Hand Washing Quality among Biosafety Level 2 Research Laboratory Workers

Abstract

Soap and water hand washing (HW) is recommended as the standard microbiological practice for removing transient microbes from laboratory workers' hands. The effectiveness of HW in preventing pathogen transmission depends largely on the technique used by the individual, but little is known about laboratory workers' compliance with recommended HW protocols. This study evaluated the quality of HW performed by research workers (N = 93) in 21 biosafety level 2 (BSL-2) laboratories at a large university. Study personnel measured the quality of workers' HW by direct observation while subjects performed their regularly assigned work tasks. Five HW quality indicators as well as hand and wrist jewelry use were measured using an existing tool designed for use in the healthcare setting and modified for this study. A total of 49 soap and water washes were measured during 118 hours of observation. Duration of scrubbing was 9 seconds or less in 41 (84%) cases. Soap was used in 45 (92%) washes, but in 25 (51%) cases where soap was used, lathering was not visible to the observer. Subjects covered dorsal, wrist, palm, and interdigital areas as recommended in only 16 (33%) cases. In 29 (59%) HW events subjects turned off the faucet with bare hands. Hand or wrist jewelry was worn by 60 (65%) participants while in the containment lab. In this study, four of five HW quality indicators were poorly performed. Poor quality HW may result in low reductions of transient pathogens on workers' hands, and may explain many laboratory-associated infections where the route of transmission is otherwise unknown.