Hand Hygiene: History and Its Importance

Hand hygiene. Whether or not we choose to participate in the necessary steps to achieve cleanly hands, we are all very aware of the importance and consequences. Now imagine that you do not know anything about hand hygiene. You go about your day without ever once washing your hands let alone thinking about it. This is how life used to be.

Enter Ignaz Philipp Semmelweis. Semmelweis, a Hungarian physician, is known today as an early pioneer of antiseptic procedures. He discovered that childbed fever (or puerperal fever), a bacterial infection which affects women during childbirth, could be drastically reduced by the use of hand disinfection.

Childbed fever was common in mid-19th-century hospitals and often fatal. In 1847 while working in Vienna General Hospital's First Obstetrical Clinic, Semmelweis was troubled that the doctors' wards had three times the mortality rates of midwives' wards. It was unknown as to why there were so many occurrences of childbed fever in the doctors' ward. Semmelweis set out to study childbed fever by recreating the same conditions in both wards. Despite harvesting identical conditions, the doctors' ward remained a truly deadly problem. Semmelweis was puzzled by his findings until he realized that childbed fever may be caused by a factor outside of the hospital.

Semmelweis theorized that childbed fever was being brought into the clinic by microscopic particles on the hands of doctors who were in contact with dead bodies, ill people in other parts of the hospital, and other doctors who had contact with both. He published a book of his findings, Etiology, Concept and Prophylaxis of Childbed Fever.

Doctors were coming into contact with something that midwives were not. Germs.

Semmelweis began a campaign for hand washing in the clinics. Although he showed that hand-washing reduced mortality to below 1%, Semmelweis's observations were not accepted and received harsh criticism. His theory went against the current scientific opinion, which blamed diseases on an imbalance of the basic "humours" in the body. Some doctors were even offended at the suggestion that they should wash their hands. Because Semmelweis couldn't completely explain his theory and because there was no proof of germs in 1847, his recommendations were ignored. As he got older and continued to support germ theory, he was seen as crazy.

Semmelweis began acting erratically. He began to display symptoms today we might call "germ-phobia" or even O.C.D and ultimately suffered a nervous breakdown. He was committed to an insane asylum at the age of 47. Semmelweis died of blood poisoning within months of entering the asylum.

Years after his death, Semmelweis' practice earned widespread acceptance after Louis Pasteur confirmed the germ theory, which proposes that microorganisms are the cause of many diseases.

Hand Sanitizer Facts

• Consumer alcohol-based hand sanitizers and health care hand alcohol or alcohol hand antiseptic agents are antiseptic products used to avoid transmission of pathogens. They come in liquid, foam, and easy-flowing gel formulations. The alcohol level varies between 60% and 85%. The most commonly used level is 62%.


• The alcohol is what effectively destroys the microorganisms that live on the skin, especially under the fingernails, and webs between the fingers. Rubbing a few drops of sanitizer on the hand thoroughly for about 30 seconds is known to eliminate bacteria and viruses. The hand sanitizer should not be washed off, but should dry on its own. Many hand sanitizer products claim they can destroy up to 99.99 percent of bacteria.


• When hands are not visibly dirty, the United States Centers for Disease Control and Prevention and many other world public health authorities recommend alcohol hand sanitizers as an acceptable alternative to soap and water.


• The Centers for Disease Control says the most important way to prevent the transmission of dangerous diseases is to frequently wash your hands with soap and water or use a hand sanitizer. Hand sanitizers kill many different kinds of bacteria, including antibiotic resistant bacteria and TB bacteria. Hand sanitizer also has high viricidal activity against many different kinds of viruses, including enveloped viruses such as the flu virus.