Official Recommendations On Hand Washing and Drying: Paper Towels, Cloth Towels and Electric Hand Dryers
(part 4 – Australia – Canada – USA)

AUSTRALIA

2011 – From the “Better Health Channel.” Produced in association with the State Government of Victoria Department of Health

  • A fact sheet under the ‘Preventing Infection’ section of a site with content that “has been prepared for Victorian residents and wider Australian audiences.”

“How to wash your hands properly
To wash hands properly:

  • Wet your hands with warm water.
  • Apply one dose of liquid soap and lather (wash) well for 15–20 seconds (or longer if the dirt is ingrained).
  • Rub hands together rapidly across all surfaces of your hands and wrists to help remove dirt and germs.
  • Don’t forget the backs of your hands, your wrists, between your fingers and under your fingernails.
  • If possible, remove rings and watches before you wash your hands, or ensure you move the rings to wash under them, as microorganisms can exist under them.
  • Rinse well under running water and make sure all traces of soap are removed, as residues may cause irritation.
  • Pat your hands dry using paper towels (or single-use cloth towels). Make sure your hands are thoroughly dry.
  • Dry under any rings you wear, as they can be a source of future contamination if they remain moist.
  • Hot air driers can be used but, again, you should ensure your hands are thoroughly dry.
  • At home, give each family member their own towel and wash the towels often.”

CANADA

Ontario Agency for Health Protection and Promotion

2010 Provincial Infectious Diseases Advisory Committee (PIDAC)

Describes “Best Practices for Hand Hygiene In All Health Care Settings” (see page 44)

Effective hand drying is important for maintaining hand health. Considerations include:

  • Disposable paper hand-towels provide the lowest risk of cross-contamination and shall be used for drying hands in clinical practice areas.
  • Cloth drying towels shall not be used.
  • Towel dispensers shall be mounted such that access to them is unobstructed and splashing or dripping onto adjacent wall and floor surfaces is minimized.
  • Towel dispenser design shall be such that only the towel is touched during removal of towel for use.
  • To avoid recontamination of the hands, paper towels should be available to use on the exit door hardware and a waste container for used towels should be located near the exit door.
  • Hot-air dryers must not be used in clinical areas and shall not be used with hand hygiene sinks.
  • If hot-air dryers are used in non-clinical (public) areas:
    • hands-free taps are required
    • there must be a contingency for power interruptions.

http://www.publichealthontario.ca/en/eRepository/2010-12%20BP%20Hand%20Hygiene.pdf

 

Community and Hospital Infection Control Association-Canada

2008 Position Statement: Hand Hygiene

“Hand Washing

To wash your hands, use warm, running water, soap, and friction for at least 15 seconds. Wet hands, then lather and clean all surfaces of the hands concentrating on fingertips, between fingers, nail beds, back of hands and base of thumbs and thoroughly rinse after lathering and rubbing. Ideally, use individual paper towels to pat hands dry. Turn off the taps with the paper towel to avoid recontaminating your hands.”

http://www.chica.org/pdf/handhygiene.pdf

 

Public Health Agency of Canada

2010 Hand Hygiene Recommendations for Remote and Isolated Community Settings

“When Running Water is Available

When running tap water* is available (day-to-day and during an outbreak) in a community, wash hands with plain soap and water and dry thoroughly.  The recommended procedure for hand washing using running water is as follows:

[…]  dry hands with a clean cloth or paper towel while taking special care to dry thoroughly between the fingers turn off the tap/spout with a paper towel or cloth

When Running Water is Not Available

[…] dry hands with a clean cloth or paper towel while taking special care to dry thoroughly between the fingers.  Throw out the water from the hand washing container following each individual use”

 

Centre for Healthcare Related Infection Surveillance and Prevention & Tuberculosis Control – Department of Health (Queensland Government)

The Guideline Hand Hygiene of September 2013 (p. 3) state:

Routine/Social Hand Hygiene – Soap and Water:

1. Ensure jewellery has been removed

2. Wet hands thoroughly and lather vigorously using a neutral pH liquid soap for 15-30 seconds

3. Rub hands palm to palm

4. Right palm over left dorsum with interlaced fingers and vice versa

5. Palm to palm with fingers interlaced

6. Backs of fingers to opposing palms with fingers interlocked

7. Rotational rubbing of left thumb clasped in right palm and vice versa

8. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa

9. Rinse under running water

10. Do not touch taps with clean hands – if elbow or foot controls are not available, use paper towel to turn off taps

11. Pat hands dry using paper towel.

http://www.health.qld.gov.au/qhpolicy/docs/gdl/qh-gdl-321-1-1.pdf

 

Ontario Provincial Infectious Diseases Advisory Committee

The Hand Hygiene Fact Sheet for Health Care Settings recommends:

“Dry hands thoroughly by blotting hands gently with a paper towel.”

http://www.pdhu.on.ca/assets/uploads/pages/file/For%20Health%20Professionals/Outbreak%20Management/Appendix%2011%20-%20Hand%20Hygiene%20Fact%20Sheet%20For%20Health%20Care%20Settings.pdf

Please see also the following links:

http://publications.gc.ca/collections/collection_2012/aspc-phac/HP40-74-2012-eng.pdf (in particular section 2.4 at p. 36)

http://nsemo.org/hazards/health-emergencies/influenza

http://www.health.gov.bc.ca/library/publications/year/2012/best-practice-guidelines-handhygiene.pdf (p. 33)

 

 

UNITED STATES

US Center for Disease Control

2009 Outbreak Prevention and Response Control – OPRP – General information on Hand Hygiene

  • Information disseminated to the cruise line industry, which is heavily affected by outbreaks of gastroenteritis among passengers.

“Wet hands have been known to transfer pathogens much more readily than dry hands or hands not washed at all. The residual moisture determines the level of bacterial and viral transfer following hand washing.  Careful hand drying is a critical factor for bacterial transfer to skin, food and environmental surfaces.

The drying times required to reduce the transfer of these pathogens varies with drying methods.  Repeated drying of hands with reusable cloth towels is not recommended and should be avoided.  Recommended hand drying methods and drying times are outlined below:

Drying method Protocol Total drying time Comments
Single-use paper towels Rub hands on two paper towels drying hands for 10 seconds on each

20 seconds

 The first towel removes the bulk of the water; the seconds achieves complete drying
Air dryer Rub hands together for while rotating them under warm air

30 – 45 seconds

  A prolonged drying period is required to achieve complete drying
Single-use cloth towel Rub hands on two sections of the towel, drying hands for 10 seconds on each section

20 seconds

 The first section of the towel removes the bulk of the water; the seconds achieves complete drying”

http://www.cdc.gov/nceh/vsp/cruiselines/hand_hygiene_general.htm

 

2002 Guideline for Hand Hygiene in Health-Care Settings

  • Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force
  • From the introduction: “The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings.”

Hand-hygiene technique

  1. When decontaminating hands with an alcohol-based hand rub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry (IB) (288,410). Follow the manufacturer’s recommendations regarding the volume of product to use.
  2. When washing hands with soap and water, wet hands first with water, apply an amount of product recommended by the manufacturer to hands, and rub hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fingers. Rinse hands with water and dry thoroughly with a disposable towel. Use towel to turn off the faucet (IB) (90-92,94,411). Avoid using hot water, because repeated exposure to hot water may increase the risk of dermatitis (IB) (254,255).
  3. Liquid, bar, leaflet or powdered forms of plain soap are acceptable when washing hands with a non-antimicrobial soap and water. When bar soap is used, soap racks that facilitate drainage and small bars of soap should be used (II) (412-415).
  4. Multiple-use cloth towels of the hanging or roll type are not recommended for use in health-care settings (II) (137,300).”

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm