Table of contents :

• shower curtains awash with potentially harmful bacteria : around 80% belonged to sphingomonads and methylobacteria. Each time you take a shower you are engulfed by an aerosol of bacteria : in most cases, that will not be dangerous but if you have an unprotected cut, or your immune system is suppressed, it could be a different story with species that are opportunistic pathogens. The bacteria probably feed on volatile organic chemicals shed from human bodies (when you cough, belch or fart, you're putting a lot of organic chemistry in there) and plasticizers (chemicals which make shower curtains more flexible) rather than on soap. Other studies have found that the air just above water level in a typical Jacuzzi, or hot tub, is packed with bacteria that can cause lung infections.
• cloth hygiene
• detergent-free cleaning is being developed by researchers in Australia. Oil and grease can be washed away with nothing but pure water. Oily dirt does not normally dissolve in water. But water is much better at dispersing oily substances if any air dissolved in it is removed, in a process called degassing. Water can be degassed cheaply and efficiently by using several cycles of freezing and vacuum pumping through a porous membrane and then sprayed on to surfaces and fabrics. Industrially, other methods may be more appropriate, such as passing the water through a membrane made from hydrophobic material, which would absorb dissolved gas. This could reduce our use of detergents, which create environmental problems when they are washed into the water system: detergents can fertilize algal growth so much that animals in swamps and lakes are harmed. Normal water contains tiny nitrogen and oxygen bubbles. These accumulate on the surface of water-repellent, or hydrophobic, materials that are in contact with the water. This layer of gas molecules causes larger bubbles to form between hydrophobic surfaces. And the surface tension of any bubble bridging 2 surfaces pulls the particles together. In effect, air bubbles act like a glue that prevents oily substances from breaking up. This makes it harder for an oil droplet to detach from a greasy stain and become dispersed in water. But if the tiny bubbles are removed, that happens more easily. Conventional detergents surround grease droplets with a layer of detergent molecules, giving them a water-soluble coating. The team removes gas from water samples using several cycles of freezing and vacuum pumping. Degassed water reabsorbs gases when exposed to the air, but the this would happen so slowly that it would not harm the cleaning power of freshly degassed water sprayed on dirty material. In fact, as air seeps into the used water, it could cause dirt particles in the water to stick together, making them easy to filter out^ref.
• self-cleaning clothes : cotton clothes are coated with 20-nm titanium dioxide particles (catalysts that help to produce free-radical oxygen, a powerful oxidizing agent that can break down carbon-based molecules into smaller particles such as CO₂ and water and require only Sun UV rays to trigger the reaction. Because the catalyst does not get used up, it can keep on working as long as it is exposed to sunlight) arranged in an 'anatase' crystal structure (which boosts the particles' catalytic power) by dipping cotton patches into a liquid slurry of titanium dioxide for just half a minute before removing them, padding them dry, and heating them to 97 °C in an oven for 15'. 3 hours in boiling water completed the coating process. Self-cleaning materials are particularly popular in the Far East, and a quarter of all toilet bowls coming on to the market in Taiwan, for example, now come with self-cleaning nano-coatings. So clothes may be the next step^ref.
• keyboards and keyboard covers of computers : some potentially harmful bacteria can survive for prolonged periods of time. The problem is especially important in hospitals and other healthcare environments where patients are at risk of contracting bacterial infections from healthcare providers who use computers. VRE and MRSA were capable of prolonged survival, with growths of the bacteria evident 24 hours after contamination. Pseudomonas aeruginosa, on the other hand could be recovered only up to 1 hour on the keyboard and 5 minutes on the keyboard cover. The more contact with the contaminated keyboards, the more the likelihood of transmitting bacteria to the hands. The most effective quaternary ammonium disinfectant was one in which the solution remains on the cleaned surface for 10 minutes before it is wiped off. Another, with a recommend exposure to the surface of 5 minutes effectively disinfected keyboards, but not keyboard covers.
• liquid carbon dioxide (CO₂), which forms when the gas is compressed to > 100 times atmospheric pressure, is increasingly used as an environmentally friendly solvent to remove undesirable chemicals: for example, it is used to extract caffeine from coffee. It is a greener alternative to the ozone-depleting carbon tetrachloride (CCl₄)  found in standard dry cleaning fluids.
