Women's hands are dirtier than men's, southerners' are cleaner than
northerners'. We look at the dirty truth behind the nation's hygiene
the toilets of a service station, at an undisclosed location along a
motorway in middle England, Dr Val Curtis is waging a one-woman war on
Britain's filthy hands.
As weary travellers flush, zip and button, an electronic message board
on the wall flashes: “Washing hands with soap avoids disease... Is the
person next to you washing with soap?”
The amount of soap used in any given period is measured by sensors on
the dispensers and, when compared with the number of people that enter
the washrooms in the same time, gives a depres- singly accurate
picture of modern Britain's slovenliness.
Curtis, the director of the Hygiene Centre at the University of
London, a co-founder of the Global Partnership for Handwashing with
Soap, and all-round hand-washing aficionado, has not collated the
final results yet. But even the most disgusting electronic message she
could think of, “Soap it off or eat it later”, has failed to elicit a
scrum for the soap. “I think what we need to do next is put up a
poster with a big photo of poo on it,” she sighs.
Two years ago, the United Nations declared 2008 to be the
International Year of Sanitation. Britain, a nation that has produced
sanitation visionaries such as John Snow, who proved that cholera was
spread by water, and Edwin Chadwick, who conceived of sewage disposal
and piping water into homes, should have been leading the way.
Instead, our hands have remained decidedly dirty.
Last month, on Global Handwashing day no less, Dr Curtis caused a stir
when she did a swab test of commuters' hands in London, Cardiff,
Birmingham Liverpool and Newcastle. The results appeared to show that
northerners' hands were dirtier than those of southerners. But beyond
the geographic hyperbole, the survey had much more worrying
implications than a few angry Geordies. Averaged out, the figures
showed that more than one in four Britons had faecal matter on their
hands - no matter where they came from. And while the number of men
with dirty hands varied between the North and the South, the number of
women, often the family food preparers and child carers, remained
constant at a startling 30 per cent.
An earlier study carried out by Curtis in Huddersfield, West
Yorkshire, found that just 43 per cent of mothers washed their hands
after changing their baby's nappy. “We all wash our hands in
principle, but in practice, we've all got an excuse,” says Curtis.
According to John Oxford, a professor of virology and the chairman of
the UK Hygiene Council, just half the UK population has an
understanding of the importance of hand hygiene and too many do not
put their knowledge into action. “Hygiene has not been high on the
agenda,” Oxford says. “You say you're a professor of hygiene and
people tend to think that you're the man who cleans the toilets.”
In an international study of seven countries conducted by the Hygiene
Council in May, the UK was found to be the third worst nation for
germs after India and Malaysia. The study, which also included Saudi
Arabia, South Africa, Germany and the US, found 33 per cent of
surfaces in British homes covered in E. coli, faecal matter and other
dangerous pathogens spread by dirty hands.
“Most people we interviewed in the UK did not appreciate that we can
catch diseases from our hands,” says Oxford. “They didn't realise that
hands had anything to do with it.”
But hands have everything to do with it. Research carried out this
month in America found that an average hand is home to 150 species of
bacteria - comparable to, or even more than are found in the mouth,
oesophagus and lower intestine. And womens' hands were found to have
50 per cent more varieties than men due to skin acidity, hormones and
hand cream.
The majority of these organisms are harmless; others are not.
Britain's 12 million annual cases of norovirus and gastroenteritis,
causing projectile vomiting and diarrhoea, the MRSA epidemic in
hospitals last winter, and an outbreak of E. coli in Scotland the year
before are all down to pathogens on dirty hands.
It is estimated that most of the 120 million common colds contracted
each year in the UK are also caused by viruses spread by hands (See Dr
Thomas Stuttaford, page 15).
The average child misses one week of school a year due to communicable
ill- nesses such as these. In the UK, this equates to an annual 36
million days lost to absenteeism. But the Hygiene Council has found
that good hand-washing practices and ready access to the hand
sanitiser in school can reduce this figure by almost 50 per cent.
Absentee numbers have plummeted at one school, George Watson's
College, in Edinburgh after it introduced mandatory hospital-style
handwashing for all its pupils in January.
“The bugs that make us sick come from the toilet,” says Curtis. “And
the point after going to the toilet when you don't wash your hands is
the superhighway moment.”
The germs spread to hotspots such as door handles, light switches,
remote controls, basin taps and telephones where other people pick
them up. Or a person will infect themselves by putting their fingers
in their mouth or rubbing their eyes or nose. Once a bug is inside a
person, it will “multiply like crazy and then pump out by the billion
at the other end”, says Curtis. A stool from an infected person
contains ten billion pathogenic microbes, many of which rise into the
air to continue the cycle.
The solution should be simple. Hygiene is cheap soap and water, the
experts say, still the most effective method of hand washing. “Hygiene
is self-empowering,” says Oxford. “People don't need an expert like me
next to them. They can do something about hygiene themselves.”
Guidance issued by the Centre for Disease Control in Atlanta in the US
says that a person should sing Happy Birthday twice as they wash their
hands. Coughs and sneezes should be directed into elbows rather than
hands.
But Curtis believes that the problem of Britain's dirty hands is more
complex. “Disgust is a ‘gene' that evolved in our animal ancestors to
help us survive and avoid infection,” she says. And out of disgust
came hygiene: there is evidence that neanderthals used seashell
tweezers to pluck hairs and remove skin parasites, and that woman used
the residue of animal fat and ash from roast meat to remove stains.
“A caveman would go to the loo in a field, see and smell what they had
done and be disgusted by it, so they would be sure to wipe their hands
after,” says Curtis. “Now we live in this beautiful, pristine
environment with white tiles on the wall and we do everything to make
our poo invisible and unsmellable. We're not feeling the same sense of
contamination.”
Our hands are dirty, Curtis concludes, because our toilets are simply
too clean.
Germ warfare: the facts
100,000: Average number of bacteria found on one square inch of
healthy skin
1,000,000: Number of lives that could be saved in the world each year
if everyone washed their hands with soap
One in four: The proportion of British kitchen cloths that harbour the
E. coli virus, an indicator of faecal contamination
Two hours: Length of time that some bacteria can remain alive on
surfaces after being deposited by hands
20 seconds: The length of time hands should be washed with soap and
warm water
30: Number of years added to our average life expectancy in the past
century through advances in hygiene
