The health benefits of handwashing were first described in the 1800s by a Hungarian doctor named Ignaz Semmelweis during the time before we even knew about germs. He noticed that women giving birth in two different parts of his hospital in Vienna had different rates of death mainly caused by fevers and infections. In the ward where doctors and medical students delivered babies, the rates were much higher than in the ward where they were delivered by midwives. He hypothesized boldly that it was not due to the ventilation (popular opinion) but rather the unclean hands that were causing excess deaths. It was very common at that time to go directly from anatomy classes to the hospital as a part of medical education for students. Unfortunately for the pregnant women at the time, the medical students would handle cadavers in the morning learning about anatomy and then without cleaning their hands would move over into the hospital to deliver babies. When he mandated the students and doctors to wash their hands prior to examining patients, the rates of fevers and deaths drastically declined. It was only twenty years later, with the discovery of germs by Pasteur, Koch, and Lister that the importance of Semmelweis’s intervention was truly appreciated.
Modern access to fresh water in wealthy nations has reduced death and infection by providing clean water for drinking as well as the ability to wash our hands before eating. The increased life expectancy of public health interventions such as this have added 25 years of life expectancy from 1900-1999. Cleaning hands destroy the germs that cause disease in a variety of ways. Soap will cause them to destroy their outer membrane and basically explode, but only if that soap comes in contact with the germs. There are hiding places including under the nails and in between fingers that germs can continue to grow and do their thing if someone does not properly clean those areas. The water can also help some germs fall off of our hands but is not very effective compared to the combination of soap and water.
Although most people are aware that they can spread germs by coming into contact with unwashed only 31% of men and 65% of women wash their hands after using the bathroom. It is most disheartening when people skip handwashing after using the bathroom. The parts of the hands most commonly uncleaned after someone washes their hands is on the back of the hands. Soap does not have to contain a special antibacterial label, just plain soap is effective enough4. Air dryers for the hands are one of the cleanest ways to dry your hands, but a disposable paper towel or clean hand towel are also acceptable. Keep in mind that you should be changing your hand towels in the bathroom every 2 days because the growth of bacteria on those towels can make your hands dirty again right after you wash them.
To wash your hands properly, all you need is soap and running water, and a clean dry towel. Once your hands are wet, you apply the soap and create a foam scrubbing all surfaces of your hands, on the back of the hands, in between the fingers, and underneath the nails. The scrubbing portion of the handwashing should continue for at least 20 seconds which is the amount of time it takes to sing the Happy Birthday song twice. If you are not near running water you may want to clean your hands with an alcohol-based hand sanitizer. Make sure that it is at least 60% or more alcohol by volume. It is important to apply the sanitizer to all areas of the hands and then wait at least 20 seconds until your hands are fully dry.
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 Cutler, David, and Grant Miller. “The role of public health improvements in health advances: the twentieth-century United States.” Demography 42.1 (2005): 1-22.
 “Ten Great Public Health Achievements — United States, 1900-1999.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 Apr. 1999. Available at: https://bit.ly/3f6TC8p
 “Show Me the Science – How to Wash Your Hands.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 Dec. 2020, Accessed on 03/24/2021. https://bit.ly/3vYpwtB.
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