Official Recommendations On Hand Washing and Drying: Paper Towels, Cloth Towels and Electric Hand Dryers
(part 3 – UK)
Health Protection Agency
1992 HPA Guideline: Handwashing in Primary Schools
- Excerpt from a guideline of the ‘recommended technique’ of handwashing in primary schools. Based on Ayliffe GAJ et al. Control of hospital infection; a practical handbook. 3rd ed. Chapman and Hall, London, 1992.
“Handwashing is one of the most important ways of controlling the spread of infections, especially those that cause diarrhoea and vomiting, and respiratory disease. The recommended method is the use of liquid soap, water, and paper towels.”
2009 HPA Guideline: Farm visits
- A guideline regarding safety around farm animals, with particular emphasis on handwashing after touching the animals. Slated towards teachers and parents bringing children to farms.
“E.coli O157, another risk from contact with animals, can be particularly serious for younger children.
The HPA North West advice to parents and teachers taking children on farm visits is:
- Check that there are good hand-washing facilities at the farm with hot water, soap and paper towels.”
2011 HPA Guideline: Farm visits
- Further guidelines regarding touching farm animals, in light of a seasonal upswing in cases of gastro-intestinal infection in Britain.
During and after farm visits:
- Do not eat or drink or put your fingers in your mouth while you are near animals or before you have washed your hands.
- Ensure small children are supervised when washing their hands with hot water, soap and paper towels – there should be hand washing facilities on site.
- Clean your shoes and pushchair wheels before leaving the farm and before you enter your car and home.
2009 HPA Hospital infection control guidance
- From the introduction: “This document intends to give infection control and other general guidance to those personnel who may be involved in receiving and caring for patients who may have SARS, primarily within acute healthcare settings, and should be used in conjunction with local policies.”
“Hand hygiene supplies – supplies of liquid soap, antiseptic hand wash solutions and also alcohol hand solutions in case of lack of water supply or access to this. Disposable paper hand towels, readily available.”
2011 Health Protection Agency Northwest: Infection Prevention and Communicable Disease Control Guidance for Early Years and School Settings
- From the introduction: “Nurseries and schools are an ideal environment for the spread of infection and infectious diseases. Young children, in particular those who attend nurseries and pre-school facilities, may be more susceptible to infection and infectious diseases…This guidance document provides you with information on the prevention and control of infection within a nursery, pre-school or school setting.”
“Dry hands thoroughly on disposable paper towels. Cotton (terry) towels are not recommended for general hand hygiene. Children will share towels (even if they are instructed not to do so) and this can be an excellent way of spreading infection. Even if each child has their own towel with their name on it, the risk of sharing is high, increasing the risk of cross-infection. Hot air hand dryers are not suitable for nurseries and schools. In a nursery, pre-school or school or school setting the only satisfactory method of drying hands is with good quality disposable paper towels.”
2008 Essex Health Protection Unit Community Infection Control Guidelines
- This document establishes what Essex calls “Standard Principles of Infection Control (or Universal Precautions).” From the introduction: “The recommendations on standard principles provide guidance on infection control precautions that should be applied by all healthcare personnel, and other carers, to the care of patients in community and primary care settings. Everyone involved in providing health and social care should know, and have a duty to apply the standard principles of hand decontamination, the use of protective clothing and the safe disposal of sharps.”
[Note: the same guidelines are also outlined in Essex HPU’s guidelines on dental practice, funeral home services, tattooing practice, ambulatory service, chiropody & podiatry practice, and prison practice]
This is an essential part of hand hygiene. Dry hands thoroughly using good quality paper towels. In clinical settings, disposable paper towels are the method of choice because communal towels are a source of crosscontamination. Store paper towels in a wall-mounted dispenser next to the washbasin, and throw them away in a pedal operated fire-retardant domestic waste bin. Do not use your hands to lift the lid or they will become recontaminated.
Hot air dryers are not recommended in clinical settings. However if they are used in other areas, they must be regularly serviced and users must dry hands completely before moving away.”
2000 UK Health Protection Agency’s Newsletter for Schools
- An update sent to schools following an outbreak of infections among children of ‘itchy skin infections.’
[…] Schools can also help prevent the spread of infection by ensuring that children do not share personal items such as towels, and roller towels in wash areas are replaced by driers or paper towels. The single most effective method for controlling the spread of infection is by frequent and thorough hand washing. A supply of hot and cold water, soap and single-use hand-drying facilities (such as paper towels or hot air dryers) should be provided for children and staff.”
2010 Guidelines for the Control of Infection and Communicable Disease in School and Early Years Settings
- From the South West London Health Protection Unit
Disposable paper towels are recommended for drying hands, as re-usable towels are often damp and can harbour germs and re-contaminate hands. Drying hands thoroughly after washing is important as wet surfaces transfer micro-organisms more effectively than dry ones. It is suggested that paper towels rub away more germs that are loosely attached to hands. Ineffective drying may also lead to skin damage. Warm air hand dryers are generally not recommended as they blow germs back onto the hands, they take longer to dry hands than paper towels, people often do not spend long enough using the dryer and they can only serve one person at a time. However, if roller towels or air dryers are used, then they must be maintained regularly. Roller towels must be replaced frequently. Cloth/cotton towels/tea towels should not be used as they allow recontamination of the hands.”
2006 Control of communicable disease in schools and nurseries
- From the Surrey and Sussex Health Protection Unit
“School and nursery hygiene
Staff should encourage children to learn basic principles of good hygiene. One of the most important is hand washing.
Box 1: Hand-washing
[…] Rinse hands together under warm running water and dry hands with a hand dryer or clean towel (preferably paper). Ideally hot air dryers should not be used.”
NHS National Services Scotland
The document titled “Infection Prevention and Control in Childcare Settings (Day Care and Childminding Settings)” lists under Good hand hygiene practise:
Dry hands thoroughly using paper towels (childminders may use kitchen roll or a designated hand towel, which should be washed every day or more often if visibly dirty) http://www.documents.hps.scot.nhs.uk/hai/infection-control/guidelines/infection-prevention-control-childcare.pdf
Please see also the following articles:
The Irish Health Service provides this indication:
“Good quality disposable paper towels should be used in clinical areas. Hand dryers are not advised as they usually result in a longer time for complete hand drying. (hence result in poor practice), only allow one-person use at a time, and require maintenance.”
See pg. 20 in the document: Guidelines for Hand Hygiene in Irish Health Care Settings published by SARI Infection Control Subcommittee http://www.hpsc.ie/A-Z/Gastroenteric/Handwashing/Publications/File,1047,en.pdf)
The Recommendations on the same page state: “Air dryers are not recommended (II). The use of good quality disposable paper towels and hand lotions are recommended (III).”