The World Health Organization, the Centers for Disease Control and Prevention (CDC) and other reputable organizations tout how simple hand hygiene can prevent the spread of illnesses including the common cold, E. Coli, SARS, MRSA, and even H1N1, a.k.a. swine flu. Yet every year the U.S. spends upwards of $80 billion on medical costs, absenteeism and presenteeism resulting from the preventable spread of harmful bacteria.

This disconnect doesn’t surprise Brian Sansoni, vice president of communications at the Soap and Detergent Association (SDA) in Washington, D.C.

“We were established in the late 1920s and our message is startlingly the same,” he says. “Wash your hands.”

Regardless of the message, 85 percent of people surveyed in 2008 said they always wash their hands after using the restroom, but observation revealed that fewer women and only two-thirds of men washed hands after using a public restroom. Additionally, 46 percent of people say they wash for 15 seconds or less, and 39 percent say they seldom or never wash after coughing or sneezing.

The health and economic implications of these statistics are hefty. Deputy Director of Chicago-based Healthy Schools Campaign (HSC) Mark Bishop cites a study by the American Journal of Infection Control that showed students not using proper hand hygiene miss 20 percent more school than their peers.

“It doesn’t sound like a lot,” he explains. “But that has enormous implications in lost revenue for schools, challenges for parents dealing with sick kids and kids getting sick unnecessarily.”

Today it’s clear that healthy hand programs can have great positive impact. Yes, cleaners can disinfect phones, keyboards, light switches, door handles, drinking fountains, elevator buttons and fax and copy machines, but it only takes a split second for a germ to transfer back onto that surface, where it can linger for days. So it’s important to promote habits that prevent the spread of germs. For cleaners, that means observing proper disinfecting techniques that prevent cross-contamination. For everyone else, sneeze or cough into a tissue, resist touching mouths and noses and most important: wash hands a full 20 seconds with soap and water or rub them thoroughly with alcohol-based hand sanitizer when soap and water aren’t available.

It may sound easy but compliance can be tricky, so we asked a few experts for their tips on creating successful hand hygiene programs.

Well-Stocked Restrooms

Restrooms that are convenient, clean and well stocked will attract more users. If financially feasible, consider installing touch-free toilets, faucets, soap dispensers and towel dispensers. In addition to touch-free, Sansoni emphasizes the importance of multiple sinks, soap and towel dispensers in each restroom to streamline the process and encourage hand washing.

“Schools are hard settings,” observes Charles Barnes, Sr., president of Memphis Chemical and Janitorial Supply Company, Memphis, Tenn. “Thirty kids pour into a bathroom during a five-minute break, so it’s the challenge of having enough paper towels and soap. It’s a maintenance issue, but should also be on the agenda for the building operation maintenance program.”

The Gold Standard

The workhorse of a healthy hands program is simple: use soap and water to scrub hands and underneath fingernails for a full 20 seconds, followed by a good rinse to send everything down the drain. Then dry hands by patting versus rubbing the skin, which will avoid chapping.

“Soap and water is the gold standard of hand hygiene,” says Sansoni. “Soap lifts the dirt and germs from your hands and washes them down the drain.”

Sansoni recommends mild and unscented soaps versus soaps that are unnecessarily harsh or perfumed, which can create an aversion. “Some soaps even come with a little lotion to keep the skin softer,” he says, adding that the SDA is impartial to gel, lotion or foam soaps.

But both Barnes and Bishop prefer foam.

“Bacteria gets between the fingers and under your nails, and foam has better coverage that penetrates all the areas of your hand,” says Barnes. “It also cuts the cost of soap in half.”

“Personally I’m a big fan of foam soaps,” agrees Bishop. “A little product can go a long way and a school can actually cut some of their soap costs down. With foam you also benefit with coverage. But the reality is if you wash your hands properly, it can do an effective job whether it’s lotion or foam.”

Antibacterial soaps that don’t just remove germs but also kill them, are used primarily in health care, daycare and food service industries.

