Hand Washing Use Research Articles

Changes in complacency to adherence to COVID-19 preventive behavioral measures and mental health after COVID-19 vaccination among medical and dental healthcare professionals

ABSTRACT Medical and dental professionals should continue to adhere to preventive measures after COVID-19 vaccination due to their increased risk of exposure to the virus, particularly as new variants emerge that may heighten their risk perception and susceptibility. Therefore, this study aimed to explore the effects of COVID-19 vaccination on complacency to adherence to COVID-19 preventive behavioral measures and mental health among medical and dental professionals. In this cross-sectional study 410 medical and dental professionals were recruited from different medical and dental hospitals in Islamabad, Pakistan. The data was collected using a valid and reliable questionnaire comprising of three sections (socio-demographic, information of preventive behaviors performance against COVID-19 after vaccination, mental health status). A chi-square test and ordinal logistic regression were used for analysis. Post COVID-19 vaccination there was decrease in the frequency of use of hand washing, sanitizers (70.2%), and social distancing (60.5%), however greeting with a handshake (58.8%) and use of public transport (45.9%) seen upward trend among participants. Only face mask usage post-vaccination was statistically significant (p < .05) in association with age, marital status, and years of working Experience. The greatest decrease in the usage of masks after COVID-19 vaccination was seen in age group of 10–30 (41.7%) and working experience group of 0–5 years (39.7%). All the preventive behaviors are statistically significant (p < .05) associated with the mental status of the participants except online shopping and use of public transport. These results indicate the presence of vaccination-induced complacency in adherence to COVID-19 preventive behavioral measures among healthcare professionals.

Evaluation of Community Empowerment in Hand Washing Use Soap (CTPS)

Behavior Washing your hands with soap (CTPS) using running water can protect yourself and others from infectious diseases. The proportion of good and correct CTPS behavior in Indonesia is still low. Community empowerment is one strategy to improve community behavior in CTPS. The aim of the research is to evaluate the community empowerment program in CTPS. This type of research is descriptive with survey methods. The aspects evaluated include aspectsinput, proses, and output based on a societal perspective. The population is all managers of facility installation locations, namely 10 units and households who live in Baturraden District. The research sample was all facility installation site managers and 200 heads of households. Data collection techniques through observation and interviews. Observations were carried out on 10 installed facilities. Interviews with facility managers cover aspects of input, process and output from the results of the installation of facilities, while interviews with heads of households relate to the use of facilities. The collected data is then processed and displayed in the form of tables and narratives. Evaluation of community empowerment in CTPS in Baturraden District based on: 1) The input aspect shows that there is no budget and operational officers; 2) The process aspect shows that soap and soap are not available tissue/ drying rags and the community has not been involved in maintaining/maintaining the facilities; 3) The output aspect shows that facilities that are still functioning well do not meet the requirements. Based on the perspective of the community using CTPS, it shows that most of the facilities are dirty, soap is not availabletissue/clean rag. Budget limitations and the absence of operational officers have caused CTPS facilities to not function and not meet the requirements, resulting in the community not using the facilities optimally.

Is Personal Protective Equipment Worth the Hassle? Annual Risk of Cryptosporidiosis to Dairy Farmers and How Personal Protective Equipment and Handwashing Can Mitigate It.

Cows are known carriers of Cryptosporidium parvum (C. parvum), a protozoa that can cause the gastrointestinal illness cryptosporidiosis in humans. Despite this potential exposure, dairy farmers tend to wear personal protective equipment (PPE) to protect the milk from contamination, rather than to protect themselves from zoonotic diseases, such as cryptosporidiosis. In this study, cow feces were collected from individual cattle on dairy farms and analyzed for C. parvum using qPCR. Quantitative microbial risk assessment (QMRA) was used to determine the risk of cryptosporidiosis to the dairy farmer with and without the use of handwashing and PPE (gloves and masks). The annualized risk of cryptosporidiosis to dairy farmers was 29.08% but was reduced significantly in each of the three interventions. Among the individual interventions, glove use provided the greatest reduction in risk, bringing the annual risk of cryptosporidiosis to 4.82%. Implementing regular handwashing, the use of gloves and a mask brought the annual risk of cryptosporidiosis to 1.29%. This study provides evidence that handwashing and PPE use can significantly reduce the risk of cryptosporidiosis to farmers and is worth implementing despite potential barriers such as discomfort and cost.

