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Failure of hand disinfection with frequent hand washing: a need for prolonged field studies

Published online by Cambridge University Press:  15 May 2009

Juhani Ojajärvi ,
Paavo Mäkelä  and
Ilari Rantasalo
Juhani Ojajärvi
Affiliation:
The Department of Public Health Science, University of Helsinki, and HelsinkiUniversity Central Hospital, Finland
Paavo Mäkelä
Affiliation:
The Department of Public Health Science, University of Helsinki, and HelsinkiUniversity Central Hospital, Finland
Ilari Rantasalo
Affiliation:
The Department of Public Health Science, University of Helsinki, and HelsinkiUniversity Central Hospital, Finland
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Summary

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In a prolonged field trial a 4% chlorhexidine digluconate detergent scrub (HibiscrubR), that had earlier proved to be an effective hand disinfectant, was studied in hospital wards. Finger tips were found to harbour more bacteria than the hand dorsum and the samples collected from them yielded more information on the bacteriological and dermatological effects of hand disinfectants in practice.

In wards with a relatively low hand-washing frequency (less than 20 times in 8 hours) the bacteriological results resembled those obtained by in-use tests with volunteers. In the neonatal unit where the hand washing frequency was remarkably high, even occasionally over 100 times/8 h shift, an increase in the bacterial colony counts of the majority of the staff was recorded both before and after hand washing already after using the preparation for 1 week. Age, occupation and hand-washing frequency all correlated with the bacteriological results. Twenty-seven out of 37 persons complained of side effects such as wounds of finger tips and redness or heavy drying of the skin. Wounds, particularly on finger tips, resulted in the failure of disinfection. An increase in bacterial counts was sometimes noted without any dermatological or subjective changes. Drying of the skin was complained of less often when no increase in skin bacteria occurred.

After the changeover of washing practice to a detergent followed by a rinse with spirit solution containing chlorhexidine and glycerol a decrease was recorded in the bacterial counts. It is concluded that more attention should be paid to long-term testing of hand washing and disinfection methods to ensure optimum final results in practice. It is obvious that the knowledge obtained from short time in-use testing cannot be applied to all conditions of use.

Type
Research Article
Information
Journal of Hygiene , Volume 79 , Issue 1 , August 1977 , pp. 107 - 119
Copyright
Copyright © Cambridge University Press 1977

References

REFERENCES

Ayliffe, G. A. J., Babb, J. R., Bridges, K., Lilly, H. A., Lowbury, E. J. L., Varney, J. & Wilkins, M. D. (1975). Comparison of two methods for assessing the removal of total organisms and pathogens from the skin. Journal of Hygiene 75, 259.CrossRefGoogle ScholarPubMed
Brunn, J. N., Bøe, J. & Solberg, C. O. (1968). Disinfection of the hands of ward personnel. A comparison of six disinfectants. Acta medica scandinavica 184, 417.CrossRefGoogle Scholar
Brunn, J. N. & Solberg, C. O. (1973). Hand carriage of gram-negative bacilli and Staphylococcus aureus. British Medical Journal ii, 580.CrossRefGoogle Scholar
Cooley, W. W. & Lohnes, P. R. (1962). Multivariate Procedures for Behavioral Sciences. New York: John Wiley and Sons.Google Scholar
France, D. R. (1968). Survival of Candida albicans in hand creams. New Zealand Medical Journal 67, 552.Google ScholarPubMed
Hall, L. B. & Hartnett, M. J. (1964). Measurement of the bacterial contamination on surfaces in hospitals. Public Health Reports 79, 1021.CrossRefGoogle ScholarPubMed
Joress, S. M. (1962). A study of disinfection of the skin: A comparison of Povidone–Iodine with other agents for surgical scrubs. Annals of Surgery 155, 296.CrossRefGoogle ScholarPubMed
Knights, H. T. & Harvey, J. (1964). Hand creams containing hexachlorophene and cross infection with gram-negative bacteria. New Zealand Medical Journal 63, 653.Google ScholarPubMed
Lowbury, E. J. L. & Lilly, H. A. (1960). Disinfection of the hands of surgeons and nurses. British Medical Journal i, 1445.CrossRefGoogle Scholar
Lowbury, E. J. L. & Lilly, H. A. (1973). Use of 4% chlorhexidine detergent solution (Hibiscrub) and other methods of skin disinfection. British Medical Journal i, 510.CrossRefGoogle Scholar
Lowaury, E. J. L., Lilly, H. A. & Bull, J. P. (1960). Disinfection of the skin of operation sites. British Medical Journal ii, 1039.Google Scholar
Lowbury, E. J. L., Lilly, H. A. & Bull, J. P. (1964 a). Disinfection of hands: Removal of transient organisms. British Medical Journal ii, 230.CrossRefGoogle Scholar
Lowbury, E. J. L., Lilly, H. A. & Bull, J. P. (1964 b). Methods for disinfection of hands and operation sites. British Medical Journal ii, 531.CrossRefGoogle Scholar
Lilly, H. A. & Lowbury, E. J. L. (1971). Disinfection of the skin: An assessment of some new preparations. British Medical Journal iii, 674.CrossRefGoogle Scholar
Lilly, H. A. & Lowbury, E. J. L. (1974). Disinfection of the skin with detergent preparations of Irgasan DP 300 and other antiseptics. British Medical Journal iv, 372.CrossRefGoogle Scholar
Morse, L. J. & Schonbeck, L. E. (1968). Hand lotions – a potential nosocomial hazard. New England Journal of Medicine 278, 376.CrossRefGoogle ScholarPubMed
Ojajärvi, J. (1976). An evaluation of antiseptics used for hand disinfection in wards. Journal of Hygiene 76, 75.CrossRefGoogle ScholarPubMed
Poland, M. K. (1968). The interaction of detergents and the human skin. Journal of the Society of Cosmetic Chemists 19, 3.Google Scholar
Rubenstein, A. D. & Morse, L. J. (1967). Study reveals hand lotions may be source of gramnegative bacteria. New England Journal of Medicine 277, 472.Google Scholar
Spiegel, M. R. (1961). Theory and Problems of Statistics. New York: Schaum Publishing Co.Google Scholar
Wilson, P. E. (1970). A comparison of methods for assessing the value of antibacterial soaps. Journal of Applied Bacteriology 33, 574.CrossRefGoogle ScholarPubMed
Walter, C. W. (1965). Disinfection of hands. American Journal of Surgery 109, 691.CrossRefGoogle ScholarPubMed
Walter, C. W. & Kundsin, R. B. (1969). The bacteriologic study of surgical gloves from 250 operations. Surgery, Gynecology and Obstetrics 129, 949.Google ScholarPubMed