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November 2018

Is good hygiene making us sick?

Written by Nathalie Leblond
Workplace Hygiene

One of the earliest blog posts that I wrote for the Initial Insights page was titled 5 reasons you should let your child play in the dirt, and in it, I presented some science in support of letting children get dirty.

In that blog, two of the more compelling arguments I could find for letting your kids get dirty centred around the need for the human body to strengthen its immune system through exposure to common germs in childhood (the Hygiene Hypothesis); and the “old friends” theory, which proposed that we have gradually lost touch with the microbes with which we evolved, and that their absence may cause abnormal functioning of the immune system.

The “old friends” theory is really a refinement of the hygiene hypothesis and was proposed in 2003 by Graham Rook as a way to explain the rise in allergies which have reached pandemic levels worldwide. Rook’s theory emphasised that there are a huge number of vital microbes that have been present throughout human existence as part of our human microbiome and which are necessary for optimal health.  

Since reading that, I have wanted to investigate the human microbiome in more detail. We’ve written about the most common bacteria found in the human body and the role they play in promoting good health in a previous fact or fiction blog post, but is the human microbiome being affected by our hygiene practices? Could we be harming it with the products we use, and conversely, is there a way to support it for better health? But firstly, let’s take a closer look at what exactly we mean by the human microbiome.

What is the Human Microbiome?

Studies of the human microbiome started as far back as the 1680’s when Antonie van Leeuwenhoek compared his oral and faecal microbiota. He noted striking differences in the microbes colonising these two habitats, and also between samples from ill and healthy individuals.

In a paper titled Defining the Human Microbiome researchers have defined it as “the genes of the 10 - 100 trillion symbiotic microbial cells harboured by each person, primarily in the gut” (but also on the skin and in the mouth).  Numerous microbiome projects have been launched worldwide with the aim of understanding the roles that these symbiotic microbial cells play and their impact on human health and wellbeing.

Allergy studies have linked the development of allergic diseases to changes in the trillions of microbial cells that reside in our colon, and scientists now think that your microbiome may also play a crucial role in a wide range of other health issues such as maintaining a healthy weight, gut health, the promotion of a healthy heart by promoting "good" HDL cholesterol and triglycerides, and lowering the risk of type 1 diabetes by controlling blood sugar.  Conversely, there are a number of diseases and conditions that are associated with a compromised microbiome, the most obvious of these being antibiotic-associated diarrhoea.

Antibiotics and the Human Microbiome:

Another interesting question that researchers are just beginning to answer is how stable over time is an individual’s microbiome. By defining what constitute “normal” changes over time, scientists will be better able to understand the “abnormal” changes in microbial communities in the gut and on the skin that may result from interventions such as antibiotics and anti-bacterial soaps or topical preparations.

Antibiotics are mainly used to combat disease-causing bacteria, however, the current generation of antibiotics are broad spectrum, meaning they target broad swaths of the “good bacteria” as well as the disease-causing bacteria, significantly affecting your gut microbiota.  Studies have shown that three to four days after treatment with a broad-spectrum antibiotic the gut microbiota experience a decrease in richness and diversity, and while they began to resemble pre-treatment states after approximately a week, the re-establishment of some species can be affected for up to four years following antibiotic treatment!

The Role of Probiotics:

These days, it’s highly unlikely that your doctor would ever prescribe a course of antibiotics without also prescribing - or at least strongly recommending - a course of probiotics. Probiotics are live bacteria and yeasts (mostly of the Bifidobacterium and Lactobacillus species) that can be ingested as food, dietary supplements, or drugs. The purpose of taking them is to try and counteract the effect that broad-spectrum antibiotics have on the gut microbiota by recolonising the gut with some of the beneficial bacteria that antibiotics wipe out.

An article on the British Medical Journal site analysed 313 trials and 46 826 participants and came to the conclusion that there is substantial evidence for probiotic supplementation having a beneficial effect in preventing diarrhoea, necrotising enterocolitis, acute upper respiratory tract infections, pulmonary exacerbations in children with cystic fibrosis, and eczema in children.

The Skin Microbiome:

According to dermatologist Toral Patel, M.D., the skin microbiome is vital not only for skin health but also for overall health. "A healthy microbiome can protect against skin infection by preventing the overgrowth of pathogenic organisms," Patel says. Your skin microbiome can also fight against external and environmental factors, as well. "It can also help keep inflammation in check, promote wound healing, and act as a barrier to some allergens and environmental toxins."  

