How much do you know about hand washing?  Take this true-false quiz and find out. Hint: it’s the most important thing we can do to prevent spreading germs that cause illness in ourselves, our families, co-workers and everyone with whom we come in contact.

Q. Wash hands BEFORE preparing food; eating; touching your eyes, nose or mouth; caring for a sick person; or treating a cut or wound.

A. True.

Q. Wash hands AFTER using the toilet, preparing food, caring for a sick person, changing diapers or cleaning up after a child who has used the toilet, handling pets or their waste, treating a cut or wound, taking out the garbage, sorting/washing laundry, and blowing your nose, sneezing or coughing.

A. True. Which of these do you routinely ignore?

Q. Use alcohol-based (with at least 60% alcohol) hand sanitizer if soap and water are not available.

A. True. Apply the product to one palm and rub it over all surfaces of your hands and fingers until your hands are dry – should take about 20 seconds. However, research shows that hand sanitizers are less effective if your hands are visibly dirty or greasy. They work best in clinical settings like hospitals where there are a lot of germs but generally not heavily soiled hands. Also, alcohol-based hand sanitizers are not good at removing harmful chemicals such as pesticides. Hand sanitizer should be kept out of the reach of young children because, if swallowed, it can cause alcohol poisoning.

Q. Alcohol-based hand sanitizer contributes to antibiotic resistance, and it’s more damaging to hands than soap and water.

A. False. Alcohol-based sanitizer kills germs quickly and in a different way than antibiotics. It does not cause antibiotic resistance. And, it causes less skin irritation than frequent washing with soap and water.

Q. Non-alcohol-based sanitizers can cause germs to develop resistance to the sanitizing agent.

A. True. They merely reduce the growth of germs rather than killing them outright. They are also more likely to irritate skin than alcohol-based sanitizers.

Q. Clean hands can be a matter of life and death.

A. True. About a million health care-associated infections occur each year in U. S. hospitals, killing about 75,000 patients during their hospital stay. The Centers for Disease Control and Prevention (CDC) calls hand-washing “a do-it-yourself vaccine.” C. difficile, a common health care-associated infection that causes severe diarrhea, forms spores that are not killed by an alcohol-based hand sanitizer. Soap and water is the preferred method for removing C. difficile spores. Hand washing with soap and water could reduce deaths from diarrhea diseases by up to 50 percent. Also, most foodborne disease outbreaks are spread by contaminated hands.

Q. You should clean under your nails twice a week.

A. False, that’s not nearly often enough. The undersides of finger nails should be cleaned frequently with soap and running water. Longer fingernails can harbor more dirt, bacteria and more easily spread infection than short nails. Before clipping or grooming nails, properly clean nail clippers, files and other equipment. Sterilizing equipment before use is especially important when nail tools are shared among a number of people, as in commercial nail salons. Avoid cutting cuticles, as they act as barriers to prevent infection. Never rip or bite a hangnail; clip it with a clean nail trimmer.

Q. Good hand washing is a two-step process.

A. False. The CDC recommends these 5 steps:

  • Wet your hand with clean, cool, running water; turn off the tap and apply plain soap. Warm water may cause more skin irritation, is costlier and does not improve germ removal.
  • Lather your hands by rubbing them together and include the palms, backs of your hands, between fingers and especially under your nails.
  • Scrub for 15-30 seconds, depending on how dirty your hands are. The soap-friction combination helps lift dirt, grease and microbes from skin.
  • Rinse hands well under clean, running water.
  • Dry hands using a clean towel or disposable paper toweling for about 20-30 seconds. Germs can be transferred more easily to and from wet hands.

Q. You don’t need to ask your doctor to clean his or her hands because they always do this before treating the next patient.

A. False. Although it is known that hand contact is a major way that germs are spread in medical facilities, studies show that some health care workers clean their hands less than half of the times they should. You have every right to ask if your doctor, nurse or anyone who touches you, your equipment, hospital bed or your clothing has cleaned his or her hands before doing so. Health care workers should also change gloves when they move from treating a contaminated or open wound site to a clean body site. In a hospital setting, additional handwashing is needed after entering a patient’s room, removing gloves, and touching surfaces such as the phone, TV remote, doorknobs, tables and bedrails.

Q. Hand washing can prevent the flu.

A. True. Flu viruses spread mainly from person-to-person through droplets made when people with flu cough, sneeze or talk; and by touching something with flu virus on it and then touching the mouth, eyes or nose. You can infect others with flu a full day before symptoms develop and up to a week after becoming sick.

Q. Don’t let children eat or drink around animals.

A. True. To decrease the possibility of contracting a disease transmitted between animals and humans (called zoonotic), it is essential to wash hands with soap and water after petting, feeding, handling, or having any contact with animals, their living quarters or their waste. Parents and teachers should supervise children to ensure they are using appropriate handwashing techniques especially after playing with pets at home or visiting fairs, pet stores, nature parks, circuses, educational farms, petting zoos and exhibits. When visiting animal areas, parents should discourage:

  • Eating or drinking
  • The use of strollers, toys, pacifiers, baby bottles, or spill-proof cups
  • Hand-to-mouth behaviors, such as thumb-sucking and nail-biting
  • Sitting or playing on the ground
  • Feeding the animals, unless the contact is controlled with barriers
  • Any contact with animals if an individual has open wounds
  • Contact with any animal waste