Students’ hand contamination before and after a training shift: relationship with self-reported hand hygiene adherence

BACKGROUND: Our objective was to measure hand bacterial contamination in a group of nursing and medical Italian students attending clinical wards for practical training, in order to verify the reliability of the information on hand hygiene (HH) adherence obtained by a self-reporting questionnaire. This questionnaire was administered with the aim to explore the effectiveness of basic education.&#x0D; METHODS: An anonymous questionnaire designed to investigate HH knowledge and practices was administered to a convenience sample of 100 nursing and 100 medical students. Data collected were combined with hand bacterial contamination measured both at the entry and the exit from the ward.&#x0D; RESULTS: HH practices and knowledge were significantly higher in nursing compared to medical students.. The most effective procedure in reducing bacterial contamination was the alternate use of handwashing and handrubbing compared to only one practice and the absence of hand hygiene (geom. mean: 180.3, 410.2 and 907.4 CFU/hand respectively, p&lt;0.001).&#x0D; Hand contamination was significantly higher in students who declared to hardly ever/never implement HH teaching during clinical practice compared to those who stated to have done it frequently/always (geom. mean: 716 vs 277.1 CFU/hand, p&lt;0.02).&#x0D; CONCLUSION: Our investigation adds something new to the topic of HH that is the measure of bacterial hand contamination to verify the reliability of the information obtained by questionnaire. The findings, pointing out some critical aspects in the HH teaching among healthcare students, highlight that solid knowledge results into correct behaviors, and consequently into a reduction of hand contamination.

Common communicable diseases in the general population in France during the COVID-19 pandemic.

In France, social distancing measures have been adopted to contain the spread of COVID-19, culminating in national Lockdowns. The use of hand washing, hydro-alcoholic rubs and mask-wearing also increased over time. As these measures are likely to impact the transmission of many communicable diseases, we studied the changes in common infectious diseases incidence in France during the first year of COVID-19 circulation. We examined the weekly incidence of acute gastroenteritis, chickenpox, acute respiratory infections and bronchiolitis reported in general practitioner networks since January 2016. We obtained search engine query volume for French terms related to these diseases and sales data for relevant drugs over the same period. A periodic regression model was fit to disease incidence, drug sales and search query volume before the COVID-19 period and extrapolated afterwards. We compared the expected values with observations made in 2020. During the first lockdown period, incidence dropped by 67% for gastroenteritis, by 79% for bronchiolitis, by 49% for acute respiratory infection and 90% for chickenpox compared to the past years. Reductions with respect to the expected incidence reflected the strength of implemented measures. Incidence in children was impacted the most. Reduction in primary care consultations dropped during a short period at the beginning of the first lockdown period but remained more than 95% of the expected value afterwards. In primary care, the large decrease in reported gastroenteritis, chickenpox or bronchiolitis observed during the period where many barrier measures were implemented imply that the circulation of common viruses was reduced and informs on the overall effect of these measures.

Do facemasks protect against COVID-19?

