Dirty Hands

Are hypersanitation trends a result of scaremongering or a lack of faith in medicine?
Sep 02, 2008

Michelle Hoffman
Lately, I've noticed an unusual new piece of hardware in many public restrooms. It's a large metal hook-like thing nailed to the inside of the door. As I understand the instructions, you're supposed to hook your arm in it and pull the door open. I think the idea is to spare people from having to touch the doorknob with their hands on their way out so as not to come into contact with other people's infectious germs. (The principle, I guess, is that one's arm is less susceptible to infection than one's hand.)

Sometimes, instead of this hook (I don't know whether it has an official name yet: A description of the device came up in a Google search for "sanitary door opener," as did mentions of animal-operated door openers—the animals use their snouts, much more sanitary than peoples' hands, no doubt; and foot pedals that open lavatory doors), there is a box of tissue papers by the door that people can use to cover the (supposedly) contaminated doorknob as they grasp it with their hands. In the absence of either accessory, I have seen people use toilet paper or paper towels to cover the doorknob.

The use of paper towels seems to have come first, but very occasionally, and now come specialized devices—sanitary door openers. So, I guess it's a widespread practice reflecting a widespread concern. But where did this concern come from? Why? And why now?

Well, for one thing, there seem to be more ads on TV designed to make us afraid of the germs "lurking" in our kitchens and bathrooms at home. I don't know whether this is a symptom or a cause of the same phenomenon that put sanitary door openers in restrooms, but the ads are not only more abundant, they're more urgent than I remember them being at any other time in my own (rather long and comprehensive) TV-watching career.

As much as it would be easy to say that this fear of contracting something—no one knows what—from doorknobs and kitchen sponges is an advertising ploy to sell paper towels, antibacterial soap, and sanitary door-opening paraphernalia, I suspect something else is operating here. For those of us who grew up in the years after the polio vaccine was widely available and after small pox and malaria had been eliminated in the developing world, there was nothing you could catch, it seemed, that couldn't be cured in a few days with an antibiotic. Medicine may not have cured cancer, but plagues and scourges that decimated whole populations in the past had become mere inconveniences, thanks to modern antibiotics and vaccines.

Then came AIDS, an infectious disease that could kill people and for which no "cure" or preventive vaccine has to date been found (although there now exist very effective treatments that allow people [who can afford the drugs] to live a relatively normal, disease-free life). Close on the heels of AIDS followed reports of Ebola, Hantavirus, and more recently, SARS, and avian flu (the human version being called, quite ominously, pandemic flu). Add to that, the emergence of antibiotic-resistant tuberculosis, antibiotic resistance in general, and the re-emergence of smallpox, and I find myself wondering whether all the alarm stems from the dual fears of contagions that arise seemingly from out of nowhere, and a lack of public confidence in the medical and pharmaceutical establishments to vanquish them.

This past week, a stomach ailment that in its severest form gives rise to symptoms that mimic acute appendicitis seems to be sweeping through my office. The causative agent is probably a virus, but no one knows for sure. And when colleagues talk about it, I think I detect a slight note of fear and insecurity that perhaps this is another one of those scourges that we can't so easily wash our hands of.

Michelle Hoffman is editor-in-chief of Pharmaceutical Technology,