ECJ EUROPEAN Cleaning Journal

We all know how important it is to wash our hands. But some people are still not doing it as frequently – nor as effectively – as they should. Could hand hygiene training be the answer and if so, who would it benefit most asks ECJ?

Hand washing is important. Health bodies all over the world agree that this is the case and like to tell us exactly how and when to do it.

The National Health Service in the UK asks us to sing happy birthday twice while washing our hands to ensure we take the required 40 seconds. The Centers for Disease Control in the USA lists 10 everyday activities that need to be followed by a hand wash including blowing one’s nose, changing a nappy and petting an animal.

And the World Health Organisation advocates a five-moment hand hygiene regime for anyone working in hygiene-critical sectors such as healthcare.

Yet not everyone seems to have received the message. According to various surveys only 60 to 90 per cent of people say they always wash their hands after visiting the washroom, while observational studies show that actual hand washing compliance figures are often much lower than people are willing to admit.

A record-breaking attempt to instruct children in the art of good hand hygiene was staged in October this year for World Hand Hygiene Day. A large-scale lesson for primary school children was held throughout the UK as more than 100 schools attempted to break a Guinness World Record.

Students joined the live-streamed event in which they were given instructions on proper hand washing techniques with the aid of hand hygiene stories and talking puppets. But is hand hygiene instruction for children – and for people in general – the right way to go about instilling good hand hygiene habits into the population?

Still not correct

It is a sad fact that hand hygiene is still not being carried out correctly by all of us, says Principle Cleaning’s head of safety and compliance Ian Sinclair. “Not everyone consistently follows the proper procedures, despite the fact there has been significant progress in hand hygiene awareness as a result of the government’s campaigning during the pandemic,” he said. “Poor hand hygiene compliance can pose serious risks, particularly in shared or high-traffic environments where the potential for contamination is higher.”

The reasons why people are failing to wash their hands comes down to several factors, says Sinclair. “Many people underestimate the importance of thorough hand hygiene - particularly if they haven’t directly experienced its consequences,” he said. “In other cases bad habits may be caused by complacency or the fact that there are few reminders around.”

Not an alternative

Many people have come to believe hand sanitiser are a suitable alternative to hand washing following the Covid-19 pandemic, he says. “However, this is not as thorough a method as using soap and water and washing for at least 40 seconds.”

According to Sinclair, some people avoid frequent hand washing because they believe their immune systems may not develop properly if their hands are too clean. “This idea comes from the hygiene hypothesis which suggests that limited exposure to microbes during childhood might increase susceptibility to allergies and autoimmune conditions,” he said.

“However, experts clarify that while it is beneficial to be exposed to a variety of bacteria through normal daily life - during outdoor activities and when interacting with pets, for example - avoiding basic hygiene practices such as hand washing does not actually build immunity,” he said. “Regular hand hygiene keeps us safe from harmful bacteria and viruses while natural exposure to everyday microbes helps the immune system develop.”

He believes training can significantly increase compliance, however. “Studies show that when people are taught effective hand-washing techniques - and when they are also given reminders and made to understand the benefits of hand hygiene - they are more likely to practise it more consistently,” he said. “Training reinforces knowledge about when and how to wash the hands properly and can reduce the spread of germs and illness in workplaces, particularly in industries where maintaining high standards of hygiene is crucial.”

Hand hygiene training is important in healthcare facilities, food preparation environments, schools and offices, he says. “These are places where people are in close contact with each other or where they handle sensitive materials,” said Sinclair. “Beyond these it is beneficial to promote good hand hygiene habits in public spaces such as transport hubs and recreational facilities. Teaching such principles in early education can instil lifelong good practices.”

He believes a combination of hands-on demonstrations, informative signage, digital resources and regular refresher courses can all play a role in teaching people about hand hygiene. “Posters and videos will demonstrate the correct techniques, while interactive training sessions can ensure that people understand why these practices matter,” he said.

Principle Cleaning produces posters on hand washing techniques and conducts training at client locations.

End users are often insufficiently informed about the active ingredients in soaps and hand sanitisers, according to Salveco’s marketing manager Elvire Mathieu. “We saw this particularly during Covid when children and healthcare staff were using hydroalcoholic gels very regularly,” she said. “The consequences for their skin were disastrous: certain fragile populations should not be exposed to dangerous active ingredients and if they use them without precautions this can pose a major risk.”

Hand hygiene is important in all sectors, she says. “People in the medical sector and carers in particular are heavy users of hand hygiene products, and this can cause problems if the product has long-term irritating effects,” said Mathieu. “In some environments there is also the risk of product ingestion, which is particularly dangerous for certain categories of product.”

According to Mathieu, teaching children about hygiene and sanitary risks is essential for educating future generations about the importance of hygiene for long-term health. “In schools it is important to make children aware about the need for hand hygiene, the time they should spend hand washing and the precautions they should take if products irritate their eyes or skin,” she said.

“Posters are a good way of communicating the hand hygiene message in public washrooms. It is also crucial to inform people about the cleaning and hygiene products they use so they can protect themselves from the health risks indicated on the products with pictograms.

“And healthcare staff need to understand the desired frequency of hand hygiene ad how long it should take, while Institutions should seek out safe and sustainable products to protect end users from chemical hazards.”

The company offers training materials to its customers’ sales teams so they can pass this information on to the end user.  Salveco’s plant-based hand hygiene products are said to feature a low concentration of active ingredients and reduce any health risks for the user.

Enhance practices

Despite the well-documented risks associated with contaminated hands it is clear that hand hygiene practices are not consistently being followed by everyone, says Essity’s communications director Jenny Turner.

“However, we should consider the many reasons why people may not adopt hand hygiene,” she said. “People often feel too busy to wash their hands properly and may be deterred by hand hygiene systems that are not intuitive to use. Run-outs of soap and paper towels can also discourage hand washing. And many individuals may not fully understand the importance of hand hygiene or the correct techniques for doing so.”

She believes relevant training and information can significantly enhance people’s hand hygiene practices. “When people are informed about the correct methods and the critical importance of hand hygiene, they are more likely to adhere to those practices,” said Turner.

She says hand hygiene training is particularly crucial in environments where the risk of contamination and infection is high. “These include healthcare settings, schools and the food industry,” she said. “However, it is also beneficial in other public spaces such as offices, gyms and public transport hubs to ensure a broader impact on public health.

“By teaching children good practices at a young age we can help to instil lifelong habits. When children learn the importance of washing their hands properly they are more likely to continue these practices into adulthood.”

Effective hand hygiene education can take various forms, according to Turner. “Engaging and informative materials will teach schoolchildren the importance of hand hygiene, while comprehensive training programmes will reinforce proper hand hygiene techniques for healthcare staff,” she said. “And posters and stickers placed in strategic locations in public washrooms provide visual reminders that encourage good practices.”

Habit forming

Tork offers a range of hand hygiene training and informational aids including Tork VR Clean Hands Training, an interactive virtual reality experience for healthcare settings, and Tork Ella and Max hand hygiene trainings which are designed to teach children the importance of proper hand washing through fun and educational activities. The company also offers educational posters and stickers that can be used with the new Tork Signage Holder.

According to Turner, it is not sufficient to simply tell people that hand hygiene is important in order to cause a behavioural change. “Significant change can only be produced with the aid of a deliberate programme combining several elements including the right tools for the task; education on the need for hand hygiene and visual reminders,” she said. “A new habit takes time to form, and needs to be continually reinforced.”