Whitworth PhD Institute of Biological Environmental and Rural Sciences Aberystwyth University Ceredigion United Kingdom Key Words Pathogen Transmission Bacteria Greeting Hygiene The handshake is a commonplace greeting in many cultures but it has the ID: 40290
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Briefreportstbump:AmorehygienicalternativetothehandshakeSaraMelaBSc,DavidE.WhitworthPhDInstituteofBiological,Environmental,andRuralSciences,AberystwythUniversity,Ceredigion,UnitedKingdomKeyWords:PathogenTransmissionHygieneThehandshakeisacommonplacegreetinginmanycultures,butithasthepotentialtotransmitinfec-tiousorganismsdirectlybetweenindividuals.Wedevelopedanexperimentalmodeltoassaytransferofbacteriaduringgreetingexchange,andshowthattransferisdramaticallyreducedwhenengaginginalternativeso-calleddapgreetingsknownasthehighveandstbumpcomparedwithatraditionalhandshake.Adoptionofthestbumpasagreetingcouldsubstantiallyreducethetransmissionofin-fectiousdiseasebetweenindividuals.Copyright2014bytheAssociationforProfessionalsinInfectionControlandEpidemiology,Inc.PublishedbyElsevierInc.Allrightsreserved. *AddresscorrespondencetoDavidE.Whitworth,PhD,InstituteofBiological,Environmental,andRuralSciences,AberystwythUniversity,Ceredigion,SY233DD,UnitedKingdom.E-mailaddress:dew@aber.ac.uk(D.E.Whitworth).ictsofinterest:Nonetoreport. American Journal of 0196-6553/$36.00-Copyright2014bytheAssociationforProfessionalsinInfectionControlandEpidemiology,Inc.PublishedbyElsevierInc.Allrightsreserved.http://dx.doi.org/10.1016/j.ajic.2014.04.011 AmericanJournalofInfectionControl42(2014)916-7 .05).Wealsoassessedifthegripexertedduringahandshakeaffectedbacterialtransferbyapplyingdifferingamountsofgrip-pingpressure.ModerateandstronggripsweremeasuredusingaTakeiTKK5401dynamometer(TakeiScienticInstrumentsCoLtd,Tokyo,Japan),givingmeanstandarddeviationreadingsof49kgand251kg,respectively.Stronggripsresultedinsignigreatertransferofbacteriaperareaofcontactthanmoderate-strengthhandshakes(Fig1B)(.01).Thisexperimentalmodelprovidesevidencethatdapgreetingsresultinreducedtransmissionofbacteriabetweenparticipantscomparedwithahandshake.Thehightransmissionlevelobservedforhandshakesdoesnotappeartobepurelyafunctionofitslargecontactarea,butalsodependsondurationandstrength.Trans-missionisgreaterwithincreaseddurationandgrip,whichpre-sumablyincreasestheintimacyofassociationbetweenhands.Usingalaboratorymodelmeantthatwewereabletoeliminateallvariablesexceptthosedeliberatelyassessedduringtheexper-iment:thetypeofgreeting,greetinglongevity,andtheforceofgreetingcontact.Outsidethelaboratory,manyothervariableswillpresumablyalsoaffecttransmission.Forinstance,the3greetingstestedinvolvecontactbetweendifferentpartsofthehand,anditisprobablethatineverydaylifedifferentpartsofahandwouldhavedifferingamountsofbacterialfauna,whichwouldalsodependontheparticipantshygienehabits,occupation,andlocation.Althoughweinvestigatedthetransferofanonpathogenicbac-terium,similarresultswouldbeexpectedforotherpathogenicmicroorganisms(includingvirusessuchasinuenza),someofwhichareverycostlyinbothhumanandeconomicterms.IntheUnitedStatesalone,community-acquiredpneumoniacauses60,000deathsannually,withanestimatedannualeconomiccostof$17billion.Itisunlikelythatano-contactgreetingcouldsup-plantthehandshake;however,forthesakeofimprovingpublichealthweencouragefurtheradoptionofthestbumpasasimple,free,andmorehygienicalternativetothehandshake.ReferencesHartmannB,BensonM,JungerA,QuinzioL,RöhrigR,FenglerB,etal.Computerkeyboardandmouseasareservoirofpathogensinanintensivecareunit.JClinMonitComput2004;18(1):7-12RastogiS,ShahR,PerlmanJ,BhutadaA,GrossmanS,PagalaM,etal.Patternofbacterialcolonizationinanewneonatalintensivecareunitanditsassociationwithinfectionsininfants.AmJInfectControl2012;40(6):512-5BishaiD,LiuL,ShiauS,WangH,TsaiC,LiaoM,etal.Quantifyingschoolofexposuretobacterialpathogensatgraduationceremoniesusingrepeatedobservationalmeasures.JSchNurs2011;27(3):219-24GivenLI.Thebacterialsignicanceofthehandshake.AmJNurs1929;29(3):ChaplinWF,PhillipsJB,BrownJD,ClantonNR,SteinJL.Handshaking,gender,personality,andrstimpressions.JPersSocPsychol2000;79(1):110DolcosS,SungK,ArgoJJ,Flor-HenryS,DolcosF.Thepowerofahandshake:neuralcorrelatesofevaluativejudgmentsinobservedsocialinteractions.JCognNeurosci2012;24(12):2292-305StewartGL,DustinSL,BarrickMR,DarnoldTC.Exploringthehandshakeinemploymentinterviews.JApplPsychol2008;93(5):1139MakoulG,ZickA,GreenM.Anevidence-basedperspectiveongreetingsinmedicalencounters.ArchInternMed2007;167(11):1172WallaceLS,CassadaDC,ErgenWF,GoldmanMH.Settingthestage:surgeryexpectationsforgreetingsduringroutineofcevisits.JSurgRes2009;FileTMJr,MarrieTJ.Burdenofcommunity-acquiredpneumoniainNorthAmericanadults.PostgradMed2010;122(2):130-41 Fig1.Transferofbacteriain3greetings.(A)Areaofcontact(palegrey),transferofbacteriaduringnaturalgreetings(white),andprolongedgreetings(darkgrey)areallexpressedasapercentageofvaluesobtainedforthehandshake.(B)Transferperareaofcontactinthe3greetings(prolongedandnaturalduration),andforstrongandmoderate-strengthhandshakes(asapercentagerelativetothemoderate-strengthhandshake).Errorbarsdenote1standarddeviation(n5inallcases).S.Mela,D.E.Whitworth/AmericanJournalofInfectionControl42(2014)916-7917