TCS Daily


Frontiers in Germicidal Living

By Glenn Harlan Reynolds - October 25, 2006 12:00 AM

There was nearly a political scandal last week, over hand sanitizer. The New York Times reported that President Bush had shaken hands with Sen. Barack Obama, only to have an aide immediately squirt some sanitizer on his hands. Not much of a scandal there, as the full story included Bush offering some to Obama, and telling him it's a good way to prevent colds.

True enough, and in fact, as Mary Cheney reported in her recent political autobiography, liberal use of hand sanitizer may be vital to a politician's prospects:

"The truth is, all candidates use it -- or suffer the consequences. When Wesley Clark entered the 2004 presidential race, he caught a cold, lost his voice, and was unable to campaign for several days. Some people speculated that the pace of a national campaign had knocked the former NATO commander off the campaign trail. I knew it was because he hadn't learned about hand sanitizer. National candidates shake hundreds, if not thousands, of hands every day. They will get sick unless they wash their hands early and often."

Of course, what's true for politicians is true for the rest of us -- we may not shake hundreds of hands a day, but we get exposed to a lot of germs. I often attend the Association of American Law Schools' annual recruiting conference, where thousands of job candidates meet with recruiters from 150 or so law schools. It's a big deal, so people drag themselves there even if they're sick, and -- of course -- everybody shakes hands. It draws people from all over the country, right at the start of cold-and-flu season, and I've become a fanatical handwasher after getting quite sick the first couple of times.

According to the BBC, Donald Trump thinks the custom should be abolished:

"'I'm not a big fan of the handshake,' he told US TV channel NBC.

"'I think it's barbaric, shaking hands, you catch colds, you catch the flu, you catch this, you catch all sorts of things.'"

Perhaps we should substitute bows or heel clicks, but I doubt that will happen. We'll probably just have to make the best of it.

Fortunately, technology is making that easier. Before hand sanitizer, you had to find soap, water, and a (clean) towel. That wasn't always easy. (Even paper towels were a substantial step forward for public health, and now, as I've noted, there are even electric hand dryers that actually, you know, dry your hands in short order). Now hand sanitizers let you de-germ your grubby mitts pretty much anywhere. And they work.

Now they're distributing free hand sanitizer on the Washington Metro, as a means of preventing flu. Will it work? I guess we'll find out. My guess is that it will do some good. And when I mentioned this on my blog, numerous readers wrote in to report that all sorts of places, from childcare centers, to shopping malls, to cruise ships, were bringing hand sanitizers out and encouraging their use. (I like the idea of sanitizing people who go through a buffet line.)

But I think this is just the beginning. As I've noted here before, the false sense of security that resulted from the introduction of antibiotics caused us to let our guard down on a lot of sanitation and public-health issues. But with the growth of antibiotic resistance -- along with threats like avian flu and bioterrorism -- I think that people are likely to start taking these kinds of public health issues much more seriously.

And I suspect that technology will play a role. Hand sanitizer is a good example of what technology can offer -- it's cheap, portable, and easy to use. As we look toward the future, we need to look for similar technologies that will help us kill germs, keep water clean, and otherwise cut down on the risks of infection. Some of these will be big technologies that sit in water treatment plants, or in the air filters of public places. But others will be cheap, portable, and easy for ordinary people to use. Something like . . . a nose spray that blocks cold germs? Someday, somebody's going to make a lot of money selling those, and I say: bring it on.

The author is a TCS Daily Contributing Editor and founder of Instapundit.

Categories:

26 Comments

a better idea
Good idea, but as usual, I've got an even better one. Why not just stop the ridiculous and very primitive filth custom of shaking hands all the time? Why not the more sensible jap style of slight bowing, or the one where you put your open hand to your chest, or the old Royal Navy one where sailors would knock their forehead? All of these are more sensible than the dirty european one of shaking hands. In fact, I've read that some important people are already refusing to shake hands, but I think it's mostly old, rich people, who don't have to worry about giving offense. This is not to say that I'm against the european custom of kissing girls when meeting; that's different!

I like Dietmar's suggestion, but I would take it a step further...
If they're cute gals, I think deep tongue-kissing should be mandatory.

If this custom is adopted, I am going to post my email address, and start soliciting money to do research in to a quick, effective oral sterilizer. You can all be millionaires!

Penn and Teller do a show called "Male Cow Excrement," on Showtime. (If you cannot figure out what the real name of the show is, consider the initials B.S.) They had an interesting suggestion for how to replace hand-shaking...

I find it interesting that hand sanitizer will be distributed to the population
while in most states, self-service gas stations do not have disposable gloves and filling hoses with vapor capture shrouds.

These are common and inexpensive items would help reduce exposure to the toxic hydrocarbon vapors. Excessive exposure causes nerve damage and nervous disorders later in life.

