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Hand hygiene, cough etiquette, cleaning and laundry - Advice and information to the general public

Published Updated

Here you will find advice and information about hand hygiene, cough etiquette, cleaning and laundry.

Here you will find advice and information about hand hygiene, cough etiquette, cleaning and laundry.


How to prevent transmission

The SARS-CoV-2 virus that leads to COVID-19 disease is spread primarily via droplet and contact transmission, when the virus is transmitted from the respiratory tract of an infected person to a healthy person. Therefore, good hygiene is an important measure to limit transmission in the population.

Cough etiquette and social distancing are crucial to limiting droplet transmission, while hand hygiene, and especially avoiding touching the face with unclean hands, is important to prevent indirect contact transmission.

See also: 

Hand hygiene

Avoid touching your face with unclean hands. This will prevent stop transmission via the hands to the eyes, mouth and respiratory tract.

When should hand hygiene be performed?

  • Before cooking or eating food
  • After using the toilet (or changing nappies)
  • With visibly dirty hands
  • After contact with bodily fluids (e.g., after wiping the nose)
  • After contact with animals
  • When you arrive at work / childcare centre / school
  • After touching contact points in areas used by many people, including work / childcare centre / school
  • Before putting on a face mask and immediately after removing it

Hand wash or hand disinfection?

Both hand washing and alcohol-based hand disinfection are, in most cases, effective methods of hand hygiene.

Alcohol-based hand disinfection is less effective when hands are wet, visibly dirty or soiled with organic matter such as food or bodily fluids. Therefore, washing with soap and water is normally recommended as a method outside the healthcare service.

However, during the COVID-19 pandemic, hand hygiene is performed more frequently than usual. Alcohol-based hand disinfection is easily available and less irritating to the skin on the hands. Therefore, it can be a good alternative to hand washing when your skin is dry and not visibly dirty.

For the best effect, follow the manufacturer's recommendations for how much to use and how long it takes to work.

NB: There is no need to perform both hand washing and hand disinfection – one is sufficient.

Effective hand washing, step by step: 

How to wash hands

 

Choice of disinfectant

During the ongoing COVID-19 pandemic, there is a great demand for hand disinfectants and many new products have come on the market in recent months. It is important that the products used are both effective, safe and skin friendly.

The Norwegian Institute of Public Health, like WHO and ECDC,  primarily recommends alcohol-based hand disinfection, based on ethanol or isopropanol. Ethanol is less irritating to skin, eyes and mucous membranes and may therefore be preferred as a main ingredient. The alcohol concentration should be between 70-90 per cent v/v.

Alcohol-based hand disinfectants have been used by the healthcare system in Norway for several decades. Even though some react with irritated skin, experience shows that alcohol-based disinfection is effective and is gentle to skin on the hands.

Hand disinfectants must comply with the requirements of the biocide regulations managed by the Norwegian Environment Agency. 

Hand disinfectants with active ingredients other than alcohol are also available. In order to be sold in  Norway, these products, like alcohol-based hand disinfectants, must comply with the requirements of the biocide regulations. They must show documented effect according to ES-NS-1500. There is limited experience with clinical use of these products.

How should you dry your hands after washing them?

You can dry your hands with disposable paper towels or warm air hand dryers. It is important that hand dryers are kept clean. They should be designed so that water does not collect at the bottom and then be blown out during use.

Hand towels can be used in private homes but should be changed regularly.

Warm air hand dryers should not be used in healthcare institutions. Read more about drying hands in the national hand hygiene guide in the health service.

How to prevent dry and sore hands?

Here is some advice to prevent dry and sore skin on the hands due to frequent hand hygiene:

  • Use skin-friendly soaps (perfume-free, pH <5.5) and use good quality paper towels to reduce drying out of the skin. At home, clean towels are a good option.
  • Wash your hands in lukewarm water, not hot water.
  • Wet your hands before applying soap.
  • Rinse your hands thoroughly after washing so that all soap suds are washed away.
  • Pat your hands with the paper towel / towel until they are completely dry, avoid rubbing hard.
  • Use hand cream to prevent dry and sore skin, as often as needed (e.g., after hand washing).
  • When using shared tubes (other than by people in the same household), it is important to ensure that the tube opening does not come into contact with skin or objects during use, to avoid contaminating the cream.

Film about skin-friendly handwashing in several languages

See these animated films in several languages from the Psoriasis and Eczema Association (PEF).

The film is intended to promote skin-friendly handwashing during the coronavirus pandemic.

The film is available in these languages:

Use of disposable gloves

Transmission by hands wearing gloves happens in the same way as for hands without gloves. Therefore, we do not recommend the general use of disposable gloves, see Routine use of gloves for shop employees and customers is not recommended

Precautions with use of hand disinfectants

  • Alcohol-based hand disinfectants are flammable. Do not store or use at high temperatures or near open flames.
  • Hands must be dry after using hand disinfectant before activities that may involve contact with heat, sparks or open fire (normal drying time is 20-30 seconds). Cases have been reported where hands that are damp with alcohol-based hand disinfectant have been set alight after close contact with open flames, for example, when lighting a candle or lighting a fire in a stove.
  • Hands must also be dry before touching nearby objects because of the risk of static electricity. Sparks can arise. Cases have been reported where hands that are damp with alcohol-based hand disinfectant have touched metal objects, causing sparks. 
  • Alcohol-based hand disinfectants can be harmful if swallowed or if they come into contact with the eyes. Consider safe use and placement in areas where children, people with mental disorders or who are mentally impaired or other groups are at increased risk of accidental ingestion.

