Jo Waters June 23, 2017

When there are nasty stomach bugs doing the rounds, or an outbreak of colds and flu, good hand hygiene is crucial to help you avoid catching or passing on an infection.

Antibacterial gels, alcohol wipes and sprays are marketed as bug-busters that will blitz your hands of dirt and grime. They're handy for when you're out and about and want to clean up after touching something grubby, but can they really be as effective as a good old-fashioned scrub with soap and hot water? What does the science say?

Why soap and water is still best

Experts say soap and water is still the best way to reduce the number of microbes on your hands in the majority of cases. i

Handwashing can stop bugs being transferred by removing any traces of faeces that may be on the hands. A sobering thought for those who skip washing their hands after going to the toilet or changing their child's nappy is that 1g of faeces contains a trillion germs. ii iii

Your hands can also pick up germs from touching objects that have been contaminated by someone who has coughed, sneezed or come into contact with it. Scientists have shown that handwashing can reduce the number of people who get sick with diarrhoea by 30 per cent iv and respiratory illnesses like colds and flu by 16 to 20 per cent. v It's also been shown that soap and water is more effective than hand sanitisers at removing certain bugs which can cause diarrhoeal illness such as the norovirus, vi and Clostridium difficile. vii

When hand sanitisers can be good alternatives

Sometimes it just isn't practical to wash your hands with soap and water, for example if you're bed-bound in hospital, a hospital visitor, living in a developing country where access to clean water is an issue, or you simply can't get to a bathroom. This is when hand sanitisers can be worth a shot.

Experts say hand sanitisers can kill different types of bugs provided enough of the product is used, it's allowed to dry before wiping off, and it contains at least 60 per cent alcohol. viii

What are the limitations of hand sanitisers?

The main problem is people don't apply enough of the liquid or spray and don't allow it to dry before wiping their hands so lose most of the protection. ix x

Another limitation is that some sanitisers don't contain a high enough alcohol concentration xi to kill all bugs - particularly some of the most troublesome ones, such as norovirus, Cryptosporidium and Clostridium difficile. There's also concern that some types may irritate the skin and just reduce the number of bugs on your hands rather than kill them completely.

Some research suggests that hand sanitisers do not remove as many chemicals and pesticides from skin as soap and water, xii so if you work with chemicals it's always a good idea to wash with soap and water rather than use sanitisers.

How to wash your hands

Most of us just don't wash our hands thoroughly and running your hands under a tap without soap followed by a cursory wipe on a towel (that may be contaminated with bacteria) just isn't doing enough to protect yourself.

According to the World Health Organisation (WHO), washing your hands should take as long as singing Happy Birthday twice. xiii

To wash your hands properly:

• Remove rings and bracelets

• Rinse hands under running water, which should be warm if possible

• Lather with soap and cover the skin and nails of the hands and fingers, including in between the fingers and rinse off with running water

• Turn off the tap by using your wrist or elbow

• Dry your hands with a clean paper towel or hand dryer. xiv

Supplements that may protect you against infections

If you want to reduce your risk of picking up an infection, consider taking a vitamin D supplement.

Vitamin D plays an important role in immunity and helps to activate T cells, which are part of the immune system responsible for reacting to, and fighting off, bacteria and viruses. xv A 2016 study found older people in long-term care given high doses of vitamin D3 monthly were 40 per cent less likely to suffer from acute respiratory illnesses. xvi A study published in 2017 in the British Medical Journal xvii found daily or weekly vitamin D supplements halved the risk of respiratory infections in people with the lowest levels of the vitamin. In people who had higher vitamin D levels, supplements cut their risk of an infection by 10 per cent.

A healthy, well-balanced diet full of vitamin C-rich, fruit and vegetables, is important for immunity. One study found that people under short-term extreme physical stress who took vitamin C supplements halved their risk of catching a cold. xviii Vitamin C is also shown to increase white blood cells. xix Good sources of vitamin C include oranges, red and green peppers, strawberries and blackcurrants. Alternatively, take a supplement.

References

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