hand hygiene
By Margot Smith , DrPH
Why We Wash Our Hands
Semmelweis ’ idea of handwashing was considered bizarre for decades . Doctors then believed that infections were due to miasmas or bad air , or to the imbalance of cold , hot , moist , and dry humors within a patient ’ s body that could be relieved by bloodletting . Doctors who performed autopsies were revered because they were actively investigating the causes of sickness .”
We all know that handwashing is an important action we can take to prevent infections by cold and flu viruses as well as other pathogens , but I personally observed the critical importance of handwashing and cleanliness when I spent time with my son in the intensive care unit ( ICU ) at my local hospital . In the 10 days I kept vigil until his recovery , staff efforts at keeping the room sterile were impressive . Hands were washed and a new pair of gloves donned every time healthcare personnel entered the room . They wore masks . Blood pressure cuffs and other monitors were wiped down frequently . For the short time he was considered contagious , we all donned paper aprons when entering , and discarded them when leaving .
Dr . Ignaz Semmelweis would have been so pleased . In 1847 he tried to convince the doctors in his Viennese maternity ward to simply wash their hands . He believed that they were carrying puerperal fever into his ward , an infection that caused death to new mothers . Jane Seymour ( the third wife of King Henry VIII ) died of this fever in 1537 , two weeks after giving birth to Henry ’ s only surviving son , Edward VI of England . In 1797 , Mary Wollstonecraft died of fever 10 days after delivering Mary Shelley , the author of Frankenstein .
Semmelweis ’ idea of handwashing was considered bizarre for decades . Doctors then believed that infections were due to miasmas or bad air , or to the imbalance of cold , hot , moist , and dry humors within a patient ’ s body that could be relieved by bloodletting . Doctors who performed autopsies were revered because they were actively investigating the causes of sickness . Their colleagues believed that the dirtier the doctor , the better the doctor ; doctors were proud to display their coats stiff with blood from the last autopsy or surgery they performed as they headed for the maternity ward . The idea that the doctor could be an agent of disease transmission was considered preposterous and wholly rejected .
However , others besides Semmelweis advocated handwashing . British nurse Florence Nightingale at a military hospital in Turkey in 1854 was shocked to discover that 10 times as many soldiers fighting in the Crimean War were dying from infections than in battle . Nightingale brought in soap , towels , fresh sheets , and she insisted on hand washing . “ Every nurse ought to be careful to wash her hands very frequently during the day ,” she later wrote in her book Notes on Nursing ( 1859 ).
In the U . S . in 1855 , Oliver Wendell Holmes also thought that physicians with unwashed hands were responsible for transmitting puerperal fever to patients . He was promptly attacked by the leading Philadelphia obstetrician , Charles D . Meigs , who declared that “ Doctors are gentlemen , and gentlemen ’ s hands are clean … any practitioner who met with cases of puerperal fever was simply unlucky … I prefer to attribute them to accident , or Providence .”
Handwashing : Not a New Idea
As early as 2800 BC ancient Babylonians used soap ; Egyptians ( 1500 BC ) bathed with soap-like substances made from plants combined with animal and vegetable oils . In ancient Greece , hands were cleaned using mud and ashes . In developing countries today where soap is not available , mud and ashes are still used . Soap is a mixture of boiled animal fat and lye ; lye is made from water run through ashes from a wood fire . Among American Indians , yucca root was used for soap , as it forms a lather .
Some religions require hand and / or foot washing as part of their rituals . According to the World Health Organization ( WHO ), Judaism , Islam and Sikhism , for example , have precise rules for handwashing included in the holy texts and this practice punctuates several crucial moments of the day .
The Discovery of Germs
Long before Biblical days it was known that diseases were contagious , but how a disease spread was not known . In the 1840s , Semmelweis was ahead of his time . In the 1860s , Louis Pasteur and Robert Koch showed that microbes could cause diseases such as tuberculosis and smallpox ; their germ theory at last explained how diseases were transmitted . Pasteur himself developed rabies and anthrax vaccines that prevented disease . He also connected his germ theory with Semmelweis ’ data and worked to making handwashing more popular . In