health benefits of hand washing

Can anyone point me to some research on the health benefits (or lack thereof) of hand washing, in particular hand washing prior to food preparation, after urination, and after bowel movement?

I ask because I grew up being indoctrinated into washing my hands before food preparation and after bowel movement (to the point that the thought of not doing so fills me with considerable aversion), and now I have become very close to someone who regularly does not do so. This bothers me a lot and so I’m looking for scientific evidence before I decide whether the best course of action is for me to encourage this person to start doing things my way, or for me to abandon my own (possibly irrational) beliefs on sanitary practices.

Have your friend Google Cholera, Hepatitis A, Polio, Rotavirus, E. coli or Salmonellosis.

My personal opinion is that washing prior to food preparation is the most crucial. I mean yes, you should wash after eliminating bodily waste, but absent infection fresh urine is sterile (in some cultures it is used for cleansing, odd and even abhorrent as that may be to some of us) and most customs around bowels either involved using something else to remove traces (paper) or water for washing which one would assume would clean the hands at least somewhat (though not always). But we touch many other things between the toilet and the kitchen, and few or none of those are sanitary. Washing prior to food preparation ensures the cleanest hands prior to handling food - and it’s contaminated food that cause a lot of the problems that contamination/filth causes.

I recall reading a study of antibiotic soap vs plain soap, they found that you need to wash and soap your hands for at least 30 seconds to have a benefit. They found little difference between regular soap and antibiotic soap.

So even if your employees wash their hands it needs to be done for at least half a minute

But, I presume, a significant difference between not washing and any washing.

From Wiki because my Semmelweis book is at work.

Beyond that initial threshold, the gain from particular cleansers decreases. Gawande talks about it here, and, I think, in Better, which is also at work.

Bear this in mind: When you flush a toilet, your hand is acquiring stuff from the handle, left there by whoever previously flushed that toilet. So even if you didn’t touch anything harmful, that handle may have. Think about all the things other people may have done, and touched, while using that toilet.

And how many people ever think of disinfecting the toilet handle, especially in public restrooms?

Ever hear of Typhoid Mary?

http://www.1st-in-handwashing.com/handwashing_and_typhoid_mary.html
Other reasons to wash your hands:

http://1st-in-handwashing.com/handchartwithgermnames.JPG

The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers

Here are the tangentially relevant Straight Dope columns/Staff Reports:

Why are men supposed to wash their hands after urination?

What’s more important in cleaning, soap or hot water?

What diseases can you catch from toilet seats?

Does flushing the toilet cause dirty water to be spewed around the bathroom?

Is coprophagia dangerous? (the accompanying illustration is one of Slug’s classics)

One of the protocols that must be observed in order to be close to my nephew Jack (15 months old, liver transplant at 3 months) is vigorous hand washing, followed by an alcohol-based sanitizer such as Purell. My mom volunteers in the mother-baby unit at a local hospital, and they use “Happy Birthday” as a hand washing timer. Plain old soap is just fine. We only use the soap/Purell combo because Jack is immune-suppressed and a garden-variety germ could really screw him up.

It’s not just the charmingly named fecal-oral transmission route you need to be worried about. Other diseases like Trachoma can be spread by e.g. rubbing your eyes after shaking hands with someone who has been rubbing their (infected) eyes - or holding a rail on the bus that has been held by someone with infectius material on their hands. One of the great advantages of post-elimination washing is that since most people go to the toilet at least once a day, it establishes a minimum baseline of one hand-scrub per day, as well as targeting the single largest concentration of nasties which most people will encounter[li]. Also even in really primitive cultures the meme that 'shit or piss = dirty" is relatively easy to establish and condition into people.[/li]
[*]I vaguely remember (information not to be relied on without verification0 that even without use of paper or washing, the level of fecal bacteria on the skin drops fairly rapidly with time due to dryness, light, pressure of better-adapted skin bacteria etc. So even though it’s not likely that ordinary washing will ever remove all the fecal bacteria, it may be more effective to remove 90% immediately and then let nature deal with the remainder than to try scrubbing off the last stubborn remainder before embarking on some food prep. Although obviously it’s best to do both. Unless the cooks handtowel is a festering rag full of lurgies, that is.

Isn’t this like saying that cars are perfectly safe unless you crash? :dubious:

Not really. Urinary tract infections are rather uncommon and tend to make themselves annoying enough that the sufferer will want to get it treated ASAP. However, no-longer-fresh urine can serve as a good medium for bacteria to hang out in.

…but only to notice a benefit to using antibacterial soap. If you want to kill 99% of bacteria, then wash for an extra 30 seconds, otherwise you’ll only kill 98% of them.

no cite handy but all soap is antibacterial, most of the stuff labeled as such has caustic smelling scents added to make it seem all medical but there is no real difference.