View source for Hygiene

{{Short description|Practices performed to preserve health}}
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{{About||the social movement|Social hygiene|the community in the United States|Hygiene, Colorado}}
{{More citations needed|date=August 2023}}

[[File:OCD handwash.jpg|thumb|right|Washing one's hands,<ref name="UNICEF WHO 2021" /> a form of hygiene, is the most effective way to prevent the spread of [[infectious diseases]].]]
'''Hygiene''' is a set of practices performed to preserve [[health]].
According to the [[World Health Organization]] (WHO), "Hygiene refers to conditions and practices that help to maintain health and prevent the spread of [[disease]]s."<ref>{{cite web|url=https://www.afro.who.int/health-topics/hygiene|title=Hygiene: Overview|publisher=World Health Organization (WHO)|access-date=29 January 2020}}</ref> '''Personal hygiene''' refers to maintaining the body's cleanliness. Hygiene activities can be grouped into the following: home and everyday hygiene, personal hygiene, medical hygiene, sleep hygiene, and [[Food safety|food hygiene]]. Home and every day hygiene includes [[hand washing]], respiratory hygiene, food hygiene at home, hygiene in the kitchen, hygiene in the bathroom, laundry hygiene, and medical hygiene at home.

Many people equate hygiene with "cleanliness", but hygiene is a broad term. It includes such personal habit choices as how frequently to take a shower or bath, wash hands, trim [[Nail (anatomy)|fingernails]], and wash clothes. It also includes attention to keeping surfaces in the home and workplace clean, including [[bathroom]] facilities. Adherence to regular hygiene practices is often regarded as a socially responsible and respectable behavior, while neglecting proper hygiene can be perceived as unclean or unsanitary, and may be considered socially unacceptable or disrespectful, while also posing a risk to public health.
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== Definition and overview ==
Hygiene is a practice<ref>{{Cite book |title=Hygiene and its role in health|year=2008|publisher=Nova Science Publishers|editor-first=Patrick L.|editor-last=Anderson |editor-first2=Jerome P.|editor-last2=Lachan|isbn=978-1-60456-195-1|location=New York|oclc=181862629}}</ref> related to [[Lifestyle (sociology)|lifestyle]], [[cleanliness]], [[health]], and [[medicine]]. In medicine and everyday life, hygiene practices are preventive measures that reduce the incidence and spread of germs leading to [[disease]].<ref>{{cite journal |last1=Aiello |first1=Allison E. |last2=Coulborn |first2=Rebecca M. |last3=Perez |first3=Vanessa |last4=Larson |first4=Elaine L. |date=2008 |title=Effect of Hand Hygiene on Infectious Disease Risk in the Community Setting: A Meta-Analysis |journal=American Journal of Public Health |volume=98 |issue=8 |pages=1372–1381 |doi=10.2105/AJPH.2007.124610|pmid=18556606 |pmc=2446461 |hdl=2027.42/61196 |hdl-access=free }}</ref>

Hygiene practices vary from one [[culture]] to another.<ref>{{Cite book |title=WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care|year=2009|publisher=World Health Organization |isbn=978-92-4-159790-6|location=Geneva|oclc=854907565}}</ref>

In the manufacturing of food,<ref>{{Cite book |title=Hygiene in food processing: principles and practice|year=2014 |editor-first=H.L.M.|editor-last= Lelieveld |editor-first2=J.T.|editor-last2=Holah |editor-first3=D.|editor-last3=Napper|isbn=978-0-85709-863-4|edition=2nd|location=Oxford |publisher=Woodhead |oclc=870650548}}</ref> pharmaceuticals,<ref>{{Cite book |title=Containment in the pharmaceutical industry|year=2020|editor-first=James P.|editor-last= Wood|isbn=978-0-429-07494-3|location=Boca Raton |publisher=CRC Press |oclc=1148475943}}</ref> cosmetics,<ref>{{Cite book |title=Cosmetic microbiology: a practical approach|year=2020|editor-first=Philip A. |editor-last=Geis|isbn=978-0-429-52443-1|edition=Third|location=Boca Raton |publisher=CRC Press |oclc=1202989365}}</ref> and other products, good hygiene is a critical component of [[quality assurance]].

The terms cleanliness and hygiene are often used interchangeably, which can cause confusion. In general, hygiene refers to practices that prevent spread of disease-causing organisms. Cleaning processes (e.g., [[Hand washing|handwashing]]<ref name="UNICEF WHO 2021">{{citation|author=UNICEF and WHO|title=State of the World's Hand Hygiene: A global call to action to make hand hygiene a priority in policy and practice|publisher=UNICEF|location=New York|year=2021}}</ref>) remove infectious microbes as well as dirt and soil, and are thus often the means to achieve hygiene.

Other uses of the term are as follows: ''body hygiene'', ''[[Personal care|personal hygiene]]'', ''[[sleep hygiene]]'', ''[[mental hygiene]]'', ''[[Oral hygiene|dental hygiene]],'' and ''[[occupational hygiene]]'', used in connection with [[public health]].

=== Home hygiene overview ===
Home hygiene pertains to the hygiene practices that prevent or minimize the spread of disease at home and other everyday settings such as social settings, public transport, the workplace, public places, and more. Hygiene in a variety of settings plays an important role in preventing the spread of infectious diseases.<ref name="globalburden">{{cite web|vauthors=Bloomfield SF, Exner M, Fara GM, Nath KJ, Scott EA, Van der Voorden C|title=The global burden of hygiene-related diseases in relation to the home and community|url=https://www.ifh-homehygiene.org/review/global-burden-hygiene-related-diseases-relation-home-and-community|publisher=International Scientific Forum on Home Hygiene|year=2009}}</ref> It includes procedures like hand hygiene, respiratory hygiene, food and water hygiene, general home hygiene (hygiene of environmental sites and surfaces), care of domestic animals, and home health care (the care of those who are at greater risk of infection).<ref>{{Cite web |title=Surface Hygiene {{!}} HARTMANN SCIENCE CENTER |url=https://www.hartmann-science-center.com/en/hygiene-knowledge/surface-hygiene |access-date=2024-07-23 |website=www.hartmann-science-center.com |language=en}}</ref>

At present, these components of hygiene tend to be regarded as separate issues, although based on the same underlying microbiological principles. Preventing the spread of diseases means breaking the chain of infection transmission so that infection cannot spread. "Targeted hygiene" is based on identifying the routes of pathogen spread in the home and introducing hygiene practices at critical times to break the chain of infection.<ref name="ISFHH 2021">{{cite book|title=Developing and promoting hygiene in home and everyday life to meet 21st Century needs|publisher=the International Scientific Forum on Home Hygiene|date=July 2021|url=https://www.ifh-homehygiene.org/sites/default/files/publications/2021%20IFH%20White%20Paper%2038pp%20%281%29.pdf|archive-url=https://web.archive.org/web/20220517010101/https://www.ifh-homehygiene.org/sites/default/files/publications/2021%20IFH%20White%20Paper%2038pp%20%281%29.pdf |archive-date=2022-05-17 }}</ref> It uses a [[probabilistic risk analysis|risk-based approach]] based on Hazard Analysis Critical Control Point ([[HACCP]]).<ref>{{Cite web |title=Environmental hygiene in healthcare |url=https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Clinical+Resources/Clinical+Programs+and+Practice+Guidelines/Infection+and+injury+management/Healthcare+associated+infections/Prevention+and+management+of+infections+in+healthcare+settings/Environmental+hygiene+in+healthcare |access-date=2024-07-23 |website=Government of South Australia}}</ref>

The main sources of infection in the home are people (who are carriers or are infected), foods (particularly raw foods), water, pets, and domestic animals.<ref name="bloomfield2012" /> Sites that accumulate stagnant water – such as sinks, [[toilet]]s, waste pipes, cleaning tools, and face cloths – readily support microbial growth and can become secondary reservoirs of infection, though species are mostly those that threaten "at risk" groups. [[Pathogens]] (such as potentially infectious bacteria and viruses – colloquially called "germs") are constantly shed via mucous membranes, feces, vomit, skin scales, and other means. When circumstances combine, people are exposed, either directly or via food or water, and can develop an infection.<ref>{{Cite web |title=environmental hygiene — European Environment Agency |url=https://www.eea.europa.eu/help/glossary/eea-glossary/environmental-hygiene#:~:text=Practical%20prevention%20and%20control%20measures,quality%20of%20the%20human%20environment. |access-date=2024-07-23 |website=www.eea.europa.eu |language=en}}</ref>

