Hand Sanitizers or Soap &
Water?
Hand
Sanitizers are one of those products that have been created to make money where
none should exist. By 2015, the Hand Sanitizer market is expected to be almost
worth 400 million USD. I have always felt that soap and water is a better and
cheaper alternative to hand sanitizers for hygiene and germ free environment. I wonder why health
care professionals keep on pushing alcohol based sanitizers as a panacea for
all infections and germs. This policy is flawed and needs to be junked.
My
belief that no one actually needs a hand sanitizer was confirmed during my
visits to two of the top hospitals in Boston. The reception of both the
hospitals, like almost everywhere else in the hospitals, had prominently
displayed hand sanitizers of a popular brand. The first hospital had the world
‘COMPLIMENTARY’ written above the sanitizer stations and the second one had messages
that said something about ‘Clean hands and a Germ Free world’. During my short
stay at both the places, I observed that more people were using the
‘Complimentary’ sanitizer and less at the second hospital. This implied that
people don’t use a sanitizer for its hygiene related qualities but they do so
as they feel they are getting something free.
So,
what affects the behavior of people who use a sanitizer at a public place. The
core issue is attitudes of people towards hand washing – either with a
sanitizer or with soap and water. Behavioral Scientists will call it the Want-Should
conflict. Most people feel that they should wash hands but when it comes
to actually washing, they avoid doing so as they are in a hurry or think that
they will use it at the next available opportunity.
Part of this problem is psychological. Most people suffer
from cognitive biases that skew their judgment from risk. In the case of health
care workers, research has shown that they maintain an ‘illusion of
vulnerability’. Many of them are so confident of their immunity to infection
that they ignore the fact that they are most vulnerable to come in contact with
germs. Even memories are biased. They are able to recall instances when they
didn’t wash and didn’t get sick. The actual instances when they were sick and
had not washed are easily forgotten as other direct reasons are ascribed to the
sickness.
Researchers
at Michigan University have studied the variables affecting hand sanitizer use
in public facilities. Loukas and Dixon in their experiment found that the
psycho educational approach is a more effective means to promote behavior
change with regard to use of hand sanitizers. In the study they compared two sets of data,
one of people using free sanitizers next to the revolving gate with posting of
information relating to Swine Flu incidence in US. In the second instance, next
to the sanitizer station there was a student volunteer with a manually operated
sanitizer in hand, who would ask people to use the sanitizer and thank them
profusely when they did. It was found that in the second instance, with a
verbal cue and social praise by the student volunteer, the percentage of people
using the hand sanitizers goes upto almost 52% as against less than 1 % when
there is a sanitizer station with just messages pasted regarding the benefits
of the use. Thus the reason for the use of a hand sanitizer is externally
influenced.
In
another interesting experiment, Adam Grant of
the Wharton School and David Hofmann, of the Kenan-Flagler Business School,
found that doctors and nurses are more motivated by messages that emphasize
patients’ welfare rather than their own. Messages like “Hand hygiene prevents patients
from catching diseases” were found to yield better results than the ones like “Hand
hygiene prevents you from catching diseases.”
These
behavioral and cognitive psychology insights are used by hand sanitizer
manufacturers to drive their demand by make people paranoid about personal
health care as also making issues like Swine Flu a major concern, worldwide.
Studies
have also shown that that hand sanitizers are no more effective than soap and
water in preventing infection and spread of cold and flu. Dr Ron Cutler of
Queen Mary University of London and an expert in infection control says that,
"People think they're more effective than water because you don't see
advertisements for soap and water saying the percentage of germs they
kill." Thus the ease of recall and
vividness of a sanitizer with regard to hygiene is forced upon through
advertisements. The use of sanitizers is so much like the use of bottled water,
preferable from the point of view of choice and convenience, but not
necessarily essential for a country which has safe tap drinking water and where
chances of infections are minimal.
So
it is clear, Soap and Water is a better alternate to hand sanitizers.
