Hand hygiene education is becoming an important aspect of personnel training in many different settings. For instance, in 2005, a medical products distributor started an infection control program called “Just Say NOsocomial.” The whimsical name — which incorporates the 1980s’ “Just Say No” antidrug campaign slogan and the term nosocomial, which refers to diseases or infections that are acquired by patients in hospital settings — was intended to make the program cute, funny, and memorable. However, its goal was serious: to educate health-care workers regarding the importance of proper hand hygiene in order to stop the spread of hospital-acquired diseases.

As most of us know, the Centers for Disease Control and Prevention (CDC) says that “hand hygiene is the single most critical measure for reducing the transmission of [potentially harmful] pathogens and organisms.” However, even in medical facilities, where nosocomial illnesses and the spread of germs, pathogens, and bacteria are a very serious concern, lack of proper hand hygiene compliance continues to be a problem.

In Canada, it is estimated that less than half of all health-care workers wash as often as they should. And the situation is not much better in the United States, where studies indicate compliance among health-care providers, while improving, is still around 50 percent. The goal is 90 percent compliance, indicating a significant gap.

Although proper hand hygiene is not the only way to prevent nosocomial disease, it certainly contributes to the estimated 220,000 cases of hospital-acquired illnesses in Canada each year. In the U.S., that number is nearly two million.

Hand hygiene on the factory floor While several studies regarding hand-washing compliance have taken place in health-care facilities, few such studies have been conducted in industrial settings. Of these few, there have been none that could be generalized, meaning the findings in one industrial setting were not necessarily applicable to other types of industrial facilities. Hand-washing programs and compliance requirements in a food service facility, for instance, would not necessarily apply to the hand washing needs and requirements of workers in a car factory.

But according to Mike Nelson, Vice President of Marketing for Pro-Link, Inc., a marketing and buying group based in Canton, Massachusetts that focuses on the professional cleaning industry, “Proper hand care is very important in [industrial settings] in order to prevent the spread of disease, improve worker productivity, and reduce absenteeism,” he says. “Employees must be trained to wash their hands correctly and adequately, and to know why these procedures are necessary.”

Why is proper hand hygiene such a priority in industrial settings? Nelson explains that disease can spread in industrial settings in the same way that it does in schools, offices, homes, and medical facilities. For instance:


  • Many workers fail to wash their hands after using the restroom.


  • Workers touch soiled counters, aprons, machines, door knobs and other “high touch” areas, as well as items that have fallen to the floor and then touch other surfaces, potentially spreading contaminants.


  • Computer keyboards and mice may be shared by many workers on the industrial floor. Surveys show these can become very contaminated; workers who use them can then spread pathogens and disease.


“Even if workers wear gloves, they continue to touch their faces, eyes, and contaminated surfaces, coating the gloves with microorganisms and spreading them to other surfaces and workers,” adds Nelson. “Worse yet, in many instances, due to inadequate training, personnel wearing gloves assume that because they are wearing gloves, hand washing is less necessary.”

However, many gloves are in fact porous, allowing contaminants to seep through and reach the skin. Additionally, when workers remove gloves, germs and bacteria can spread to, potentially causing cross contamination if workers do not use the proper technique to remove them. This is why good hand hygiene is still very important even when personnel protective gear, such as gloves, are worn.

Nelson believes that programs promoting the importance of proper hand hygiene are necessary in factory and industrial settings just as they are in educational and healthcare facilities—and they can be very successful. “For instance, Pro-Link has a program for school children because so many of our members work with school districts,” he says. “We have found that [the program] is proving beneficial and more children—and teachers—are aware of the need for proper hand hygiene.”

Teaching and promoting proper hand hygiene Proper hand hygiene techniques are not difficult to learn or to encourage, according to Nelson. But first, facility managers should make it convenient for tenants to wash or sanitize their hands. “Too often, sinks are located only in restrooms, which in an industrial setting, can be far from work areas,” says Nelson. “Studies in schools have found that when hand washing stations have been installed in where students spend most of their time such as in classrooms, laboratories, cafeterias, even in halls, students wash their hands more frequently.”

So what does proper hand washing entail? Here are the key steps:


  • Wash with soap and water for at least 20 seconds with warm water at approximately 100 degrees Fahrenheit.


  • Scrub hands, but scrub gently. Overly aggressive scrubbing can cause cracks and small cuts, giving pathogens a place to grow.


  • Dry hands thoroughly. Wet hands are more likely to spread germs.


  • Use hand lotions. These keep skin intact so that cuts and cracks do not develop.


Recently it has been discovered that even if workers do wash their hands properly, they may be exposed to germs and bacteria during the actual hand washing process, which can prove harmful to themselves as well as others. This is because many industrial soap dispensers are “open,” meaning soap is poured into them to refill them. Studies by Dr. Charles Gerba, a microbiologist with the University of Arizona, have found that this exposes the dispensers to airborne contaminants, which can then contaminate the soap. Additionally, the soap may be “touched” by cleaning workers and others, further contaminating the soap.

“The way to prevent this is simple,” says Nelson. “Using soap dispensers in which the contents are dispensed from a factory sealed, disposable refill essentially eliminates the problem. Using touch free soap dispensers also help prevent cross contamination.”

Finally, Nelson advises that a successful hand hygiene program requires a committed manager. “If facility managers are not concerned about hand hygiene, employees will not be concerned. They [managers] must view the problem as a potentially serious, but preventable, health issue—which it is.”

Robert Kravitz is a writer for the professional cleaning, healthcare, and building industries.