Cough etiquette

  • Avoid coughing or sneezing directly onto others.
  • Try to cough / sneeze into a paper tissue (carefully disposed of afterwards), or into the crook of your elbow if you do not have tissues available.

Laundry and home cleaning

  • In households where coronavirus infection has not been confirmed, normal cleaning can be performed.
  • In households where infection has been confirmed: Clean surfaces that are touched by both the infected person and others daily, such as bathroom sinks, toilets, door handles and kitchen worktops. Ordinary detergents can be used. Towels and bedding used by the sick person must be washed on a minimum of 60 degrees, other textiles at the highest possible temperature. Clothes and textiles that have been in contact with the infected person should be kept separately from other objects before washing. Wash your hands after handling the used textiles.

 

References

  1. Marasinghe KM. A systematic review investigating the effectiveness of face mask use in limiting the spread of COVID-19 among medically not diagnosed individuals: shedding light on current recommendations provided to individuals not medically diagnosed with COVID-19, 27 March 2020, PREPRINT (Version 2) available at Research Square. DOI: 10.21203/rs.3.rs-16701/v2
  2. Feng S, Shen C, Xia N, Song W, Mengzhen F, Cowling BJ. Rational use of face masks in the COVID-19 pandemic, Lancet Resp Med. Published:March 20, 020. DOI: https://doi.org/10.1016/S2213-2600(20)30134-X
  3. Saunders-Hastings P, Crispo JAG, Sikora L, Krewski D. Effectiveness of personal protective measures in reducing pandemic influenza transmission: A systematic review and meta-analysis. Epidemics, 2017, 1-20. DOI: https://doi.org/10.1016/j.epidem.2017.04.003
  4. Cowling BJ, Zhou Y, Ip DJM, Leung GM. Face masks to prevent transmission of influenza virus: a systematic review. Epidemiology & Infection 2010. DOI: https://doi.org/10.1017/S0950268809991658
  5. Facemasks for respiratory tract infections, systematic reviews
  6. Should individuals in the community without respiratory symptoms wear facemasks to reduce the spread of COVID-19? – a rapid review Iversen BG, Vestrheim DF, Flottorp S, Denison E, Oxman ad.; 2020.ISBN elektronisk: 978-82-8406-106-1: https://www.fhi.no/publ/2020/bor-personer-i-samfunnet-bruke-ansiktsmasker-for-a-redusere-spredningen-av-/
  7. Using face masks in the community - Reducing COVID-19 transmission from potentially asymptomatic or pre-symptomatic people through the use of face masks ECDC, report 8.4.2020: https://www.ecdc.europa.eu/en/publications-data/using-face-masks-community-reducing-covid-19-transmission
  8. WHO: Advice on the use of masks in the context of COVID-19. Interim guidance 5. Juni 2020 . WHO/2019-nCov/IPC_Masks/2020.4: https://apps.who.int/iris/handle/10665/331693

History

04.03.2021: Removed sentence about temporary reduction in requirements for alcohol-based disinfectants.

18.12.2020: Moved section about precautions with hand disinfectants to own chapter.

10.12.2020: Added films about handwashing

29.10.2020 Moved information about face mask use to a separate article: Face mask use in the general public

27.10.2020 Minor changes in formulation of advice around use of hand disinfectants with other active ingredients than alcohol. 

10.10.2020 Updates to section about alcohol-based disinfectants, according to Norwegian version

25.09.2020 Updated section about face masks. Removed paragraph about cleaning.

27.08.2020 Added illustrations of how to use a face mask/cloth face covering. Added a sentence about wearing a mask with the coloured side facing out.

14.08.2020 Updated the paragraph about using face masks and cloth face coverings - added link to WHO's page about face masks. Updated the paragraph about recommendations and advice to people who use face masks and cloth face coverings.

11.08.2020
Adjusted definition of non-medical face mask to cloth face coverings. Added European standard for production of non-medical face masks. Updated knowledge base on use of face masks, with latest advice and recommendations from ECDC and WHO.

11.06.2020
New paragraph about drying hands.

29.05.2020 
Added illustration about effective hand hygiene.

27.05.2020
Updated advice about washing hands. Added paragraph about choosing disinfectants.

22.05.2020 
Updated information about Cleaning and laundry at home, as per Norwegian version.

22.04.2020
Updated information about use of non-medical face masks and updating of knowledge base, as per Norwegian version.

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Facts

Coronavirus

SARS-CoV-2 is the name of the virus that is causing the outbreak of COVID-19 disease.

The virus is related to another coronavirus that caused the SARS outbreak in 2002/2003 but is not the same virus.