Australia’s hand washing report card: who washes and why it matters

Do you wash your hands every time you go to the toilet? And do you do it before you start preparing food? Be honest.

Australia’s Food Safety Information Council has published its latest report card on national hand washing habits. According to the findings, 19% of Australians do not wash their hands every time they use the toilet. Nearly half (42%) also concede they do not always wash their hands before handling food.

That raises an obvious question: who is getting hand hygiene right, who is falling short - and why does it matter?

What did the report find?

For this report, researchers asked 1,229 people about their hand washing practices. The results broadly match what previous surveys have shown.

Women again reported slightly better habits than men when it comes to washing hands after using the toilet (80% of men said they wash every time, compared with 83% of women). The gap was wider for washing hands before touching food: 55% of men said they do this, versus 62% of women.

Age appeared to be linked with behaviour too. Among people under 34, 69% said they washed their hands every time they used the toilet. For those aged over 65, the figure rose to 86%.

While some patterns are not surprising - including the difference between men’s and women’s hand washing habits - the underlying reasons are still not well understood.

Why don't people wash their hands?

Public health campaigns often explain the right technique for washing hands. What is less commonly examined is how consistently people adopt those behaviours in everyday life - and, importantly, why some people are still skipping soap and water, which may suggest the messages are not cutting through.

One study exploring this issue in India asked schoolchildren what stopped them from washing their hands. Most participants (91%) reported low "illness threat perception". Put simply, they did not feel they were at risk of becoming unwell if they failed to wash their hands after using the toilet.

Not being able to see germs was another major barrier: 46% of children mentioned it. At the same time, social influence mattered - 72% said they would wash their hands if their friends did.

It is easy to assume these explanations apply to other groups as well, but there is not enough evidence to be sure. The reasons people do (or do not) wash their hands are likely to change throughout life and depending on circumstances.

What are the risks?

Urine and faeces contain huge numbers of germs - particularly faeces, which contains more than 100 billion germs per gram.

Using the toilet involves touching surfaces in the bathroom, which means you can pick up germs. If you then leave without washing your hands, you can carry those germs out with you and leave them behind on every surface you touch afterwards.

You might not become ill yourself, but you will contribute to the spread of bacteria. That, in turn, increases the risk of infection and illness for others - including people with weakened immune systems, such as older adults and those receiving common forms of cancer treatment.

Washing hands before cooking and eating matters as well, and the risk runs in both directions. If you have disease-causing germs on your hands (perhaps because you did not wash after the toilet), you can transfer them to food. There, they may multiply and may even produce toxins. Anyone who eats the food could then become unwell, often with vomiting and diarrhoea.

Conversely, some foods naturally carry germs before cooking - for example salmonella and campylobacter bacteria in raw poultry. If you do not wash your hands after handling these foods, you can spread germs to other surfaces and increase the risk of infection.

How should I wash my hands?

Use these three straightforward tips to wash your hands properly:

1. Wet your hands, then rub them together to build a good lather with soap for at least 20 seconds. Remember to clean between your fingers and under your nails - you may need to use a nail brush.
2. Rinse thoroughly under running water so the bugs are washed off.
3. Dry your hands completely using a clean towel for at least 20 seconds. Touching surfaces with damp hands makes it easier for bugs to move from the surface to your skin.

What about hand sanitiser?

When running water is not available, an alcohol-based hand sanitiser can be used instead. These products quickly inactivate a broad range of germs, making them non-infectious. Hand sanitisers work against many bacteria and viruses responsible for common gastrointestinal and respiratory infections.

But they are not effective if your hands are dirty with organic matter - such as blood, faeces, meat, sand or soil. In those situations, you should wash with soap and water.

The bottom line

Hand washing is similar to wearing a seat belt - you do it every time you get into a car, not only on the days you "plan" to have an accident. The point is that hand washing is a simple, fast step that protects you and the people around you - but only if you actually do it.

Christine Carson, Senior Research Fellow, School of Medicine, The University of Western Australia

This article is republished from The Conversation under a Creative Commons licence. Read the original article.