What is targeted hygiene and why do we need it?

Introducing targeted hygiene practices into your home is the best way to have peace of mind, that you are doing your best to protect yourself and your family from infectious disease.

Targeted hygiene provides a means to maximize protection against harmful microbes whilst at the same time sustaining exposure to the friendly microbes which we need to build a healthy microbiome in our gut, respiratory tract and mouth and on our skin, which reduces the risk of developing allergies and other types of diseases.

The key to targeted hygiene is that it is focused on breaking the chain of infection. This differs significantly from the traditional view that hygiene means getting rid of dirt which is where harmful microbes are mainly found. In reality, the source of harmful microbes is mainly other people, contaminated food and water, and domestic animals.

Break the chain of infection to prevent the spread of harmful microbes

Harmful microbes enter the home mainly through people or pets, contaminated food or water. They are continuously shed and then spread through carriers such as hands, toilets, cloths etc. We can be infected by these microbes by for example touching an infected surface and then touching the mouth, nose or eyes, or by eating food contaminated by handling it with contaminated hands. This is known as the ‘chain of infection’. All links in the chain need to be in place for an infection to spread. So, if we break one of the links in the chain, then an infection cannot spread.

Hygiene practices are used in the home to prevent the ongoing spread of harmful microbes by breaking this chain of infection.

There are some species of microbes which are known to be potentially harmful (e.g. some gut bacteria) which can grow and multiply to form permanent reservoirs in place where stagnant water accumulates such as basins/bath/shower drains, under the flushing rim of the toilet and in wet cleaning cloths and sponges. These are not normally harmful but can be a risk to people who have lowered immunity to infection.

When do you need to practice targeted hygiene?

Targeted hygiene means focusing hygiene practices at the times (known as moments) when harmful microbes are most likely to be spreading from the sources mentioned above. These moments include when you:

1. Handle food
2. Eat with your fingers
3. Use the toilet or change a baby’s nappy
4. Cough, sneeze and blow your nose
5. Handle and launder dirty clothing and household linens
6. Touch surfaces frequently touched by others
7. Care for domestic animals
8. Handle and dispose of rubbish
9. Care for an infected family member.

During these nine moments, hygiene measures like handwashing, surface cleaning etc must focus on the critical surfaces (called critical control points) most likely to spread harmful microbes. In all of these nine risk moments, hands are a critical control point, but food contact surfaces and cleaning cloths are also key control points in many situations. Harmful microbes can also be spread via clothing and household linens, baths, showers and sinks, and occasionally also by floors and furnishings.

But it is important to realise that while keeping our homes clean by daily or weekly cleaning routines can contribute to preventing the spread of infection, its contribution is relatively small compared to hygiene practices carried out at key risk moments, to protect ourselves from exposure to harmful microbes.

How to break the chain of infection

The purpose of a hygiene practice is to reduce the number of harmful microbes on hands, surfaces and fabrics to a level which is not harmful to health. This can be done by:

1. Removal of the microbes from the surfaces - using cleaning products (e.g. detergents or soap) and cleaning utensils with water. Rinsing under clean running water is a vital step in the process
2. Inactivation of the microbes on the surfaces in situ - using products/processes i.e. heat (e.g. using higher temperature washing for laundry), disinfectants, hand sanitizers.

In many or most situations, cleaning-followed by rinsing and drying-is sufficient to prevent the spread of infection. But there are some situations where cleaning followed by disinfection may be needed e.g. using hand sanitisers where we do not have access to soap and water, or cleaning surfaces which cannot be effectively rinsed.

Hand hygiene is the single most important hygiene practice and is a central part of hygiene practice at all the 9 risk moments described above.

To make sure hands are hygienically clean always rub your hands thoroughly with soap and water, rinse them well under clean running water and then dry them. Wet hands pick up microbes more quickly than dry hands. If you don’t have access to running water and a towel, use a hand sanitizer.

Targeted hygiene is a framework for sustainable hygiene, in that it avoids the over-use of cleaning products. It also ensures prudent use of disinfectant products to avoid any risks associated with development of antibiotic resistance.

Further reading on targeted hygiene by the IFH.

This article has been co-authored with Professor Sally Bloomfield who is the Chair and a member of the Scientific Advisory Board of IFH as well as Honorary Professor with the London School of Hygiene and Tropical Medicine. Professor Bloomfield is an acknowledged expert on home hygiene, with more than 30 years' experience in hygiene research and education. The International Scientific Forum (IFH) was established in 1997 to develop and promote hygiene in home and everyday life settings based on sound scientific principles.