• pressurized washing machine to clean lab coats contaminated with Co and Sr using water and supercritical carbon dioxide CO₂ - a liquid form of the gas. Any radioactive metals become trapped inside tiny water bubbles and a surfactant stabilizes the tiny bubbles suspended inside the CO₂ : then, when the pressure is released, the contaminated water can be removed and the clean CO₂ reused. The surfactant may be too costly to allow immediate commercialization of the process, but many scientists are developing new CO₂-soluble surfactants, which will inevitably get cheaper. The radioactive materials could be turned into a solid for easier storage. The technique uses 100 times less water (currently discharged directly into sewage systems) than conventional laundry methods, and > 90% of the contamination is removed after just one hour of washing at 40°C
Web resources :
• The interatomic structure of water at supercritical temperatures
• Supercritical fluids as solvents for chemical and materials processing

• aseptic or sterile technique : any procedure designed to keep a surgical field as nearly aseptic as possible, e.g., gloving of the surgeon and aides, draping of the patient, autoclaving of instruments, and proper disposal of waste
• asepticism : the principles and practices of aseptic techniques.
• aseptic-antiseptic : both aseptic and antiseptic

• acids or alkals at 1÷2% don't affect Streptococci, Staphylococci, Mycobacteria (that resist 10% acids and 4% alkales !)
• halogens act peroxidating membranes
• iodine-based topical (cutaneous) antisepticals : iodine inactivates sulphydryl groups in enzymes. They are very effective against both gram positive and gram negative bacteria, aand have intermediate effectiveness against mycobacteria, spores, fungi and viruses. They are also used for disinfection of objects and surfaces.
• iodine tincture : a preparation of 2% iodine and sodium iodide in diluted 70% alcohol, used as an anti-infective on the skin
• iodoquinol / diiodohydroxyquin : an amebicide, used in the treatment of intestinal amebiasis, administered orally, and in Trichomonas vaginalis vaginitis, administered intravaginally. It has also been used topically in fungal and bacterial skin infections and in seborrheic dermatitis
• iodochlorhydroxyquin / clioquinol : an antibacterial and antifungal agent with antieczematic and antipruritic properties, used as a local anti-infective in a wide range of dermatoses, including all types of eczema, and in vaginitis due to Trichomonas vaginalis, Candida albicans, Trichophyton, or mixed bacteria; administered topically or intravaginally. It was formerly administered orally in the treatment of amebic dysentery; this use has been discontinued because of associated neurotoxicity.
• iodoform : chemical name: triiodomethane. A greenish yellow powder or crystals, CHI₃, having a strong, penetrating odor, containing about 96% of iodine, and soluble in chloroform and ether and somewhat in alcohol and water: used as a topical anti-infective, applied to the skin
• povidone-iodine (PVP-I) (Betadine^®) : a complex produced by reacting iodine with the polymer povidone, which slowly releases iodine; it occurs as a yellowish brown, amorphous powder and is used as a topical anti-infective
• iodophores : any of various compounds of iodine with carriers such as polyvinylpyrrolidone; used as surgical scrubs, surface disinfectants, and veterinary medicine skin disinfectants, acting at acidic pH
• mercury-based compounds
• mercury chloride (HgCl₂) inactivates proteins by reacting with sulfide groups. Disinfectant, although occasionally used as an antiseptic on skin.
• nitromersol : a mercurial compound used as a local anti-infective; applied in solution topically to the skin and mucous membranes. It is also used to disinfect surgical and dental instruments
• organomercurial antiseptic
• thimerosal / thiomersal / thiomersalate / ethyl mercury / timerfonate / sodium mercuthiolate / merthiolate / ethylmercurithiosalicylate is actively antifungal and bacteriostatic for many nonsporulating bacteria; used as a topical anti-infective and as a preservative in pharmaceutical preparations
• silver nitrate (AgNO₃) precipitates proteins : general antiseptic and used in the eyes of newborns.
• alcohols denature (coagulate) proteins and solubilize lipids. They have intermediate effectiveness against both gram positive and gram negative bacteria, poor effectiveness against spores, fungi and most viruses, and are not effective against Mycobacterium tuberculosis : used on skin, they are effective against HBV and most likely against HCV as well. However, it is important to ensure adequate contact between the disinfectant and the viruses on contaminated surfaces. This may not always occur by simple wiping with alcohol.
• ethanol ( is best effective at 70-80% ^v/_v)
• isopropanol (70-80%)
• phenolic compounds at low concentrations disrupt cell membranes and at high concentrations denature proteins. They have variable activity according to compounds and are also used for disinfection of objects and surfaces.
• carbolic acid / phenol
• lysol
• hexylresorcinol
• hexachlorophene
• trichlorophenol : a disinfectant and external antiseptic.
