Home hygiene: a risk approach.

The need to place "prevention through hygiene" at the core of strategies for infection prevention has been emphasised by recent events. Indications are that re-evaluation of current practice and the promotion of improved hygiene in the domestic setting could have a significant impact in reducing infectious disease. If the public are to play a part however they must be properly informed. Encouraging the concept of the home as a setting in which the whole range of activities occur, including food hygiene, personal hygiene and hygiene related to medical care, provides the opportunity for a rational approach to home hygiene based on risk assessment. In the home surfaces (including hand surfaces) and other sites play an important part in the transmission of infection, especially food-borne infections. From an assessment of the frequency of occurrence of pathogens and potential pathogens at reservoirs, disseminators and hand and food contact sites together with the potential for transfer within the home, the risks of exposure can be assessed. This can be used to develop a rational approach in which effective hygiene procedures involving cleaning and disinfection as appropriate are targeted at these sites to reduce risks of cross contamination. This approach is consistent with the view that good home hygiene is not about "getting rid of household germs" but about targeting hygiene measures appropriately to reduce exposure to germs and thereby prevent cross infection. In motivating change, education programmes must take account of concerns related to antimicrobial resistance, the environment and the "health" of the immune system.