Protect those hands at work and at play

June 30, 2008
Healthy, uncompromised skin is your No. 1 best protection against germs and virus at work says Leslie Canham, CDA, RDA.

By Leslie Canham, CDA, RDA

When the weather gets warm, people gravitate to the great outdoors. We may spend more time in the garden, swimming pool, or around the campfire. Remember to protect your skin, especially your hands, when engaged in outdoor activities.

Healthy, uncompromised skin is your No. 1 best protection against germs and virus at work. Damaged skin often harbors increased numbers of pathogens. Moreover, washing damaged skin is less effective at reducing bacteria than washing normal skin. The numbers of organisms shed from damaged skin are often higher than from healthy skin.

If you accidentally sustain cuts or abrasions on your hands, be sure to take these precautions:

1. For damaged skin, a mild, nonantimicrobial skin-cleansing product may be used to remove dirt and debris.

2. Use an additional barrier under exam gloves to protect open wounds, such as finger cots or nonfabric bandages.

3. Dry, cracked skin may benefit from skin emollients or barrier creams.
(Skin moisturizing products should be carefully assessed for compatibility with any topical antimicrobial products and gloves).

What is hand hygiene?
Hand hygiene is any method that removes or destroys microorganisms on hands. It is well documented that the most effective measure for preventing the spread of pathogens is hand washing. Hand washing is achieved by vigorously rubbing together all surfaces of lathered hands for at least 20 seconds, followed by rinsing with water. Hand washing suspends microorganisms and mechanically removes them with water.

The fundamental principle of hand washing is removal, not killing. The amount of time spent washing hands is important to reduce the transmission of pathogens to our patients, inanimate objects, and other frequently touched surfaces. The minimum amount of time that should be spent washing hands with soap and water is 15 seconds.

Drying hands is also important because wet hands can transfer pathogens 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 to prevent bacterial transfer to skin, food, and environmental surfaces. Also, be sure that hands are dry before donning gloves to reduce the chances of skin irritation.

If hands are not visibly soiled, an alcohol-based hand rub may be used as an alternative to soap and water. Alcohol hand rubs are rapidly germicidal when applied to the skin and should include antiseptics such as chlorhexidine, quaternary ammonium compounds, octenidine, or triclosan to achieve persistent activity.

Some products marketed to the public as antimicrobial hand sanitizers are not effective in reducing bacterial counts on hands. For alcohol-based hand sanitizers used in the health-care professions, the Food and Drug Administration recommends a concentration of 60 to 95% ethanol or isopropanol, the concentration range of greatest germicidal efficacy.

Can hand washing damage skin?
Frequent hand washing with soaps and antiseptic agents can cause chronic irritant contact dermatitis among dental health-care providers. Damage to the skin changes skin flora, which results in more frequent colonization by staphylococci and gram-negative bacteria.

Can I skip washing my hands if I'm wearing gloves?
Wearing gloves does not eliminate the need for hand washing. Hand hygiene should be performed immediately before donning gloves and every time gloves are removed. Because gloves can have small, nearly invisible defects or can be torn during use, hands can become contaminated. Bacteria can multiply rapidly in the moist environment underneath gloves, and thus the hands should be dried thoroughly before donning gloves and washed again immediately after glove removal.

What is contact dermatitis?
Contact dermatitis can develop from frequent and repeated use of hand hygiene products, exposure to chemicals, and glove use. Contact dermatitis is classified as either irritant or allergic. Irritant contact dermatitis develops as dry, itchy, irritated areas on the skin around the area of contact. Allergic contact dermatitis often manifests as a rash that begins hours after contact, and similar to irritant dermatitis, is usually confined to the area of contact. Allergic contact dermatitis can result from exposure to accelerators used in the manufacture of gloves as well as from other chemicals found in the dental practice setting.

If you suffer from contact dermatitis, you may want to discuss your condition with your health-care provider and get an accurate diagnosis. Remember, healthy, uncompromised skin is your No. 1 protection against germs and virus at work.

Leslie Canham is a dental speaker and consultant specializing in infection control and OSHA compliance. She has more than 36 years of experience in dentistry. Canham is the founder of Leslie Canham Seminars, providing in-office training, mock inspections, consulting, and online seminars and webinars to help the dental team navigate state and federal regulations. Reach her at Leslie Canham, or at (888) 853-7543.

References available upon request.