• anionic tensioactive compounds (soaps) disrupt cell membranes

• hair hygiene. Common shampoos usually contain :
• dental, mouth or oral hygiene : the personal maintenance of cleanliness and hygiene of the teeth and oral structures by toothbrushing, tissue stimulation, gum massage, hydrotherapy, and other procedures recommended by the dentist or dental hygienist for the preservation of dental and oral health. Common toothpastes (e.g. Dentosan^®) usually contain :
• water
• chlorhexidine : an antibacterial, very effective against a wide variety of gram-positive bacteria, intermediately effective against gram-negative bacteria, poorly effective against fungi, and not effective against mycobacteria and spores
• chlorhexidine acetate : the diacetate salt of chlorhexidine, having the same actions as the base; used mainly as a preservative for eye drops
• chlorhexidine gluconate (Corsodyl^®) : the digluconate salt of chlorhexidine, used as a topical anti-infective for the skin and mucous membranes.
• chlorhexidine hydrochloride : the dihydrochloride salt of chlorhexidine, having the same actions as the base; used as a topical anti-infective for the skin and mucous membranes.
• sorbitol
• hydrated silica
• PEG-32
• sodium lauryl sulfate
• aroma
• cellulose gum
• Salvia officinalis extract
• guaiazulene
• glycerin
• sodium benzoate
• sodium fluoride
• disodium phosphate
• trisodium phosphate
• sodium saccharine
• methylparaben
• propylparaben
• imidazolidinyl urea
• CI 77891
• CI 75810
• hand hygiene (HH) : general term that applies to handwashing, antiseptic handwash, antiseptic hand rub, or surgical hand antisepsis. Many studies have shown that the bacteria that cause nosocomial (hospital-acquired) infections are most frequently spread from one patient to another on the hands of healthcare workers. A scientific study performed in a hospital nursery found that babies acquired staphylococci more frequently when cared for by nurses who didn't wash their hands than babies cared for by nurses who washed their hands between patient contacts with an anti-microbial soap. Numerous studies show that proper HH reduces the spread of bacteria in various healthcare settings. Nurses, doctors and other healthcare workers can contaminate their hands by doing simple tasks, including:
• assisting patients with mobility (pulling patients up in bed)
• taking a patient’s blood pressure or pulse;
• touching the patient’s hand
• rolling patients over in bed
• touching the patient’s gown or bed sheets
• touching equipment, including bedside rails, over-bed tables, IV pumps.
Resistant bacteria on the skin or in the gastrointestinal tract of patients can often be found on common items and healthcare workers can contaminate their hands by touching environmental surfaces near affected patients. The frequency of environmental contamination of surfaces in the rooms of patients with methicillin-resistant S. aureus (MRSA) patients is :
• bed linen (55%)
• patient gown (52%)
• overbed table (42%)
• BP cuff (35%)
• side rails (30%)
• bath door handle (22%)
• IV pump button (18%)
• room door handle (8%)
Why do we need to improve hand hygiene practices?
• serious nosocomial (hospital-acquired) infections
• 90,000 patient deaths per year
• costs of treatment: $4.5 Billion per year in the U.S.
• hand washing compliance rates are unacceptable (average 40%)
Patients often carry resistant bacteria on their skin. Patients with resistant bacteria like methicillin-resistant S. aureus (MRSA) or vancomycin-resistant enterococci (VRE) often carry the organism on many areas of their skin, even when they don’t have any wounds or broken skin. Patients often carry the MRSA organism on the skin under their arms (13-25%; where temperature is usually measured), on their hands or wrists (40%), or in the groin area (30-39%).
In 34 studies of hand washing, workers washed their hands only 40% of the time. There are a variety of reasons for such a poor compliance with recommended hand washing guidelines including
• heavy workloads (too busy) . a recent study showed that the busier healthcare workers are, the less likely they are to wash their hands when recommended. Nursing shortages have caused nurses to be busier than ever before
• sinks used for handwashing are often installed in inconvenient locations. Personnel may fail to wash their hands when indicated  because it is too much trouble to get to the sinks provided
• skin irritation and dryness caused by frequent exposure to soap and water. In the winter months, some personnel may even develop cracks in their skin that cause bleeding
• hands don't look dirty
• handwashing takes too long
Since washing hands frequently with soap and water is inconvenient, time-consuming, and often causes skin irritation and dryness experts have suggested that hospitals, extended care facilities, and home health agencies develop new strategies for improving hand hygiene among healthcare workers. We need to make it easier for you to clean your hands quickly, with a minimum of effort and skin irritation. One way to accomplish these goals is to clean your hands with an alcohol-based hand rub (ABH). One study found it took ICU nurses an average of 62 seconds to go to a sink, wash and dry their hands, and return to patient care activities. However, in the same hospital, it was estimated that if an ABH was available at each patient's bedside, it would take nurses about 15 seconds to clean their hands. Hand hygiene compliance by ICU personnel before (25%) and after alcohol dispensers were installed next to every 4th bed (42%) and next to every bed (49%).