Respiratory viruses like coronaviruses and influenza infect us through inhaling droplets or by touching contaminated surfaces then rubbing our nose, mouth or eyes. Virus can spread further in an aerosol if an infected patient is subjected to an aerosol-generating procedure such as a nebuliser or mechanical ventilation. There are two major classes of facemask: medical/surgical masks are loose-fitting, disposable masks that filter out droplets, while tight-fitting N95 or P2 respirator masks are designed to be more effective filters of airborne particles. N95/P2 masks are more expensive. Both surgical and N95 masks may become a scarce resource. Evidence on the efficacy of masks is confounded by whether or not they are being used in a pandemic; whether by health-care workers or the public, and by the concomitant use of hand-washing, social distancing and other personal protective equipment. A meta-analysis of randomised controlled trials of pre-COVID-19 showed that surgical masks or N95 respirators reduced clinical respiratory illness in health-care workers by 41% and influenza-like illness by 66%: they work but are far from perfect.1 N95 masks were not statistically better than surgical masks in preventing proven influenza,2 nor in preventing COVID-19, although the latter is based on weak data.3 N95 masks are more efficient filters of small particles, but these findings suggest it is reasonable to recommend that health-care workers use surgical masks when there is risk of droplet spread and reserve precious N95 masks for health-care workers performing aerosol-generating procedures. Some health-care and ancillary hospital staff have mooted wearing surgical facemasks all the time even when asymptomatic to protect themselves and patients.4 However, given the current low and declining transmission within the Australian community, the risk of a health worker inadvertently catching or spreading the infection if not wearing a mask is very low. Symptomatic health-care workers should not return to work until they have been tested and found to be negative for COVID-19. The public might wear masks to avoid infection or to protect others. During the 2009 pandemic of H1N1 influenza (swine flu), encouraging the public to wash their hands reduced the incidence of infection significantly whereas wearing facemasks did not.5 There is no good evidence that facemasks protect the public against infection with respiratory viruses, including COVID-19.6 However, absence of proof of an effect is not the same as proof of absence of an effect. During the pandemics caused by swine flu and by the coronaviruses which caused SARS and MERS, many people in Asia and elsewhere walked around wearing surgical or homemade cotton masks to protect themselves. One danger of doing this is the illusion of protection. Surgical facemasks are designed to be discarded after single use. As they become moist they become porous and no longer protect. Indeed, experiments have shown that surgical and cotton masks do not trap the SARS-CoV-2 (COVID-19) virus, which can be detected on the outer surface of the masks for up to 7 days.7, 8 Thus, a pre-symptomatic or mildly infected person wearing a facemask for hours without changing it and without washing hands every time they touched the mask could paradoxically increase the risk of infecting others. Because the USA is in a desperate situation, their Centers for Disease Control has recommended the public wear homemade cloth masks. This was essentially done in an effort to try and reduce community transmission, especially from people who may not perceive themselves to be symptomatic, rather than to protect the wearer, although the evidence for this is scant. In contrast, the World Health Organization currently recommends against the public routinely wearing facemasks. In Australia and New Zealand currently, the questionable benefits arguably do not justify health-care staff wearing surgical masks when treating low-risk patients and may impede the normal caring relationship between patients, parents and staff. We counsel against such practice, at least at present.

Lessons Learned and Future Directions

Lessons Learned and Future Directions

Perceptions and behaviors related to hand hygiene for the prevention of H1N1 influenza transmission among Korean university students during the peak pandemic period

BackgroundThis study was performed to better assess the perceptions, motivating factors, and behaviors associated with the use of hand washing to prevent H1N1 influenza transmission during the peak pandemic period in Korea.MethodsA cross-sectional survey questionnaire was completed by 942 students at a university campus in Suwon, Korea, between December 1 and 8, 2009. The survey included questions regarding individual perceptions, motivating factors, and behaviors associated with hand washing for the prevention of H1N1 influenza transmission.ResultsCompared to one year prior, 30.3% of participants reported increasing their hand washing frequency. Female students were more likely to practice more frequent hand washing. Women also perceived the effectiveness of hand washing to be lower, and illness severity and personal susceptibility to H1N1 infection to be higher. Study participants who were female (OR: 1.79-3.90) who perceived of hand washing to be effective (OR: 1.34-12.15) and illness severity to be greater (OR: 1.00-3.12) washed their hands more frequently.ConclusionsKorean students increased their frequency of hand hygiene practices during the pandemic, with significant gender differences existing in the attitudes and behaviors related to the use of hand hygiene as a means of disease prevention. Here, the factors that affected hand washing behavior were similar to those identified at the beginning of the H1N1 or SARS pandemics, suggesting that public education campaigns regarding hand hygiene are effective in altering individual hand hygiene habits during the peak periods of influenza transmission.

