Friday, August 1, 2014

Shake, Pump & Fives!

The American Journal of Infection Control has the media world abuzz with talks of fist pumps vs. handshakes today, as they released a recent study confirming that a quick greeting of fist pumps "substantially reduce" the transfer of bacteria between people (compared with shaking hands.) This investigation confirms previous similar studies, such as the 2013 report from the Journal of Hospital Infection, Reducing pathogen transmission in a hospital setting Handshake vs. fist bump: a pilot study.
We know that fist bumps (and high fives) are typically very brief- less than a second, versus hand shakes that can last for several seconds. Additionally, there is less skin to skin contact in a fist bump. However, these studies have shown that hand shakes pass more bacteria from person to person than you would expect simply based on time and area of contact. Fist pumps, it turns out, are up to 20 times more hygienic than hand shakes.

As a primary care physician, I have long greeted children with high fives, and switched to fist pumps as they became trendy over the last few years. With adults, I have primarily used the traditional handshake- but I literally wash my hands in the exam room in front of the patient (to ease any concerns they might have of me bringing in germs from the patient before them.) Everyone knows that washing hands reduces the spread of germs, and most people are vigilant about this within the health care setting or in restaurants. However, what about the rest of our busy lives? If you bump into a friend or business partner at an event, and they introduce you to the group of people they are with, what is the healthiest way to greet these new people? Do you shake hands, but then whip out your hand sanitizer and pass it around? Or perhaps, based on these studies, do we replace the handshake with a fist pump? There are, indeed, researchers suggesting "handshake-free zones" in healthcare settings.  And what about hugs? Does this more intimate gesture pass more germs, or because we are only touching clothing (and avoiding skin-to-skin contact,) is that safer?

Personally, I think the real take home message here is a reminder about the importance of HAND WASHING. Choose high fives and fist pumps (or smiles and nods) when those are socially acceptable alternatives, and especially if you are feeling ill. If you have the opportunity to wash your hands, don't skimp! How long should you wash? 20-30 seconds (much longer than the usual speedy dash of hands through the water en route to grabbing a paper towel that we see in public restrooms.) Use soap and make it foam up, scrubbing especially under rings and around the finger nails. If you use sanitizer, be sure to use enough that you still have 20-30 seconds of "scrubbing".

BOTTOM LINE: Good hand hygiene is the MOST EFFECTIVE way to limit the spread of germs from person to person- choose fist pumps or high fives before handshakes when appropriate, and mainly, remember to wash your hands early & often!