Years ago, we traveled through Turkey on a bus from Istanbul to Cappadocia (the Turkish equivalent to Yellowstone National Park).1 Along the way, the bus made lots of stops at the Turkish equivalent of truck stops and 7-11 convenience stores. The bathrooms were often short of warm water and soap and had faucet handles you needed to touch to use. I declined to wash my hands under such conditions and used alcohol wipes instead. Ann did wash her hands–with the dubious faucet handles and all. Later in the trip, she got the worst bout of diarrhea that she had ever experienced. For two days she had to stay within fifteen minutes of a toilet at all times and missed the balloon ride (above).
Coincidence? Maybe, maybe not. But most people don’t wash their hands well enough. Normally, not washing your hands properly might only give you diarrhea or something you’ll probably survive, but occasionally you get stories about how people get tapeworms in the brain or hepatitis or norovirus. In any case, even if you “only” get a stomach virus, that’s more than enough incentive to wash your hands better. And as the U.S. Centers for Diseases Control (CDC) puts it:
Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water.
Feces (poop) from people or animals is an important source of germs like Salmonella, E. coli O157, and norovirus that cause diarrhea, and it can spread some respiratory infections like adenovirus and hand-foot-mouth disease. These kinds of germs can get onto hands after people use the toilet or change a diaper, but also in less obvious ways, like after handling raw meats that have invisible amounts of animal poop on them. A single gram of human feces—which is about the weight of a paper clip—can contain one trillion germs. Germs can also get onto hands if people touch any object that has germs on it because someone coughed or sneezed on it or was touched by some other contaminated object. When these germs get onto hands and are not washed off, they can be passed from person to person and make people sick.2
Handwashing with soap removes germs from hands. This helps prevent infections because:
- People frequently touch their eyes, nose, and mouth without even realizing it. Germs can get into the body through the eyes, nose and mouth and make us sick.
- Germs from unwashed hands can get into foods and drinks while people prepare or consume them. Germs can multiply in some types of foods or drinks, under certain conditions, and make people sick.
- Germs from unwashed hands can be transferred to other objects, like handrails, table tops, or toys, and then transferred to another person’s hands.
- Removing germs through handwashing therefore helps prevent diarrhea and respiratory infections and may even help prevent skin and eye infections.
What the CDC doesn’t like telling people (perhaps for fear of grossing you out) is that if you don’t wash your hands, you risk eating poop–either your poop, or someone else’s, or perhaps an animal’s poop. The average person touches his or her face 16 times per hour–sometimes after touching raw food, door knobs coated with germs from coworkers or visitors to your workplace, or subway handles and seats coated with mold and “fecal and skin-borne bacteria resistant to antibiotics,” including strains that can cause “potentially lethal infections.”3 There have been various studies done, like coating people’s hand with dust that glows under ultraviolet light and seeing how much they wash off with their regular handwashing routine (answer: not all of it), but my personal favorite stat is how one in six cell phones has fecal matter on it. As the Briton who co-authored the study put it: “People may claim they wash their hands regularly, but the science shows otherwise.”
So how do you wash your hands properly?
Turn on the faucet to get warm water. (Hot water also works but can damage your skin.) Hopefully you don’t have to actually touch the faucet, but if you do, wad up a napkin or piece of toilet paper to make a barrier between your hand and the faucet.
- Use a handsfree (sensor) soap dispenser if possible (e.g., if you are at home and not at a public restroom). There are surprisingly few good-quality handsfree soap dispensers for the consumer market, but I can vouch for the Simplehuman handsfree soap dispensers, in either 8-ounce soap capacity or 13-ounce soap capacity. (For high-traffic areas like the kitchen sink, we’ve had to refill the 8-ounce pump about once per month, or once every 1.5 months for the 13-ounce model.) I’ve used four Simplehuman pumps for over two years without any clogs, sensor oversensitivity, or other issues that plague other designs. They even let you adjust how much soap you want dispensed. Just leave it on and it will automatically dispense hand soap (or dish soap if you fill it up with that). There are knockoffs that bribe reviewers with free samples to get good reviews, like the Eparé Automatic Soap Dispenser which might be adequate substitutes, but I haven’t used such brands and can’t personally vouch for their durability compared to the rock-solid Simplehumans. (For the record, we buy and use all products reviewed at this site. We have never accepted any free samples from any company.)
- Get liquid soap in bulk from a reliable brand and then refill the soap dispenser as needed. I can vouch for Softsoap (available in one-gallon sizes) as being a brand of soap that won’t clog or mess up the Simplehuman soap dispenser–I’ve used it for years now in place of the more-expensive Simplehuman liquid soap which costs about $27 per gallon (50% higher than Softsoap), even if you buy the Simplehuman 6-packs (6 liters, or 1.59 gallons).
