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MEDICAL SCIENCES / «ШУУШШШУМ-ШУГМаУ» 2022
MEDICAL SCIENCES
УДК: 614.4
Malyshevska Olha
Doctor of Science. (Biology), Associate Professor
Motriuk Vira Phd. Sc. (Medical), Associate Professor Rudyak Oleksandra Phd. Sc. (Medical), Associate Professor Ivano-Frankivsk National Medical University DOI: 10.24412/2520-6990-2022-18141-25-28 HAND HYGIENE AND ITS CONNECTION WITH VIRAL DISEASES
Abstract.
Hand hygiene of the population and its impact on the spread of viral diseases. Hand hygiene (HH) of the population and its impact on diseases are becoming increasingly important issues. The results of this study can make a significant contribution to understanding gaps in knowledge and public attitudes towards НН.
Methods. An epidemiological study was conducted using an online platform (SurveyMonkey) and questionnaires.
Results. A total of 815 valid questionnaires were collected. Most respondents were able to differentiate between diseases that may or may not be transmitted by poor HH, but respondents' knowledge of HH was relatively inadequate. Female respondents had significantly better knowledge of HR. Most respondents indicated that they only used water instead of washing their hands with soap. Many men wiped their hands on their clothes.
Conclusions. A female, middle-aged, college educated is the main protective factor with the best knowledge of HR. A number of misconceptions about GR have been identified. Respondents' self-assessment of hand drying methods showed that additional training in this area is needed. The results of this study may provide information on gender-responsive health promotion activities and creative campaigns to achieve sustainable improvement in GR practices.
Keywords: hand hygiene, viral disease prevention, public health, preventive hygiene
Introduction. Effective hand hygiene (HH) is important to prevent disease transmission in clinical and community settings. The behavior of the population regarding handwashing and its impact on diseases is becoming increasingly important [1, 2]. It is not clear if people can practice HH correctly. Many people overlook the importance of HH. Hand washing with soap (HW) is the most effective way to remove pathogens from hands and prevent the spread of infectious diseases [3]. However, many studies have identified a gap between the perception and practice of MRM. In the study, the majority of respondents (90%) are aware of the importance of performing MRM before meals and after defecation, but only 21% and 88% of respondents reported doing it, respectively [4].
Formulation of the problem. Certain socio-demo-graphic factors are associated with compliance with GR requirements. In studies conducted, people living in urban areas with a high level of education and sufficient knowledge about infectious diseases have a high level of handwashing compliance. Women wash their hands more often than men [5].
The effectiveness of HH is a combination of the effectiveness of washing and drying hands. Studies have shown that hand washing is approximately 85% effective in removing microorganisms from hands, and hand drying further reduces transient flora [4]. Insufficiently dried hands are more likely to transmit microorganisms compared to completely dried hands [6]. Compared to the scientific evidence related to GH compliance among healthcare professionals [7], information
on the level of knowledge and behavior of HH in the population is limited. Studies have shown that GR focuses on handwashing compliance and ignores the importance of hand drying [1, 2, 5].
The aim of the study is to determine the level of knowledge and behavior during the GR of the population, as well as to identify the main gender differences in this matter.
Materials and methods. Respondents aged >18 years were recruited using a snowball method from different socio-demographic groups, including age groups, educational level and working status. A platform called SurveyMonkey was used to facilitate data collection [8]. SurveyMonkey is an online survey application for applications such as WeChat, WhatsApp and Facebook. This application analyzes and exports results after collecting responses [5, 9]. Paper questionnaires were distributed among the elderly.
The hand washing and drying questionnaire was compiled based on a literature review on key issues related to hand washing and drying [2,5,10,11]. This questionnaire consisted of three parts. Part 1 mainly collects socio-demographic data and personal habits. Part 2 focuses on knowledge of HH (12 questions) requiring correct or false answers. The questions were chosen according to common myths and misconceptions about HH described in the literature. The score of the questionnaire ranged from 0 to 12, with the score indicating the level of knowledge about HH. Part 3 included questions related to hand washing and drying practices.