The main "highways" for the spread of pathogens in the home are the hands, hand and food contact surfaces, and cleaning cloths and utensils (e.g. [[fecal–oral route]] of transmission). Pathogens can also be spread via clothing and household linens, such as [[towels]]. Utilities such as toilets and wash basins were invented to deal safely with human waste but still have risks associated with them. Safe disposal of human waste is a fundamental need; poor [[sanitation]] is a primary cause of diarrhea disease in low-income communities. Respiratory viruses and fungal spores spread via the air.<ref>{{Cite web |title=Environmental health |url=https://www.who.int/health-topics/environmental-health |access-date=2024-07-23 |website=www.who.int |language=en}}</ref>

Good home hygiene means engaging in hygiene practices at critical points to break the chain of infection.<ref name="ISFHH 2021" /><ref name="bloomfield2012" /> Because the "infectious dose" for some pathogens can be very small (10–100 viable units or even less for some viruses), and infection can result from direct transfer of pathogens from surfaces via hands or food to the mouth, nasal mucous, or the eye, "hygienic cleaning" procedures should be adopted to eliminate pathogens from critical surfaces.<ref>{{Cite web |title=Around home – household hygiene – Hygiene for Health |url=https://hygieneforhealth.org.au/home/ |access-date=2024-07-23 |language=en-US}}</ref>
[[File:Pupil washes hands during COVID-19 pandemic in Ghana.jpg|thumb|Hand washing during pandemic ]]

===Hand washing===
[[File:Hand Hygiene Sign in Public Restroom.jpg|thumb|Hand hygiene sign in public restroom]]
{{excerpt|Hand washing|paragraphs=1,2|file=no}}Regular handwashing with soap is one of the most effective ways to prevent the transmission of pathogens. It significantly reduces the risk of gastrointestinal and respiratory infections.[[File:Finished UDDT in Pumpuentsa (5630907486).jpg|thumb|A tippy tap for handwashing after using a [[urine-diverting dry toilet]] in Pumpuentsa, Ecuador]]
[[File:Hand washing bowl.jpg|thumb|Washing hygiene ]]

===Respiratory hygiene===
{{see also|Cough etiquette}}
Correct respiratory and [[hand hygiene]] when coughing and sneezing reduces the spread of pathogens particularly during the [[cold]] and [[flu]] season:<ref name="globalburden" />
* Carry tissues and use them to catch coughs and sneezes, or sneeze into your elbow.
* Dispose of tissues as soon as possible.

===Hygiene in the kitchen, bathroom and toilet===
[[File:かやく (41976193705).jpg|thumb|Hygiene in the kitchen]]
[[File:Small Bathroom Renovation in Wellington.jpg|thumb|Hygiene in the bathroom ]]
Routine cleaning of hands, food, sites, and surfaces (such as [[toilet seat]]s and [[Flush toilet|flush]] handles, door and tap handles, work surfaces, and bath and basin surfaces) in the kitchen, [[bathroom]], and [[Toilet (room)|toilet rooms]] reduces the spread of pathogens.<ref name="hygiene procedures">{{cite web|url=https://www.ifh-homehygiene.org/best-practice-review/hygiene-procedures-home-and-their-effectiveness-review-scientific-evidence-base|title=Hygiene procedures in the home and their effectiveness: a review of the scientific evidence base|year=2008|publisher=International Scientific Forum on Home Hygiene|vauthors=Beumer R, Bloomfield SF, Exner M, Fara GM, Nath KJ, Scott EA}}</ref> The infection risk from [[flush toilet]]s is not high, provided they are properly maintained, although some splashing and [[aerosol]] formation can occur during flushing, particularly when someone has diarrhea. Pathogens can survive in the scum or scale left behind on baths, [[shower]]s, and washbasins after washing and [[bathing]].<ref>{{Cite web |title=Hygiene in the Kitchen |url=https://www.hansgrohe.com/magazine/health/kitchen-hygiene |access-date=2024-07-23 |website=www.hansgrohe.com}}</ref><ref>{{Cite web |last=Cushelle |title=10 Important Bathroom Rules – With Printable Toilet Rules! |url=https://www.cushelle.com/hygiene-and-care/personal-hygiene/10-toilet-hygiene-rules/ |access-date=2024-07-23 |website=Cushelle |language=en}}</ref><ref>{{Cite web |title=Proper use of the toilet |url=https://lessonotes.com/v2/primary-1/lesson-notes-for-primary-1-3rd-term-week-3-prevocational-studies-topic-is-toilet-hygiene.html#:~:text=NOTE-,Toilet%20hygiene%20means%20the%20proper%20and%20safe%20use%20of%20the,hand%20to%20remove%20the%20waste |access-date=2024-07-23 |website=lessonotes.com}}</ref>
[[File:Citron Hygiene sanitary bin in a disabled toilet.jpg|thumb|Hygiene in the toilet]]
Thorough cleaning is important to prevent the spread of fungal infections. Molds can live on wall and floor tiles and on shower curtains. Mold can be responsible for infections, cause allergic reactions, deteriorate/damage surfaces, and cause unpleasant odors. Primary sites of fungal growth are inanimate surfaces, including carpets and soft furnishings.<ref>{{Cite web |last=Australia |first=Healthdirect |date=2023-10-31 |title=Personal hygiene |url=https://www.healthdirect.gov.au/personal-hygiene |access-date=2024-07-25 |website=www.healthdirect.gov.au |language=en-AU}}</ref><ref name="Cole2000">{{cite journal|vauthors=Cole E|title=Allergen control through routine cleaning of pollutant reservoirs in the home environment|journal=Proceedings of Healthy Building|year=2000|volume=4|pages=435–36}}</ref> Airborne fungi are usually associated with damp conditions, poor ventilation, or closed air systems.<ref>{{Citation |last1=Saad-Hussein |first1=Amal |title=Health Impact of Airborne Fungi |date=2019 |work=Handbook of Healthcare in the Arab World |pages=1–16 |editor-last=Laher |editor-first=Ismail |url=https://doi.org/10.1007/978-3-319-74365-3_59-1 |access-date=2024-07-23 |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-319-74365-3_59-1 |isbn=978-3-319-74365-3 |last2=Ibrahim |first2=Khadiga S.|url-access=subscription }}</ref>
[[File:Cleaning corridor.jpg|thumb|Hygiene cleaning]]
Hygienic cleaning can be done through:<ref>{{Cite web |title=Types of Hygiene – Humanitarian Global |url=https://humanitarianglobal.com/types-of-hygiene/ |access-date=2024-07-23 |language=en-US}}</ref><ref>{{Cite web |title=Hygiene cleaning |url=https://www.thejanitorialstore.com/public/What-are-the-3-types-of-cleaning-2598.cfm |website=[[The janitorial store]]}}</ref>
* Mechanical removal (i.e., cleaning) using a [[soap]] or [[detergent]]. To be effective as a hygiene measure, this process must be followed by thorough rinsing under running water to remove pathogens from the surface.
* [[File:Musoke Deo MDK-MUSO CAN IMPROVED HYGIENE &SANITATION LEAD TO BETTER HEALTH IN KAMPALA?.png|thumb|Hygiene cleaning to improve sanitation in Kampala ]]Using a process or product that inactivates the pathogens ''in situ''. Pathogen kill is achieved using a "micro-biocidal" product, i.e., a [[disinfectant]] or [[antibacterial]] product; [[hand sanitizer|waterless hand sanitizer]]; or by application of heat.
* In some cases, combined pathogen removal with kill is used, e.g., laundering of clothing and household linens such as towels and bed linen.
* House deep-cleaning an intensive cleaning process targeting often-neglected areas, enhancing aesthetics, and improving health by reducing allergens and bacteria. It typically includes tasks like detailed dusting, appliance cleaning, and carpet shampooing, recommended biannually to maintain a home's hygiene and air quality.