Toward a germ-free life
Now I'm recalling the baby cradles in Robert Silverberg's "The World Inside". These used a blast of ionized air to sanitize the hands of anyone reaching in, to make sure no one passed any germs to Baby.

I wonder if we might soon see the equivalent of air hand dryers that also sanitize hands. That would be a start. Eventually, it might become impossible to walk through a doorway without being blasted by jets of sanitizing ions.

reality check
The shrouds on pumps were put in place to keep the hydrocarbons out of the atmosphere, in the mistaken belief that it would help to reduce ozone polution. They have nothing to do with preventing personal exposure to hydrocarbons.

Additionally, the extremely tiny amount of hydrocarbon fumes that you encounter while pumping gas, or multiple orders of magnitude to small to cause any harm.

I'm Not Sure Thats Such a Good Idea
It takes exposure to germs to develop any tolerance to them. Likewise, it takes exposure to atmospheric pollutants to avoid developing allergies.

Too clean of an environment from birth onward could lead to a generation of people who *need* clean-room conditions in order to survive.

Likewise, I'm skeptical of the value of sanitizers and such for general usage. Seems way to likely to just produce bacteria resistant to the sanitizers, at best, and also any chemically related antibiotics, at worst.

You mean in California?
There is a society outside of California. That is what I was referring to.

The vapor is enough to do damage to the myelin sheath surrounding your nerves. The myelin is lipid layer and so the nonpolar vapors would preferentially dissolve in that tissue.

Of course you can also absorb the chemicals through your skin. That is why most gas stations in Europe have the chap plastic gloves available at the pumps. One can avoid solvent poisoning if they so desire. But it is their choice whether or not to put the gloves on.

I was, in fact, surprised to see so many people using them there, compared to here when people pump gas all over the car, the ground, and their skin and cloths, pour the stuff all over their lawn mowers, breath the vapors in their garages, etc.

In general, people are more more aware of the danger in Europe.

For starters...
...it would be nice if people who are sick would stay home; but if they can't do that, then they should at least have the common decency not to shake someone's hand.

In addition to using hand sanitizers, it would also be helpful if people who are sick don't use co-workers' phones or keyboards simply because they are too lazy to walk back to their own desks.

Whenever possible, I use my own pen to sign receipts. On one occasion, when I refused the cashier's pen, he became indignant and started to make references to me being a racist. I asked him to consider how many of the people who used his pen that day might have been sick, especially since it was the flu season. He looked at me in surprise, at the pen with disgust, said that he felt like throwing the pen out, and then apologized.

Good health to you all . . .

Allergies...
...are quite frequently an inherited trait. Overexposure to certain foods and things in the environment can cause allergies. One can also develop chemical sensitivities, which are not the same as allergies, but can be just as debilitating. People with diseases such as Chronic Fatigue Syndrome frequently develop allergies and chemical sensitivities.

Using environmental controls within one's living area (most particularly the bedroom) can provide an individual's immune system with sufficient downtime from the onslaught of allergic inhalants and irritants so that less medication is needed to control the problem(s).

As for clean-room conditions, 150 years ago most homes had wood floors with area rugs that could be taken outside and beaten. In the winter, the rugs would be left to freeze in the snow (kills dustmites). Now homes have wall-to-wall carpeting with thick padding underneath -- it can harbor a great deal of dust and animal dander and provides the perfect environment for dust mites.

Another thing -- about animals -- 150 years ago, their role in the family was more utilitarian in nature. In most instances they did not live in the house.

more reality for stephen
That is the reason the sleeves were installed everywhere.

As to Europe. Most Europeans are paranoid regarding potential health threats. Just because they provide gloves, doesn't prove the gloves are needed. The gloves are probably more dangerous to your health than are the extremely tiny amounts of hydrocarbon vapors you will breath while pumping gas.

My grandfather, along with almost all mechanics, used to wash their hands with gasoline to get the oil off. He lived into his 90's.

animals
In other parts of the world, many farm animals did live in the house. Provided warmth and meant one less area to keep warm when it got really cold.

That may be true . . .
And I suspect that they had/have more problems with their allergies, not to mention fleas and parasites.

Don't get me wrong, I love animals; and despite the fact that I developed severe allergies, I am taking injections and using environmental controls so that my animals can stay with me until they live out their lives. Unfortunately, I won't be able to replace them when they pass on.

What does not kill you makes you stronger.
I grew up on a dairy farm. And anyone who grew up on a farm was exposed to a lot of manure. I also drank raw milk with all those horrible bacteria that must be killed.
That is how people lived 150 years ago. Even in cities, it was said the dried horse manure was a significant 'pollutant'. And with no anti-biotics, what did not kill you made you stronger.
Being too clean will make 'civilized' humans weak.

longetivity
Up until the turn of the century, life expectancy was barely 30 years. It has never been 150 years.