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The value of the coefficient of intraclass correlation of the level of knowledge about GR (part 2) was 0.941 (95% confidence interval = 0.857-0.976, p < 0.001). The item agreement for GR practice (Part 3) between the two measurements was satisfactory. All statistical tests were two-sided with a significance level of p < 0.05.
The results and their analysis. The study was conducted from September 2021 to February 2022. A total of 1002 questionnaires were collected using Sur-veyMonkey (n = 945), in paper format (n = 57). Sur-veyMonkey's survey completion rate was 80.2%, with an average completion time of 11 minutes. After excluding incomplete questionnaires, questionnaires from 758 SurveyMonkey respondents were included. Respondents from two nursing centers and two groups of college students completed a paper questionnaire. Thus, questionnaires of 815 respondents were included for analysis.
Socio-demographic characteristics of respondents. Respondents were divided into age groups (18-29, 3049, 50-59, 60 and older). More than half of these respondents were married or had partners (52.3%, n = 426), worked full-time (59.5%, n = 485), and were in good or excellent health (56.4%, n = 463). The majority of respondents had a higher education or higher (72.8%, n = 593) and did not have concomitant diseases (79.0%, n = 644). Only approximately 32.0% received an influenza vaccine in the last 12 months (32.4%, n=306). The characteristics were comparable between the sexes, except that the number of female participants was higher than that of male participants between the ages of 40 and 49.
In general, most interviewees can differentiate diseases that may or may not be transmitted by poor HH. Regarding the concepts related to HH, the level of knowledge of the respondents was relatively low. The majority of respondents were mistaken in the statements that keeping hands clean all the time can reduce the body's defense mechanism (79.0%, n = 644), while soaping hands should be kept under water (64.8%, n = 528), and the content of 40% alcohol in hand sanitizer is sufficient for good disinfection (56.4%, n = 460). Slightly more than half of the respondents correctly answered the question related to the statement that soaping hands for 10 seconds before rinsing is not enough to disinfect hands (57.1%, n = 465). More than 30% of respondents believe that water temperature can affect the cleansing effect during handwashing (31.3%, n = 255). In general, female respondents had a significantly better level of knowledge about HH than males (9.38 ± 1.75 versus 9.06 ± 1.73; p < 0.05).
Self-assessment of handwashing and drying practices. Most respondents reported occasional handwashing, including before and after handling/preparing food (>98.0%), before eating (90.4%), after urinating/defecating (>99.0%), after discarding garbage bags (97.1%), after sneezing/coughing (82.5%) or when hands are visibly dirty (99.6%). Respondents performed handwashing after feeding a child (94.8%), caring for the sick (99.1%), after daily work (88.5%), after touching pets (99.2%), after gardening (99.0%). Studies have found that a significantly larger number of
women than men performed GR not just with water, but with the use of detergents or disinfectants (p < 0.001). Over 70% of respondents indicated that they use less than 10 seconds to wash their hands.
Women respondents were more likely than men to use paper towels to turn off the faucet or use their elbow to avoid re-soiling their hands after washing. More than 70% of respondents performed HH more often during outbreaks of infectious diseases (76%). More male respondents than women ignored washing their hands if they were in a hurry (p < 0.01), when no one was in the toilet (p < 0.05) or when they had just urinated (p < 0.001).
With regard to hand drying, more male respondents than females dry their hands on their own clothes (46.5% versus 37.7%, p < 0.01), while women more often dry their hands by evaporating water from their hands on air (70.4% versus 67.3%, p < 0.05). Respondents generally prefer to use paper towels from the re-strooms rather than their own personal towels/handkerchiefs/napkins. Respondents most often used paper towels (96.4%), a warm hand dryer (83.6%), a jet hand dryer (78.5%) and rolls of cloth towels (15.1%) to dry their hands. Most respondents shake their hands to get rid of excess water before drying (87.5%) and limit themselves to using two paper towels (90.2%). More than half of the respondents rub their hands while using the dryer under warm jets of air (51.1%). The average time to use a warm hand dryer was overall short, with more than 60% of respondents drying less than 10 seconds using a warm (60.9%) or jet hand dryer (64%).
