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For Health in Hospitals, Ban Handshakes and Start Fist-Bumping

Don’t shake your doctor’s hand; it’s for your own good.

Some of the biggest advancements in public health have come from relatively small changes. Cleaning our water supply, realizing smoking is terrible for you—these acknowledgements cut down premature deaths drastically. Writing in the Journal of the American Medical Association, doctors Mark Sklansky and Lynn Ramirez-Avila now think it’s time to make another small change for the sake of public health—ban the handshake in hospitals.

Hospital acquired infections are a tremendous problem. The CDC estimates that on any given day, about 1 in 25 hospital patients has at least one healthcare-associated infection. These infections are especially harmful in hospitals, where recovering and immune system compromised patients are vulnerable. And the more chances pathogens within hospitals get to spread, the more resistant to conventional treatments they can become. If we do cross into a post-antibiotic age, the problem of superbugs in hospitals will only get worse.

The handshake has been established as a pathogen-transmitting practice since the 20th century. Hospitals all over the world instituted hand-cleaning practices as a result, which is why you can’t walk a few feet in a hospital without seeing Purell. However, hospital staff compliance can be as low as 40%, the article notes, and alcohol-based hand soaps aren’t nearly as effective as we think, even harmful in the long run.

Handshakes aren’t the only way pathogens spread either. Microbes may even be getting rides on physician’s neckties and causing infections.

Despite efforts to cleanse the hands of hospital workers, handshakes are still very likely to transfer pathogens between patients and doctors and nurses. The solution, Sklansky and Ramirez-Avila write, is to find a different greeting.

Instead of offering a handshake, wave at your doctor, or give a simple verbal acknowledgement to your nurse. If you must touch a physician, even the fist-bump has been shown to transmit fewer pathogens than the handshake. And when in doubt, just keep your hands to yourself.

If we can learn to cover our mouths when we cough, we should be able to learn avoid shaking hands in hospitals. The authors of the article propose putting up signage saying something like “Handshake-free zone: to protect your health and the health of those around you, please refrain from shaking hands while on these premises.” Given that you will see the same sort of message for sneezes and coughs in hospitals, banning the handshake based on available evidence should not be that far-fetched.

“Given the tremendous social and economic burden of hospital-acquired infections and antimicrobial resistance…it would be a mistake to dismiss, out of hand, such a promising, intuitive, and affordable ban.”

PAPER: Banning the Handshake From the Health Care Setting

Kyle Hill is the Science Officer of the Nerdist enterprise. Follow him on Twitter @Sci_Phile.

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