Developing and promoting home and everyday life hygiene to meet 21st Century needs; What can we learn from the COVID-19 pandemic?

The report shows that hygiene in our homes and everyday lives is of paramount importance in the 21st century and has played a critical role in fighting the coronavirus pandemic in 2020/21. Fundamental changes in the last 30 years have reinstated hygiene on the public health agenda. These changes include not only threats posed by emerging pathogens, but also new strains of existing pathogens, particularly those resistant to antimicrobial agents. It also includes growing numbers of those more vulnerable to infection now living or being cared for in domestic settings. Hopefully, the pandemic will refocus the attention of politicians, healthcare professionals, academics and others on the vital role of public hygiene understanding and hygiene behaviour. We need to recognise the next pandemic, the spread of AMR is already underway where public hygiene behaviour also has a major role by reducing antibiotic prescribing and spread of AMR strains.

The report evaluates how household hygiene needs to change to meet 21st century needs. It centres around developing a risk management approach (Targeted Hygiene) for addressing the issues we currently face. It also includes findings of a new study on public understanding of hygiene carried out in 23 European countries. The poll indicates that the public is confused about what hygiene means and how it differs from cleanliness. It shows that, although the public’s actions are to some extent guided by their perception of risk, there is limited understanding of what are key risk situations, and when (and where) hygiene is needed.

The major findings are:

• Hygiene in our homes and everyday lives (HEDL) is of paramount importance in the 21st century, but needs to be better recognised by national and international policy makers as an equal partner to infection prevention in healthcare and other settings, and given a more equal allocation of resources.
• If hygiene in HEDL is to be effective, it needs an approach appropriate to the issues we currently face. Targeted Hygiene provides a framework for developing hygiene that is effective, and also addresses sustainability and other issues. However, work is needed, using new scientific methods, to develop this approach and estimate its effectiveness in reducing infection risks.
• Targeted Hygiene provides a framework for addressing hygiene-related  issues including sustainable use of resources (chemicals, energy, microbiocides) and minimizing environmental impacts and adverse effects that cleaning and cleaning agents might have on human interaction with essential microbes. Lack of a unified voice advocating for hygiene in home and everyday life means that these issues can take precedence, leaving hygiene and its importance in second place.
• Realising the benefits of Targeted Hygiene depends on educating the public and getting them to adopt this approach. Misunderstandings and myths around hygiene and cleanliness are currently undermining efforts to promote hygiene behaviour change. To achieve behaviour change we need further work to explore cognitive influences on hygiene understanding and behaviour, and better understand the drivers for behaviour change. Only by incorporating these learnings into hygiene promotion strategies will we be able to realise the health benefits that Targeted Hygiene can deliver.

The report is intended to providing a framework for workable solutions. It calls on the many stakeholder groups including scientists, healthcare professionals, environmentalists, the media etc to work together to achieve the objectives set out in this report. It is only by working together that we will be able to achieve the health benefits hygiene in home and everyday life offers.

A short briefing documenty is also downloadable which summarises the key findings of the white paper