It was found that the majority of respondents can differentiate diseases associated with poor HH, and female respondents are generally better informed than men (9.38 points versus 9.06 points out of 12 points). Respondents' misconceptions about HH were revealed. For example, the time spent washing hands and the degree of friction that occurs during foaming are more important in removing dirt and microorganisms than water temperature, and warm water causes skin irritation and is not environmentally friendly [4, 12].
Only 12.8% of respondents indicated that they always lather their hands with soap for more than 20 seconds before rinsing, while the percentage of female respondents is slightly higher than that of males (14.9% versus 7.8%) [5]. The results of multiple regression analysis also showed that women had significantly higher HH knowledge scores than men after adjusting for age and educational attainment. The age of 30-49 years and a high level of education was the criterion that demonstrated the best knowledge about HH among the studied respondents.
While the majority of respondents indicated that they do handwashing in a variety of specific situations, they admitted to using only water or, on rare occasions, using alcohol-based hand rubs or handwash wipes instead of alcohol-based disinfection. Empirical evidence suggests that disinfection and HH reduces the incidence of diarrhea, respiratory infections, and influenza, and is also considered the most cost-effective way to control diseases by breaking the chain of transmission [1-3]. Almost half of the respondents believe that 40% alco-
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hol is enough to disinfect hands with antiseptics. However, antiseptics do not kill all types of germs such as coronovirus, Clostridium difficile and some parasites; therefore, they are not recommended for use without HH when the hands are very dirty or greasy, for example, after gardening or outdoor activities [12].
Anger [3] also reported that factors such as being busy, tired or hungry can prevent male respondents from doing HH. Positively, the frequency and quality of HH is influenced by the presence of other people in the toilets due to the clustering effect. HH is considered a social norm that must be observed in the corresponding social group [3, 13].
Female respondents are in the habit of wearing rings, long nails or bracelets, while males are in the habit of wearing watches. An analysis of the studies performed showed that the bacterial load was 2.63 times higher on hands with rings than on hands without rings [14, 15]. Therefore, the public should be reminded to pay special attention to these areas when washing their hands.
More than 70% of respondents are more likely to perform HH during infectious disease outbreaks. This fact suggests that public education campaigns are effective in changing the behavior of the population regarding HH during outbreaks of infectious diseases [16].
In terms of hand drying, more men than women dry their hands on their own clothes, while women air dry their hands. Drying hands with dirty clothes reduces the benefits of handwashing to almost zero. It has also been found that insufficiently dried hands are more likely to transmit microorganisms compared to completely dried hands [6].
Respondents most frequently used paper towels to dry their hands, followed by warm hand drying, jet drying, and rolls of cloth towels. The most common hand drying method is paper towel drying. Paper towels effectively dry hands, remove bacteria, and pollute the air less with bacteria in toilets [17]. However, the use of paper towels has adverse effects in terms of waste disposal and sustainability in the environment. It has been found that hand dryers with warm air are more environmentally friendly than paper towels [18]. However, hand dryers are much slower than paper towels or jet hand dryers, taking approximately 45 s to remove only 3% of residual water [6]. The average time of using warm hand dryers among the respondents was generally insufficient - less than 10 s. As a result, a significant amount of water remains on the hands, which can easily re-contaminate hands after touching environmental objects such as doorknobs when leaving the toilet [12].
The results of our cross-sectional study provided an opportunity to understand gaps in knowledge and public behavior regarding HH, as well as gender differences in relation to this issue. The results obtained can be used in gender-responsive health promotion activities and creative campaigns that aim to improve compliance with HH and achieve sustainable improvements in HH practice.