When compared to traditional soap and water handwashing, ABH have the following advantages :
• take less time to use
• can be made more accessible than sinks
• cause less skin irritation and dryness
• are more effective in reducing the number of bacteria on hands
• makes ABH readily available to personnel
• has led to improved HH practices
Wash your hands with plain soap and water; or with antimicrobial soap and water if :
• your hands are visibly soiled (dirty)
• hands are visibly contaminated with blood or body fluids
• before eating
• after using the restroom
How to wash your hands effectively :
• wet hands first with water (avoid HOT water)
• apply 3 to 5 ml of soap to hands
• rub hands together for at least 15 seconds
• cover all surfaces of the hands and fingers
• rinse hands with water and dry thoroughly
• use paper towel to turn off water faucet
New guidelines developed by the Centers for Disease Control and Prevention (CDC) and infection-control organizations recommend that healthcare workers use an alcohol-based hand rub (ABH) (an alcohol-containing gel, rinse or foam designed for application to the hands to reduce the number of microorganisms on the hands. In the United States, such preparations usually contain 60-95% ethanol or isopropanol) to routinely clean their hands between patient contacts, as long as hands are not dirty. Use an ABH for routinely cleaning your hands if your hands are not visibly soiled or contaminated with blood or body fluids :
• before having direct contact with patients;
• after having direct contact with a patient’s skin;
• after having contact with body fluids, wounds or broken skin;
• after touching equipment or furniture near the patient; and
• after removing gloves.
DO NOT OPT FOR AN ALCOHOL-BASED HAND-RUB WHEN HANDS ARE VISIBLY SOILED OR CONTAMINATED WITH BLOOD OR BODY FLUIDS!
How to use an alcohol-based hand rub :
• apply 1.5 to 3 ml (about the size of quarter) of an alcohol gel or rinse to the palm of one hand, and rub hands together;
• cover all surfaces of your hands and fingers, including areas around/under fingernails; and
• continue rubbing hands together until alcohol dries (about 15-25 seconds).
Make sure your hands are completely dry prior to putting on gloves. Wash your hands with soap and water when you feel a “build-up” of emollients on your hands (after cleaning 5 to 10 times). Both washing and wiping must be done in a distal => proximal manner. If you clean your hands with an ABH before putting on gloves, make sure the alcohol has dried completely before putting on gloves. > 20 published studies prove alcohol-based hand rubs are more effective than soap in reducing the number of bacteria on hands. Several studies show that nurses who routinely cleaned their hands between patients by using an alcohol-based hand rub had less skin irritation and dryness than nurses who washed their hands with soap and water. Alcohol-based hand rubs contain skin conditioners (emollients) that help prevent the drying effects of alcohol.
• handwashing : washing hands with plain (non-antimicrobial) soap and water (reduces permanent microflora).
• hand antisepsis : refers to either ....
• antiseptic handwash : washing hands with water and soap or other detergents containing an antiseptic agent.
• antiseptic hand rub : applying an antiseptic hand rub product to all surfaces of the hands to reduce the number of microorganisms present.
• surgical hand antisepsis : antiseptic handwash or antiseptic hand rub performed preoperatively by surgical personnel to eliminate transient bacteria and reduce resident hand flora. Antiseptic detergent preparations often have persistent antimicrobial activity.
• decontaminate hands : reducing bacterial counts on hands by performing antiseptic hand rub or antiseptic handwash.
• cumulative effect : a progressive decrease in the numbers of microorganisms recovered following repeated applications of a test material.
• substantivity : an attribute of some active ingredients that adhere to the stratum corneum, remaining on the skin after rinsing or drying, to provide an inhibitory effect on the growth of bacteria remaining on the skin.
• visibly soiled hands : hands showing visible dirt or visibly contaminated with proteinaceous body substances (e.g., blood, fecal material, urine).
• soap : any compound of one or more fatty acids, or their equivalents, with an alkali. Soap is detergent and is much employed in liniments, enemas, and in making pills. It is also a mild aperient, antacid, and antiseptic.
