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Hand disinfection – also reasonable outside the clinical setting?

Interview with Prof. Dr. Axel Kramer

Prof. Dr. med. Axel Kramer, Managing Director of the Institute of Hygiene and Environmental Medicine, Ernst Moritz Arndt University, Greifswald, Germany
Prof. Dr. med. Axel Kramer

Prof. Kramer – latest media reports state that performing hygienic hand disinfection in private life is questionable. Is it only reasonable to use alcohol-based hand disinfectants in healthcare facilities?

Unfortunately, these reports address the importance of hand disinfection inappropriately – or even describe it falsely. Experts throughout the world agree that hygienic hand disinfection is the most effective individual measure to prevent infection in healthcare and nursing facilities. Hence, the “AHOI” project supported by the Federal Ministry of Health deliberately involves hospitalised patients and their visitors in hand disinfection. We have been able to already establish this approach at the Greifswald University Hospital. But also in other institutions such as kindergartens, schools and those open to the public, e.g. libraries and citizens’ offices, it is reasonable to disinfect hands. Even if the disinfection is performed in an undirected manner, the infection rate could be reduced and thus the number of days of sick leave.

Why is hand disinfection that efficient to break chains of infection?

Pathogens of, for example, gastroenteritis, or multidrug-resistant bacteria are primarily transmitted via the hands. In all areas – including when entering the home or when travelling – this chain of infection can only be effectively inhibited by hand disinfection.

It is often said that it is sufficient to wash hands with soap – can you confirm this?

No, because it has not been proved that a handwash with soap could prevent infection, except for infections with worms and then prevention of the spread of Clostridioides difficile spores in case of Clostridioides difficile-associated diarrhoea. In fact, frequent handwashing with soap may dry the skin and cause skin irritations.

Whereas hand disinfectants based on alcohol possess good skin compatibility and are absolutely harmless.

Prof. Kramer, thank you very much for this interview.