PHOTOGRAPH BY SCOTT OLSON, GETTY IMAGES
Published December 19, 2013
What started off as a joke between friends became a study published in the Journal of Hospital Infection with a surprising conclusion: Fist-bumping reduces the transmission of bacteria by about four times, compared with shaking hands.
W. Thomas McClellan, a plastic and hand surgeon in Morgantown, West Virginia, was talking with two colleagues about MRSA (methicillin-resistant Staphylococcus aureus), a difficult-to-treat, antibiotic-resistant bacterial infection prevalent in hospitals.
"When you go into a room with a patient with MRSA, you put on a gown and wash your hands," he said. "Meanwhile, the patient's family is there without any of that on, and you go shake their hands, which probably have MRSA on [them]." So McClellan had an inspiration, prompted by how he greets his young kids: "Hey, how about a fist bump?" We asked him to elaborate on the merits of fist-bumping.
Aside from use in hospitals, do you think fist-bumping should be adopted in daily life?
I do. And I'll tell you why. One, MRSA is really rampant in the community. When you go to Whole Foods or something like that, you wipe your cart handle down with an antibacterial cloth. We have alcohol sanitizers in hospitals. Well, that stuff is ineffective against some bacteria. When you think about the kinds of pathogens you are exposed to in the community, it makes a lot of sense to limit your exposure.
What part does hand-washing or hand-sanitizing play in fist-bumping?
You can't fist bump and never wash your hands. The one thing about fist-bumping is that it's not the usable surface of your hand. If you shake someone's hand, you then eat with that part of the hand. Fist-bumping protects that usable surface. You need to wash your hands; you need to limit exposure; and you need to use alcohol sanitizers.
The holiday season is approaching, which means there will be a lot of physical contact—hugging, kissing on the cheeks. Is fist-bumping the safest kind of greeting?
I'm not saying that everyone should be going around fist-bumping, but people should have an awareness of what they're doing. If you're shaking hands and about to sit down for a meal, you should wash your hands. If you have an open wound on your hand, you should definitely be washing your hands more frequently.
Are you planning any related research in the future?
This study did not address viruses. Viruses are much more easily transmitted. I think viruses are much more communicable than bacteria, particularly with the rise of H1N1, bird flu, and other viral pathogens.
Do you fist bump more now?
Yes, I fist bump everybody now! I still shake hands in meetings. But in the hospital, I don't. It's caught on at the hospital because it's catchy and people understand it. The number of hospital infections has decreased since we presented our study. I can't directly attribute it to our research, but it could be just be an increase in awareness.
I like the salute idea or how about the more peaceful hands folded as if in prayer with a small bow? I agree that fist bumping is not perfect however it is vastly better than palm-to-palm. It is surprising how this simple practical suggestion written by a physician generates some very impolite remarks.
H1N1 has already reared its ugly head this year and it is not even new year's. Five dead in Texas, two dead in Alberta, It appears to be a particularly virulent strain,
I am in Santa Barbara where meningococcal disease has reared its ugly head. I work with HEAL (Health, Empowerment and Love), a project of the Interfaith Initiative of Santa Barbara. We have developed the Cough Hygiene Initiative which includes WASH/2 protocols based upon the UNICEF program of Water Sanitation and Hygiene. We modified it it to Water-Awareness-Sanitation-Hygiene, hence the "2". Awareness is the simple facts of science: germs carry disease, they get on your hands, you must wash them frequently. Cough into your elbow.
We teach this to the houseless/homeless with surprisingly good response. But there is still resistance from the staff of the warming center who seem to think that the freedom to spread germs is some kind of inalienable right. The Unitarian Society of Santa Barbara runs these emergency homeless shelters and there is a campaign to get them to adopt better hygiene, California state law mandates that homeless shelters separate people with respiratory tract infections but the staff of these places are reluctant to do so. There seems to be a sense that they tend to be cigarette smokers and a bit of bronchitis is their idea of normal. As a result, indiscriminant coughing, hand shaking and general lack of soap and even water resulted in more than one case of influenza pneumonia amongst the staff of county public health department personnel who interact with the homeless.
With deepest regret, I find myself promoting disease prevention in an adversity with the Unitarians (USSB) and their collaborating churches Trinity Episcopal Church, First United Methodist Church (FUMCSB) and others. Some ministers have provided me with moral support and IISB/HEAL has helped resolve this nasty dispute.
I have been a fan of National Geographic since I was a kid and it is heartening to find this well thought out article avallable. I will send copies on to my supporters including FB friends and invite like minded people to F/F me and review the petitions at www.causes.com/teach
We are also through Action Vs Infectious Disease developing a statement for the FDA regarding its proposed new rule on antibacterial soap.
Many readers may find such gravitus over such a simple thing as hand washing and cough hygiene to be silly. However, it is not. Just consider a child, or a grandmother, or a college kid suffering from meningitis or influenza, which can be lethal. Hygiene is not a joke.
- Geof Bard
Cough Hygiene Initiative of T.E.A.C.H. (Teach Everywhere About Community Health)
Should one also 'explode' the fist bump after giving/receiving to send a message to those little germies?
This is a rehash of the same bad article from The Atlantic.
Lets think about this, you're still exchanging bacteria (even if its a smaller amount) It does not matter if you're exchanging hundreds of billions of microorganisms or just a few billion because for most of the diseases in question it takes only a few hundred (and here is the important part) on broken skin to infect you.
And what's a great way to break the skin of your knuckles? Bro bumping...
Fact is that simple hand washing isf thousands of times more effective then just limiting exposure surface. Proper hand washing eliminates 99.99% of pathogens present on your hands (except those under your fingernails)
Or you could just dispense with any casual physical contact at all in a medical setting. Fist bumping with one's doctor is ludicrous.
Interesting, why not follow the lead of the military and greet with a gesture such as a salute that eliminates contact?
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