July 29, 2014
News Review From Harvard Medical School -- Study: Bump Beats Shake for Germ Control
To reduce the spread of germs, at least in hospitals, a new article argues for bumping fists instead of shaking hands. Researchers worked in pairs. Both put on a pair of new, germ-free (sterile) gloves for each experiment. One person dipped a glove into a solution containing E. coli bacteria. The researchers bumped fists. Then they removed the gloves so the germs on the formerly sterile glove could be measured. Using different gloves, they tried the same experiment with two other greetings: handshaking and "high fives" (slapping palms together). Handshaking transferred 10 times as many germs as a fist bump and twice as many as a "high five." The Journal of the American Medical Association recently called for banning handshakes in hospitals. The new findings appear in the American Journal of Infection Control. HealthDay News wrote about them July 28.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
The handshake may be the most important nonverbal way that we communicate. It is a standard gesture when we say hello, goodbye and make an agreement. We don't know exactly when it began. Apparently, it became accepted practice before written history.
But is it time to consider changing this centuries-old tradition? Hands carry germs that can spread infections to others. Some of these infections can be very serious, including those that can't be killed by standard antibiotics.
Authors of a recent article suggest that handshaking be banned in hospitals. That's because, despite the daily efforts of infection-control teams, hospital workers only get hand cleansing right 40% of the time.
The Journal of the American Medical Association published the article. It's a bold opinion piece. The handshake is a traditional way doctors and all health-care professionals convey warmth and empathy to patients, family members and colleagues.
This article takes a scientific look at one potential alternative to the handshake -- the "fist bump." Two people touch only the outsides of each other's closed hands. This can be embellished with some flair as you quickly pull away your fist, then open your hand toward the other person.
The authors' experiment was simple. Two people at a time were paired up. Each person put a sterile glove on the right hand. One person dipped the gloved hand into a solution filled with E. coli bacteria. The other kept the glove sterile. They shook hands.
Then they took off the gloves, washed their hands and put on new sterile gloves. Again, one of them dipped into the bacterial solution. The other kept the glove sterile. This time they did a fist bump. The process was repeated many times.
The gloves that were sterile before the handshakes and fist bumps were tested for the amount of bacteria on them. The handshake transmitted 10 times as many bacteria to the sterile hand as the fist bump.
What Changes Can I Make Now?
The fist bump will take a lot of getting used to. For many, it just won't be a good substitute for the handshake.
So frequent hand cleaning remains an important way to prevent infection and avoid spreading germs to others. It's especially important if you are a hospital patient or visiting a patient.
Alcohol-based hand cleansers usually work just as well as washing with soap and water. The important exception is Clostridium difficile ("C. diff"). This bacterial infection causes diarrhea. Alcohol does not kill it. Hand washing with soap and water is a must when visiting a patient with this infection.
What Can I Expect Looking to the Future?
The authors of this opinion piece suggest that hospitals begin the movement to seek alternatives to handshaking. Perhaps we could place signs everywhere, saying: "Handshake-free zone. To protect your health and the health of those around you, please refrain from shaking hands while on these premises."