“A little water clears us of this deed.”

Lady Macbeth, The Tragedy of Macbeth, William Shakespeare

As I entered the utility building I was met by a combination of unidentifiable smells. Here, the sewage plant, the water treatment plant and the solid waste incinerator for the pipeline construction camp were protected from the Alaskan winter. The operator waved me into his office and offered me a glazed donut from a bag on his desk. I tried to ignore the grime embedded in his hands, and took one from the bag. The glaze was gooey in the hot building, and left my hands sticky. I had to work at not licking the glaze off my fingers.

As a sanitary engineer in college, I had researched sewage treatment plant workers’ health records. After all, working day in and out with other people’s waste would seem to be very dangerous. I learned that these workers were seldom seriously ill, but often had minor infections, often respiratory. Apparently, exposure to many germs made them hardier than most people (assuming they survived, I guess).

There is now evidence for the Hygiene Hypothesis, that relates early childhood exposures to other children and animals to children with fewer allergies later in life. Children who had lots of brothers and sisters, especially older ones and especially brothers, who lived on a farm, who went to daycare in their first year or who had a cat, were discovered to do better at avoiding allergic diseases than children in none of these circumstances.

On the other hand, it is believed that the epidemic plagues of history began in Mongolia through transmission from human proximity to livestock or wild animals. Katherine Ashenburg notes that the archetypal link between dirt and guilt, and cleanliness and innocence, is built into our language – perhaps into our psyches. We talk about dirty jokes and laundering money, for example.

Miriam Sibide says that “Diarrhea and pneumonia are among the top two killers of children under five, and what we can do to prevent these diseases isn’t some smart, new technological innovation. It’s one of the world’s oldest inventions: a bar of soap. Washing hands with soap, a habit we all take for granted, can reduce diarrhea by half, can reduce respiratory infections by one third. Handwashing with soap can have an impact on reducing flu, trachoma, SARS, and most recently in the case of cholera and Ebola outbreak, one of the key interventions is handwashing with soap.”

Sibide has studied handwashing and reports that “statistics are actually showing that four people out of five don’t wash their hands when they come out of the toilet, globally. And the same way, we don’t do it when we’ve got fancy toilets, running water, and soap available, it’s the same thing in the countries where child mortality is really high.”

In 1847 when the Viennese doctor Ignaz Semmelweis insisted that delivery room doctors and medical students wash their hands before attending their patients, he was ridiculed, even though the practice dramatically reduced deaths from puerperal sepsis (infections following childbirth). Ivory soap was immediately popular upon its invention in 1878, and by the 1880’s, Pears soap was advertising in England. In the 1880’s in Tierra del Fuego, the primitive Fuegian Indians claimed that Pears soap cured their diseases. The Lifebuoy brand was launched in 1894 in Victorian England to specifically combat cholera.

But as humans, we often overdo it. Sibide also notes that “The children most likely to develop allergies and asthma were only children who lived in cities, did not go to daycare, had no pets, washed their hands more than five times a day and bathed more than once a day.”

Stuart Levy concluded, “The recent entry of products containing antibacterial agents into healthy households has escalated from a few dozen products in the mid-1990s to more than 700 today. Antibacterial products were developed and have been successfully used to prevent transmission of disease-causing microorganisms among patients, particularly in hospitals. They are now being added to products used in healthy households…(that) could lead to a greater chance of allergies in children.”

So, we need to moderate our zeal for cleanliness a little. In countries where disease is endemic, we need more hand washing and in developed countries, we need to be a little more rational and wash routinely, but not excessively. “All things in moderation,” is still the best guide.

I will come clean, myself. Working in sewage treatment plants got me to stop a lifelong habit of chewing my fingernails. It also made licking the donut glaze off my fingers a little less enjoyable …

Additional information

Katherine Ashenburg, The Dirt on Clean, 2007

Lucas Bridges, The Uttermost Part of the Earth, 1948

Stuart B. Levy, “Antibacterial Household Products: Cause for Concern,” Emerging Infectious Diseases Vol. 7, No. 3 Supplement, June 2001

Miriam Sibide, The Simple Power of Hand Washing, TedTalks, Sept. 2014

See the “Help a Child Reach 5” campaign for how you can help reduce childhood mortality. http://www.lifebuoy.com/article/category/1102088/help-a-child-reach-5