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100,000 deaths in the US alone could be avoided each year if health care workers washed their hands more, according to the CDC.

Do 100,000 deaths in the US occur per year which could be avoided by health care workers washing their hands more?

The CDC Foundation (not the CDC itself) says that 99,000 deaths a year are caused by healthcare associated infections, but doesn't say how many are caused by a lack of hand-washing.

Hygiene Fast Facts by the CDC claims that 1 million deaths world-wide are caused by a lack of hand-washing by everyone (not just healthcare workers).

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    I don't see how this could possibly be determined scientifically. How would one setup a controlled experiment that could plausibly come to this conclusion? It seems like mere conjecture. Health care workers likely surveyed to find out how often they wash their hands, and then some correlation drawn between those figures and the amount of patients who died from germs introduced during their care. Do we have an actual peer reviewed source that details the controlled experiment used to arrive at this assertion? – crush Feb 4 '14 at 18:19
  • @crush As long as you can semi-reliably measure hand washing rates, you should be able to do this—take a bunch of health care facilities, split into multiple groups randomly. Have a control group, and several more groups with different programs to encourage hand washing. Measure handwashing rates in each group. Measure death by infection rates in each group. You'll likely want to continue observations after the encouragement programs end. May not be a cheap study, but seems doable. – derobert Feb 4 '14 at 23:52
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    The problem is that you can't reliably restrict the introduction of infectious germs to the lack of washing of hands of health care workers. The germs could come from a number of sources. Proving that they came solely from a lack of hand washing is virtually impossible. You may see a correlation in the rates, but that doesn't necessarily mean they are responsible. – crush Feb 5 '14 at 18:44
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Not necessarily, but it's too broad an assertion to make really. There is plenty of literature supporting a correlation between handwashing and infection rates, all concluding that more handwashing = less infection. There's also plenty on actually swabbing hands for pathogens. These are useful articles on the subject:

NIH Handwashing EBM paper

Effectiveness of handwashing techniques

So, there's plenty of info that handwashing is good, and even that it reduces infection rates, but to put a figure on how many deaths are caused by not washing hands would be an educated guess at best - collecting even some of the data on this would be a huge task, bear in mind these questions:

  • How do you attribute a death to a lack of handwashing (lab tests on every death correlated are restrictively expensive)
  • How do you find out whether a found pathogen got into the body via hands, or by another contaminated item?
  • How do you fund such research

So yeah, the possibility is there that this estimate is too low, too high, or exactly right - tracking pathogens is too difficult to put an accurate quantity on this kind of thing.

  • It would basically require observing each health care worker throughout their interaction with said patient. Furthermore, each patient would need to be observed and protected from outside influence (say a visitor) that could introduce the germs leading to death. This seems impossible. – crush Feb 4 '14 at 18:22
  • Maybe not impossible, but certainly implausible. The cost alone would be the biggest obstacle, but reliable data collection would be another, not to mention a simple yet reliable design for data collection – Owen C. Jones Feb 6 '14 at 16:32
  • The problem is that you can't prevent all other sources of contamination without compromising the study. Let me ask you this question: if you know you are part of a study that is trying to determine if you are responsible for a patient's death because you didn't wash your hands, are you going to continue to not wash your hands while being studied? Maybe if it could somehow be guaranteed that you wouldn't be punished criminally or civilly when a patient died. – crush Feb 6 '14 at 16:37

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