Can adenosine triphosphate be a proxy measure in evaluation of hand disinfection effect?

Contaminated hands may contribute to the transmission of pathogens. In the prevention of healthcare-associated infections the effect of disinfection methods should ideally be possible to measure in a simple way. Microbial cultivation is the reference standard, but it is a rather complicated and time-consuming procedure, and the use of swabs for measuring adenosine triphosphate (ATP) has become a much-used proxy measurement (bioluminescence). We evaluated the effect of three hand-disinfection methods on eradication of Escherichia coli from artificially contaminated hands, using cultivation and ATP measurements in parallel. ATP measurement was found to be an unsuitable method as this reflects the total amount of cellular material left on the hands, not only the viable bacteria.

Effects of hand disinfection with alcohol hand rub, ozonized water, or soap and water: time for reconsideration?

The effect of alcohol hand rub was tested in eradicating Escherichia coli, and compared with hand wash using ozonized tap water or soap and water. Alcohol eradicated all bacteria in 10 out of 35 participants, but with an average (SD) of 2330 (4227) cfu/mL left after disinfection, whereas ozonized water removed all bacteria in 10 out of 55 participants, with an average of only 538 (801) cfu/mL left (P = 0.045). Soap washing was the most effective with total removal of bacteria in six out of 20 participants, with an average of 98 (139) cfu/mL (P = 0.048 and 0.018 versus ozonized water and alcohol, respectively).

Ozonized water as an alternative to alcohol-based hand disinfection.

BACKGROUND: Hand hygiene plays a vital role in the prevention of transmission of micro-organisms. Ozone (O3) is a highly reactive gas with a broad spectrum of antimicrobial effects on bacteria, viruses, and protozoa. It can easily be produced locally in small generators, and dissolved in tap water, and quickly transmits into ordinary O2 in the surrounding air. AIM: To compare ozonized tap water and alcohol rub in decontamination of bacterially contaminated hands. METHODS: A cross-over study among 30 nursing students. Hands were artificially contaminated with Escherichia coli (ATCC 25922), then sanitized with ozonized tap water (0.8 or 4 ppm) or 3 mL standard alcohol-based rub (Antibac 85%). The transient microbes from fingers were cultivated and colony-forming units (cfu)/mL were counted. The test procedure was modified from European Standard EN 1500:2013. FINDINGS: All contaminated hands before disinfection showed cfu >30,000/mL. The mean (SD) bacterial counts in (cfu/mL) on both hands combined were 1017 (1391) after using ozonized water, and 2337 (4664) after alcohol hand disinfection. The median (range) values were 500 (0-6700) and 250 (0-16,000) respectively (non-significant difference). Twenty per cent of participants reported adverse skin effects (burning/dryness) from alcohol disinfection compared with no adverse sensations with ozone. CONCLUSION: Ozonized tap water is an effective decontaminant of E. coli, and it could be an alternative to traditional alcohol-fluid hand disinfectants both in healthcare institutions and public places. Ozonized water may be especially valuable for individuals with skin problems.

[Adolescents living on their own--social control and health related behavior]. / Ung på hybel--sosial kontroll og helserelatert atferd.

BACKGROUND AND OBJECTIVES: Social control is an important dimension in the interaction between members of social groups. Such control may contribute to adherence to group norms and prevent health related risk behaviour. Adolescents moving out from home to live on their own may become left to themselves and lose their social network and mechanisms of control. We wanted to examine to what extent high school students living in lodgings were different from students living at home concerning health and health related behaviour. MATERIAL AND METHODS: The study was based on data from a cross sectional inquiry among 828 high school students (91% of all students) in Førde carried out in 1997. One in four students lived alone in bedsitters. Bivariate analyses were performed separately for the two age groups 15-17 and over 18 years of age. Students living on their own were compared with students living at home concerning self-reported health and health behaviour. Multivariate analyses were performed to control for confounding. RESULTS: Students living in bedsitters more often reported health risk behaviour than their home-living peers. The differences was most conspicuous in the youngest age group. Differences were found for cigarette smoking, alcohol use, unhealthy diet, and age of sexual debut. Health-risk behaviour was most prevalent among students in vocational courses living alone. Self-reported health and emotional wellbeing were as good among students living alone as it was among their home-living peers. CONCLUSION: Reduction of social control among students living alone in lodgings seem correlated with increased health risk behaviour. Students in vocational courses may be at particular risk. Social planning of education should consider the need to belong and the need for new social networks among students leaving home to continue their education.

