Research for infection protection

Hand disinfection at home – does it have a clear advantage?
Why is hand disinfection important?

Hand disinfection is the most important individual measure to break the chain of infection in healthcare facilities and, for example, prevents the spread of antibiotic-resistant pathogens. Depending on the occupational group and field of work, hand hygiene compliance averages between 41 % and 55 %, with a wide range of variation [1] – and thus is not satisfactory. The reasons are manifold and are, for example, attributed to high workloads and a lack of awareness of the hand hygiene’s significance. Hence, the BODE SCIENCE CENTER supports the efforts of the World Health Organization (WHO) [2] to enhance the acceptance of hand disinfection.

This, however, not only applies to healthcare workers. The Robert Koch-Institute (RKI) advocates that patients and visitors regularly disinfect their hands as well, as this has been shown to also prevent the spread of pathogens [1].


Hand disinfection at home

At home, it is not necessary to routinely disinfect the hands without appropriate indication. However, according to current research, there are situations in which hand disinfection has an advantage in terms of infection protection for all citizens:

  • In case of communicable infectious diseases such as a cold to reduce the risk of a spread to healthy housemates [3]; the ill person should for example disinfect the hands before having contact to other persons; healthy people can protect themselves by disinfecting their hands after contact with an ill person.
  • Before having contact with family members, who are cared for at home and are immunocompromised or have chronic wounds [3]. This is to protect the family member in need of care. And when patients need home care after early hospital discharge [3].
  • When having contact with, for example, immunosuppressed relatives and friends, who are at risk of acquiring an infection [3].
  • While travelling: situations that involve a risk of coming into contact with pathogens and in which there is no clean water available for a handwash.

For journeys, the German Foreign Office recommends “disinfecting hands, where appropriate” [4], for example after using the toilet and before eating.


Development of resistances – no problem with alcohol-based hand disinfectants

Usually, hand disinfectants with alcohol-based active ingredients are used in Germany. Due to the alcohols’ unspecific mode of action, “there is no development of resistance known or to be expected”, as stated by RKI [5].


Allergies: Tolerability of hand disinfectants

In addition to a reviewed efficacy, skin compatibility is among the most important properties of hand disinfectants. WHO, RKI and medical societies consider alcohol-based hand disinfectants the “gold standard” in hand disinfection [6]. RKI classifies alcohol-based hand disinfectants as “considerably more tolerable than preparations for washing hands” [5]. Allergies to alcohols are extremely rare. A ten-year study at a 1 000-bed hospital and with data on more than 3 500 employees did not reveal a single allergy to the alcohol-based hand disinfectant used [7].


Sources:
1. Händehygiene in Einrichtungen des Gesundheitswesens. Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI), Bundesgesundheitsblatt 2016, 59:1189-1220.
2. World Health Organization (2005): Safe lives. Clean your hands. Guide to Implementation. A Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy.
3. Kampf G, Dettenkofer M. Desinfektionsmaßnahmen im häuslichen Umfeld – was macht wirklich Sinn? Hygiene & Medizin, 2011; 36 (1): 8-11
4. Gesundheitsdienst 07/16/GB Merkblatt für Beschäftigte und Reisende Krankheitsprävention und Hygiene im Ausland (insb. Tropen)(Kurzfassung für den eiligen Leser). http://www.auswaertiges-amt.de/cae/servlet/contentblob/740646/publicationFile/218571/HygieneAusland.pdf. Accessed on 17 August 2017.
5. Robert Koch-Institut. Die hygienische Händedesinfektion – ein Beitrag zum Internationalen Tag der Händehygiene am 5.5. Epidemiologisches Bulletin Nr. 17, 29. April 2013.
6. World Health Organization (2006): WHO Guidelines on Hand Hygiene in Health Care. Global Patient Safety Challenge (2005-2006).
7. Widmer AF. Replace Hand Washing with Use of a Waterless Alcohol Hand Rub? Clinical Infectious Diseases 2000; 31:136–43.