Hygiene

"Hygienist" redirects here. For specific kinds of hygienist, see

Industrial hygienist and Dental hygienist.
For the community in the United States, see Hygiene, Colorado.

Poster to raise awareness about the importance of clean water for good hygiene (poster
designed for use in Asian countries) by CAWST.[1]

Hygiene is a series of practices performed to preserve health.

According to the World Health Organization (WHO), "Hygiene refers
to conditions and practices that help to maintain health and prevent
the spread of diseases."[2] Personal hygiene refers to maintaining
the body's cleanliness.

Many people equate hygiene with 'cleanliness,' but hygiene is a

broad term. It includes such personal habit choices as how
frequently to take a shower or bathe, wash hands, trim fingernails,
and change and wash clothes. It also includes attention to keeping
surfaces in the home and workplace, including bathroom facilities,
clean and pathogen-free.

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 Some regular hygiene practices may be considered good habits by
a society, while the neglect of hygiene can be considered
disgusting, disrespectful, or threatening.

Etymology
First attested in English in 1676, the word hygiene comes from the
French hygiène, the latinisation of the Greek ὑγιεινή (τέχνη)
hygieinē technē, meaning "(art) of health", from ὑγιεινός hygieinos,
"good for the health, healthy",[3] in turn from ὑγιής (hygiēs),
"healthful, sound, salutary, wholesome".[4] In ancient Greek religion,
Hygeia (Ὑγίεια) was the personification of health, cleanliness, and
hygiene.[5]

Background

Washing one's hands, a form of hygiene, is the most effective way

to prevent the spread of infectious diseases
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 Hygiene is a concept related to cleanliness, health and medicine. It
is as well related to personal and professional care practices. In
medicine and everyday life settings, hygiene practices are employed
as preventative measures to reduce the incidence and spreading of
disease.

Hygiene practices vary, and what is considered acceptable in one

culture might not be acceptable in another.

In the manufacturing of food, pharmaceutical, cosmetic and other

products, good hygiene is a critical component of quality assurance.

The terms cleanliness and hygiene are often used interchangeably,

which can cause confusion. In general, hygiene refers to practices
that prevent spread of disease-causing organisms. Cleaning
processes (e.g., handwashing) remove infectious microbes as well
as dirt and soil, and are thus often the means to achieve hygiene.

Other uses of the term appear in phrases including body hygiene,

personal hygiene, sleep hygiene, mental hygiene, dental hygiene,
and occupational hygiene, used in connection with public health.
Hygiene is also the name of a branch of science that deals with the
promotion and preservation of health.

Medical hygiene
Medical hygiene pertains to the hygiene practices related to the
administration of medicine and medical care that prevents or
minimizes the spread of disease.

Medical hygiene practices include:

Isolation or quarantine of infectious persons or materials to

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 prevent spread of infection.
Sterilization of instruments used in surgical procedures.
Use of protective clothing and barriers, such as masks, gowns,
caps, eyewear and gloves.
Proper bandaging and dressing of injuries.
Safe disposal of medical waste.
Disinfection of reusables (i.e., linen, pads, uniforms).
Scrubbing up, hand-washing, especially in an operating room,
but in more general health-care settings as well, where
diseases can be transmitted.

Most of these practices were developed in the 19th century and

were well established by the mid-20th century. Some procedures
(such as disposal of medical waste) were refined in response to
late-20th century disease outbreaks, notably AIDS and Ebola.

Home and everyday hygiene

Home hygiene pertains to the hygiene practices that prevent or
minimize the spread of disease at home and other everyday settings
such as social settings, public transport, the workplace, public
places, etc.

Hygiene in a variety of settings plays an important role in preventing

the spread of infectious diseases.[6] It includes procedures used in a
variety of domestic situations such as hand hygiene, respiratory
hygiene, food and water hygiene, general home hygiene (hygiene of
environmental sites and surfaces), care of domestic animals, and
home health care (the care of those who are at greater risk of
infection).

At present, these components of hygiene tend to be regarded as

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 separate issues, although based on the same underlying
microbiological principles. Preventing the spread of diseases means
breaking the chain of infection transmission. Simply put, if the chain
of infection is broken, infection cannot spread. In response to the
need for effective codes of hygiene in home and everyday life
settings the International Scientific Forum on Home Hygiene has
developed a risk-based approach based on Hazard Analysis Critical
Control Point (HACCP), also referred to as "targeted hygiene."
Targeted hygiene is based on identifying the routes of pathogen
spread in the home and introducing hygiene practices at critical
times to break the chain of infection.

