Becker's Clinical Quality & Infection Control

7 HAND HYGIENE Rethinking Hand Hygiene: 5 Things to Know About the Little-Known World of Skin Microbiota By Brian Zimmerman W hile the debate between hand dry- ers and paper towels in terms of superior hand-washing technique has inspired a public relations war with mul- tiple industry-funded studies, the question at its core is deeply flawed because it is predicat- ed upon the notion that bacteria is bad. In an article in e Atlantic, staff writer Sarah Zhang examined the scientific community's growing understanding of the skin microbiota and the short-sided nature of the hand dryer or paper towel debate. Here are five key takeaways from Ms. Zhang's piece in e Atlantic. 1. Historically, studies of skin bacteria have consisted of swabbing the skin and growing sampled microbes in a petri dish. However, only 1 percent of microbes can actually grow in such dishes, giving researchers a limited view of the skin's diverse microbiome. DNA sequencing has revealed the nature of the re- maining 99 percent. 2. e scientists who study the communities of harmless and even beneficial bacteria liv- ing on skin are known as microbial ecologists. e research field is new and has only recently trickled into the world of clinical microbiolo- gy, which is primarily concerned with finding ways to eliminate harmful bacteria. 3. "e central insight of the ecological view is that getting rid of harmless or beneficial microbes can have consequences, too. Once they're gone, pathogenic microbes have little competition. Complicating the idea of 'good' versus 'bad' bacteria is that some bacteria are perfectly harmless until for some reason they're not. Staphylococcus aureus, for exam- ple, can cause dreaded staph infections. But it also lives in the nose of many people with no ill effects," wrote Ms. Zhang. 4. While DNA sequencing of the skin is more common now than it was in the past, the prac- tice is still limited due to the associated costs. erefore, due to our slow-growing knowl- edge, how to create hand hygiene practices that both eliminate harmful germs and nur- ture helpful ones will likely have be answered by scientists in the future. 5. In regards to the hygienic efficacy of hand dryers versus paper towels, Val Curtis, PhD, a hygiene expert at the London School of Hy- giene and Tropical Medicine, told e Atlan- tic, "e important question is, 'What is the health impact of different way[s] of washing hands? It doesn't matter if you get rid of a load of bacteria that's not harmful." n Peer Pressure, Fear of the Flu Can Boost Hand Hygiene: 6 Survey Findings By Brian Zimmerman W hen others are present, people are more likely to wash their hands in a public restroom, accord- ing to the annual Healthy Hand Washing survey conducted by the Bradley Corporation. The Bradley Corp. has manufactured commercial restroom and emergency safety products for nearly a century. For the hand-washing survey, the company queried 1,042 Amer- ican adults online from Dec. 12 to Dec. 15. Respondents were asked about their hand-washing habits and their con- cerns regarding germs and the spread of viral infections like influenza. Here are six key findings from the survey. 1. More than 50 percent of respondents said the presence of others in public restrooms either drives them to wash their hands longer than usual or wash them when they nor- mally wouldn't. 2. Approximately 40 percent of participants admitted to being more likely to wash their hands after seeing signage instructing employees to wash before returning to work. 3. Seventy percent of respondents reported washing their hands more frequently or for extended periods of time after hearing about the spread of influenza. 4. More than 80 percent of participants reported either frequently or occasionally witnessing others leave the re- stroom without washing their hands. 5. Sixty-seven percent of Americans reported cutting cor- ners during hand hygiene practices and only rinsing with water on occasion. 6. A majority of respondents reported hand-washing to be a must after sneezing or coughing (69 percent) and han- dling a sick child (58 percent). n

• Cover