Conclusions. The results of the study showed that female respondents in general have a higher level of knowledge about HH than male respondents. HH was
most correctly and fully performed by middle-aged women with higher education. There are misconceptions among the public about some of the concepts associated with HH. Self-assessment of respondents' knowledge of drying methods and HH showed that the population needed additional training. The results of this epidemiological study are useful for gender-responsive health promotion activities and creative campaigns to achieve sustainable improvement in HH practices.
Referens
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УДК : 612.392.69:546.47
Каньовська Л.В., Ляхович О.Д.
Буковинський державний медичний унгверситет DOI: 10.24412/2520-6990-2022-18141-28-31 ЦИНК ТА ЙОГО РОЛЬ ДЛЯ ОРГАН1ЗМУ ЛЮДИНИ
Kaniovska L. V., Liakhovych O.D.
Bukovinian State Medical University
ZINC AND ITS ROLE FOR THE HUMAN BODY
Анотаця
Серед есенцгальних м1кроелемент1в цинк грае найважливгшу роль в регуляцИ гомеостазу организму людини, що пов'язано з структурною та каталгтичною роллю цинкзалежних ензимгв. Ргвень свгтовог смертностг, внаслгдокмгкроелементозгв становить 6%, а юльюсть людей, що страждають eid ггпоцин-коз1в, - бшьше 1,1 млрд. КлШчш прояви недостатностi цинку вiдображаються в комплексному порушент роботи iмунноl, нервовог, травног, серцево-судинног систем.
Abstract.
Among the essential trace elements, zinc is crucial in regulating the homeostasis of the human body, which is associated with the structural and catalytic role of zinc-dependent enzymes. The global mortality rate due to trace elements constitutes 6%, and the number of people suffering from hypozincosis represents more than 1.1 billion incidents. Clinical manifestations of zinc deficiency may exhibit complex disorders of the immune, nervous, digestive, and cardiovascular systems.
Ключовi слова: Цинк, ферменти, iмунiтет, ковiд, патологiя внутрiшнiх оргатв.
Key words: Zinc, enzymes, immunity, Covid-19, pathology of internal organs.
Main part. Zinc is one of the most essential and indispensable trace elements for the human body. The first work on its study dates back to 1963. Its biological role was established in 1969 when J. Raulin showed the necessity of this element for the growth of the fungus Aspergillus niger. Subsequently, the importance of zinc for plant and animal growth was confirmed. The main symptoms of zinc deficiency of varying severity are the following: diarrhea [1], immune dysfunction [2], infection [3], memory loss [4], and cognitive impairment [5]. Zinc deficiency was considered a risk factor for anemia [6], gastrointestinal dysfunction [3], and hypogonadism [6].
The body of an adult contains 1.5-3 g of zinc. Zinc can be observed in all organs and tissues, but the most considerable amount is found in the prostate, semen, skin, hair, muscle tissue, and blood cells.
The content of zinc in the human body, according to the literature, is the following:
• in general: 1.3-2.3 g / 70 kg;
• in the blood: 4-8.6 mg / l;
• in urine: 0.005-0.85 mg / l;
• in the hair: 50-400 mg / kg.
In children during the first year of life, the serum zinc content averages 6.5-7.5 mg / l; this figure does not change with age. According to the WHO, the optimal intake of zinc in the body is recommended in the following quantities: for children under 6 months: 3 mg / d; 6 months - 1 year: 5 mg / day, 1 year - 6 years: 10 mg / day; for children from 10 years and adults: 15 mg / day.
Zinc enters the body with food. Food rich in mineral zinc includes beef, liver, seafood, rice bran, wholemeal flour, carrots, onions, and nuts. The need for mi-cronutrients increases during intensive growth and pregnancy, amounting to 20-25 mg/day. Zinc deficiency can develop with insufficient intake of this element in the human body (1 mg/day or less), and the threshold toxicity is 600 mg/day.
Zinc plays an essential role in skin regeneration, hair and nail growth, and sebaceous gland secretion. The main supply of zinc (about 30%) in the human
