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Lifestyle

Pandemic washout

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It’s yucky that there are still all kinds of people out there who don’t wash their hands after they go to the bathroom.

You don’t need to look far for the evidence, like signs all over the place in public washrooms practically begging people to scrub their damn hands, and big posters on the TTC, part of a campaign launched by the Ontario Ministry of Health and Long-Term Care.

Folks don’t always admit it, though. Studies usually show that more people claim to wash their hands than actually do.

On the other end of the spectrum, I’ve got some pals who wonder of they aren’t washing just a bit too often and behaving a little irrationally, avoiding touching things like doorknobs and the handles of grocery carts.

At what point does it go from sensible caution to obsessive compulsive?

What the experts say

“The most sensitive areas are your mucous membranes, your eyes, nose and mouth. That’s how 95 per cent of illnesses, including respiratory illnesses, enter your body. What wasn’t reported about the 1918 flu pandemic was the health-risk behaviours of those people who were nose pickers, eye rubbers, teeth pickers, thumbsuckers. That’s how the pandemic was perpetuated. There are four priniciples of hand awareness, of which one is washing. The other three are: Do not cough into your hands. Do not sneeze into your hands. And do not put your hands in your eyes, nose or mouth. The Centers for Disease Control (CDC) has recently started endorsing these guidelines, but you very rarely hear them publicly promoted as primary prevention. You hear prevention for flu particularly promoted as “get the vaccine,” but that is a secondary prevention. If we simply taught people to wash regularly and keep their fingers out of their eyes, nose and mouth, there would be no pandemics.”

DR. WILL SAWYER, family physician, founder of the Henry the Hand Foundation, Cincinatti, Ohio

“Getting people to clean their hands when they’re supposed to is a problem that’s been around for decades, so expecting a big difference in one or two years is unrealistic. The hand hygiene guideline published by the CDC recommends that health care facilities offer alcohol-based hand sanitizers. It takes less time to clean your hands with the sanitizers, and they have been shown in a number of studies to be more effective than soap and water. But just providing health care workers with the sanitizers in and of itself will probably not improve hygiene practices. Its best to do some kind of monitoring.

JOHN BOYCE, chief of infectious diseases division, St. Raphael Hospital, New Haven, Connecticut

“As far as what you can catch and where, it’s incredibly varied. Throughout the day we are all constantly using our hands, constantly touching things in our environment and subsequently touching our eyes, nose and mouth. Hands are a common element in the transmission of many diseases, including the common cold, influenza and many food-borne diseases. A perfect example is the norovirus, which is suspected of causing gastrointestinal outbreaks on cruise ships. When we use the bathroom, our hands can come in contact with urine or fecal matter and become a mode of transmission for disease-causing microbes.

JIM SLIWA, office of communications, American Society for Microbiology, Washington, DC

“The essential features we look for in obsessive-compulsive disorder (OCD) are intrusive or unwanted thoughts, images or impulses or rituals of repetitive acts people engage in to deal with their anxieties. When people wash their hands because of OCD, they will often describe unwanted thoughts of things being contaminated, even though they know better. It’s different from someone who is a clean freak, likes everything meticulous and is happy to be that way. The hallmark of OCD is knowing better but feeling compelled to do it anyway.”

PEGGY RICHTER, staff psychiatrist, Centre for Addiction and Mental Health, professor of psychiatry, U of T

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