[Smoking, self-experienced health and social integration among adolescents]. / Røyking, selvopplevd helse og sosial integrasjon blant ungdom.

BACKGROUND AND OBJECTIVE: In spite of increased preventive efforts against smoking in the Norwegian population, a substantial number of adolescents starts smoking. This study was meant to increase our understanding of smoking behaviour among adolescents by examining the relationship between subjective and emotional health and social integration on the one hand and smoking on the other. METHOD: The study was based on data from a cross-sectional survey of 828 students in upper secondary schools (91% of all students) in Førde carried out in 1997 (age group 16-19). Univariate and multivariate analyses were used to examine the relationship between smoking and relevant predictor variables. RESULTS: Self-assessed health, emotional and psychosomatic health were lower among smokers than non-smokers. Female students were also worse off concerning these health complaints. Smoking prevalence was three times higher among students attending vocational secondary schools compared to students attending college proparatory programmes. Smokers reported better social integration and intimacy with friends than did non-smokers. They also reported greater problems with intimacy with parents. CONCLUSION: In preventive work among adolescents, we have to be aware of an important ambiguity: Smoking is associated with reduced subjective and emotional health, but also with better social integration and intimacy with friends.

[Experience of family break-up during childhood--health and health behavior in adolescence]. / Familieoppløsning i barndom--helse og helseatferd i ungdommen.

During recent years the prevalence of family break-up has increased. Every third child growing up in Norway today may experience divorce among their parents. In this paper we try to illustrate to what extent experiencing divorce during childhood is related to subjective health and health behaviour in adolescence. The study is based on a self-administered questionnaire among 828 students in secondary schools in Førde (91% of all). Every fifth student reported experience of family break-up, and we compared this group with the rest concerning subjective health and health behaviour. We found significant differences in the disfavour of adolescents whose parents were divorced, with regard to both physical and emotional health complaints. We also demonstrated marked differences concerning health risk behaviour, especially smoking. The subjective assessment of wellbeing and performance in school were lower among adolescents with divorce experience. It is concluded that family break-up represents a major stressful event for children with marked health consequences in adolescence. Such consequences should be considered in plans for preventive health measures and health care for children and adolescents.

[Hearing aids among the elderly--not only in the drawer!]. / Høreapparater hos eldre--ikke bare i skuffen!

The majority of hearing-aids are offered to elderly patients with presbyacusis. It is commonly assumed in the general population and among health professionals that many hearing-aids are not being used regularly on a daily basis. 83 patients over the age of 70 were visited unannounced and interviewed in their homes. They had received their first or replacement hearing-aid from six months to two years earlier. The main purpose of the interview was to examine to what extent the hearing-aids were in regular use. Nearly half of the patients said they wore their hearing-aid when they opened the front door and that they used it constantly during the day. This was also confirmed by relatives. One of five stated that they did not use the hearing-aid at all, or that they were not able to find it. The majority of users were satisfied with their hearing-aid, and relatives found it to be of great help. Even patients over 80 years old managed to fit their hearing-aid themselves, regulate the volume and change the batteries. There was an even distribution of all-day users regardless of the extent of hearing loss. Whether the hearing-aid was prescribed on the initiative of a third party or not made little difference to the extent of its use. A significant difference was found between first-time users and those with a replacement hearing-aid, replacement hearing-aids being used much more frequently. We conclude that hearing-aids are indeed being used by the majority of elderly people with impaired hearing and that they are of great benefit to them. It is difficult to predict from the medical history and audiometric data of the individual patient exactly how much the hearing-aid will be used later and how beneficial it will be. Patients should therefore be allowed to test a hearing-aid at home for a period of time and to return it if it is found to be of little benefit.