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Workplace Wellness

Proper Handwashing

Quick Tips #285

What do Dr. Ignaz Semmelweis and mothers everywhere have in common? The knowledge that proper handwashing is an important means of preventing the spread of disease-causing germs. Dr. Semmelweis was a Hungarian physician who, in the 1840s, demonstrated that the mortality rate among mothers who delivered in the First Obstetrics Clinic at the General Hospital of Vienna was significantly lower when hospital staff cleaned their hands with an antiseptic agent prior to patient contact.

This was the beginning of the concept of infection control, not just in hospital settings, but in public health in general. Today the value of proper handwashing is recognized not only in healthcare settings, but also in schools, child care settings and eating establishments, as well as throughout the general community.


The Centers for Disease Control and Prevention (CDC) recommends cleaning hands in a specific way to avoid getting sick and spreading germs to others:

  1. Wet hands with clean running water (warm or cold), turn off the tap and apply soap (liquid or clean bar);
  2. Lather hands (palms, backs, between fingers and under nails) by rubbing them together;
  3. Scrub hands for at least 20 seconds or for the time it takes to hum the “Happy Birthday” song from beginning to end twice;
  4. Rinse hands well under clean running water;
  5. Dry hands using a clean disposable towel or air dry; and
  6. Turn off tap using disposable towel.

In the event handwashing facilities are not available, an alcohol-based hand sanitizer can be used. The CDC suggests using a sanitizer with an alcohol concentration of 60% or greater. It is important to note that hand sanitizers are effective against common diseases but are ineffective against certain organisms such as bacterial spores. Also, hand sanitizers are less effective if your hands are soiled. Removing any dirt or debris before using the sanitizer will increase the effectiveness.

To use hand sanitizers, apply the product to the palm of one hand, rub hands together and then rub the product over all surfaces of the hands and fingers until hands are dry.

Hand sanitizer should not be used in place of soap and water all of the time due to decreased effectiveness. The reason for decreased effectiveness is alcohol in sanitizers can remove natural oils from your hands, which will cause your hands to dry out and crack. Germs can remain trapped within the cracks of your hands.

Foodborne Illnesses

The Food and Drug Administration (FDA) and CDC work together to control the transmission of pathogens that can result in foodborne illnesses. Transmission of pathogenic bacteria, viruses and parasites from raw food, or from infected workers to food by way of improperly washed hands, continues to be one of the major factors in the spread of foodborne illnesses. For more information, read Quick Tips #335: Foodborne Illnesses.

The FDA’s Food Code contains federal recommendations for the prevention of foodborne illnesses in restaurants, grocery stores, institutions and vending locations. This code is used by local, state and federal regulators as a model for their own safety rules. The Food Code contains specific hand hygiene guidelines for retail and food service workers, describing where, when and how to wash and sanitize hands. OSHA’s Bloodborne Pathogen standard (29 CFR 1910.1030) mandates that institutions require proper handwashing facilities. If they are not feasible, antiseptic cleansers or antiseptic towelettes must be made available.

Commonly Asked Questions

Q: What is hand hygiene?

A: Hand hygiene is a general term that applies to routine handwashing, antiseptic hand wash, antiseptic hand rub or surgical antisepsis.

Q: Are alcohol-based hand gels accepted in place of washing with soap and water in a retail or food service setting?

A: Retail food and food service work involves a high potential for wet hands, and scientific research questions the efficacy of alcohol on moist hands. Alcohols do not adequately reduce important foodborne pathogens on the preparer’s hands, thus the ingredients in alcohol-based gels for retail or food service must be approved food additives and approved under the FDA monograph or as a New Drug Application. Proper handwashing with soap and water is still the preferred method.

Q: Should disinfectants be used for washing hands?

A: No, disinfectants are designed for objects and surfaces and may be too harsh for use on skin tissue. Antimicrobial soaps and alcohol-based soaps are best for proper handwashing.


CDC’s Clean Hands Save Lives

FDA’s Retail Food Protection: Employee Health and Personal Hygiene Handbook

The information contained in this article is intended for general information purposes only and is based on information available as of the initial date of publication. No representation is made that the information or references are complete or remain current. This article is not a substitute for review of current applicable government regulations, industry standards, or other standards specific to your business and/or activities and should not be construed as legal advice or opinion. Readers with specific questions should refer to the applicable standards or consult with an attorney.

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