Developing and promoting hygiene in home and everyday life to meet 21st Century needs
Since 1997 IFH has been developing Targeted Hygiene, an approach based on scientifically validated risk management approaches developed by the food and pharmaceutical industries since the 1960s to control microbial risks. It means focusing hygiene practices at the times (moments) and in the places as needed to protect us from becoming exposed to harmful microbes. If we are not exposed we cannot be infected! This approach acknowledges the shortcomings of “C20th hygiene” which focuses on elimination of “dirt”, assumed to be the main source of harmful microbes.
The following web areas contain materials which IFH have produced to support the development and promotion of Targeted Hygiene.
This Jan 2023 review is an update on IFH risk management/9 moments approach to hygiene, its promotion through behaviour change models, and the evidence supporting this approach. The paper identifies issues that must be addressed to develop behaviour that meets ongoing needs:
- The separate aspects of hygiene (food safety, healthcare, AMR, pandemic preparedness) must be unified into an approach which recognises they are all governed by the same microbiological principles and communicated in a user-centred manner.
- Hygiene behaviour policies must be based on a Microbial Risk Management that focuses on reducing population exposure to harmful microbes.
- Despite high awareness of importance of hygiene, people have poor understanding of the nature of infection routes and risks they encounter. Getting behaviour change depends on communicating hygiene in a manner which builds understanding, and dispels current myths and misunderstandings.
In response to the pandemic, the UK Government has published a 2021 vision for a National Health Resilience Strategy. This affirms that a “whole-of-society approach” is needed to make us better able to adapt to uncertainty and adversity, including threats posed by disease outbreaks, and tackling antimicrobial resistance by reducing antibiotic prescribing. Drawing on results of a recent public poll conducted by Royal Society for Public Health/IFH, it highlights:
- How the public’s commitment to home and everydaylife (HEDL) hygiene is strong, but confusion persists about how to implement it effectively.
- The need for a fundamental rethink to ensure that HEDL hygiene is both effective and appropriate to the issues we currently face
- How a targeted approach to hygiene, based on risk management, offers a framework to meet these challenges.
This report puts forward key recommendations outlining how policy makers can further embrace Targeted Hygiene to improve health resilience.
Since 2020, UK government, prompted by the pandemic, has launched a number of national enquiries aimed at learning the lessons from COVID, including developing home and everyday life hygiene to meet future needs. IFH has made submissions to these enquiries. In this short summary of the submissions:
Section 1 identifies shortcomings of strategies adopted during the COVID-19 pandemic.
Section 2 discusses why developing public hygiene behaviour is vital in the post COVID era.
Sections 3,4,5 set out policy recommendations for change.
In 2021, a group of 18 global hygiene experts published a consensus report on the need to improve public frontline hygiene behaviour to meet current and ongoing needs, and ensure sustainable use of resources.
The report centres around the principles of risk assessment and risk management which means focusing hygiene practices at the times (moments) and in the places as needed to prevent us becoming exposed to harmful microbes. If we are not exposed we cannot be infected. This approach, known as Targeted Hygiene recognises the inadequacy of C20th approaches to hygiene based on public belief that, by maintaining “cleanliness” by regular cleaning and disinfection, deep cleaning and “frequent” handwashing it is possible to “keep” ourselves and our homes hygienic.
The report makes calls to action to refocus attention of politicians, healthcare professionals and scientists, and ensure that public hygiene behaviour is recognised as an equal and interdependent partner in controlling the burden of infectious diseases and tackling antimicrobial resistance (AMR). It also offers workable solutions to achieve this.
Targeted Hygiene is an holistic approach which focuses hygiene practices at the times (the key moments) when harmful microbes are most likely to spread in order to break the chain of infection. It is applicable to all types of infections including foodborne and other intestinal infections, respiratory infections, skin infections etc. It focuses on hygiene as the public experience it, as a set of interrelated, interdependent actions performed throughout daily life.
This approach communicates hygiene actions in the way the public need it, firstly knowing “WHEN” to act e.g after using the toilet etc, secondly “WHERE” to act e.g hands, food contact surfaces etc and finally HOW to act e.g cleaning, disinfection, wearing masks etc.
This material is designed to enable the public, and those who communicate with the public, to understand how to practice Targeted Hygiene in our homes and everyday lives in public spaces.
This animated YouTube explains the principles of Targeted Hygiene and how to put this risk management approach to hygiene into practice in our homes and everyday lives. It shows that good hygiene is not about keeping our homes (or our workplaces or schools or public spaces) looking clean and free from dirt, it’s about what we do at the times in our daily lives when cleanliness matters to prevent the spread of infection.
Thus 30 sec YouTube produced by AISE, the International Association for Soaps, Detergents and Maintenance products, summarises the 9 key moments in our daily lives where hygiene is most important, and the places where we need to practice hygiene at each of these moments to prevent the spread of infection.
This is a video of the presentation given by Professor Sally Bloomfield, Chairman of the International Scientific Forum on Home Hygiene (IFH), at the UK Infection Prevention Society Meeting in Liverpool, September 2021. It presents the key findings of the IFH 2021 white paper and the 2021 IFH AISE report as detailed above.
A key issue which COVID-19 has highlighted is the importance of hygiene in shared use of public spaces. To remain open, offices, restaurants, shops and supermarkets have to implement strategies to make their facilities so-called “COVID secure”. Despite attempts to promote a targeted approach (social distancing, ventilation, masks, hands, contact surfaces), strategies illustrate an ongoing belief that untargeted, “deep cleaning” can make a public space “COVID secure”. There is a lack of awareness that safety depends on whether the public are adopting hygienic behaviours in public spaces. Facility managers are dependent on the public to keep facilities COVID-19 secure, and need to pay equal attention to enabling and encouraging the public to practice effective hygiene.
