Hand washing key disease prevention measure not always practiced

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Hand washingHand washing is a simple yet important component in preventing illness that often goes overlooked. Two recent studies on hygiene practices of the public and veterinarians illustrate this point. Results showed both groups do not wash their hands consistently, and could do more to prevent spreading diseases.

The first study was a meta-analysis of community-based intervention studies by investigators from the University of Michigan and Columbia University (Am J Public Health 2008 Aug; 98:1372). The analysis identified more than 5,000 relevant studies published from 1960 to 2007 on proper hand washing techniques and what effect that has on preventing illnesses in the community.

The authors pointed to results from one study indicating that only 67 percent (75 percent of women and 58 percent of men) washed their hands after using a public restroom.

Compared with no education, hand-hygiene education alone (seven studies) significantly reduced the risk for gastrointestinal illness by 31 percent and for respiratory illness (four studies) by 14 percent. Education plus use of nonantibacterial soap (six studies) significantly reduced the risk for GI illness by 39 percent and for respiratory illness (one study) by 51 percent, compared with control conditions, but had no significant effect in the two studies that combined the two outcomes. Results also suggested that use of nonantibacterial soap and hand-hygiene education significantly reduces respiratory and GI illnesses.

The second study was published in the June 15, 2008, JAVMA, and the PDF can be found here. It assessed the knowledge and use of infection control practices among small animal, large animal, and equine veterinarians.

Researchers found most veterinarians do not consistently make sure to protect themselves against zoonotic disease transmission and are not aware of the appropriate protective equipment to use.

On average, 12 percent of respondents said they sometimes wash their hands before eating, drinking, or smoking at work; 47 percent said mostly; and 38 percent said always.

Forty percent reported they sometimes eat or drink in animal handling areas while 7 percent said they mostly do and 3 percent said they always do.

Finally, 22 percent said they sometimes wash or sanitize their hands between patient contact, 39 percent said they mostly do, and 28 percent said they always do.

Overall, the survey showed small animal and equine veterinarians in practices that did not have a written infection control policy were significantly more likely to have a low precaution awareness ranking. Men were more likely associated with low precaution awareness ranking among small animal and large animal veterinarians, equine practitioners not working in a teaching or referral hospital were more likely to have low precaution awareness ranking than equine practitioners working in such places.

"Unwashed hands pose a risk for zoonotic disease transmission to humans and for nosocomial transmission among veterinary patients. The more appropriate behaviors could be promoted by practice policies that require hand washing and that designate break rooms or eating areas separate from animal areas in clinic settings," according to the report.