The main sources of infection in the home[7] are people (who are
carriers or are infected), foods (particularly raw foods) and water,
and domestic animals (in the U.S. more than 50% of homes have
one or more pets[8]). Sites that accumulate stagnant water—such
as sinks, toilets, waste pipes, cleaning tools, face cloths, etc. readily
support microbial growth and can become secondary reservoirs of
infection, though species are mostly those that threaten "at risk"
groups. Pathogens (potentially infectious bacteria, viruses etc.—
colloquially called "germs") are constantly shed from these sources
via mucous membranes, feces, vomit, skin scales, etc. Thus, when
circumstances combine, people are exposed, either directly or via
food or water, and can develop an infection.

The main "highways" for the spread of pathogens in the home are
the hands, hand and food contact surfaces, and cleaning cloths and
utensils. Pathogens can also be spread via clothing and household
linens, such as towels. Utilities such as toilets and wash basins, for
example, were invented for dealing safely with human waste but still
have risks associated with them. Safe disposal of human waste is a
fundamental need; poor sanitation is a primary cause of diarrhea

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 disease in low income communities. Respiratory viruses and fungal
spores are spread via the air.

Good home hygiene means engaging in hygiene practices at critical

points to break the chain of infection.[7] Because the "infectious
dose" for some pathogens can be very small (10-100 viable units or
even less for some viruses), and infection can result from direct
transfer of pathogens from surfaces via hands or food to the mouth,
nasal mucous or the eye, 'hygienic cleaning' procedures should be
sufficient to eliminate pathogens from critical surfaces.

Hygienic cleaning can be done through:

Mechanical removal (i.e., cleaning) using a soap or detergent.

To be effective as a hygiene measure, this process must be
followed by thorough rinsing under running water to remove
pathogens from the surface.
Using a process or product that inactivates the pathogens in
situ. Pathogen kill is achieved using a "micro-biocidal" product,
i.e., a disinfectant or antibacterial product; waterless hand
sanitizer; or by application of heat.
In some cases combined pathogen removal with kill is used,
e.g., laundering of clothing and household linens such as
towels and bed linen.

Hand washing

Main article: Hand washing

Hand hygiene is defined as hand washing or washing hands and

nails with soap and water or using a water less hand sanitizer. Hand
hygiene is central to preventing the spread of infectious diseases in
home and everyday life settings.[9]

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 In situations where hand washing with soap is not an option (e.g.,
when in a public place with no access to wash facilities), a water
less hand sanitizer such as an alcohol hand gel can be used. They
can be used in addition to hand washing to minimize risks when
caring for "at-risk" groups. To be effective, alcohol hand gels should
contain not less than 60%v/v alcohol.

The WHO(World Health Organization) recommends hand washing

with ash if soap is not available in critical situations,[10] schools
without access to soap[11] and other difficult situations like post-
emergencies where use of (clean) sand is recommended, too.[12]
Use of ash is common in rural areas of developing countries and has
in experiments been shown at least as effective as soap for
removing pathogens.[13]

Respiratory hygiene

Correct respiratory and hand hygiene when coughing and sneezing

reduces the spread of pathogens particularly during the cold and flu
season.[6]

Carry tissues and use them to catch coughs and sneezes

Dispose of tissues as soon as possible
Clean your hands by handwashing or using an alcohol hand
sanitizer.

Food hygiene at home

Main article: Food hygiene

Food hygiene is concerned with the hygiene practices that prevent

food poisoning. The five key principles of food hygiene, according to
WHO, are:[14]

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 1. Prevent contaminating food with mixing chemicals, spreading
from people, and animals.
2. Separate raw and cooked foods to prevent contaminating the
cooked foods.
3. Cook foods for the appropriate length of time and at the
appropriate temperature to kill pathogens.
4. Store food at the proper temperature.
5. Use safe water and raw materials.

Hygiene in the kitchen, bathroom and toilet

Routine cleaning of (hand, food, drinking water) sites and surfaces

(such as toilet seats and flush handles, door and tap handles, work
surfaces, bath and basin surfaces) in the kitchen, bathroom and
toilet reduces the risk of spread of pathogens.[15] The infection risk
from flush toilets is not high, provided they are properly maintained,
although some splashing and aerosol formation can occur during
flushing, particularly when someone has diarrhea. Pathogens can
survive in the scum or scale left behind on baths, showers and wash
basins after washing and bathing.

Water left stagnant in the pipes of showers can be contaminated

with pathogens that become airborne when the shower is turned on.
If a shower has not been used for some time, it should be left to run
at a hot temperature for a few minutes before use.

Thorough cleaning is important in preventing the spread of fungal

infections.[16] Molds can live on wall and floor tiles and on shower
curtains. Mold can be responsible for infections, cause allergic
responses, deteriorate/damage surfaces and cause unpleasant
odors. Primary sites of fungal growth are inanimate surfaces,
including carpets and soft furnishings.[17] Air-borne fungi are usually

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 associated with damp conditions, poor ventilation or closed air
systems.