“Antibacterial soaps do clean hands, but no better than regular soap and water,” says Barnes. “In critical areas like hospitals, because of the uniqueness of the germs, they don’t want to take a chance. But anywhere else, regular soap is just as effective.”

Soap and water is the ultimate cleaning machine, concludes Barnes. “It cleans better than anything. Always has and always will — but it’s not always convenient.”

For Everywhere Else

Alcohol-based hand sanitizer is a very valuable tool that’s appropriate in situations where soap and water isn’t available. According to the CDC, if hand washing is not available, building occupants should use alcohol-based hand sanitizer to disinfect hands.

“The alcohol dries out the germs and doesn’t contribute to bacteria that can become resistant to antibiotics,” explains Bishop. “The CDC recognizes alcohol-based hand sanitizers, but there are also many plant-derived products now available, which we’re tracking for CDC acceptance.”

Different facilities offer foam, spray, wipe or gel hand sanitizer in different locations. At many schools it’s offered in cafeteria entrances.

“Many students get 20 minutes to eat lunch, including waiting in line, so they don’t have time to stop at a restroom before their next class,” explains Bishop. “Some schools spray for the kids, others have mounted dispensers with supervision to ensure that it’s being used properly.”

Meeting and boardrooms are also good places to offer hand sanitizer, and it’s ideal for employees who travel.

Hospitals also offer hand sanitizer in public hallways and cafeterias, nurse stations and just inside patient rooms, mounted onto the wall at shoulder level. Some dispensers are even hands-free via a battery-operated sensor or foot pedal.

The CDC also recommends hand sanitizers in emergency situations where hurricanes, floods, earthquakes and tornados can interrupt fresh water supplies needed for hand washing.

“We never put hand sanitizer in bathrooms,” adds Barnes. “We don’t want people to think that hand sanitizer can replace soap and water. Sanitizer kills germs — but it doesn’t clean.”

Education And Promotion

Signs, brochures, stickers, videos, podcasts, slides and other educational hand-washing materials are available at minimal to no charge from manufacturers, distributors and health organizations such as the CDC, SDA, HSC, the Clean Hands Coalition and the Clean Hands Campaign. A successful hand washing program could kick off with an educational push and materials posted in restrooms, kitchens, lunchrooms or coffee stations to encourage good hand hygiene.

Interactive education makes a big impression, too. Bishop uses an ultraviolet light to show students how many germs can be left on their hands after inadequate washing. Another activity is rubbing a drop of oil onto hands followed by a dusting of cinnamon to represent germs. Participants can then see how it takes 20 seconds of washing (the equivalent of singing “Happy Birthday” twice) to remove the cinnamon. “No reason an adult couldn’t do this,” Bishop adds.

Even with a great program in place, enforcing good hand hygiene is a challenge. Bishop says there is a bill in Illinois that could mandate hand washing in schools before every lunch period.

“It’s not very practical, but there is recognition that we need to be more vigilant about these programs to protect our students,” he says. “We need to put the right products, equipment and education in front of them, and lead people to make the right decisions for themselves.”

Partnering with human resources to track absenteeism and presenteeism before and after a hand hygiene program is incorporated can be very motivational. Showing a significant drop in sick days (one school district had a 43 percent improvement) could be the best motivation of all.

Lauren Summerstone is a freelance writer based in Madison, Wis.

Soaps and Hand Sanitizers Help Prevent H1N1, a.k.a. Swine Flu

Since the H1N1 pandemic has been in the news and affected many communities, the risks of poor personal hygiene have been made clear.

“As infections evolve, common sense really comes into play,” says Soap and Detergent Association Vice President of Communications Brian Sansoni. “It goes back to common sense hygiene practices: cleaning hands with soap and water. It’s simple, safe, effective and inexpensive. And when you’re out and about and soap and water are not available, portable products like sanitizing hand wipes are useful.”

He urges cleaners to stay on top of what’s going on in local communities. Listen to local health officials and credible organizations like the Centers for Disease Control and Prevention and follow suggestions on how to prevent the spread of infection — whether it be through cleaning or developing a proper hand washing program for building occupants. According to the CDC, clean hands save lives. Disease prevention is in our hands — literally.