Too Clean?
" When Is Clean Too Clean?

Even with use of antiseptic preparations, which substantially reduce counts of hand flora, no reductions beyond an equilibrium level are attained (66). The numbers of organisms spread from the hands of nurses who washed frequently with an antimicrobial soap actually increased after a period of time; this increase is associated with declining skin health (67). In a recent survey, nurses with damaged hands were twice as likely to be colonized with S. hominis, S. aureus, gram-negative bacteria, enterococci, and Candida spp. and had a greater number of species colonizing the hands (64).

The trend in both the general public and among health-care professionals toward more frequent washing with detergents, soaps, and antimicrobial ingredients needs careful reassessment in light of the damage done to skin and resultant increased risk for harboring and transmitting infectious agents. More washing and scrubbing are unlikely to be better and may, in fact, be worse. The goal should be to identify skin hygiene practices that provide adequate protection from transmission of infecting agents while minimizing the risk for changing the ecology and health of the skin and increasing resistance in the skin flora.

Recommendations for the General Public

Bathing or showering cleans the skin by mechanical removal of bacteria shed on corneocytes. Bacterial counts are at least as high or higher after bathing or showering with a regular soap than before. Frequent bathing has aesthetic and stress-relieving benefits but serves little microbiologic purpose. Mild, nonantimicrobial soap should suffice for routine bathing. Bathing with an antimicrobial product reduces rates of cutaneous infection and could be beneficial when skin infections are likely or before certain surgical procedures. With those exceptions, available data do not support a recommendation for bathing with antimicrobial products.

No single recommendation for hand hygiene practices in the general population would be adequate. The potential advantage of sustained antimicrobial activity for certain occupations (e.g., food handlers and child-care providers) must be balanced with the theoretical possibility of emergence of resistant strains and perhaps other, as yet unrecognized, safety issues.

An alternative to detergent-based antiseptic products is the use of alcohol hand rinses, which have recently become widely available over the counter. Their advantages include rapid and broad-spectrum activity, excellent microbicidal characteristics, and lack of potential for emergence of resistance. Alcohol-based products could be recommended for use among persons who need immediate protection after touching contaminated surfaces or before and after contact with someone at high risk for infection."

http://www.cdc.gov/ncidod/eid/vol7no2/larson.htm

I said 150 years ago..

my bad, sorry
...

The reason why life expectancy increased...
...is because we have the drugs, information and techniques necessary to treat people who would have died 150 years ago; i.e. children with severe asthma can now lead pretty normal lives.

As for being too clean, we aren't. Our homes are full of materials that outgas; and now that we are sealing up our homes to save energy, there's an insufficient exchange of fresh air to eliminate indoor pollutants.

You might think it okay to drink raw milk as opposed to pasteurized, but remember that nowadays we are trying to keep alive people with weakened immune systems who would have died back then.

To say "what does not kill you makes you stronger" also suggests that you are looking to "weed out" the physically weaker individuals in our society.

But... they are not instaled everywhere.
What are you talking about? We don't have them here.

The gloves are supplied to prevent the gasoline and diesel from splashing on and soaking into the skin. They have little to do with vapor.

Europeans are not paranoid. They are actually cautious. There is nothing wrong with maximizibng your chance of success in life, is there?



The story of your grandfather and friends are anectodal evidence. You can actualy read toxicology studies if you want to knw the science behind the issue.

Good bacteria
What I am suggesting is that by not being exposed to typical bacteria and minor viruses, the body cannot develop normal resistance.

A common remedy for hay fever is to eat local honey to acclimate a hperactive immune system to pollen that is not harmful. (That's what causes allergies, a hyperactive immune system.)

And I am not alone thinking raw milk should be available to drink.

How willing are you to risk the creation of super viruses and bacteria to keep people alive? (Which is what has been occuring with over use and mis-use of anti-biotics.)

Probiotics:

"You probably don't think about your gut very often but this may make you start--the bacteria in your bowels outnumber the cells in your body by a factor of 10 to one. This gut flora has incredible power over your immune system, which, of course, is your body's natural defense system that keeps you healthy. In other words, the health of your body is largely tied into the health of your gut, and it's hard to have one be healthy if the other is not.

One of the reasons why your gut has so much power has to do with the 100 trillion bacteria--about three pounds worth--that line your intestinal tract. This is an extremely complex living system that aggressively protects your body from outside offenders.

However, if you are eating as many sugars as the typical American (about 175 pounds per year) then you are feeding the "bad" bacteria, which are more likely to cause disease than promote health, rather than promoting the "good" bacteria that help protect you from disease. Exposure to chemicals will also contribute to this disruption in your gut microflora, and over time the imbalance will lead to illness.

