are unfounded, and women should be aware of this alternative.

Menstrual cups

Researchers selected 43 studies that were eligible, with a total of 3319 participants. In all studies, the adoption of the menstrual cup required a familiarisation phase over several menstrual cycles, but the learning curve wasn’t steep — and once women got the hang of it, complications were surprisingly rare.

The leakage was similar or lower for menstrual cups than for disposable pads or tampons. Use of the menstrual cup showed no adverse effects on the vaginal flora. There were, however, issues for a few women: out of the total sample, there were five reports of severe pain or vaginal wounds, six reports of allergies or rashes, nine of urinary tract complaints, and five of toxic shock syndrome after use of the menstrual cup. In total, this adds up to 25 severe issues from a sample of 3319 — so less than 1%

“Our review indicates that menstrual cups are a safe option for menstruation management and are being used internationally,” researchers write, adding that more good-quality studies in this field are needed.

The price is also much lower for menstrual cups. There are numerous brands and options on the market, most of which cost around $10-$40 — much more than a box of tampons, but considering that you use it for years in a row, you save quite a lot of money in the long run. Researchers suggest that making menstrual cups available globally could play an important role in alleviating poverty and reducing health problems such as infections.

Being reusable rather than disposable means that menstrual cups are also more eco-friendly, which can be an important consideration for many women. Menstrual cups can also take in more blood than pads or tampons, and provide equal or lower leakage than conventional options.

All in all, researchers encourage more women to look into this alternative. With proper usage, it can be healthier, cheaper, and more sustainable than the existing alternatives.

“This systematic review suggests that menstrual cups can be an acceptable and safe option for menstrual hygiene in high-income, low-income, and middle-income countries but are not well known. Our findings can inform policy makers and programmes that menstrual cups are an alternative to disposable sanitary products, even where water and sanitation facilities are poor.”

The study has been published in The Lancet.

Physicians’ stethoscopes more contaminated than their hands

Hygiene is extremely important for hospital workers – regardless of the type of medicine they practice – because they run a high risk of further transmitting any contamination they might have. But now, research has shown that while healthcare workers’ hands are the main source of bacterial transmission in hospitals, physicians’ stethoscopes appear to play a role too.

The work is the first one to compare the contamination levels between hands and stethoscopes, and results are somewhat unsettling, though not entirely surprising. The stethoscope’s diaphragm was more contaminated than all regions of the physician’s hand except the fingertips, while the tube of the stethoscope was more contaminated than the physicians’ back of the hand, claim investigators at the University of Geneva Hospitals.

“By considering that stethoscopes are used repeatedly over the course of a day, come directly into contact with patients’ skin, and may harbor several thousands of bacteria (including MRSA) collected during a previous physical examination, we consider them as potentially significant vectors of transmission,” commented lead investigator Didier Pittet, MD, MS, Director of the Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals. “From infection control and patient safety perspectives, the stethoscope should be regarded as an extension of the physician’s hands and be disinfected after every patient contact.”

This doesn’t mean that you should steer clear of any stethoscopes, but it does raise some significant hygiene issues. Stethoscope contamination is not trivial and is comparable to the contamination of healthcare workers’ fingertips, the hand region most implicated in microbial cross-transmission.

However, physicians should be aware of this problem and pay extra attention to disinfecting their stethoscopes.

Journal Reference:

  1. Yves Longtin, Alexis Schneider, Clément Tschopp, Gesuèle Renzi, Angèle Gayet-Ageron, Jacques Schrenzel, Didier Pittet. Contamination of Stethoscopes and Physicians’ Hands After a Physical Examination. Mayo Clinic Proceedings, 2014; 89 (3): 291 DOI: 10.1016/j.mayocp.2013.11.016

The PeePoo bag: don’t poop where you eat

Nairobi, Kenya is home to one of the world’s biggest slums, more than one million people living in subhuman conditions in the African state capital. I’ve seen and read a lot of reports from there, and other African states alike, and the situation is indeed dire. Imagine having nothing to eat – now imagine having to poop the scraps of food you manage to go about during the day in the same one room apartment you have to live in.

Although public latrines are common in slums, they’re overused, insalubrious and even dangerous (women and young girls often get raped near latrines at night), so people resort to what’s commonly know as “flying toilets”, which basically means filling a plastic bags with one needs and then throwing it down right the window.

Basic sanitation, like for instance running water, is a far fetched concept for any slum dweller, due to over population and lack of infrastructure. Crap, forget about running water, think about clean water which ever so dim, gets even more contaminated with unfiltered, unsanitized waste. Every 15 seconds a child dies in the world from contaminated water and dysentery or cholera pass for common flues.

Some of you may ask how can something like this be possible in a world that calls itself civilized, where reason and technology are supposed to thrive, however traditional sanitation infrastructure is expensive and hard to implement. Of course, if government officials would start thinking about their people and stop spending western funding on buying a Rolls Royce so they can drive it across the whole 5 miles worth of paved road or on pale, white prostitutes things might have looked different, alas this is a discussion that is both interminable and unpleasant for me to enter here.

Back to Kenya and their sanitation issue, it seems a group of individuals, extrapolated on the crap filled plastic bags hovering over Nairobi and developed, let’s say, a more elegant solution.

Introducing the Peepoo…

The Peepoo bag is a long thin bag (14 x 38 cm) with a guaze liner, and coated on the inside by a thin film of Urea, which is the most common fertiliser in the world and is a non-hazardous chemical. When this chemical comes into contact with human waste, be it  faeces or urine, an enzymatic breakdown takes place into ammonia and carbonate, driven by enzymes which are naturally occurring in faeces. As the process develops, the pH levels found in waste increase, and as a result hygienization  occurs.  Waste born pathogens (viruses, bacteria and parasites) are killed over a period of a couple hours to a few weeks. Also, the bags are fully biodegradable and are actually helpful for the environment, acting like a fertilizer.

The benefits of this product are evident – waste is no longer moved around, but safely assimilated by the environment and, of course, there’s no water use. I’m a bit confused, however, how this project is actually implemented. Like I said, there are over a million people living in sub-human condition in Nairobi alone. This means, millions of such Peepoo bags are required every month. Who will pay for these, are they free for the every day African? Because it’s pretty clear to anyone from the start that someone who lives on less than a dollar a day won’t pay in his right mind anything for a bag to take a crap in.

The PeePoole behind the project deserve have our recognition, because however difficult to implement the idea sounds, it’s still a step ahead, although I believe Kenya’s, and the whole third world actually, problem lies in the social upbringing and levers. It’s  enough to read some reports written by various peace corps volunteers detailing the African mindset, will or work power, respect for ones country, those around him and even self, education and so on. It’s pretty clear Governments are interested in solving anything, and it’s up to the people over there to help themselves, to an extent.

I’d love to see this project well funded and spread towards other third world countries as well. I’d also love to hear some of your thoughts and remarks on the subject as well, so please don’t be afraid to voice out and leave a comment below the post .

Find out more at www.peepoople.com

Rubbings hands after washing increases bacteria count

According to a newly published study, it seems that rubbing your hands together in a hand dryer actually leaves them coated with more bacteria than immediately after washing.

When you rub your hands, you bring a lot of bacteria to the surface from the pores of your skin,” says Anna Snelling of the University of Bradford, UK. Snelling conducted the research with 14 volunteers, on three different types of air dryers, instructing each volunteer to use the air dryer for 15 seconds. On each model, the volunteer had to rub their hands while drying, while on the second try they would just hold their hands still.

The study revealed that when volunteers kept their hands still, the dryers reduced skin bacteria numbers by around 37% compared to just after washing. But the count rose by 18%when volunteers rubbed their hands under one of the machines. Paper towels proved the most efficient, halving the bacterial count even though volunteers rubbed their hands, so if you do happen to use an air dryer consider scrubbing your hands with a paper towel, especially if you’re around sick people. [link to study]