Laundry hygiene

Laundry hygiene involves practices that prevent disease and its

spread via soiled clothing and household linens such as towels.[18]
Items most likely to be contaminated with pathogens are those that
come into direct contact with the body, e.g., underwear, personal
towels, facecloths, nappies. Cloths or other fabric items used during
food preparation, or for cleaning the toilet or cleaning up material
such as feces or vomit are a particular risk.[19]

Microbiological and epidemiological data indicates that clothing and

household linens etc. are a risk factor for infection transmission in
home and everyday life settings as well as institutional settings. The
lack of quantitative data linking contaminated clothing to infection in
the domestic setting makes it difficult to assess the extent of this
risk.[18][19][20] It also indicates that risks from clothing and
household linens are somewhat less than those associated with
hands, hand contact and food contact surfaces, and cleaning
cloths, but even so these risks needs to be managed through
effective laundering practices. In the home, this routine should be
carried out as part of a multibarrier approach to hygiene which
includes hand, food, respiratory and other hygiene practices.[18][19]
[20]

Infectious diseases risks from contaminated clothing etc. can

increase significantly under certain conditions, e.g., in healthcare
situations in hospitals, care homes and the domestic setting where
someone has diarrhoea, vomiting, or a skin or wound infection. It
increases in circumstances where someone has reduced immunity

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 to infection.

Hygiene measures, including laundry hygiene, are an important part

of reducing spread of antibiotic resistant strains.[21][22] In the
community, otherwise healthy people can become persistent skin
carriers of MRSA, or faecal carriers of enterobacteria strains which
can carry multi-antibiotic resistance factors (e.g. NDM-1 or ESBL-
producing strains). The risks are not apparent until, for example,
they are admitted to hospital, when they can become "self infected"
with their own resistant organisms following a surgical procedure.
As persistent nasal, skin or bowel carriage in the healthy population
spreads "silently" across the world, the risks from resistant strains in
both hospitals and the community increases.[22] In particular the
data indicates that clothing and household linens are a risk factor
for spread of S. aureus (including MRSA and PVL-producing MRSA
strains), and that effectiveness of laundry processes may be an
important factor in defining the rate of community spread of these
strains.[18][23] Experience in the United States suggests that these
strains are transmissible within families and in community settings
such as prisons, schools and sport teams. Skin-to-skin contact
(including unabraded skin) and indirect contact with contaminated
objects such as towels, sheets and sports equipment seem to
represent the mode of transmission.[18]

During laundering, temperature and detergent work to reduce

microbial contamination levels on fabrics. Soil and microbes from
fabrics are severed and suspended in the wash water. These are
then "washed away" during the rinse and spin cycles. In addition to
physical removal, micro-organisms can be killed by thermal
inactivation which increases as the temperature is increased.
Chemical inactivation of microbes by the surfactants and activated
oxygen-based bleach used in detergents contributes to the hygiene

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 effectiveness of laundering. Adding hypochlorite bleach in the
washing process achieves inactivation of microbes. A number of
other factors can contribute including drying and ironing.

Laundry detergents contain a mix of ingredients including

surfactants, builders, optical brighteners, etc. Cleaning action arises
primarily from the action of the surfactants and other ingredients,
which are designed to maximise release and suspension of dirt and
microbes into the wash liquid, together with enzymes and/or an
activated oxygen-based bleach which digest and remove stains.
Although activated oxygen bleach is included in many powder
detergents to digest and remove stains, it produces some chemical
inactivation of bacteria, fungi and viruses. As a rule of thumb,
powders and tablets normally contain an activated oxygen bleach,
but liquids and all products (liquid or powder) used for "coloureds"
do not. Surfactants also exert some chemical inactivation action
against certain species although the extent of their action is not
known.

In 2013 the International Scientific Forum on Home Hygiene (IFH)

reviewed some 30 studies of the hygiene effectiveness of
laundering at temperatures ranging from room temperature to
70 °C, under varying conditions.[24] A key finding was the lack of
standardisation and control within studies, and the variability in test
conditions between studies such as wash cycle time, number of
rinses, etc. The consequent variability in the data (i.e., the reduction
in contamination on fabrics) obtained, in turn makes it extremely
difficult to propose guidelines for laundering with any confidence,
based on currently available data. As a result, there is significant
variability in the recommendations for hygienic laundering of
clothing etc. given by different agencies.[25][26][27][28][29][30]

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 Of concern is recent data suggesting that, in reality, modern
domestic washing machines do not reach the temperature specified
on the machine controls.[31][32]