A large part of the influence of the "bad" bacteria is on the intestinal lining (mucousal barrier) that is over 300 square meters, or about the size of a tennis court."

http://www.mercola.com/2003/oct/18/bacteria_gut.htm

One program does not suit all individuals...
"And I am not alone thinking raw milk should be available to drink."

I never said it should be taken off the shelf. It should be available to anyone who wants it. However, there are people who have legitimate immune disorders who could become very sick from drinking it, and their situations should be respected.

"A common remedy for hay fever is to eat local honey..."

I switched over to a health food regimen. Some things worked; some did not. I cannot tolerate the pollens in honey.

Rotation diets and yogurt with active cultures were the precursor to what is now known as probiotics...can be very effective for improving nutrient absorption and treating food allergies.

"How willing are you to risk the creation of super viruses and bacteria to keep people alive? (Which is what has been occuring with over use and mis-use of anti-biotics.)"

I do believe that in most instances, the culprits that make us sick are viruses. If you have problems with allergic rhinitis or asthma (which breaks down the protective membranes in your sinuses and bronchioles), you'll be more prone to catching a cold or the flu. The only time antibiotics should be prescribed is when a secondary infection develops; i.e. pneumonia or bronchitis.

Eating chicken, eggs and milk that are hormone and antibiotic free proved to be beneficial. I no longer need multiple courses of antibiotics to get well.

"What I am suggesting is that by not being exposed to typical bacteria and minor viruses, the body cannot develop normal resistance."

As for exposure to germs...a neighbor enrolled her son in a daycare center. The child was a year old and I suspected he had allergies (always had a runny nose). He was constantly catching colds which would turn into sinusitis and then move on to bronchitis. I recommended she pull him out of the daycare center for six months until his immune system was better developed, but she insisted that the exposure to the germs was good for him. I told her that if he continued on as he was, that he would most likely develop chronic asthma. She ignored me. One day he developed a respiratory infection that landed him in ICU. He was diagnosed with chronic asthma. Have you ever seen an 18-month old curled up in the corner of his crib because the steroids were making him feel anxious? Upsetting to watch.

Mind the hype; no claims of effectiveness against viruses
From the Purell FAQs (http://manufacturing.gojo.com/products/faq_purell.asp):

===>

Does PURELL kill viruses?

We appreciate your concern. The FDA does not allow anti-viral claims on these types of products therefore, we cannot make any claims as to PURELL's effectiveness against viruses, such as colds, flu, SARS, HIV or Hepatitis.




From the FDA fact sheet (http://www.cfsan.fda.gov/~comm/handhyg.html):

===>

...alcohol [the main active ingredient of hand-sanitizer gels] has been shown to be ineffective against protozoan oocysts and, depending on the alcohol concentration, time, and viral variant, alcohol may not be effective against hepatitis A, or other non-lipophilic viruses.



Bottom line: Gel hand-sanitizers are probably no harm, possibly a help, but not a complete substitute for a good hand-washing.

So, essentially you're going to volunteer...
...to be a human tongue depressor and collect throat cultures.

I would love to see your face when a culture comes back positive for herpes or tuberculosis!

JUST KIDDING! :)

Hygiene Hypothesis
That's what it's called: the observation that sterile environments cripple the immune system, and make one prey to the first bug to penetrate the hygienic bubble. I've seen the recommendation that in early childhood, parents feed their children ~1 tsp of soil per day. With or without sugar-free sweetener.
As to gut bacteria, all in all there are about 10x the bacteria in the human body as human cells. We're really just transport and feeding platforms for the microbial community. ;)

Dessicate 'em!
Excellent information. Thank you.

I have recently become a proselytizer and evangel for a particular alcohol: glycerol, aka glycerin. Methanol is the 1-carbon alcohol, ethanol the 2, and glycerol is 3-carbon (C3O3H8). It is non-volatile, non-toxic, and, it turns out, a signaling compound in cellular maturation, and as such rapidly reduces inflammation. But it has a secret side effect applied topically (in pure form, Glycerin USP). As a potent dessicant, it instantly dries out and kills any bacteria it contacts.

When used, it feels oily, about the viscosity of corn syrup, but self-transports into the skin over about 10 minutes (more of its signaling functionality -- it opens cellular portals). Doubles healing speed, halves scarring, marvelous treatment for psoriasis and/or any other skin disfunction. Dirt cheap; ~$2/4oz bottle at your neighborhood drugstore. That amount would last weeks of routine use.

Damaging skin
Hand-washing, vigorous and frequent, damages the skin and increases bacterial and viral loads. Read the Too Clean? post above.

TCS Daily Archives