Hygiene refers to the conditions and practices that help to maintain health and prevent the spread of diseases. Good hygiene therefore includes a specific set of practices associated with this preservation of health, for example maintaining a clean living and working environment, sterilization of drinking water, hand washing and preventing the spread of communicable diseases.

At an international level, water sanitation, and lack there-of, remains one of the most significant components of communicable disease spread. In developed nations, water sanitation is generally satisfactory, and hygiene practices at a personal level are more important, such as regular hand washing and food safety practices.

Pillar 6 focuses on the actions and behaviours that contribute to good hygiene, and the prevention of communicable diseases and illness.

Good hygiene is important because…

• Having access to good sanitation increases health, well-being and economic productivity. Inadequate sanitation impacts individuals, households, communities and countries. At an individual level, practicing good hygiene reduces the risk of communicable illness spread, protects the people around you, limits certain forms of non-communicable disease, such as dental caries, and reduces the economic burden of preventable illness, e.g. less days off sick and reduced healthcare spending.
• Hand washing is probably the most important hygiene practice that individuals can engage in. It is one of the simplest, yet most effective, health behaviours. Hand washing is a do-it-yourself “vaccine”; regular hand washing reduces the incidence of diarrhoeal and respiratory illnesses and reduces the development of bacterial resistance by reducing bacterial spread. Hand washing promotions have been shown to reduce diarrhoeal illness by 31%, reduce diarrhoeal illness in immunocompromised individuals by 58% and reduce respiratory infections by 21% (CDC, 2013).

Proper food preparation is another simple intervention that can reduce communicable disease spread. Most severe diarrhoeal illnesses in developed nations, such as salmonellosis, giardiasis and campylobacteriosis, are associated with unsanitary food preparation. Care when using uncooked food and then proper cooking greatly reduces the risk of these illnesses.

Unhygienic practices are the cause of…

• In total, 2.4 billion people do not have access to adequate sanitation facilities and approximately 1.1 billion do not have access to an improved water supply. The result is that approximately 2 million people die from diarrhoeal illnesses annually. The majority of these deaths are in children aged under five years.
• Even in developed nations where water supply and sanitation facilities are largely universal, a significant percentage of communicable diseases could be prevented by improving personal hygiene behaviours. Most diarrhoeal illnesses, such as salmonellosis or norovirus, and respiratory illnesses, such as influenza and adenovirus, can be reduced by following proper hygiene practices.

WHO recommendations for hygiene…

• The World Health Organisation’s primary concern surrounding hygiene is providing clean water and sanitation in developing nations. Providing clean water to the majority of the world’s population was one of the Millennium Development Goals; this target has now been achieved, but there is still room for improvement.
• At an individual level, hand washing remains the most important recommended behaviour in developed nations. Research indicates that the observed rates of hand washing with soap at critical times (after using the toilet or cleaning a child’s bottom or before handling food) around the world, in industrialized and developing nations, ranges from zero to 34%.
• Regular washing hands with soap and water, for twenty seconds, followed by thorough drying, is universally recommended.
• Other hygiene practices include proper food handling, regular oral healthcare, particularly brushing twice daily and flossing at least once daily. When unwell, good self-care hygiene practices include covering the face or mouth when coughing or sneezing.