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Physiologic and Microbiologic Changes in Skin Related to Frequent Handwashing

Published online by Cambridge University Press:  02 January 2015

Elaine Larson ,
James J. Leyden ,
Kenneth J. McGinley ,
Gary L. Grove  and
George H. Talbot
Elaine Larson*
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
James J. Leyden
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
Kenneth J. McGinley
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
Gary L. Grove
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
George H. Talbot
Affiliation:
Robert Wood Johnson Foundation, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Department of Dermatology, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania University of Pennsylvania Section of Infectious Diseases, Philadelphia, Pennsylvania
*
Johns Hopkins University School of Nursing, 600 N. Wolfe St., Baltimore, MD 21205
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Abstract

Handwashing practices may be adversely influenced by the detrimental effects of handwashing on skin. A protocol was developed to assess the physiologic and microbiologic effects of frequent handwashing. Fifty-two female volunteers washed their hands 24 times per day for 5 days. Five agents were tested: water alone, non-medicated bar soap, a chlorhexidine-containing antiseptic, and two agents containing povidone-iodine (one currently available on the market and one being tested for possible marketing). Some damage to the outer membrane of skin, the stratum corneum, occurred in all groups. There were significant changes in the amount of evaporation water loss (p=.001) and in self assessments of skin condition (p=.005) from pre-to-post test for the entire group. Skin damage was also assessed by visualizing desquamating stratum corneum cells, which are shed in large aggregates when detergents injure skin. Significantly less such shedding occurred in subjects using water alone, bar soap, and the Chlorhexidine formulation (p=.02). Greater antimicrobial activity of an agent was not correlated with increased skin trauma. We have quantitated, using objective physiologic parameter, the skin damage that occurs during even a short period of frequent handwashing. We recommend that further studies using the methods described be conducted to quantitate skin damage over longer periods of time, more closely resembling handwashing practices of health care personnel.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 7 , Issue 2 , February 1986 , pp. 59 - 63
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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References

1.Preston, GA, Larson, EL, Stamm, WE, The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. Am J Med 1981;70:641–645.CrossRefGoogle Scholar
2.Albert, RF, Condie, F, Handwashing patterns in medical intensive-care units. N Engl J Med 1981;304:1465–1466.CrossRefGoogle ScholarPubMed
3.Larson, E, Compliance with isolation techniques. Am J Infect Control 1981;11:221–225.Google Scholar
4.Ojajarvi, J, Makela, P, Rantasolo, I, Failure of hand disinfection with frequent handwashing: A need for prolonged field studies. J Hyg 1977;79:107–112.CrossRefGoogle ScholarPubMed
5.Larson, E, Killten, M, Factors influencing handwashing behavior of patient care personnel. Am J Infect Control 1982;10:93–99.Google Scholar
6.Hassing, JH, Nater, JP, Bleumink, E, Irritancy oflow concentrations of soap and synthetic detergents as measured bv skin water loss. Dermatologica 1982;164:314–321.Google Scholar
7.McGinley, KJ, Marples, RR, Plewig, G, A method for visualizing and quanlilat-ing the desquamating portion of the human stratum corneum. J invest Dermatol 1969;53:107–111.CrossRefGoogle ScholarPubMed
8.Steere, AC, Mallison, GF, Handwashing practices for the prevention of nosocomial infections. Ann Intern Med 1975;83:683–690.Google Scholar
9.Grove, GL, Techniques for substantiating skin care product claims, in Kliginan, AM, Leyden, JJ (eds): Safety and Efficacy of Topically Applied Drugs and Cosmetics. New York, Crune and Stratlon, 1982.Google Scholar
10.Larson, EL, Strom, MS, Evans, CA, Analysis of three variables in sampling solutions used to assay bacteria of hands: Type of isolation, use of antiseptic neutralizers, and solution temperature. J Clin Microbiol 1980;12:355–360.CrossRefGoogle ScholarPubMed
11.Armitage, P, Statistical Methods in Medical Research. Oxford. Hlackivell Scientific Publications, 1971.Google Scholar
12.Ojajarvi, J, Effectiveness of handwashing and disinfection methods in removing transient bacteria after patient nursing. J Ihg 1980;85:193–197.Google Scholar
13.Meers, PD, Yeo, GA, Shedding of bacteria and skin squames after handwashing. J Hyg 1978;81:99–105.Google Scholar
14.Quraishi, ZA, McGuckin, M, Blats, FX, Duration of handwashing In intensive care units: A descriptive study. Am J Infect Control 1984;12:83–87.CrossRefGoogle ScholarPubMed