Research Reinforces Importance of Washing Hands

Dr. Sydney Spiesel, a Connecticut pediatrician and contributor to the online magazine Slate, joins Madeleine Brand for a look at the latest research on the importance hand washing.

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MADELINE BRAND, host:

Well, this may be hard for you take but it turns out that Mom was right. You have to wash your hands before every meal. The latest medical thinking suggests it's one of the best ways to prevent serious diseases. And this is especially true in developing countries. Here now is Dr. Sydney Spiesel, a pediatrician and professor at the Yale Medical School and a regular guest here on DAY TO DAY. And welcome back, Dr. Spiesel.

Dr. SYDNEY SPIESEL (Professor, Yale Medical School): Thank you so much. Always nice to be here.

BRAND: So researchers went to Pakistan to look at whether hand washing really made a difference. And what did they find?

Dr. SPIESEL: They found that it really, really made a difference. And it made a difference in very profound ways. What they did, and some of this is sort of surprising, they went to sort of squatter settlements in Karachi and they selected neighborhoods that were close to each other and the main intervention they did was they just passed out bars of soap to some of the neighborhoods and in other neighborhoods they did a control thing, it didn't have to do with giving out soap or giving hints on hand washing. That was the only difference. And in fact, the interesting thing is that in these communities there's no running water, or much of it doesn't have running water. And most people didn't have towels. All they had were these bars of soap.

BRAND: And does it matter what kind of soap it was?

Dr. SPIESEL: Well, it turned out, to the surprise and lack of delight of the company that's passing out the soap, it didn't matter. Some of the soap had anti-bacterial materials added, you know, these things that they advertise a lot. And other soap was just plain soap, and that was the only difference between them. And it didn't matter a bit in terms of preventing infection and preventing problems. The anti-bacterial properties weren't helpful at all.

BRAND: Now, I want to get to anti-bacterial soap in a moment, but first let me ask you this. Would a similar study in the United States or in a developed country, would that make a difference, do you think, in the results?

Dr. SPIESEL: Yeah, it would, but probably not quite as profound a difference. In Canada and the United States, for example, in a similar study they showed that, oh, I don't know, there was a 12-14 percent reduction in the upper respiratory tract infections in kids. So there really is a difference. But the difference is a lot more striking and ultimately in terms of the long term effects a lot more meaningful in these developing countries.

BRAND: What sort of diseases does it prevent?

Dr. SPIESEL: Well, the three diseases that it prevented in the study done in Karachi were pneumonia and diarrheal disease and impetigo, you know these kind of horrible soars that you often see in the drip zone under kids' noses. It actually decreased pneumonia by half, it decreased diarreah by half, and it decreased impetigo by about a third.

And this is incredibly important because in the world these days about three and a half, or probably more than three and a half million children who are age less than five years die from just diarreah and acute respiratory tract infections, that is pneumonia, every year.

If half of the cases are reduced, that's one and three quarter million children whose lives could be saved by just passing out bars of soap.

BRAND: Now, let's get to those anti-bacterial soaps. And you have written that not only do they not make much of a difference, they actually might make a negative difference in terms of your health.

Dr. SPIESEL: Well, some microbiologists are concerned about that. And we don't know exactly the reason, but it seems to be true that sometimes exposure to these anti-bacterial things, for which we've never demonstrated any great positive benefit, there's some belief that it promotes resistance, and resistance to other antibiotics. So there's some worry that these anti- bacterial materials can ultimately make things worse, not better.

BRAND: So wash your hands, but wash them with good old-fashioned soap.

Dr. SPIESEL: That's what I would always recommend, yeah.

BRAND: Dr. Sydney Spiesel is a pediatrician and professor at the Yale Medical School. He also writes the medical examiner column for the online magazine Slate. Thank you for joining us.

Dr. SPIESEL: My pleasure. Always nice to be here.

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