The International Association for Soaps, Detergents and Maintenance Products and the International Forum of Home Hygiene present a collaborative industry/academia report on targeted cleaning and disinfection in homes.
Hygiene practices through which people maintain or promote good health by breaking the chain of infection are of paramount importance in the 21st century. It is critical not only in fighting the current COVID-19 pandemic and other infectious diseases, but also in addressing crucial issues such as the global problem of antibiotic resistance and protecting the increasing numbers of people living in the community who are more vulnerable to infection due to ageing or underlying health conditions. On 7 April 2021, to mark the World Health Organization’s (WHO) World Health Day, the International Association for Soaps, Detergents and Maintenance products (AISE) and the International Forum of Home Hygiene (IFH) released a joint report which highlights how targeted household hygiene is changing to meet 21st century needs. The report also contains the results of a pan-European poll carried out by AISE in 2020 to evaluate how consumer beliefs about hygiene risks affect their actions.
Targeted Hygiene: a framework for developing effective and sustainable hygiene products to meet the needs of the 21st century
Since 1997 IFH has been developing and promoting an approach to hygiene in our homes and everyday lives which has come to be known as Targeted Hygiene1. This is based on the principles of risk management and the concept that, to be effective, hygiene practices need to be focused at the times (moments) and in the places that matter to break the chain of infection and reduce the risk of exposure to harmful microbes. In this report, the principles of Targeted Hygiene are described and discussed in relation to the ways in which hygiene needs to evolve to meet current needs and challenges. Behavioural observations indicate that there are nine key moments in our daily lives where hygiene really matters. It is argued that routinely practising hygiene at each of these moments will deal with most of the risk of spread of infection in our homes2,3.
Although Targeted Hygiene was originally developed as a means to maximise the effectiveness of cleaning and hygiene practices in people’s homes and everyday lives, it also provides a framework for addressing sustainability issues by ensuring that the use of hygiene products – and other peripheral resources needed to deliver hygiene, such as water and energy – is focused on situations where these products are needed and in sufficient quantities to break the chain of infection. The product portfolio covered by AISE – detergents and maintenance products, including disinfectants – is essential to enable consumers to practise effective Targeted Hygiene.
Susanne Zänker, Director General of AISE, said: “AISE and IFH believe that getting consumers to adopt this scientifically proven approach to hygiene in their home and everyday life would have a significant impact in reducing the spread of infection, and thus securing better health for European citizens.”
Improving hygiene behaviour by European consumers through education could provide opportunities to further reduce the burden of infectious diseases
Realising the benefits that a risk management approach to hygiene in community settings could offer depends on getting consumers to adopt Targeted Hygiene techniques in their homes and everyday lives. In recent years, some misunderstandings have developed around hygiene and cleanliness which are undermining efforts to promote behavioural change. This has been exacerbated by the incorrect assumption that that excessive cleaning is depriving us of microbes from other humans and from our natural environment which are essential to health4.
The results of the pan-European poll, which was initially run in February 2020, confirm that consumers across the European region are very aware of the importance of cleanliness and hygiene. But it also indicates that, although their actions are to some extent guided by their perception of risk, there is significant misunderstanding of what the key risk situations in their homes are, and when (and where) hygiene is needed to protect against infection. Similarly, when patterns of self-reported disinfectant usage were evaluated, it was found that although consumers who used disinfectants said that they only used them in situations where they believed there was risk, in reality they reported using disinfectants only in some potentially risky situations where they are necessary; while in other similarly risky situations, they were only rarely used. Similarly, there was also excessive usage in situations which are normally considered to be low risk.
Overall, the survey suggests that consumers have rather limited awareness of how harmful microbes are spreading in their homes, and poor understanding of the need to target hygiene practices and how to use products.
In June 2020, the poll was repeated to look for changes in attitudes and behaviour as a result of the COVID-19 pandemic. Despite the fact that this provided an unprecedented opportunity for health authorities to promote important messages about hygiene practices, there was little evidence of a change in people’s perception of risk or the adoption of behaviours which better aligned with Targeted Hygiene. One place where there was a noticeable change was in consumer awareness of the importance of hygiene outside their homes, on public transport and in shops and supermarkets. There was also a marked increase in the number of consumers reporting that they washed their hands when arriving home.
Complexity of hygiene messaging and understanding across Europe: potential barriers to consumer behaviour change
A further barrier to behavioural change highlighted by the poll is the lack of clarity and consistency across Europe regarding what is meant by the terms ‘hygiene’ and ‘cleaning’, most particularly in terms of how hygiene differs from cleanliness. Addressing this issue is made even more challenging by variations in cultural attitudes to hygiene and linguistic subtleties. Although the majority of consumers agreed that hygiene is more than cleanliness and involves protection of health, a significant number of consumers thought that they were one and the same thing – that cleanliness means hygiene – while others thought that hygiene is specifically about using a disinfectant. The poll also indicated that consumers are confused about how cleaning and disinfectant products work to ‘get rid’ of microbes. This lack of clarity suggests that consumers may interpret products claims and instructions for use differently based on what they believe these terms mean.
In 2019 a policy paper produced by the Royal Society for Public Health (RSPH) in London5 concluded: ‘If action is not taken, right across the whole spectrum of stakeholders (including government agencies, community health professionals/carers, the media and the private sector), to change consumer understanding of the microbes in their modern world and how cleaning and hygiene can work to protect themselves against exposure to harmful microbes, the impact of investment in hygiene promotion will not be realised.’
“This study has made a significant contribution in developing our understanding how consumers across Europe perceive hygiene and how this dictates their behaviour,” said Professor Sally Bloomfield of the IFH, a co-author of the report. “It shows a need for action to change consumer understanding of how microbes are spread in their modern world and how adequate cleaning and hygiene behaviour works to protect health.”
AISE and IFH agree that in order to realise the health benefits to consumers from adopting an effective and sustainable approach to hygiene, a number of actions need to be taken. These include:
- For industry, together with relevant hygiene stakeholders, to engage with and persuading consumers to understand and adopt Targeted Hygiene where hygiene actions are taken at key moments in order to break chain of infection; and
- To create a dialogue within industry and with external stakeholders on terminology, product claims and usage advice, aiming for the enforcement of a Single Market approach and the provision of an increased health benefit for European citizens.
1. IFH. (2018). Containing the burden of infectious diseases is everyone’s responsibility: a call for an integrated strategy for developing and promoting hygiene behaviour change in home and everyday life. https://www.ifh-homehygiene.org/review/containing-burden-infectious-diseases-everyones-responsibility-call-integrated-strategy.
2. Bloomfield SF. RSPH and IFH call for a clean-up of public understanding and attitudes to hygiene. Perspectives in Public Health 2019; Volume: 139 issue: 6, page(s): 285-288. https://journals.sagepub.com/doi/pdf/10.1177/1757913919878367.
4. Bloomfield SF, Rook GAW, Scott EA, Shanahan F, Stanwell-Smith R, Turner P. Time to abandon the hygiene hypothesis: New perspectives on allergic disease, the human microbiome, infectious disease prevention and the role of targeted hygiene. Perspectives in Public Health 2016; 136(4): 213–224.
5. RSPH. (2019). Too clean or not too clean? The case for targeted hygiene in everyday life. https://www.rsph.org.uk/static/uploaded/06b37f30-2241-4e98-aba93fc15346e7a5.pdf.