您关注过洗手的水温吗？

dearhang

检索丨刘金淑（河南省濮阳市油田总医院）
译者丨孔晓明（江苏省溧阳市人民医院）
审核丨刘金淑  陈志锦


医务人员手卫生在预防医院感染所起的作用与地位，己受到普遍的关注。但在日常治疗和护理工作中，医务人员的手卫生现状却不容乐观，较低的手卫生依从率已成为当今医院感染管理的重点问题，我们多次关注了手卫生的依从性，但是您关注过洗手的水温吗？


用热水还是冷水，才能更有效清除手中的细菌？






我们都知道洗手可以阻止细菌传播，预防生病。然而，用热水还是冷水，才能更有效清除手中的细菌？根据新不伦瑞克省罗格斯大学的一项新研究发现，冷水清除有害细菌的能力与热水相当。


食品科学杰出教授和推广专家沙夫纳·唐纳德（Donald Schaffner）说：“人们在洗手时需要感觉舒适，但就除菌效能而言，本项研究向我们表明了所用水的温度并不重要。”


在《食品保护》杂志六月刊发表的“罗格斯”研究报告中，将高水平的无害细菌污染在21名参与者的手中，然后要求用华氏60度（约15.5℃）、79度（约26.1℃）或100（约37.8℃）度的水温，使用0.5ml、1ml或2ml的肥皂进行洗手。


这项研究可能对水能有重大意义，因为与温水或热水相比，使用冷水能节省更多的能源。而且研究还发现，洗手10秒钟就能显著地清除手上细菌。


研究还表明，肥皂的使用量对于细菌清除并没有差别，但是需要做更多的研究才能准确了解从手中清除有害微生物所需的肥皂量和类型。这是很重要的，因为最大的公共卫生需求是在食用、准备食物和使用洗手间之前，增加餐饮服务员和大众消费者的洗手或手消毒频率。


这些发现非常重要，特别是对餐饮和食品行业，因为美国食品和药物管理局（FDA）每四年向各州发布指南，该指南目前建议食品行业和餐馆的管道系统提供华氏100度（约37.8℃）的洗手用水。


水温问题已经争论了很多年，但没有足够的科学依据来支持改变指南，或提供水温在手卫生方面差异的研究。实际上不少州将FDA指南解读为要求洗手水温必须达到100华氏度（约37.8℃）。


FDA计划在2018年举行一次会议，讨论现存法规中一些本该进行修订的地方。沙夫纳希望到时候能修订水温政策，他认为这项研究能够作为指南修订的依据，对于洗手用水的水温要求，指南应该要求提供舒适用水或者温水，若将洗手用水加热到不必要的水温，只是在浪费能源！


来源：罗格斯大学


Cool Water as Effective as Hot for Removing Germs During Handwashing
Posted in News, Hand Hygiene, Research Print



We all know that washing our hands can keep us from spreading germs and getting sick; however, a new Rutgers-New Brunswick study found that cool water removes the same amount of harmful bacteria as hot.


"People need to feel comfortable when they are washing their hands but as far as effectiveness, this study shows us that the temperature of the water used didn't matter," said Donald Schaffner, distinguished professor and extension specialist in food science.


In the Rutgers study, published in the June issue of the Journal of Food Protection, high levels of a harmless bacteria were put on the hands of 21 participants multiple times over a six-month period before they were asked to wash their hands in 60-degree, 79-degree or 100-degree water temperatures using 0.5 ml, 1 ml or 2 ml volumes of soap.


"This study may have significant implications towards water energy, since using cold water saves more energy than warm or hot water," said Schaffner. "Also we learned even washing for 10 seconds significantly removed bacteria from the hands."


While the study indicates that there is no difference between the amount of soap used, more work needs to be done to understand exactly how much and what type of soap is needed to remove harmful microbes from hands, said co-author Jim Arbogast, vice president of hygiene sciences and public health advancements for GOJO. "This is important because the biggest public health need is to increase handwashing or hand sanitizing by foodservice workers and the public before eating, preparing food and after using the restroom," Arbogast said.


These findings are significant, particularly to the restaurant and food industry, because the Food and Drug Administration (FDA) issues guidelines, every four years, to states. Those guidelines currently recommend that plumbing systems at food establishments and restaurants deliver water at 100 degrees Fahrenheit for handwashing.


Schaffner said the issue of water temperature has been debated for a number of years without enough science to back-up any recommendation to change the policy guidelines or provide proof that water temperature makes a difference in hand hygiene. Many states, in fact, interpret the FDA guidelines as a requirement that water temperature for handwashing must be 100 degrees, he said.


The FDA is scheduled to hold a conference in 2018 to discuss the existing code and any modifications that should be made and Schaffner would like to see the water temperature policy revised at that time.


"I think this study indicates that there should be a policy change," said Schaffner. "Instead of having a temperature requirement, the policy should only say that comfortable or warm water needs to be delivered. We are wasting energy to heat water to a level that is not necessary."


Source: Rutgers University


图文编辑：独白
审稿：高晓东 马嘉睿