Medical hygiene at home

Medical hygiene pertains to the hygiene practices that prevents or

minimizes disease and the spreading of disease in relation to
administering medical care to those who are infected or who are
more "at risk" of infection in the home. Across the world,
governments are increasingly under pressure to fund the level of
healthcare that people expect. Care of increasing numbers of
patients in the community, including at home is one answer, but can
be fatally undermined by inadequate infection control in the home.
Increasingly, all of these "at-risk" groups are cared for at home by a
carer who may be a household member who thus requires a good
knowledge of hygiene. People with reduced immunity to infection,
who are looked after at home, make up an increasing proportion of
the population (currently up to 20%).[6] The largest proportion are
the elderly who have co-morbidities, which reduce their immunity to
infection. It also includes the very young, patients discharged from
hospital, taking immuno-suppressive drugs or using invasive
systems, etc. For patients discharged from hospital, or being
treated at home special "medical hygiene" (see above) procedures
may need to be performed for them e.g. catheter or dressing
replacement, which puts them at higher risk of infection.

Antiseptics may be applied to cuts, wounds abrasions of the skin to

prevent the entry of harmful bacteria that can cause sepsis. Day-to-
day hygiene practices, other than special medical hygiene
procedures[33] are no different for those at increased risk of
infection than for other family members. The difference is that, if

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 hygiene practices are not correctly carried out, the risk of infection
is much greater.

Disinfectants and antibacterials in home hygiene

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Chemical disinfectants are products that kill pathogens. If the

product is a disinfectant, the label on the product should say
"disinfectant" or "kills" pathogens. Some commercial products, e.g.
bleaches, even though they are technically disinfectants, say that
they "kill pathogens" but are not actually labelled as "disinfectants".
Not all disinfectants kill all types of pathogens. All disinfectants kill
bacteria (called bactericidal). Some also kill fungi (fungicidal),
bacterial spores (sporicidal) or viruses (virucidal).

An antibacterial product is a product that acts against bacteria in

some unspecified way. Some products labelled "antibacterial" kill
bacteria while others may contain a concentration of active
ingredient that only prevent them multiplying. It is, therefore,
important to check whether the product label states that it "kills"
bacteria." An antibacterial is not necessarily anti-fungal or anti-viral
unless this is stated on the label.

The term sanitizer has been used to define substances that both
clean and disinfect. More recently this term has been applied to
alcohol-based products that disinfect the hands (alcohol hand
sanitizers). Alcohol hand sanitizers however are not considered to

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 be effective on soiled hands.

The term biocide is a broad term for a substance that kills,

inactivates or otherwise controls living organisms. It includes
antiseptics and disinfectants, which combat micro-organisms, and
pesticides.

Home hygiene in developing countries

In developing countries, universal access to water and sanitation

has been seen as the essential step in reducing the preventable
infectious diseases burden, but it is now clear that this is best
achieved by programs that integrate hygiene promotion with
improvements in water quality and availability, and sanitation. This
approach has been integrated into the Sustainable Development
Goal Number 6 whose second target states: "By 2030, achieve
access to adequate and equitable sanitation and hygiene for all and
end open defecation, paying special attention to the needs of
women and girls and those in vulnerable situations".[34] Due to their
close linkages, water, sanitation, hygiene are together abbreviated
and funded under the term WASH in development cooperation.

About 2 million people die every year due to diarrheal diseases,

most of them are children less than 5 years of age.[35] The most
affected are the populations in developing countries, living in
extreme conditions of poverty, normally peri-urban dwellers or rural
inhabitants. Providing access to sufficient quantities of safe water,
the provision of facilities for a sanitary disposal of excreta, and
introducing sound hygiene behaviors are of capital importance to
reduce the burden of disease caused by these risk factors.

Research shows that, if widely practiced, hand washing with soap

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 could reduce diarrhea by almost fifty percent[36][37][38] and
respiratory infections by nearly twenty-five percent[39][40] Hand
washing with soap also reduces the incidence of skin diseases,[41]
[42] eye infections like trachoma and intestinal worms, especially

ascariasis and trichuriasis.[43]

Other hygiene practices, such as safe disposal of waste, surface

hygiene, and care of domestic animals, are important in low income
communities to break the chain of infection transmission.[44]

Cleaning of toilets and hand wash facilities is important to prevent

odors and make them socially acceptable. Social acceptance is an
important part of encouraging people to use toilets and wash their
hands, in situations where open defecation is still seen as a possible
alternative, e.g. in rural areas of some developing countries.

Household water treatment and safe storage

Household water treatment and safe storage ensure drinking water

is safe for consumption. These interventions are part of the
approach of self-supply of water for households.[citation needed]
Drinking water quality remains a significant problem in
developing[45] and in developed countries;[46] even in the European
region it is estimated that 120 million people do not have access to
safe drinking water. Point-of-use water quality interventions can
reduce diarrheal disease in communities where water quality is poor
or in emergency situations where there is a breakdown in water
supply.[45][46][47][48] Since water can become contaminated during
storage at home (e.g. by contact with contaminated hands or using
dirty storage vessels), safe storage of water in the home is
important.

