The Dirt on Cleanliness

Illustration by Meg Hunt

Melanie Davis recently treated her children to dinner at Burger King. But before the Sterling Heights mother would let them unwrap their burgers and squirt ketchup on their fries, she whipped out her hand gel and made them do a little pre-meal sanitizing. She felt a bit foolish and conspicuous — until she saw another mother sit down nearby with her children and do exactly the same thing.

Have we become a culture of germaphobes? Are people with microbe-averse behavior (think Cameron Diaz or Howie Mandel) becoming the norm rather than the slightly odd exception?

There are indicators that that’s the case. Amid concern about communicable diseases such as SARS and H1N1, for example, people barely give a second glance to face masks in airports, Mandel-style fist bumps to avoid handshakes, and grocery-store sanitizing wipes at the ready to disinfect cart handles.

The medical community has long tried to get Americans to adopt habits that hinder the spread of germs. We sneeze into our elbows and sing “Happy Birthday” to ourselves as a device to time the duration of our hand washing. Workplace and restaurant restrooms display signs admonishing us to wash our hands and even to stay home if we’re sick. We no longer visit hospital patients when we’re feeling under the weather, and if we must visit an ailing friend, we can access hand gel, tissues, and masks at the information desk.

It all adds up to a collective change in behavior. As Ira J. Firestone, a Wayne State University psychology professor, says, “When you hear something over and over, and especially if you hear it from a variety of sources, there’s a cumulative effect.”

The rapid rise in the sale of hand-sanitizer gels underscores Firestone’s point. Imports to the United States rose by more than 1,000 percent from July 2007 to December 2009, according to market research firm Panjiva. Although both Johnson & Johnson and the Walgreens drugstore chain decline to release sales figures for Purell, the popular hand gel manufactured in this country, they noted a surge in sales with the outbreak of H1N1 in the spring last year, and then again last fall, when the virus resurfaced.

All of the efforts to ward off germs may be slowing the spread of colds and flu, but they could backfire if overdone, some experts warn. They point to the “hygiene hypothesis,” which asserts that challenging an immune system with germs makes it hardier and more adept at resisting more serious illnesses, much like taxing our muscles with weight training makes them stronger. The hypothesis helps to account for the lower incidence of allergies in children who live on farms or in large families, and the lower rate of asthma in children who attend day care. These are all situations where germ exposure gives immune systems regular workouts.

The effect of the hypothesis might have life or death ramifications. A 2009 study of 1,500 people in the Philippines who lacked Western-style sanitation found that the more infants encountered germs, the less they had of a protein in later life that’s linked to inflammation and heart disease.

Some researchers also say the hygiene hypothesis may account for rising incidences of allergies and asthma, as well as for Type 1 diabetes, rheumatoid arthritis, and other auto-immune diseases.

A Stanford University study even found a genetic resistance some people have to asthma that kicks in only if they’re exposed to hepatitis-A, a non-fatal infection spread by poor bathroom habits.

So what’s a mother like Davis — or any of us, for that matter — to do?

Dr. Laura Johnson, an infectious diseases specialist at Henry Ford Hospital, advises common sense. Wash your hands, practice good respiratory etiquette (the sleeve sneeze), and stay home if you’re sick. Johnson says she carries sanitizing wipes in her purse as a precaution, but other than that practice, she advises that people not go overboard in trying to create a sterile environment.

“I’m sure there’s some marketing that’s trying to promote that,” she says. “I don’t think it’s possible to germ-proof your life.”

Wolff is a Royal Oak-based freelancer. E-mail: