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Jump to Key Points In healthcare facilities, handwashing stations must be readily accessible and equipped with running water of drinking-water quality, skin cleansers in dispensers, and disposable towels. The temperature of the water does not affect hygiene, so it may be cold, according to the Robert Koch Institute’s (RKI’s) new Epidemiological Bulletin.
The new guidance on water temperature for handwashing appears in recommendations from the Commission for Infection Prevention in Medical Facilities and in Facilities and Companies Providing Care and Integration Assistance, a German expert panel at the RKI that develops evidence-based infection prevention recommendations for healthcare settings, as well as in the updated Technical Rules for Biological Agents.
Water Temperature Has No Effect
This conclusion is based on studies showing that, in an experimental contamination of the hands with Escherichia coli, there was no difference in germ reduction whether the hands were rinsed with warm (40 °C) or cold (4 °C) water. According to the World Health Organization and the US Centers for Disease Control and Prevention, water temperature also plays no role in germ reduction during handwashing.
Warm water does not necessarily need to be provided for handwashing. However, warmer water may improve adherence because it feels more comfortable, and Germany’s Social Accident Insurance Institution for the Health and Welfare Services, for example, recommends lukewarm water.
- Water temp does not affect handwashing germ reduction.
- Cold water acceptable for healthcare handwashing stations.
- Required: running drinking-water quality + cleanser dispensers + disposable towels.
- Warm water may improve adherence via comfort, not hygiene.
- Cold water may ↓ skin irritation, resource use, and Legionella risk.
Additional Benefits
On the other hand, using cold water conserves resources and protects the environment. And the RKI points out another benefit: If hands are repeatedly exposed to higher water temperatures > 20 °C, this can lead to skin irritation. This could compromise the effectiveness of hand sanitization, which would be associated with an increased risk for transmission. Furthermore, providing only cold water significantly reduces the risk for contamination with Legionella.
This story was translated from Coliquio, part of the Medscape Professional Network.