• plain soap : detergents that do not contain antimicrobial agents, or contain very low concentrations of antimicrobial agents that are effective solely as preservatives.
• antimicrobial soap : soap (detergent) containing an antiseptic agent.
• antiseptic agent : antiseptics are antimicrobial substances that are applied to the skin to reduce the number of microbial flora. Examples include alcohols, chlorhexidine, chlorine, hexachlorophene, iodophors, chloroxylenol (PCMX), quaternary ammonium compounds, and triclosan.
• carbolic soap : a disinfectant soap containing 10% of phenol.
• curd soap / sapo domesticus.
• potash or soft soap / sapo mollis : a liquid soap made from potash and some oil
• medicinal soft or green soap / potash soap / sapo mollis medicinalis : a potassium soap made by the saponification of vegetable oils, excluding coconut oil and palm kernel oil, without the removal of glycerin. It is the chief ingredient of green soap tincture
• hexachlorophene liquid soap : a solution of hexachlorophene in a 10-13% solution of potassium soap, used as a topical anti-infective and detergent.
• superfatted soap : a soap having an excess of fat over that necessary to neutralize all the alkali.
• zinc soap : a soap containing zinc oxide or zinc sulfate; for use as an ointment or plaster.
Healthcare workers (HCW) should wash their own hands every 6' on average (!). Simples soaps usually contain :
• aqua
• sodium laureth sulfate
• glycerin
• cocaimidopropyl betaine
• polyquaternium-10
• PEG-120 methyl glucose dioleate
• PPG-20 methyl glucose ether
• parfum
• Camellia sinensis extract
• glycol distearate
• hydroxycetyl hydroxyehtyl dimonium chloride
• laureth-10
• propylene glycol
• sodium chloride
• disodium EDTA
• cocaimide MEA
• triclosan : an antibacterial effective against gram-positive and most gram-negative organisms and exhibiting slight activity against yeasts and fungi; used as a detergent in surgical scrubs, soaps, and deodorants.
• benzophenone-4
• methylchloroisothiazolinone
• methylisothiazolinone
• CI42051
• CI19140
• PEG-40 hydrogenated castor oil
• trideceth-9
• pentylene glycol
• sine adipe lac
• mel
• styrene/acrylates copolymer
• antiseptical cleaning (reduces both permanent and transient skin microflora): antiseptical liquid soap (e.g. : chlorhexidine-based, polyvidone iodine-based or alcohol-based handrubs (ABH)); lathering for 1', expecially under nails and in interdigital spaces. It is necessary before inserting urinary or peripheral venous catheters, or before contact with individuals colonized by multi-drug resistant microorganisms..
• cleaning for surgeons (eliminates transient microflora and reduces permanent microflora) : use filtered water or let it flow for 1' ; antiseptical liquid soap (see above) ; lathering a first time and washing ; lathering a second time and brushing (30" per hand) ; lathering a third time (1' per hand, 30" per forearm). Wiping with a sterile towel. Dressing : mask => cloak => sterile gloves (lower borders are folded out to allow handling : they must be stretched by inserting the sterile glove on the other hand in the fold (not on the refolded surface !)). It is necessary before surgical operations, insertion of central catheter, drainings, hemodynamic explorations or extracorporeal circulation.
Web resources :
• CDC Guidelines : Hand hygiene
• Hand Hygiene Resource Center (HHRC)
• Hopisafe by University of Geneva Hospitals
• Guidelines & Recommendations for Handwashing and Hospital Environmental Control by CDC
• Patient Education Handwashing Model by University of Pennsylvania School of Medicine
• Stalking the Mysterious Microbe (designed for school children)
• pedicures : consumers can avoid painful skin infections on their legs by following these recommendations :
• do not shave legs or have any open wounds on legs or feet before the pedicure.
• ask whether foot spas, or foot bath units, have been cleaned and disinfected after each use.
• manicurists/pedicurists should wash their hands with soap and water before touching a client's hands or feet.
• make sure the technician is washing the instruments in hot soapy water, and, that disinfectant is applied to the instruments. Soiled instruments must be stored separately from clean instruments.
• emery boards that are not approved for disinfection should be discarded after use to prevent transmission of yeast or bacterial infections.
• instruments and supplies that cannot be disinfected, such as orange sticks and the sponges placed between the toes, should be discarded after use.
• drill bits should be cleaned after each client.
• leave the salon if you have any doubts about its cleanliness.
• a person who may have acquired an infection from a salon or spa should contact a physician for immediate treatment. Manicures and pedicures should not be painful; they shouldn't make your cuticles bloody and swollen.

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