- Handsfree (sensor) soap pumps typically eat batteries like candy. The Simplehuman will flash orange instead of green if the battery is getting low, warning you to replace the battery. That’s a good thing; it would be awkward for the dispenser to run out of battery without warning right after a bowel movement. Still, you probably don’t want to have to swap batteries out of the dispenser that often, so I highly recommend getting low self-discharge (LSD) rechargeable batteries which last much longer than regular rechargeable batteries.
- If you don’t already have a recharger, then get one of the following bundles, depending on how many batteries you want and if you want to get AAA, C, or D cells while you’re at it: Panasonic Advanced Individual Cell Battery Charger with eneloop AA 2100 Cycle Rechargeable Batteries (White, Pack of 4), Panasonic KJ17MCC82A Eneloop Power Pack for 8AA, 2AAA, 2 C Spacers, 2 D Spacers, Advanced Individual Battery Charger, or Panasonic K-KJ17MZ104A Eneloop Power Pack for 10AA, 4AAA Colored Cells Advanced Battery Charger. These are made in Japan and come with advanced, “smart” chargers.
- If you want to use a third-party charger, make sure you get a “smart” charger that knows when to stop charging batteries. Cheaper, “dumb” chargers don’t know when to stop and rely on timers that may be inaccurate and thus overcharge and damage your batteries.
- Lather up your hands and wrist, all the way up into your forearms. Remember to get fingertips, between fingers, the crevices where your fingernails meet your skin, and underneath the fingernails. You should spend at least 15 seconds, preferably 30 seconds, washing your hands. If you’re teaching your child, sing the “ABCs” song to pass the time. 15 seconds kills about 90% of germs; 30 seconds kills 99.9%.4 Antibacterial soap is not necessary and isn’t even more effective than regular soap. Soap mechanically washes away dead skin cells and germs, and using antibacterial soap tends to make bacteria more resistant to further doses of antibacterials, so it doesn’t solve the problem long-term.
- Wipe dry on a dry paper towel or air-dry; if you can’t get a paper towel without pressing a button that countless other people pressed, then I would recommend wadding up a napkin or toilet paper and pressing the button that way.
- Hang onto that paper towel! If you are exiting a public restroom, you can use that paper towel to insulate yourself from the door handle. If the door swings the other way, nudge the door open with a knee or shoe to avoid re-contaminating your hands.
- Dry or cracked skin gives germs more room to grow. Try to use moisturizers to keep your skin intact, especially during those harsh winter months.
Alternatives to washing your hands:
If you can’t wash your hands for some reason, then use hand sanitizer with at least 60% concentration of alcohol. (Alcohol kills germs by denaturing proteins in bacteria and viruses. Alcohol can reduce bacteria counts better than soap and water, especially if you don’t wash your hands thoroughly. However, alcohol can’t kill some spores, viruses, and bacteria, so it’s still an overall better bet to thoroughly wash your hands.)
Squirt some alcohol-based hand sanitizer into one hand, then get every bit of both hands wet from wrist to fingernail, including fingertips, between fingers, underneath fingernails, and in the crevices where your nails meet your skin at the tops of your fingers. Don’t be stingy with hand sanitizer–several studies have shown that you need to thoroughly wet everything you want to sanitize.
Remember to sanitize the exterior of your hand sanitizer bottle, too–usually I do this by simply gripping the bottle after I’ve applied the hand sanitizer. Please note that sanitizers that don’t contain alcohol may not kill germs, and that you should give your hands at least a minute to dry before you do anything like eat food with them; this gives the alcohol time to work.
For greater cost-effectiveness, I would recommend buying some of the following travel-sized bottles (no more than 3.4 ounces due to TSA carry-on airline restrictions). Put them in your luggage, car, work desk, etc.:
- Flip-top bottles (these are 70% alcohol) are my favorite style because they are compact and you can’t accidentally trigger them.
- Spray-pump bottles (this one is 71% alcohol) are okay but take up more space and are more prone to accidental triggering.
- Hand sanitizing wipes with alcohol (these are 62.5% alcohol, individually wrapped) also work, but I find them harder to use because wipes often give you more or less than you need. Hand sanitizer wipes also come in canisters (these are 70% alcohol). Be careful because many hand sanitizer canisters do not use alcohol and are more for general cleaning of household furniture and such.
To save money, I recommend refilling your travel-sized hand sanitizer bottles from bulk-quantity hand sanitizer (70% alcohol) which costs less per ounce and also gives you a free pump bottle for the home (see below). We use Purell. There are other brands besides Purell, but I can’t personally vouch for them, and Purell advertises that it’s twice as effective per squirt than any other national brand. Whatever you do, make sure you use 60%+ alcohol concentration to ensure effectiveness, preferably 70%+ because they dry faster.
For areas of your home that are far away from the sink, such as a diaper-changing station, use a pump-top bottle (70% alcohol) (also available in individual 2-liter bottles). Use the back of one hand to press down on it, and the other hand to catch the squirt. The large size ensures stability while you pump, and it also means having to refill it less often.