===Laundry hygiene===
[[Laundry]] hygiene involves practices that prevent disease and its spread via soiled clothing and household linens such as towels.<ref name="bloomfield2011">{{cite web |vauthors=Bloomfield SF, Exner M, Signorelli C, Nath KJ, Scott EA|title=The infection risks associated with clothing and household linens in home and everyday life settings, and the role of laundry|year=2011|publisher=International Scientific Forum on Home Hygiene |url=https://ifh-homehygiene.org/review-best-practice/infection-risks-associated-clothing-and-household-linens-home-and-everyday-life/}}</ref> Items most likely to be contaminated with pathogens are those that come into direct contact with the body, e.g., underwear, personal towels, facecloths, nappies. Cloths or other fabric items used during food preparation, or for cleaning the toilet or cleaning up material such as feces or vomit are a particular risk.<ref name="bloomfield2012">{{cite web |vauthors=Bloomfield SF, Exner M, Signorelli C, Nath KJ, Scott EA|year=2012 |title=The chain of infection transmission in the home and everyday life settings, and the role of hygiene in reducing the risk of infection |publisher=International Scientific Forum on Home Hygiene |url=https://ifh-homehygiene.org/review/chain-infection-transmission-home-and-everyday-life-settings-and-role-hygiene/}}</ref>

Microbiological and epidemiological data indicates that clothing and household linens are a risk factor for infection transmission in home and everyday life settings as well as institutional settings. The lack of quantitative data linking contaminated clothing to infection in the domestic setting makes it difficult to assess the extent of this risk.<ref name="bloomfield2011" /><ref name="bloomfield2012" /><ref name="larson2004">{{cite journal |vauthors=Larson EL, Lin SX, Gomez-Pichardo C |title=Predictors of infectious disease symptoms in inner city households |journal=Nurs Res |volume=53 |issue=3 |pages=190–97 |year=2004 |pmid=15167507 |doi= 10.1097/00006199-200405000-00006|s2cid=46126212 }}</ref> This also indicates that risks from clothing and household linens are somewhat less than those associated with hands, hand contact and food contact surfaces, and cleaning cloths, but even so these risks need to be managed through effective laundering practices. In the home, this should be carried out as part of a multibarrier approach to hygiene which includes hand, food, respiratory, and other hygiene practices.<ref name="bloomfield2011" /><ref name="bloomfield2012" /><ref name="larson2004" />

Infectious disease risks from contaminated clothing can increase significantly under certain conditions - for example, in healthcare situations in hospitals, care homes, and the domestic setting where someone has diarrhoea, vomiting, or a skin or wound infection. The risk increases in circumstances where someone has reduced immunity to infection.

Hygiene measures, including laundry hygiene, are an important part of reducing spread of antibiotic-resistant strains of infectious organisms.<ref name="reccom">{{cite web |title=Recommendations for future collaboration between the U.S. and EU |publisher=Transatlantic Taskforce on Antimicrobial Resistance |year=2011 |url=http://ecdc.europa.eu/en/activities/diseaseprogrammes/TATFAR/Documents/210911_TATFAR_Report.pdf |archive-url=https://web.archive.org/web/20120708131641/http://ecdc.europa.eu/en/activities/diseaseprogrammes/TATFAR/Documents/210911_TATFAR_Report.pdf |archive-date=2012-07-08 }}</ref><ref name="bloomfield2013">{{cite web |vauthors=Bloomfield SF |year=2013 |title=Spread of Antibiotic Resistant Strains in the Home and Community|publisher=International Scientific Forum on Home Hygiene |url=http://www.ifh-homehygiene.org/review/spread-antibiotic-resistant-strains-home-and-community-review-preparation}}</ref><ref>{{Cite journal|last1=Maillard|first1=Jean-Yves|last2=Bloomfield|first2=Sally F.|last3=Courvalin|first3=Patrice|last4=Essack|first4=Sabiha Y.|last5=Gandra|first5=Sumanth|last6=Gerba|first6=Charles P.|last7=Rubino|first7=Joseph R.|last8=Scott|first8=Elizabeth A.|date=September 2020 |title=Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A position paper |journal=American Journal of Infection Control|language=en|volume=48|issue=9|pages=1090–1099|doi=10.1016/j.ajic.2020.04.011 |doi-access=free|pmc=7165117|pmid=32311380}}</ref> In the community, otherwise-healthy people can become persistent skin carriers of [[Methicillin-resistant Staphylococcus aureus|MRSA]], or faecal carriers of enterobacteria strains which can carry multi-antibiotic resistance factors (e.g. [[New Delhi metallo-beta-lactamase 1|NDM-1]] or [[Beta-lactamase#Extended spectrum beta-lactamase (ESBL)|ESBL]]-producing strains). The risks are not apparent until, for example, they are admitted to hospital, when they can become "self infected" with their own resistant organisms following a surgical procedure. As persistent nasal, skin, or bowel carriage in the healthy population spreads "silently" across the world, the risks from resistant strains in both hospitals and the community increases.<ref name="bloomfield2013" /> In particular the data indicates that clothing and household linens are a risk factor for spread of [[Staphylococcus aureus|''S. aureus'']] (including MRSA and [[Panton–Valentine leukocidin|PVL]]-producing MRSA strains), and that effectiveness of laundry processes may be an important factor in defining the rate of community spread of these strains.<ref name="bloomfield2011" /><ref name="bllomfield2006">{{cite web |vauthors=Bloomfield SF, Cookson BD, Falkiner FR, Griffith C, Cleary V |year=2006 |title=Methicillin resistant ''Staphylococcus aureus'' (MRSA), Clostridium difficile and ESBL-producing Escherichia coli in the home and community: assessing the problem, controlling the spread |publisher=International Scientific Forum on Home Hygiene |url=https://ifh-homehygiene.org/review-best-practice/methicillin-resistant-staphylococcus-aureus-mrsa-clostridium-difficile-and-esbl/}}</ref> Experience in the United States suggests that these strains are transmissible within families and in community settings such as prisons, schools, and sport teams. Skin-to-skin contact (including unabraded skin) and indirect contact with contaminated objects such as towels, sheets, and sports equipment seem to represent the mode of transmission.<ref name="bloomfield2011" />

During laundering, temperature and [[Laundry detergent|detergent]] work to reduce microbial contamination levels on fabrics. Soil and microbes from fabrics are severed and suspended in the wash water. These are then "washed away" during the rinse and spin cycles. In addition to physical removal, micro-organisms can be killed by thermal inactivation which increases as the temperature is increased. Chemical inactivation of microbes by the surfactants and activated oxygen-based bleach used in detergents contributes to the hygiene effectiveness of laundering. Adding hypochlorite bleach in the washing process achieves inactivation of microbes. A number of other factors can contribute including drying and ironing.

Drying laundry on a line in direct sunlight is known to reduce pathogens.<ref>{{Cite web|title=Hanging your clothes under sun OR using laundry dryer |website=SiOWfa15: Science in Our World: Certainty and Controversy|date=2015-10-21|url=https://sites.psu.edu/siowfa15/2015/10/21/hanging-your-clothes-under-sun-or-using-laundry-dryer/|access-date=2020-10-04}}</ref>

In 2013, the International Scientific Forum on Home Hygiene reviewed 30 studies of the hygiene effectiveness of laundering at temperatures ranging from room temperature to {{convert|70|C|F}}, under varying conditions.<ref>{{cite web |vauthors=Bloomfield SF, Exner M, Signorelli C, Scott EA |title=Effectiveness of laundering processes used in domestic (home) settings |year=2013|publisher=International Scientific Forum on Home Hygiene |url=https://www.ifh-homehygiene.org/review/effectiveness-laundering-processes-used-domestic-home-settings-2013}}</ref> A key finding was the lack of standardization and control within studies, and the variability in test conditions between studies such as wash cycle time, number of rinses, and other factors. The consequent variability in the data (i.e., the reduction in contamination on fabrics) in turn makes it extremely difficult to propose guidelines for laundering with any confidence. As a result, there is significant variability in the recommendations for hygienic laundering given by different agencies.<ref>{{multiref2
|1={{cite web |title=Clothing, household linens, laundry and hygiene Factsheet |year=2013
|url=https://www.ifh-homehygiene.org/factsheet/clothing-household-linens-laundry-and-home-hygiene |publisher=International Scientific Forum on Home Hygiene}}
|2={{cite web|title=Laundry treatments at high and low temperatures|url=https://www.hse.gov.uk/biosafety/blood-borne-viruses/laundry-treatments.htm|publisher=UK health and Safety Executive|year=2013}}
}}</ref>

===Medical hygiene at home===
Medical hygiene pertains to hygiene practices that prevent or minimize disease and the spreading of disease in relation to administering medical care to those who are infected or who are more at risk of infection in the home. Members of "at-risk" groups are cared for at home by a carer who may be a household member and who requires a good knowledge of hygiene. People with reduced immunity to infection, who are looked after at home, make up an increasing proportion of the population ({{as of|2009|alt=as of 2009}}, up to 20%).<ref name="globalburden" /> The largest proportion are the elderly who have co-morbidities that reduce their immunity to infection. It also includes the very young, patients discharged from hospital, taking immuno-suppressive drugs, or using invasive systems, etc. For patients discharged from hospital, or being treated at home, special "medical hygiene" procedures may need to be performed for them, such as catheter or dressing replacement, which puts them at higher risk of infection.

[[Antiseptic]]s may be applied to cuts, wounds, and abrasions of the skin to prevent the entry of harmful bacteria that can cause sepsis. Day-to-day hygiene practices, other than special medical hygiene procedures,<ref>{{cite web|url=https://ifh-homehygiene.org/best-practice-training/home-hygiene-prevention-infection-home-training-resource-carers-and-their/|title=Home Hygiene: Prevention of infection at home and in everyday life: a learning and training resource|year=2018|archive-url=https://web.archive.org/web/20220702153748/https://www.ifh-homehygiene.org/training-best-practice/home-hygiene-prevention-infection-home-and-everyday-life-learning-and-0|archive-date=2022-07-02|website=Home Hygiene & Health}}</ref> are no different for those at increased risk of infection than for other family members. The difference is that, if hygiene practices are not correctly carried out, the risk of infection is much greater.

===Disinfectants and antibacterials in home hygiene===
{{More citations needed|section|date=January 2022}}

[[disinfectant|Chemical disinfectants]]<ref>{{multiref2
|1={{cite web|title=Cleaning and disinfection: Chemical Disinfectants Explained|year=2014|url=https://www.ifh-homehygiene.org/factsheet/cleaning-and-disinfection-chemical-disinfectants-explained|website=Home Hygiene & Health}}
|2={{Cite book|title=Russell, Hugo & Ayliffe's principles and practice of disinfection, preservation and sterilization|year=2013|publisher=Wiley-Blackwell |editor-first1=Adam P.|editor-last1= Fraise |editor-first2=J.Y.|editor-last2=Maillard |editor-first3=Syed |editor-last3=Sattar|isbn=978-1-118-42587-9|edition=5th |location=Chichester|oclc=825550689}}
}}</ref> are products that kill [[pathogens]]. If the product is a disinfectant, the label on the product should say "disinfectant" or "kills" pathogens. Some commercial products, e.g. bleaches, even though they are technically disinfectants, say that they "kill pathogens" but are not actually labelled as "disinfectants". Not all disinfectants kill all types of pathogens. All disinfectants kill bacteria (called bactericidal). Some also kill fungi (fungicidal), bacterial spores (sporicidal), or viruses (virucidal).

An [[antibacterial soap|antibacterial]] product acts against bacteria in some unspecified way. Some products labelled "antibacterial" kill bacteria while others may contain a concentration of active ingredient that only prevents them from multiplying. It is, therefore, important to check whether the product label states that it "kills bacteria". An antibacterial is not necessarily anti-fungal or anti-viral unless this is stated on the label.

The term [[disinfection|sanitizer]] has been used to define substances that both clean and disinfect. More recently this term has been applied to alcohol-based products that disinfect the hands ([[hand sanitizer|alcohol hand sanitizers]]). Alcohol hand sanitizers however are not considered to be effective on soiled hands.<ref>{{Cite journal|last1=Pickering|first1=Amy J.|last2=Davis|first2=Jennifer|last3=Boehm|first3=Alexandria B.|date=2011-09-01|title=Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil|url=https://iwaponline.com/jwh/article/9/3/429/19807/Efficacy-of-alcoholbased-hand-sanitizer-on-hands|journal=Journal of Water and Health|language=en|volume=9|issue=3|pages=429–433|doi=10.2166/wh.2011.138|pmid=21976190 |bibcode=2011JWH.....9..429P |s2cid=11800640 |issn=1477-8920|doi-access=free}}</ref>

The term [[biocide]] is a broad term for a substance that kills, inactivates or otherwise controls living organisms. It includes [[antiseptics]] and disinfectants, which combat micro-organisms, and [[pesticides]].

== Personal hygiene ==

===Regular activities===
{{unreferenced section|date=January 2022}}
[[Image:Kulturbeutel1.jpg|thumb|right|A clear plastic [[toiletry bag]]]]
Personal hygiene involves those practices performed by a person to care for their bodily health and well-being through cleanliness. Motivations for personal hygiene practice include reduction of personal illness, healing from illness, optimal health and sense of wellbeing, social acceptance, and prevention of spread of illness to others. What is considered proper personal hygiene can be culture-specific and may change over time.

Practices that are generally considered proper hygiene include showering or [[bathing]] regularly, [[Hand washing|washing hands]] regularly and especially before handling food, [[face washing]], washing scalp hair, keeping hair short or removing hair, wearing clean clothing, brushing teeth, and trimming fingernails and toenails. Some practices are sex-specific, such as by a woman during [[menstruation]].

[[Toiletry bag]]s hold body hygiene and toiletry supplies.

[[Anal hygiene]] is the practice that a person performs on their anal area after [[defecation]]. The [[anus]] and [[buttocks]] may be either washed with liquids or wiped with [[toilet paper]], or by adding [[gel wipe]] to toilet tissue as an alternative to [[wet wipes]] or other solid materials in order to remove remnants of [[Human feces|feces]].

People tend to develop a routine for attending to their personal hygiene needs. Other personal hygienic practices include covering one's mouth when coughing, disposal of soiled tissues appropriately, making sure toilets are clean, and making sure food handling areas are clean, besides other practices. Some cultures do not kiss or shake hands in order to reduce transmission of bacteria by contact.

[[Personal grooming]] extends personal hygiene as it pertains to the maintenance of a good personal and public appearance, which need not necessarily be hygienic. It may involve, for example, using deodorants or perfume, [[shaving]], or [[combing]].

===Hygiene of internal ear canals===
{{See also|Earwax}}

Excessive cleaning of the [[ear canals]] can result in infection or irritation. The ear canals require less care than other parts of the body because they are sensitive and mostly self-cleaning. There is a slow and orderly migration of the skin lining the ear canal from the eardrum to the outer opening of the ear. Old earwax is constantly being transported from the deeper areas of the ear canal out to the opening where it usually dries, flakes, and falls out.<ref>{{cite web|url=https://www.medicinenet.com/ear_wax/article.htm|title=How to Remove Ear Wax|website=MedicineNet|first=Melissa Conrad|last=Stöppler}}</ref> Attempts to clean the ear canals through the removal of [[earwax]] can push debris and foreign material into the ear that the natural movement of ear wax out of the ear would have removed.