Methods for treatment of drinking water,[15][48] include:

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 1. Chemical disinfection using chlorine or iodine
2. Boiling
3. Filtration using ceramic filters
4. Solar disinfection – Solar disinfection is an effective method,
especially when no chemical disinfectants are available.[49]
5. UV irradiation – community or household UV systems may be
batch or flow-though. The lamps can be suspended above the
water channel or submerged in the water flow.
6. Combined flocculation/disinfection systems – available as
sachets of powder that act by coagulating and flocculating
sediments in water followed by release of chlorine.
7. Multibarrier methods – Some systems use two or more of the
above treatments in combination or in succession to optimize
efficacy.

Personal hygiene
Regular activities

A clear plastic toiletry bag

Personal hygiene involves those practices performed by an

individual to care for one's bodily health and wellbeing through
cleanliness. Motivations for personal hygiene practice include
reduction of personal illness, healing from personal illness, optimal
health and sense of wellbeing, social acceptance and prevention of

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 spread of illness to others. What is considered proper personal
hygiene can be cultural-specific and may change over time.

Practices that are generally considered proper hygiene include

showering or bathing regularly, washing hands regularly and
especially before handling food, washing scalp hair, keeping hair
short or removing hair, wearing clean clothing, brushing teeth,
cutting finger nails, besides other practices. Some practices are
gender-specific, such as by a woman during her menstruation.
Toiletry bags holds body hygiene and toiletry supplies.

Anal hygiene is the practice that a person performs on the anal area
of themselves after defecation. The anus and buttocks may be
either washed with liquids or wiped with toilet paper or adding gel
wipe[50] to toilet tissue as an alternative to wet wipes or other solid
materials in order to remove remnants of feces.

People tend to develop a routine for attending to their personal

hygiene needs. Other personal hygienic practices would include
covering one's mouth when coughing, disposal of soiled tissues
appropriately, making sure toilets are clean, and making sure food
handling areas are clean, besides other practices. Some cultures do
not kiss or shake hands to reduce transmission of bacteria by
contact.

Personal grooming extends personal hygiene as it pertains to the

maintenance of a good personal and public appearance, which need
not necessarily be hygienic. It may involve, for example, using
deodorants or perfume, shaving, or combing, besides other
practices.

Excessive body hygiene

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 Excessive body hygiene is one example of obsessive compulsive
disorder.

Excessive body hygiene and allergies

The hygiene hypothesis was first formulated in 1989 by Strachan

who observed that there was an inverse relationship between family
size and development of atopic allergic disorders—the more
children in a family, the less likely they were to develop these
allergies.[51] From this, he hypothesized that a lack of exposure to
"infections" in early childhood transmitted by contact with older
siblings could be a cause of the rapid rise in atopic disorders over
the last 30 to 40 years. Strachan further proposed that the reason
why this exposure no longer occurs is not only because of the trend
towards smaller families, but also "improved household amenities
and higher standards of personal cleanliness".

Although there is substantial evidence that some microbial

exposures in early childhood can in some way protect against
allergies, there is no evidence that humans need exposure to
harmful microbes (infection) or that it is necessary to suffer a
clinical infection.[52][53][54][55] Nor is there evidence that hygiene
measures such as hand washing, food hygiene etc. are linked to
increased susceptibility to atopic disease.[43][44] If this is the case,
there is no conflict between the goals of preventing infection and
minimising allergies. A consensus is now developing among experts
that the answer lies in more fundamental changes in lifestyle etc.
that have led to decreased exposure to certain microbial or other
species, such as helminths, that are important for development of
immuno-regulatory mechanisms.[56] There is still much uncertainty
as to which lifestyle factors are involved.

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 Although media coverage of the hygiene hypothesis has declined, a
strong ‘collective mindset’ has become established that dirt is
‘healthy’ and hygiene somehow ‘unnatural’. This has caused
concern among health professionals that everyday life hygiene
behaviours, which are the foundation of public health, are being
undermined. In response to the need for effective hygiene in home
and everyday life settings, the International Scientific Forum on
Home Hygiene has developed a "risk-based" or targeted approach
to home hygiene that seeks to ensure that hygiene measures are
focussed on the places, and at the times most critical for infection
transmission.[7] Whilst targeted hygiene was originally developed as
an effective approach to hygiene practice, it also seeks, as far as
possible, to sustain "normal" levels of exposure to the microbial
flora of our environment to the extent that is important to build a
balanced immune system.

