Major article
Face touching: A frequent habit that has implications for hand hygiene

https://doi.org/10.1016/j.ajic.2014.10.015Get rights and content

Highlights

  • High frequency of observed mouth and nose touching provides an essential teaching aid to break the colonization and transmission cycle between health care workers and patients.

  • A better understanding of self-inoculation as a route of transmission may help to improve hand hygiene compliance.

  • Hand hygiene programs should include a message that mouth and nose touching is a common practice.

Background

There is limited literature on the frequency of face-touching behavior as a potential vector for the self-inoculation and transmission of Staphylococcus aureus and other common respiratory infections.

Methods

A behavioral observation study was undertaken involving medical students at the University of New South Wales. Their face-touching behavior was observed via videotape recording. Using standardized scoring sheets, the frequency of hand-to-face contacts with mucosal or nonmucosal areas was tallied and analyzed.

Results

On average, each of the 26 observed students touched their face 23 times per hour. Of all face touches, 44% (1,024/2,346) involved contact with a mucous membrane, whereas 56% (1,322/2,346) of contacts involved nonmucosal areas. Of mucous membrane touches observed, 36% (372) involved the mouth, 31% (318) involved the nose, 27% (273) involved the eyes, and 6% (61) were a combination of these regions.

Conclusion

Increasing medical students' awareness of their habituated face-touching behavior and improving their understanding of self-inoculation as a route of transmission may help to improve hand hygiene compliance. Hand hygiene programs aiming to improve compliance with before and after patient contact should include a message that mouth and nose touching is a common practice. Hand hygiene is therefore an essential and inexpensive preventive method to break the colonization and transmission cycle associated with self-inoculation.

Key Words

Face touching
Self-inoculation
Medical students
Hand hygiene compliance

Cited by (0)

Conflicts of interest: An unfunded project and the authors declared have no conflict of interest.

View Abstract