=== Oral hygiene ===
{{Main|Oral hygiene}}

It is recommended that all healthy adults brush twice a day,<ref>{{cite web|url=http://www.colgate.com/en/us/oc/oral-health/basics/brushing-and-flossing|title=Brushing & Flossing: Technique & Choosing Dental Products|website=www.colgate.com|access-date=2018-04-15|archive-date=2017-11-20|archive-url=https://web.archive.org/web/20171120095430/http://www.colgate.com/en/us/oc/oral-health/basics/brushing-and-flossing}}</ref><ref>{{Cite web |title=Oral Hygiene {{!}} National Institute of Dental and Craniofacial Research |url=https://www.nidcr.nih.gov/health-info/oral-hygiene |access-date=2023-09-18 |website=www.nidcr.nih.gov |language=en}}</ref> softly,<ref>{{cite web|url=https://www.abc.net.au/everyday/are-you-brushing-your-teeth-too-hard/11155502|title=Are you brushing your teeth too hard? |website=Australian Broadcasting Corporation|date=3 June 2019}}</ref> with the correct technique, replacing their toothbrush every few months (~3).<ref>{{cite web|url=https://www.mouthhealthy.org/all-topics-a-z/brushing-your-teeth/|title=Brushing Your Teeth |publisher= American Dental Association|website=mouthhealthy}}</ref>
[[File:1st Dental Battalion teaches children good dental hygeine 160223-M-QB247-008.jpg|thumb|Teaching a child how to properly brush the teeth]]
There are a number of common oral hygiene misconceptions. The [[National Health Service (England)|National Health Service (NHS) of England]] recommends not rinsing the mouth with water after brushing – only to spit out excess [[toothpaste]]. They claim that this helps [[fluoride]] from toothpaste bond to teeth for its preventative effects against tooth decay.<ref>{{cite web|url=https://www.nhs.uk/Live-well/healthy-teeth-and-gums/how-to-keep-your-teeth-clean/|title=How to keep your teeth clean |website=NHS|date=26 April 2018 }}</ref> It is also not recommended to brush immediately after drinking acidic substances, including sparkling water.<ref>{{Cite web|first=Mary Kay|last=Kleist|date=2013-04-01|title=Wait, Before You Brush — Why Brushing your Teeth After Eating Could be Bad for You|url=https://napervillemagazine.com/2013/04/wait-before-youbrush-why-brushing-your-teeth-after-eating-could-be-bad-for-you/|access-date=2020-10-04|website=Naperville Magazine|archive-date=2020-02-20|archive-url=https://web.archive.org/web/20200220140220/http://napervillemagazine.com/2013/04/wait-before-youbrush-why-brushing-your-teeth-after-eating-could-be-bad-for-you/}}</ref> It is also recommended to floss once a day,<ref>{{cite web|url=http://www.ada.org/en/science-research/science-in-the-news/the-medical-benefit-of-daily-flossing-called-into-question|title=The Medical Benefit of Daily Flossing Called Into Question|website=American Dental Association|archive-url=https://web.archive.org/web/20180416012922/http://www.ada.org/en/science-research/science-in-the-news/the-medical-benefit-of-daily-flossing-called-into-question|archive-date=2018-04-16}}</ref> with a different piece of floss at each flossing session. The effectiveness of [[amorphous calcium phosphate]] products, such as Tooth Mousse, is in debate.<ref>{{cite journal|title=Is there a place for Tooth Mousse® in the prevention and treatment of early dental caries? A systematic review|first1=Sarah|last1=Raphael|first2=Anthony|last2=Blinkhorn|date=25 September 2015|journal=BMC Oral Health|volume=15|issue=1|page=113|doi=10.1186/s12903-015-0095-6|pmid = 26408042|pmc=4583988 |doi-access=free }}</ref> Visits to a dentist for a checkup every year at least are recommended.<ref>{{cite web|url=https://www.bbc.com/future/article/20140926-how-often-must-we-see-a-dentist|title=How often do you need to see a dentist?|first=Claudia|last=Hammond|date=2014-09-26|website=BBC Future}}</ref>

===Sleep hygiene===
{{Main|Sleep hygiene}}
Sleep hygiene is the recommended behavioral and environmental practices that promote better quality sleep.<ref name="SH2014">{{cite journal|last1=Irish|first1=Leah A.|last2=Kline|first2=Christopher E|last3=Gunn|first3=Heather E|last4=Buysse|first4=Daniel J|last5=Hall|first5=Martica H|date=October 2014|title=The role of sleep hygiene in promoting public health: A review of empirical evidence|journal=Sleep Medicine Reviews|volume=22|pages=23–36|doi=10.1016/j.smrv.2014.10.001|pmc=4400203|pmid=25454674}}</ref> These recommendations were developed in the late 1970s as a method to help people with mild to moderate [[insomnia]], but, {{as of|2014|lc=y}}, the evidence for effectiveness of individual recommendations is "limited and inconclusive".<ref name="SH2014" /> Clinicians assess the sleep hygiene of people who present with insomnia and other conditions, such as depression, and offer recommendations based on the assessment. Sleep hygiene recommendations include establishing a regular sleep schedule, using naps with care, not exercising physically or mentally too close to bedtime, and avoiding [[alcohol (drug)|alcohol]] as well as [[nicotine]], [[caffeine]], and other [[stimulant]]s in the hours before bedtime.<ref>{{Cite web |title=Healthy Sleep |url=https://medlineplus.gov/healthysleep.html |access-date=2023-09-20 |website=medlineplus.gov}}</ref> Further recommendations include limiting worry, limiting exposure to light in the hours before sleep, getting out of bed if sleep does not come, not using the bed for anything but sleep, and having a peaceful, comfortable, and dark sleep environment.

=== Personal care services hygiene ===
Personal care services hygiene pertains to the care and use of instruments used in the administration of personal care services to people:

Personal care hygiene practices include:
* sterilization of instruments used by service providers including [[hairdresser]]s, [[esthetician|aestheticians]], and other service providers
* sterilization by [[autoclave]] of instruments used in [[body piercing]] and [[tattoo]]ing
* cleaning hands

===Challenges===
Excessive body hygiene is a possible sign of [[obsessive–compulsive disorder]]. Neglecting bodily hygiene, or the cleanliness of one's environment, may be a sign of [[major depression]] and other psychological disorders.

====Hygiene hypothesis and allergies====
{{Main|Hygiene hypothesis}}
Although media coverage of the [[hygiene hypothesis]] has declined, popular folklore continues to sometimes assert that dirt is healthy and hygiene unnatural. This has caused health professionals to be concerned that hygiene behaviors which are the foundation of public health are being undermined. In response to the need for effective hygiene in home and everyday life settings, the International Scientific Forum on Home Hygiene developed a "risk-based" or targeted approach to home hygiene that seeks to ensure that hygiene measures are focused on the places and times most critical for infection transmission.<ref name="ISFHH 2021" /> While targeted hygiene was originally developed as an effective approach to hygiene practice, it also seeks, as far as possible, to sustain "normal" levels of exposure to the microbial flora of our environment to the extent that is important to build a balanced immune system.

Although there is substantial evidence that some microbial exposures in early childhood can in some way protect against allergies, there is no evidence{{Citation needed|date=October 2023}} that humans need exposure to harmful microbes (infection) or that it is necessary to develop a clinical infection.<ref>{{multiref2
|1={{cite web|year=2012|title=The Hygiene Hypothesis and its Implications for Home Hygiene, Lifestyle and Public Health|url=https://www.ifh-homehygiene.org/best-practice-review/hygiene-hypothesis-and-its-implications-home-hygiene-lifestyle-and-public-0|publisher=International Scientific Forum on Home Hygiene|vauthors=Stanwell Smith R, Bloomfield SF, Rook GA}}
|2={{cite web|year=2012|title=The Hygiene Hypothesis and its implications for home hygiene, lifestyle and public health: Summary|url=https://www.ifh-homehygiene.org/best-practice-review/hygiene-hypothesis-and-its-implications-home-hygiene-lifestyle-and-public|publisher=International Scientific Forum on Home Hygiene}}
|3={{cite journal|last1=Bloomfield|first1=S. F.|last2=Stanwell-Smith|first2=R.|last3=Crevel|first3=R.W.R.|last4=Pickup|first4=J.|date=April 2006|title=Too clean, or not too clean: the Hygiene Hypothesis and home hygiene|url=https://researchonline.lshtm.ac.uk/id/eprint/19637/1/cea_2463.pdf|journal=Clinical and Experimental Allergy|volume=36|issue=4|pages=402–25|doi=10.1111/j.1365-2222.2006.02463.x|pmc=1448690|pmid=16630145}}
}}</ref> Nor is there evidence{{citation needed|date=October 2023}} that hygiene measures such as hand washing, food hygiene, etc., are linked to increased susceptibility to [[atopy|atopic disease]]. If this is the case, there is no conflict between the goals of preventing infection and minimizing allergies. A consensus is now developing among experts that the answer lies in more fundamental changes in lifestyles that have led to decreased exposure to certain microbial or other species, such as helminths, that are important for development of immuno-regulatory mechanisms.<ref name="Rook2010">{{cite journal|last1=Rook|first1=G.A.W.|date=11 March 2010|title=99th Dahlem Conference on Infection, Inflammation and Chronic Inflammatory Disorders: Darwinian medicine and the 'hygiene' or 'old friends' hypothesis|journal=Clinical & Experimental Immunology|volume=160|issue=1|pages=70–79|doi=10.1111/j.1365-2249.2010.04133.x|pmc=2841838|pmid=20415854|quote=The scientific establishment is slowly beginning to accept evidence for the involvement of specific organisms (for example, hepatitis A virus, gut microbiota and helminths) in the regulation of the immune system.}}</ref> There is still much uncertainty as to which lifestyle factors are involved.