Excessive body hygiene of internal ear canals

See also: Earwax

Excessive body hygiene of the ear canals can result in infection or

irritation. The ear canals require less body hygiene care than other
parts of the body, because they are sensitive, and the body
adequately cares for them. Most of the time the ear canals are self-
cleaning; that is, there is a slow and orderly migration of the skin
lining the ear canal from the eardrum to the outer opening of the
ear. Old earwax is constantly being transported from the deeper
areas of the ear canal out to the opening where it usually dries,
flakes, and falls out.[57] Attempts to clean the ear canals through the
removal of earwax can reduce ear canal cleanliness by pushing
debris and foreign material into the ear that the natural movement of
ear wax out of the ear would have removed.

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 Excessive application of soaps, creams, and ointments can
adversely affect certain of the natural processes of the skin. For
examples, soaps and ointments can deplete the skin of natural
protective oils and fat-soluble content such as cholecalciferol
(vitamin D3), and external substances can be absorbed, to disturb
natural hormonal balances.[citation needed]

Oral hygiene

Main article: Oral hygiene

It is recommended that all healthy adults brush twice a day,[58]

softly,[59] with the correct technique, replacing their toothbrush
every few months (~3) or after a bout of illness.[60]

There are a number of common oral hygiene misconceptions. It is

not correct to rinse the mouth with water after brushing.[61] It is also
not recommended to brush immediately after drinking acidic
substances, including sparkling water.[citation needed] It is also
recommended to floss once a day,[62] with a different piece of floss
at each flossing session. The Effectiveness of Tooth Mousse is in
debate.[63] Visits to a dentist for a checkup every year at least are
recommended.[64]

Culinary (food) hygiene

Main article: Food safety

Culinary hygiene pertains to the practices related to food

management and cooking to prevent food contamination, prevent
food poisoning and minimize the transmission of disease to other
foods, humans or animals. Culinary hygiene practices specify safe
ways to handle, store, prepare, serve and eat food.

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 Culinary practices include:

Cleaning and disinfection of food-preparation areas and

equipment (for example using designated cutting boards for
preparing raw meats and vegetables). Cleaning may involve use
of chlorine bleach, ethanol, ultraviolet light, etc. for disinfection.
Careful avoidance of meats contaminated by trichina worms,
salmonella, and other pathogens; or thorough cooking of
questionable meats.
Extreme care in preparing raw foods, such as sushi and
sashimi.
Institutional dish sanitizing by washing with soap and clean
water.
Washing of hands thoroughly before touching any food.
Washing of hands after touching uncooked food when
preparing meals.
Not using the same utensils to prepare different foods.
Not sharing cutlery when eating.
Not licking fingers or hands while or after eating.
Not reusing serving utensils that have been licked.
Proper storage of food so as to prevent contamination by
vermin.
Refrigeration of foods (and avoidance of specific foods in
environments where refrigeration is or was not feasible).
Labeling food to indicate when it was produced (or, as food
manufacturers prefer, to indicate its "best before" date).
Proper disposal of uneaten food and packaging.

Personal service hygiene

Personal service hygiene pertains to the practices related to the
care and use of instruments used in the administration of personal

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 care services to people:

Personal hygiene practices include:

Sterilization of instruments used by service providers including

hairdressers, aestheticians, and other service providers.
Sterilization by autoclave of instruments used in body piercing
and tattoo marking.
Cleaning hands.

Sleep hygiene
Main article: Sleep hygiene

Sleep hygiene is the recommended behavioral and environmental

practice that is intended to promote better quality sleep.[65] This
recommendation was developed in the late 1970s as a method to
help people with mild to moderate insomnia, but, as of 2014[update],
the evidence for effectiveness of individual recommendations is
"limited and inconclusive".[65] Clinicians assess the sleep hygiene of
people who present with insomnia and other conditions, such as
depression, and offer recommendations based on the assessment.
Sleep hygiene recommendations include establishing a regular
sleep schedule, using naps with care, not exercising physically or
mentally too close to bedtime, limiting worry, limiting exposure to
light in the hours before sleep, getting out of bed if sleep does not
come, not using bed for anything but sleep and avoiding alcohol as
well as nicotine, caffeine, and other stimulants in the hours before
bedtime, and having a peaceful, comfortable and dark sleep
environment.

History

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 Three young women bathing, 440–430 BC. Ancient Greece.

Swedish ad for toiletries, 1905/1906.

The earliest written account of Elaborate codes of hygiene can be

found in several Hindu texts, such as the Manusmriti and the Vishnu
Purana.[66] Bathing is one of the five Nitya karmas (daily duties) in
Hinduism, and not performing it leads to sin, according to some
scriptures.