Cochrane review: Hand washing for preventing diarrhoea

AbstractBackgroundDiarrhoea is a common cause of morbidity and a leading cause of death among children aged less than five years, particularly in low‐ and middle‐income countries. It is transmitted by ingesting contaminated food or drink, by direct person‐to‐person contact, or from contaminated hands. Hand washing is one of a range of hygiene promotion interventions that can interrupt the transmission of diarrhoea‐causing pathogens.ObjectivesTo evaluate the effects of interventions to promote hand washing on diarrhoeal episodes in children and adults.Search strategyIn May 2007, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2007, Issue 2), MEDLINE, EMBASE, LILACS, PsycINFO, Science Citation Index and Social Science Citation Index, ERIC, SPECTR, Bibliomap, RoRe, The Grey Literature, and reference lists of articles. We also contacted researchers and organizations in the field.Selection criteriaRandomized controlled trials, where the unit of randomization is an institution (eg day‐care centre), household, or community, that compared interventions to promote hand washing or a hygiene promotion that included hand washing with no intervention to promote hand washing.Data collection and analysisTwo authors independently assessed trial eligibility and risk of bias. We stratified the analyses for cluster adjusted and non‐adjusted trials. Where appropriate, incidence rate ratios (IRR) were pooled using the generic inverse variance method and random‐effects model with 95% confidence intervals (CI).Main resultsFourteen randomized controlled trials met the inclusion criteria. Eight trials were institution‐based in high‐income countries, five were community‐based in low or middle‐income countries, and one was in a high‐risk group (people with acquired immune deficiency syndrome (AIDS)). Considering only trial results that adjusted for cluster randomization, interventions promoting hand washing resulted in a 39% reduction in diarrhoea episodes in children in institutions in high‐income countries (IRR 0.61, 95% CI 0.40 to 0.92; 2 trials) and a 32% reduction in such episodes in children living in communities in low‐ or middle‐income countries (IRR 0.68, 95% CI 0.52 to 0.90; 4 trials).Authors' conclusionsInterventions that promote hand washing can reduce diarrhoea episodes by about one‐third. This significant reduction is comparable to the effect of providing clean water in low‐income areas. However, trials with longer follow up and that test different methods of promoting hand washing are needed.Plain Language SummaryStrategies to encourage hand washing can reduce the incidence of diarrhoea by about one thirdDiarrhoea is a serious global public health problem, particularly in low‐income and middle‐income countries. The World Health Organization estimates that over three million episodes occur each year, with many people dying, especially children aged less than five years in low‐ and middle‐income countries. Persistent diarrhoea can also contribute to malnutrition, reduced resistance to infections, and sometimes impaired growth and development. The organisms causing diarrhoea can be transmitted from infected faeces to people through food and water, person‐to‐person contact, or direct contact. Hand washing after defecation and handling faeces, and before preparing and eating food can reduce the risk of diarrhoea. This review looked at trials of interventions to increase the use of hand washing in institutions in high‐income countries and in communities in low‐ or middle‐income countries, and found many of the interventions like educational programmes, leaflets, and discussions to be effective.