== Medical hygiene ==
Medical hygiene pertains to hygiene practices related to the administration of [[medicine]] and medical care that prevents or minimizes the spread of disease.

Medical hygiene practices include:
* [[Isolation (health care)|isolation]] of infectious persons or materials to prevent spread of infection
* [[Sterilization (microbiology)|sterilization]] of instruments used in [[surgery|surgical procedures]]
* proper [[Bandage|bandaging]] and [[dressing (medical)|dressing]] of [[injuries]]
* safe [[waste disposal|disposal]] of [[hazardous waste|medical waste]]
* disinfection of reusables (i.e., linen, pads, uniforms)
* scrubbing up, [[Hand washing|handwashing]], especially in an operating room, but in more general health-care settings as well, where diseases can be transmitted
* ethanol-based sanitizers

Most of these practices were developed in the 19th century and were well-established by the mid-20th century. Some procedures (such as disposal of [[medical waste]]) were refined in response to late-20th century [[disease outbreaks]], notably [[AIDS]] and [[Ebola]].

== Food hygiene ==
{{Main|Food safety}}

Culinary hygiene (or food hygiene) pertains to practices of food management and cooking that prevent [[Food contaminants|food contamination]], prevent [[food poisoning]], and minimize the [[Disease transmission|transmission of disease]] to other foods, humans, or animals. Culinary hygiene practices specify safe ways to handle, store, prepare, serve, and eat food.{{excerpt|Food hygiene|paragraphs=1|file=no}}

== Hygiene aspects in low- and middle-income countries ==
{{Further|Water, sanitation and hygiene}}
In [[Developing country|developing countries]] (or low- and middle-income countries), universal access to water and [[sanitation]], coupled with hygiene promotion, is essential in reducing infectious diseases. This approach has been integrated into the [[Sustainable Development Goal 6|Sustainable Development Goal Number 6]] whose second target states: "By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end [[open defecation]], paying special attention to the needs of women and girls and those in vulnerable situations".<ref name="SDG6">{{multiref2
|1={{cite web |title=Goal 6: Clean water and sanitation |url=http://www.undp.org/content/undp/en/home/sustainable-development-goals/goal-6-clean-water-and-sanitation.html|archive-url=https://web.archive.org/web/20210414161838/http://www.undp.org/content/undp/en/home/sustainable-development-goals/goal-6-clean-water-and-sanitation.html|archive-date=2021-04-14|access-date=18 April 2017|website=UNDP}}
|2={{cite journal|url=https://ourworldindata.org/sdgs/clean-water-sanitation|title=Sustainable Development Goal 6: Ensure access to water and sanitation for all|journal=Our World in Data|year=2023 |last1=Roser |first1=Max}}
}}</ref> Due to their close linkages, water, sanitation, hygiene are together abbreviated and funded under the term [[WASH]] in [[Development aid|development cooperation]].

About two million people die every year due to diarrheal diseases; most of them are children less than five years of age.<ref name="WHO2008">{{cite web |title=The global burden of disease: 2004 update |url=https://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/ |archive-url=https://web.archive.org/web/20090324043636/http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/ |archive-date=March 24, 2009 |website=World Health Organization}}</ref> The most affected are people in developing countries who live in extreme conditions of poverty, normally peri-urban dwellers or rural inhabitants. Providing access to sufficient quantities of safe water and facilities for a sanitary disposal of excreta, and introducing sound hygiene behaviors are important in order to reduce the burden of disease.

Research shows that, if widely practiced, [[hand washing with soap]] could reduce diarrhea by almost fifty percent<ref>{{multiref2
|1={{cite journal |vauthors=Curtis V, Cairncross S |year=2003 |title=Effect of washing hands with soap on diarrhea risk in the community: a systematic review |journal=Lancet Infectious Diseases |volume=3 |issue=5 |pages=275–81 |doi=10.1016/S1473-3099(03)00606-6 |pmid=12726975}}
|2={{cite journal |last1=Aiello |first1=AE |last2=Coulborn |first2=RM |last3=Perez |first3=V |last4=Larson |first4=EL|date=August 2008 |title=Effect of Hand Hygiene on Infectious Disease Risk in the Community Setting: A Meta-Analysis |journal=American Journal of Public Health |volume=98 |issue=8 |pages=1372–81 |doi=10.2105/AJPH.2007.124610 |pmc=2446461 |pmid=18556606}}
|3={{cite journal |vauthors=Fewtrell L, Kauffman RB, Kay D, Enanoria W, Haller L, Colford JM |year=2005 |title=Water, sanitation, and hygiene interventions to reduce diarrhea in less developed countries: a systematic review and meta-analysis |journal=Lancet Infectious Diseases |volume=5 |issue=1 |pages=42–52 |doi=10.1016/S1473-3099(04)01253-8 |pmid=15620560|url=https://issuelab.org/resources/14169/14169.pdf}}
}}</ref> and respiratory infections by nearly twenty-five percent<ref>{{multiref2
|1={{cite web |first=Jeroen |last=Ensink|year=2006 |title=Health impact of handwashing with soap |url=http://www.lboro.ac.uk/well/resources/fact-sheets/fact-sheets-htm/Handwashing.htm |archive-url=https://web.archive.org/web/20100619145147/http://www.lboro.ac.uk/well/resources/fact-sheets/fact-sheets-htm/Handwashing.htm |archive-date=2010-06-19 |publisher=WELL}}
|2={{cite journal |vauthors=Jefferson T, Foxlee R, Del Mar C, etal |year=2007 |title=Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review |journal=British Medical Journal |volume=336 |issue=7635 |pages=77–80 |doi=10.1136/BMJ.39393.510347.BE |pmc=2190272 |pmid=18042961}}
}}</ref> Hand washing with soap also reduces the incidence of skin diseases,<ref>{{multiref2
|1={{cite journal |vauthors=Luby S, Agboatalla M, Feikin DR, Painter J, Billhimmer W, Atref A, Hoekstra RM |year=2005 |title=Effect of hand-washing on child health: a randomized control trial |journal=Lancet |volume=366 |issue=9481 |pages=225–33 |doi=10.1016/S0140-6736(05)66912-7 |pmid=16023513 |s2cid=13024434}}
|2={{cite journal |vauthors=Luby S, Agboatwalla M, Schnell BM, Hoekstra RM, Rahbar MH, Keswick BH |year=2002 |title=The effect of antibacterial soap on impetigo incidence, Karachi, Pakistan |journal=American Journal of Tropical Medicine and Hygiene |volume=67 |issue=4 |pages=430–35 |doi=10.4269/ajtmh.2002.67.430 |pmid=12452499 |doi-access=|s2cid=9987503 }}
}}</ref> and eye infections like trachoma and intestinal worms, especially [[ascariasis]] and [[trichuriasis]].<ref name="ashmudd">{{cite web |year=2009 |title=Use of ash and mud for hand-washing in low income communities |url=https://ifh-homehygiene.org/review-best-practice/use-ash-and-mud-handwashing-low-income-communities/ |publisher=International Scientific Forum on Home Hygiene |vauthors=Bloomfield SF, Nath KJ}}</ref> Other hygiene practices, such as safe disposal of waste, surface hygiene, and care of domestic animals, are important in low income communities to break the chain of infection transmission.<ref name="guidelines">{{cite web |year=2002 |title=Guidelines for the prevention of infection and cross-infection in the domestic environment: focus on home hygiene issues in developing countries |url=https://www.ifh-homehygiene.org/best-practice-care-guideline/guidelines-prevention-infection-and-cross-infection-domestic-0 |publisher=International Scientific Forum on Home Hygiene}}</ref>

Cleaning of [[toilet]]s and hand wash facilities is important to prevent odors and make them socially acceptable. Social acceptance is an important part of encouraging people to use toilets and wash their hands, in situations where [[open defecation]] is still seen as a possible alternative, e.g. in rural areas of some developing countries.