Regular bathing was a hallmark of Roman civilization.[67] Elaborate

baths were constructed in urban areas to serve the public, who

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 typically demanded the infrastructure to maintain personal
cleanliness. The complexes usually consisted of large, swimming
pool-like baths, smaller cold and hot pools, saunas, and spa-like
facilities where individuals could be depilated, oiled, and massaged.
Water was constantly changed by an aqueduct-fed flow. Bathing
outside of urban centers involved smaller, less elaborate bathing
facilities, or simply the use of clean bodies of water. Roman cities
also had large sewers, such as Rome's Cloaca Maxima, into which
public and private latrines drained. Romans didn't have demand-
flush toilets but did have some toilets with a continuous flow of
water under them. The Romans used scented oils (mostly from
Egypt), among other alternatives.

Christianity places an emphasis on hygiene.[68] Despite the

denunciation of the mixed bathing style of Roman pools by early
Christian clergy, as well as the pagan custom of women naked
bathing in front of men, this did not stop the Church from urging its
followers to go to public baths for bathing,[69] which contributed to
hygiene and good health according to the Church Father, Clement
of Alexandria. The Church built public bathing facilities that were
separate for both sexes near monasteries and pilgrimage sites; also,
the popes situated baths within church basilicas and monasteries
since the early Middle Ages.[70] Pope Gregory the Great urged his
followers on value of bathing as a bodily need.[71]

Islamic world

Islam stresses the importance of cleanliness and personal hygiene.

[72] Islamic hygienical jurisprudence, which dates back to the 7th

century, has a number of elaborate rules. Taharah (ritual purity)

involves performing wudu (ablution) for the five daily salah
(prayers), as well as regularly performing ghusl (bathing), which led

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 to bathhouses being built across the Islamic world.[73][74] Islamic
toilet hygiene also requires washing with water after using the toilet,
for purity and to minimize germs.[75]

In the Abbasid Caliphate (8th-13th centuries), its capital city of

Baghdad (Iraq) had 65,000 baths, along with a sewer system.[76]
Cities of the medieval Islamic world had water supply systems
powered by hydraulic technology that supplied drinking water along
with much greater quantities of water for ritual washing, mainly in
mosques and hammams (baths). Bathing establishments in various
cities were rated by Arabic writers in travel guides. Medieval Islamic
cities such as Baghdad, Córdoba (Islamic Spain), Fez (Morocco)
and Fustat (Egypt) also had sophisticated waste disposal and
sewage systems with interconnected networks of sewers. The city
of Fustat also had multi-storey tenement buildings (with up to six
floors) with flush toilets, which were connected to a water supply
system, and flues on each floor carrying waste to underground
channels.[77]

A basic form of contagion theory dates back to medicine in the

medieval Islamic world, where it was proposed by Persian physician
Ibn Sina (also known as Avicenna) in The Canon of Medicine (1025),
the most authoritative medical textbook of the Middle Ages. He
mentioned that people can transmit disease to others by breath,
noted contagion with tuberculosis, and discussed the transmission
of disease through water and dirt.[78] The concept of invisible
contagion was eventually widely accepted by Islamic scholars. In
the Ayyubid Sultanate, they referred to them as najasat ("impure
substances"). The fiqh scholar Ibn al-Haj al-Abdari (c. 1250–1336),
while discussing Islamic diet and hygiene, gave advice and warnings
about how contagion can contaminate water, food, and garments,
and could spread through the water supply.[79]

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 Hard toilet soap with a pleasant smell was invented in the Middle
East during the Islamic Golden Age, when soap-making became an
established industry. Recipes for soap-making are described by
Muhammad ibn Zakariya al-Razi (854–925), who also gave a recipe
for producing glycerine from olive oil. In the Middle East, soap was
produced from the interaction of fatty oils and fats with alkali. In
Syria, soap was produced using olive oil together with alkali and
lime. Soap was exported from Syria to other parts of the Muslim
world and to Europe.[80] Two key Islamic innovations in soapmaking
was the invention of bar soap, described by al-Razi, and the
addition of scents using perfume technology perfected in the
Islamic world.[81] Soapmaking thus first became an established
trade during the Islamic Golden Age, corresponding to the so-called
"Dark Ages" in Europe.

In the 9th century, Ziryab invented a type of deodorant to get rid of

bad odors.[82] He also promoted morning and evening baths, and
emphasized the maintenance of personal hygiene. Ziryab is thought
to have invented a type of toothpaste, which he popularized
throughout Islamic Iberia.[83] The exact ingredients of this
toothpaste are not currently known,[84] but it was reported to have
been both "functional and pleasant to taste."[83]

Medieval Europe

Contrary to popular belief[85] and although the Early Christian

leaders, such as Boniface I,[86] condemned bathing as unspiritual,
[87] bathing and sanitation were not lost in Europe with the collapse

of the Roman Empire.[88][89]

Northern Europeans were not in the habit of bathing: in the ninth

century Notker the Stammerer, a Frankish monk of St Gall, related a

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 disapproving anecdote that attributed ill results of personal hygiene
to an Italian fashion:

There was a certain deacon who followed the habits of the

Italians in that he was perpetually trying to resist nature. He used
to take baths, he had his head very closely shaved, he polished
his skin, he cleaned his nail, he had his hair cut as short as if it
were turned on a lathe, and he wore linen underclothes and a
snow-white shirt.

