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Must we really wash our hands? - (3/10/2020)

By Dr. Ron Gasbarro 

Mrs. Swan came into the pharmacy and asked the pharmacist where the hand sanitizers are. “I ran out yesterday,” the pharmacist replied, “And I am not sure when I can get another delivery.” “The other stores have empty shelves too,” Mrs. Swan said. “Is it really that important to wash hands constantly?”

Hands get dirty. That includes the fingernails. Remember, your fingernails are like your own personal tools to scratch yourself, pry things open, drum on surfaces, and to dig into things. Washing the hands, especially when not at home but out and about, hardly ever involves scrubbing under your nails. That’s usually reserved for your shower or bath. While it may seem like men’s nails can harbor pathogens like bacteria, fungi, and viruses more than women’s nails do, look at those gals who just came out of the nail salon. The nails are long, like claws. Within a short time, the nails are contaminated. 

A 2018 study from Poland took samples from under the fingernails of healthcare workers (HCWs) within their healthcare system. The researchers found that the longer the nails, the less effective hand washing was. Moreover, the problem is not only the length of the nails but also what is on top of them. Another 2018 study performed at three medical centers in the Midwestern US analyzed samples from the dominant hand of 88 HCWs. This study aimed to evaluate the bacterial burden of gel nails, standard nail polish, and natural nails on the hands of the workers. These investigators revealed that, while bacteria accumulated on the tops of the fingernails in the hours after the samples were taken, those HCWs with gel nails harbored the most pathogens immediately after hand sanitizing. This is due to crevices created as nails with gel polish grow, making hand sanitizing more difficult.

The Centers for Disease Control and Prevention (CDC) says that whether or not you know it, your hands probably encounter poop on a regular basis. Feces from humans or domesticated animals are a chief source of germs like Salmonella, E. coli, and norovirus that cause diarrhea. In addition, poop can spread respiratory infections like adenovirus and hand-foot-mouth disease. These kinds of bugs can not only get onto hands after people use the restroom or change Junior's diaper but also in less obvious ways, like after handling raw meats that have undisclosed amounts of animal excrement on them.

Proper and regular hand washing can reduce illnesses. It reduces the number of people who get sick with diarrhea by up to 40%. Hand sanitizing also cuts down the occurrence of respiratory illnesses, such as colds, by up to 21%, according to the CDC. About 1.8 million children under the age of 5 die each year from diarrheal diseases and pneumonia. Hand sanitizing actually saves lives.  

Handshaking was started in the Middle Ages to show the other guy was not holding a weapon. When you consider that handshaking goes on many times a day, the trillions of germs that are exchanged are enough to make you sick. Literally. That is why many HCWs, including doctors, now forgo shaking hands with patients. A 2016 study in the American Journal of Infection Control showed that a fist bump transferred only 5% of the germs a handshake can transfer. Giving a “high five” transmitted half the germs. An elbow bump can be cleaner. A smile is probably the best.

Whether we are on the verge of a pandemic as the coronavirus drama unfolds, hand washing is the least we can do. Use an alcohol-based sanitizer, or at the very least, warm-to-hot water AND soap, because water by itself does little to scare away the germs.

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com.


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