=== Household water treatment and safe storage ===
[[File:Indonesia-sodis-gross.jpg|thumb|[[Solar water disinfection|Solar water disinfection (SODIS)]] application in [[Indonesia]] using clear [[Polyethylene terephthalate|polyethylene terephthalate (PET)]] plastic beverage bottles]]
Household water treatment and safe storage ensure drinking water is safe for consumption. These interventions are part of the approach of [[Self-supply of water and sanitation|self-supply of water]] for households.<ref>{{Citation |last1=Priadi |first1=Cindy R. |title=Self-supply for safely managed water: To promote or to deter? |date=February 2022 |url=https://www.unicef.org/indonesia/media/13706/file/Self-supply%20for%20safely%20managed%20water.pdf |last2=Putri |first2=Gita Lestari |last3=Foster |first3=Tim |last4=Willetts |first4=Juliet |last5=Odagiri |first5=Mitsunori |author-link4=Juliet Willetts}}</ref> [[drinking water|Drinking water quality]] remains a significant problem in developing<ref name="WHO2007">{{cite web |date=2007 |title=Combating waterborne disease at the household level |url=https://www.who.int/water_sanitation_health/publications/combating_diseasepart1lowres.pdf |archive-url=https://web.archive.org/web/20210308084514/https://www.who.int/water_sanitation_health/publications/combating_diseasepart1lowres.pdf|archive-date=2021-03-08|publisher=World Health Organization}}</ref> and in developed countries;<ref name="IFHhhwater">{{cite web |first1=K. J.|last1=Nath|first2=Sally|last2=Bloomfield|first3=Martin|last3=Jones|year=2006 |title=Household water storage, handling and point-of-use treatment |url=https://ifh-homehygiene.org/review-best-practice/household-water-storage-handling-and-point-use-treatment/ |publisher=International Scientific Forum on Home Hygiene}}</ref> even in the European region it is estimated that 120 million people do not have access to [[drinking water|safe drinking water]]. Point-of-use water quality interventions can reduce diarrheal disease in communities where water quality is poor or in emergency situations where there is a breakdown in water supply.<ref name="WHO2007" /><ref name="IFHhhwater" /><ref>{{cite web |date=2008 |title=Water quality interventions to prevent diarrhoea: Cost and cost-effectiveness |url=https://www.who.int/water_sanitation_health/publications/prevent_diarrhoea/en/ |archive-url=https://web.archive.org/web/20160930094757/http://www.who.int/water_sanitation_health/publications/prevent_diarrhoea/en/ |archive-date=September 30, 2016 |website=World Health Organization}}</ref><ref name="who2005-wateremergenciesdisasters">{{cite web |date=2005 |title=Household Water Treatment and Safe Storage Following Emergencies and Disasters |url=https://www.who.int/household_water/resources/emergencies.pdf|archive-url=https://web.archive.org/web/20220301172138/https://www.who.int/household_water/resources/emergencies.pdf|archive-date=2022-03-01|website=World Health Organisation}}</ref>
Since water can become contaminated during storage at home (e.g. by contact with contaminated hands or using dirty storage vessels), [[household water storage|safe storage of water]] in the home is important.

Methods for treatment of drinking water at the household level include:<ref name="hygiene procedures" /><ref name="who2005-wateremergenciesdisasters" />
* chemical disinfection using chlorine or iodine
* boiling
* filtration using ceramic filters
* solar disinfection — Solar disinfection is an effective method, especially when no chemical disinfectants are available.<ref>{{cite web |date=2002 |title=Managing water in the home |url=https://www.who.int/water_sanitation_health/publications/wsh0207/en/ |archive-url=https://web.archive.org/web/20160518010409/http://www.who.int/water_sanitation_health/publications/wsh0207/en/ |archive-date=May 18, 2016 |website=World Health Organization}}</ref>
* UV irradiation — Community or household UV systems may be batch or flow-though. The lamps can be suspended above the water channel or submerged in the water flow.
* combined flocculation/disinfection systems — available as sachets of powder that act by coagulating and flocculating sediments in water followed by release of chlorine
* multibarrier methods — Some systems use two or more of the above treatments in combination or in succession to optimize efficacy.
* [[portable water purification]] devices

==History==
[[File:Stamnos women bath Staatliche Antikensammlungen 2411.jpg|thumb|Three young women bathing, {{BCE|440–430}}. Ancient Greece.]]
[[File:Katalog vintern 1905-1906. AB Nordiska Kompaniet. Hår-, Toalett- & Tandvatten, Pomada & Brilliantine - Nordiska Museet - NMA.0040796.jpg|thumb|Swedish advert for toiletries, 1905–1906]]
{{See also|Public health#History|History of water supply and sanitation}}

===Asia===
====China====
Bathing culture in [[Chinese literature]] can be traced back to the [[Shang dynasty]] ({{BCE|1600–1046}}), when [[oracle bone]] inscriptions describe people washing their hair and body in a bath. The ''[[Book of Rites]]'', a work regarding [[Zhou dynasty]] ({{BCE|1046–256}}) ritual, politics, and culture compiled during the [[Warring States period]], recommends that people take a hot shower every five days, and wash their hair every three days. It was also considered good manners to take a bath provided by the host before a [[dinner]]. In the [[Han dynasty]], bathing became a regular activity, and for government officials bathing was required every five days.<ref name="woc">{{cite web|url=https://www.theworldofchinese.com/2021/07/bathing-in-ancient-times/ |title=Bathing in Ancient Times |website= theworldofchinese |date=1 July 2021 |first=Jiahui |last=Sun}}</ref>

Ancient bath facilities have been found in ancient Chinese cities, such as Dongzhouyang archaeological site in [[Henan Province]]. Bathrooms were called {{transliteration|zh|Bi}} ({{zh|t=湢}}), and bathtubs were made of bronze or timber.<ref name="vc">{{cite web|author=Awen|url=https://www.viewofchina.com/ancient-chinese-bath-culture/ |title=Ancient Chinese Bath Culture |website=View of China |date=30 April 2019}}</ref> Bath beans – a powdery soap mixture of ground beans, cloves, eaglewood, flowers, and even powdered jade – were recorded in the Han dynasty. Bath beans were considered luxury toiletries, while common people simply used powdered beans without spices mixed in. Luxurious bathhouses built around hot springs were recorded in [[Tang dynasty]].<ref name="woc"/> While royal bathhouses and bathrooms were common among ancient Chinese nobles and commoners, public bathhouses were a relatively late development. In the [[Song dynasty]] ({{CE|960–1279}}), public bathhouses became popular and people could find them readily.<ref name="vc" /> [[Bathing]] became an essential part of social life and recreation. Bathhouses often provided massage, nail cutting service, rubdown service, [[ear picking|ear cleaning]], food, and beverages.<ref name="vc" /> [[Marco Polo]], who traveled to China during the [[Yuan dynasty]], noted Chinese bathhouses were using [[coal]] to heat the bathhouse, which he had never seen before in Europe.<ref>{{cite book|last1=Golas|first1=Peter J.|last2=Needham|first2=Joseph|year=1999|title=Science and Civilisation in China|publisher=Cambridge University Press|pages=186–91|isbn=0-521-58000-5}}</ref> Coal was so plentiful that Chinese people of every social class had bathrooms in their houses, and people took showers every day in the winter for enjoyment.<ref>[https://archive.org/details/marcopolo00polouoft/page/214/mode/2up?q=logs The travels of Marco Polo the Venetian]. 1914. pp.214-215.</ref>

A typical [[Ming dynasty]] bathhouse had slabbed floors and brick domed ceilings. A huge boiler would be installed in the back of the house, connected with the bathing pool through a tunnel. Water could be pumped into the pool by [[Water wheel|turning wheel]]s attended by the staff.<ref name="vc" />

==== Japan ====
The origin of Japanese bathing is {{transliteration|ja|[[misogi]]}}, ritual purification with water.<ref name="Clark1994">{{ cite book | url = https://books.google.com/books?id=pT7tP4zFHdYC | title = Japan: A View from the Bath | isbn = 978-0-8248-1657-5 | last1 = Clark | first1 = Scott| year = 1994 | publisher = University of Hawaii Press }}</ref>

In the [[Heian period]] ({{CE|794–1185}}), houses of prominent families, such as the families of court nobles or samurai, had baths. The bath had lost its religious significance and instead became leisure. {{transliteration|ja|Misogi}} became {{transliteration|ja|gyōzui}} (to bathe in a shallow wooden tub).{{r|Clark1994|page=36}} In the 17th century, the first European visitors to Japan recorded the habit of daily baths in mixed sex groups.{{r|Clark1994}}

==== Indian subcontinent ====
The earliest written account of elaborate codes of hygiene can be found in several Hindu texts, such as the [[Manusmriti]] and the [[Vishnu Purana]].<ref>{{cite web|title=Aryan Code of Toilets (2nd Century AD)|url=https://www.sulabhtoiletmuseum.org/history-of-toilets/aryan-code-of-toilets-2nd-century-ad/|website=Sulabh International Museum of Toilets}}</ref> Bathing is one of the five {{transliteration|sa|[[nitya karma]]s}} (daily duties) in Hinduism, and not performing it leads to sin, according to some scriptures.