This is of course of huge interest to us here at Initial where we concentrate a lot of our efforts on preventing the spread of harmful bacteria by promoting good hand hygiene practices, and by extension, clean skin. But could excessive cleaning of the skin actually be putting us at risk of other illnesses by compromising the skin microbiome?

Hand Sanitisers: Help or Hinderance?

You can’t see bacteria, so there is, unfortunately, no way of knowing whether what’s being passed around the office is helpful or harmful, and antibacterial products like hand sanitisers don’t discriminate. In an article in Popular Science,  Jonathan Eisen, a microbiologist at the University of California, suggests that hand sanitisers may even be responsible for a rise in antibiotic resistance. “Even though they generally do not contain standard antibiotics, when microbes become resistant to some of the sanitisers this can make it easier for them to be resistant to more important antibiotics.”

Eisen recommends that “people use hand sanitisers with caution, and only if really needed.” He suggests you consider what your hands have recently touched. If you have just spent time in a hospital, a doctor’s office, or on public transport next to someone coughing and sneezing, taking the precaution of using a hand sanitiser is probably not a bad idea. But if you're just going about your normal day without touching too many other humans, it’s probably not necessary to sanitise your hands, and this holds especially true if you have the opportunity to use regular soap. A 2009 study found that typical soap, when used properly, is just as good at killing potentially infectious bacteria and viruses as sanitiser.  

Supporting your Skin’s Microbiome

Just like probiotics are used to support gut health, it is thought that they can also be used to support the skin’s microbiome.  A post I wrote called The Future of Hygiene took a fairly in-depth look at the use of bacteria in the beauty industry, as some big names in the cosmetics industry are doing their own research into the human microbiome and have patented several bacterial treatments for dry and sensitive skin.

There is also a living bacterial skin tonic which looks, feels and tastes like water, but which contains billions of cultivated ammonia-oxidising bacteria as a treatment for mild-to-moderate acne, and LiveScience mentions the development of topical probiotics, which can be applied directly to the skin; several manufacturers are currently experimenting with adding strains or extracts of probiotics to their skin care products, including moisturisers, cleansers, peels and lotions.  

These treatments all look at adding back beneficial bacteria after it has been stripped away. But what if you could have the confidence that by washing your hands you were not only killing harmful bacteria but at the same time adding back the beneficial bacteria that conventional sanitisers and anti-bacterial soaps strip away from our skin?

Probiotics for your Hands?

Something of which we are extremely proud here at Initial is our use of bio-enzyme products for surface cleaning. And we are taking this one step further by currently trialling a range of products that cleans and creates a protective bacterial layer at the same time. We don’t want to give too much away too soon but check back into our Insights page regularly for more news on this exciting new product development.

Just like we should be supporting our gut health with a probiotic in the face of antibiotic treatment, we should be supporting the colonies of beneficial bacteria on our skin when we clean it by using bio-enzyme products that target harmful bacteria but leaves us with the good bacteria and the confidence that our “good” hygiene practices aren’t making us sick.

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Glossary (courtesy of the BMJ):

Microbiome: the collective genomes of the micro-organisms in a particular environment

Microbiota: the community of micro-organisms themselves

Microbiota diversity: a measure of how many different species and, dependent on the diversity indices, how evenly distributed they are in the community. Lower diversity is considered a marker of microbial imbalance in the gut and has been found in autoimmune diseases, obesity, and cardiometabolic conditions, as well as in elderly people.

Nathalie Leblond

Nathalie Leblond

I joined Rentokil Initial South Africa in 2004 as the PA to the MD, and after 6 months maternity leave I re-joined the Company in 2009 as the Marketing Co-ordinator for Rentokil. I'm now the Marketing Communication Manager for Rentokil Initial. I'm still terrified of cockroaches (Americana's only!) but the rest of the creepy crawlies we deal with don't really bug me (see what I did there?), so I guess I'm in the right industry! I am passionate about what we do here at Rentokil Initial and also write for our Hygiene Blog, which can be found at blog.initial.co.za, and our Ambius blog - https://www.ambius.co.za/blog. Life outside of Rentokil Initial mostly revolves around my daughter, who has just turned twelve, and my husband (who is a bit older). I love living in Cape Town and wouldn't trade living here for anywhere else in the world.

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