Help Resist Flu by Washing and Drying Your Hands Appropriately
Ralph Morris, MD, MPH

towel
Which to use: Electric air dryer or paper towels? You may be better off drying your hands with paper towels.

It is January and the flu season is off to its earliest start in 10 years (Centers for Disease Control and Prevention (CDC)). CDC currently reports that 41 states have widespread influenza activity as of the end of December. The flu is a common strain this year but it is causing more severe symptoms.  Colds and norovirus are making the rounds too.  The CDC says good hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others.  Increasingly public health professionals are asserting that good hand hygiene consists not only of appropriate washing but also appropriate drying.

Bacteria Prefer Wet Hands

Hand Hygiene in a Nutshell

Using clean, warm running water and soap, scrub hands for at least 20 seconds (the amount of time it takes to sing the “Happy Birthday” song twice). Be sure to scrub the backs, between fingers and under nails, if a nail brush is available. Rinse with clear water. Finally, dry hands thoroughly using a clean paper or cloth towel or under an electric air dryer. To avoid introducing additional bacteria, do not rub your hands together under the electric air dryer.

It is important to dry hands thoroughly after washing because some bacteria remain on hands after washing, and these bacteria are more easily spread via wet hands than dry ones.  Many public restrooms feature electric air dryers as a hygienic option for hand drying, but a new report from the Mayo Clinic finds that people do not take the time to dry their hands completely using these devices.  Some people say it takes too long.  Instead, they may “dry their hands for a bit, then wipe them on their dirty jeans, or open the door with their still-wet hands,” according to Rodney Lee Thompson, a hospital epidemiologist at the Mayo Clinic, quoted in the Wall Street Journal.  These behaviors may be the undoing of a good hand washing.

Electric Dryers vs. Paper Towels

Air drying is a topic we addressed nearly two years ago (Hand Drying:  Here’s the Rub) when we reported that drying hands by rubbing them together under electric dryers is a poor option compared to paper towel drying or using electric air dryers that rapidly strip moisture from hands and do not require hand rubbing.

Flu Facts

Flu symptoms include fever, cough, headache, fatigue and malaise. If you have these symptoms stay home and take over the counter drugs that help reduce flu symptoms. Patients under two years old and the elderly with underlying conditions such as diabetes or heart and lung conditions should be seen by a doctor.

Remember it is never too late to be vaccinated for the flu.

Rubbing hands together under an electric dryer can bring bacteria that live within the skin to the surface.  We concluded that if rapid dryers are not available (those do not require hand-rubbing), paper towels are the best option for hand drying.  The new Mayo Clinic review of twelve studies appears to be consistent with this advice.  In fact, the study reveals that in addition to being too slow for the average restroom visitor to use properly, electric air dryers may also contaminate the restroom environment by dispersing contaminant droplets.  Other factors for comparison include skin irritation (air dryers may enhance this); noise (paper towel use is certainly quieter than electric air dryers); cost (a facility-specific cost analysis is recommended) and environmental impact (electric air dryers have a lower impact than paper use).

During flu season especially, users of public restrooms should make a conscious effort to achieve the best hand hygiene using the tools available. This includes washing hands well and drying thoroughly with paper towels, if possible. Paper towels can also be used as a barrier when turning off faucets and opening restroom doors to exit.

When it comes to hand hygiene, knowing the facts can help you act strategically to avoid infection!

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

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