Occupationally acquired infections among health care workers: Respiratory diseases

ZusammenfassungEinführungMitarbeiter im Gesundheitswesen haben aufgrund ihrer Tätigkeit ein erhöhtes Infektionsrisiko gegenüber aerogen übertragbaren Erkrankungen. Zahlreiche Todesfälle sind im internationalen Umfeld beschrieben worden. Exemplarisch seien in diesem Kontext die Todesfälle während der SARS-Epidemie sowie Todesfälle durch Influenza genannt.Methoden und ErgebnisseSelektive Literaturaufarbeitung der Autoren zu potenziell aerogen übertragbaren Erregern wie SARS-Coronavirus, Influenzavirus, Parainfluenzavirus, RSV, Adenovirus, Tuberkulose sowie Pertussis. Die Literaturrecherche zeigt, dass sowohl durch persönliche Schutzmaßnahmen (z.B. Händehygiene, Tragen von Atemschutz) als auch durch Impfungen (sofern verfügbar) die Infektionsgefährdung der Mitarbeiter reduziert werden kann.DiskussionDas Risiko arbeitsbedingter Infektionen ist mitunter ein täglicher Bestandteil der Arbeit der Beschäftigten im Gesundheitswesen. Aus arbeitsmedizinischer und infektiologischer Sicht sollten Maßnahmen ergriffen werden, um den bestmöglichen Schutz der betroffenen Mitarbeiter zu gewährleisten. Dies ist gerade vor dem Hintergrund einer etwaigen Pandemie (z.B. Influenzapandemie) dringend erforderlich.

Risk and management of blood-borne infections in health care workers.

Exposure to blood-borne pathogens poses a serious risk to health care workers (HCWs). We review the risk and management of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recommendations for postexposure prophylaxis. In the health care setting, blood-borne pathogen transmission occurs predominantly by percutaneous or mucosal exposure of workers to the blood or body fluids of infected patients. Prospective studies of HCWs have estimated that the average risk for HIV transmission after a percutaneous exposure is approximately 0.3%, the risk of HBV transmission is 6 to 30%, and the risk of HCV transmission is approximately 1.8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in place a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place a worker at risk of blood-borne pathogen infection. A sustained commitment to the occupational health of all HCWs will ensure maximum protection for HCWs and patients and the availability of optimal medical care for all who need it.

Risk and Management of Blood-Borne Infections in Health Care Workers

Exposure to blood-borne pathogens poses a serious risk to health care workers (HCWs). We review the risk and management of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recommendations for postexposure prophylaxis. In the health care setting, blood-borne pathogen transmission occurs predominantly by percutaneous or mucosal exposure of workers to the blood or body fluids of infected patients. Prospective studies of HCWs have estimated that the average risk for HIV transmission after a percutaneous exposure is approximately 0.3%, the risk of HBV transmission is 6 to 30%, and the risk of HCV transmission is approximately 1.8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in place a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place a worker at risk of blood-borne pathogen infection. A sustained commitment to the occupational health of all HCWs will ensure maximum protection for HCWs and patients and the availability of optimal medical care for all who need it.

Compliance with universal precautions in a medical practice with a high rate of HIV infection.

Universal precautions have been recommended to limit occupational exposure to the human immunodeficiency virus (HIV) and other infectious agents, but whether these recommendations have been incorporated into routine practice has not been demonstrated. Using a one-group, before-after design, we assessed the knowledge and attitudes concerning universal precautions and the level of compliance with these recommendations. The health care professionals had various levels of training and worked in an ambulatory practice with a high rate of HIV. A total of 195 procedures involving potential exposure to various body fluids were observed. No improvement in compliance with recommended precautions was observed following a didactic educational program for either latex glove use (44 percent versus 49 percent, chi 2 less than 1, P greater than 0.2) or appropriate use of hand washing (34 percent versus 47 percent, chi 2 = 3.38, P = 0.07). Faculty demonstrated the lowest levels of adherence to universal precautions. While knowledge of precautions was high, staff members at all levels overestimated their own compliance with these recommendations. Although the number of observations limits the conclusions, the results suggest that the basic protective measures included in universal precautions are not being routinely applied in ambulatory medical practice. Furthermore, didactic educational programs might not be sufficient to improve compliance. Finally, faculty in training programs should monitor their own compliance with universal precautions because of their responsibilities as role models for physicians in training.