Woman's Bath, 1496, by Albrecht Dürer

Secular medieval texts constantly refer to the washing of hands

before and after meals, but Sone de Nansay, hero of a 13th-century
romance, discovers to his chagrin that the Norwegians do not wash
up after eating.[90] In the 11th and 12th centuries, bathing was
essential to the Western European upper class: the Cluniac
monasteries to which they resorted or retired were always provided
with bathhouses, and even the monks were required to take full
immersion baths twice a year, at the two Christian festivals of
renewal, though exhorted not to uncover themselves from under
their bathing sheets.[91] In 14th century Tuscany, the newlywed
couple's bath together was such a firm convention one such couple,
in a large coopered tub, is illustrated in fresco in the town hall of San

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 Gimignano.[92]

Bathing had fallen out of fashion in Northern Europe long before the
Renaissance, when the communal public baths of German cities
were in their turn a wonder to Italian visitors. Bathing was replaced
by the heavy use of sweat-bathing and perfume, as it was thought
in Europe that water could carry disease into the body through the
skin. Bathing encouraged an erotic atmosphere that was played
upon by the writers of romances intended for the upper class;[93] in
the tale of Melusine the bath was a crucial element of the plot.
"Bathing and grooming were regarded with suspicion by moralists,
however, because they unveiled the attractiveness of the body.
Bathing was said to be a prelude to sin, and in the penitential of
Burchard of Worms we find a full catalogue of the sins that ensued
when men and women bathed together."[94] Medieval church
authorities believed that public bathing created an environment
open to immorality and disease; the 26 public baths of Paris in the
late 13th century were strictly overseen by the civil authorities.[94]
At a later date Roman Catholic Church officials even banned public
bathing in an unsuccessful effort to halt syphilis epidemics from
sweeping Europe.[95]

Until the late 19th century, only the elite in Western cities typically
possessed indoor facilities for relieving bodily functions. The poorer
majority used communal facilities built above cesspools in
backyards and courtyards. This changed after Dr. John Snow
discovered that cholera was transmitted by the fecal contamination
of water. Though it took decades for his findings to gain wide
acceptance, governments and sanitary reformers were eventually
convinced of the health benefits of using sewers to keep human
waste from contaminating water. This encouraged the widespread
adoption of both the flush toilet and the moral imperative that

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 bathrooms should be indoors and as private as possible.[citation
needed]

Modern sanitation was not widely adopted until the 19th and 20th
centuries. According to medieval historian Lynn Thorndike, people in
Medieval Europe probably bathed more than people did in the 19th
century.[96] Some time after Louis Pasteur's experiments proved the
germ theory of disease and Joseph Lister and others put them into
practice in sanitation, hygienic practices came to be regarded as
synonymous with health, as they are in modern times.

Society and culture

Religious hygienic customs

Main article: Ritual purification

Further information: Islamic hygienical jurisprudence, Ritual washing
in Judaism, and Islamic toilet etiquette

Many religions require or encourage ritual purification via bathing or

immersing the hands in water. In Islam, washing oneself via wudu or
ghusl is necessary for performing prayer. Islamic tradition also lists a
variety of rules concerning proper hygiene after using the bathroom.
The Bahá'í Faith mandates the washing of the hands and face prior
to the obligatory Bahá'í prayers. Orthodox Judaism requires a
mikveh bath following menstruation, sexual relations, and childbirth,
while washing the hands is performed before prayers.

See also
Contamination control
Human decontamination
Hygiene hypothesis

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 Hygiene program
Mysophobia
Ritual purification
Sanitation

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 account of the needs of body" ...”
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Further reading
International Journal of Hygiene and Environmental Healtn
DHRI ISSN 1438-4639, Elsevier

External links

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 Look up hygiene in Wiktionary, the
free dictionary.
Wikisource has the text of the 1905 Wikipedia's health care articles can be
New International Encyclopedia article viewed offline with the Medical
Sanitary Science. Wikipedia app.

US Centre for Disease Control and Prevention

European Centre for Disease Control and Prevention
Water Sanitation and Hygiene[permanent dead link]
The International Scientific Forum on Home Hygiene
Hygiene Centre, London School of Hygiene and Tropical
Medicine[permanent dead link]
Centers for Disease Control on hand hygiene in healthcare
settings

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