[[Ayurveda]] is a system of medicine developed in ancient times that is still practiced in India, mostly combined with conventional Western medicine. Contemporary Ayurveda stresses a [[sattvic diet]] and good digestion and [[excretion]]. Hygiene measures include [[oil pulling]], and [[tongue scraping]]. Detoxification also plays an important role.<ref>{{Cite journal|last1=Ajanal|first1=Manjunath|last2=Nayak|first2=Shradda|last3=Prasad|first3=Buduru Sreenivasa|last4=Kadam|first4=Avinash|date=2013-10-23|title=Adverse drug reaction and concepts of drug safety in Ayurveda: An overview|journal=Journal of Young Pharmacists|volume=5|issue=4|pages=116–120|doi=10.1016/j.jyp.2013.10.001|doi-broken-date=2 September 2025 |issn=0975-1483|pmc=3930110|pmid=24563588}}</ref>

===Americas===
====Mesoamerica====
[[File:Codex Magliabechiano (folio 77r).jpg|thumbnail|right|[[Codex Magliabechiano]] from the Loubat collection, 1904]]
[[Spain|Spanish]] chronicles describe the bathing habits of the peoples of [[Mesoamerica]] during and after the [[Spanish conquest of the Aztec Empire|conquest]].
[[Bernal Díaz del Castillo]] describes [[Moctezuma II|Moctezuma]] (the Mexica, or [[Aztec]], [[emperor]] at the arrival of [[Hernán Cortés|Cortés]]) in his {{Lang|es|Historia verdadera de la conquista de la Nueva España}} as being "...Very neat and cleanly, bathing every day each afternoon...".

Bathing was not restricted to the elite, but was practiced by all people; the chronicler Tomás López Medel wrote after a journey to [[Central America]] that " and the custom of washing oneself is so quotidian [common] amongst the Indians, both of cold and hot lands, as is eating, and this is done in fountains and rivers and other water to which they have access, without anything other than pure water..."<ref name="Noriega Hernández 2004">{{cite thesis |last=Noriega Hernández|first=Joana Cecilia|url=http://148.206.53.231/UAMI11028.PDF |title=El baño temascal novohispano, de Moctezuma a Revillagigedo. Reflexiones sobre prácticas de higiene y expresiones de sociabilidad|lang=es-MX|date=2004 |access-date=2012-12-18 |archive-url=https://web.archive.org/web/20130406041619/http://148.206.53.231/UAMI11028.PDF |archive-date=2013-04-06 }}</ref>

The Mesoamerican bath, known as {{Lang|es|temazcal}} in [[Spanish language|Spanish]], from the Nahuatl word {{lang|nah|temazcalli}}, a compound of {{lang|nah|temaz}} ("steam") and {{lang|nah|calli}} ("house"), consists of a room, often in the form of a small dome, with an exterior firebox known as {{lang|nah|texictle}} ({{IPA|teʃict͜ɬe}}) that heats a small portion of the room's wall made of volcanic rocks; after this wall has been heated, water is poured on it to produce steam, an action known as {{lang|nah|tlasas}}. As the steam accumulates in the upper part of the room a person in charge uses a bough to direct the steam to the bathers who are lying on the ground, with which he later gives them a massage, then the bathers scrub themselves with a small flat river stone and finally the person in charge introduces buckets with water along with soap and grass used to rinse. This bath had also ritual importance, and was tied to the goddess [[Toci]]; it is also therapeutic when medicinal herbs are used in the water for the {{lang|nah|tlasas}}. It is still used in [[Mexico]].<ref name="Noriega Hernández 2004"/>

===Europe===

====Antiquity====
[[File:Roman Baths in Bath Spa, England - July 2006.jpg|alt=Photograph of the Baths showing a rectangular area of greenish water surrounded by yellow stone buildings with pillars. In the background is the tower of the abbey.|thumb|[[Roman Baths (Bath)|Roman public baths]] ([[Thermae]]) in [[Bath, Somerset|Bath]], England]]
Regular bathing was a hallmark of [[Ancient Rome|Roman civilization]].<ref>{{cite web|title=Roman bath houses|url=http://www.channel4.com/history/microsites/T/timeteam/snapshot_rom_bath.html|archive-url=https://web.archive.org/web/20070204115107/http://www.channel4.com/history/microsites/T/timeteam/snapshot_rom_bath.html|archive-date=4 February 2007|website=Time Team|publisher=Channel Four Television Corporation}}</ref> Elaborate [[Thermae|baths]] were constructed in urban areas to serve the public, who typically demanded the infrastructure to maintain personal cleanliness. The complexes usually consisted of large, swimming pool-like baths, smaller cold and hot pools, saunas, and spa-like facilities where people could be depilated, oiled, and massaged. Water was constantly changed by an [[Roman aqueduct|aqueduct]]-fed flow. Bathing outside of urban centers involved smaller, less elaborate bathing facilities, or simply the use of clean bodies of water. Roman cities also had large [[sanitary sewer|sewers]], such as Rome's [[Cloaca Maxima]], into which public and private latrines drained. Romans did not have demand-flush toilets but did have some toilets with a continuous flow of water under them. The [[Roman Empire|Romans]] used [[scent]]ed [[oils]] (mostly from Egypt), among other alternatives.

[[Christianity]] has always placed a strong [[Ablution in Christianity|emphasis on hygiene]].<ref name="Squatriti">{{cite book|first=Myra|last=Rutherdale|chapter=Ordering the Bath: Children, Health, and Hygiene in Northern Canadian Communities, 1900–1970|editor-last=Warsh|editor-first=Cheryl Krasnick|title=Children's Health Issues in Historical Perspective|publisher=Wilfrid Laurier Univ. Press|editor-first2=Veronica |editor-last2=Strong-Boag|year=2006|isbn=978-0-88920-912-1|page=315|quote=... Thus bathing also was considered a part of good health practice. For example, Tertullian attended the baths and believed them hygienic. Clement of Alexandria, while condemning excesses, had given guidelines for Christian] who wished to attend the baths ...}}</ref> Despite rejecting [[mixed bathing]],<ref name="Gibson1903">{{cite book |last1=Gibson |first1=Margaret Dunlop |title=The Didascalia Apostolorum in English |date=1903 |publisher=C.J. Clay |pages=9–10 |language=English}}</ref> [[early Christian]] clergy encouraged believers to bath,<ref name="Squatriti" /> which contributed to hygiene and good health according to the [[Church Father]]s [[Clement of Alexandria]] and [[Tertullian]].<ref name="Mary Thurlkill">{{cite book|last=Thurlkill|first=Mary|title=Sacred Scents in Early Christianity and Islam: Studies in Body and Religion|publisher=Rowman & Littlefield|year=2016|isbn=978-0-7391-7453-1|pages=6–11|quote=...Clement of Alexandria (d. c. 215 CE) allowed that bathing contributed to good health and hygiene... Christian skeptics could not easily dissuade the baths' practical popularity, however; popes continued to build baths situated within church basilicas and monasteries throughout the early medieval period...}}</ref><ref name="Paolo Squatriti">{{cite book|last=Squatriti|first=Paolo|title=Water and Society in Early Medieval Italy, AD 400-1000, Parti 400–1000|publisher=Cambridge University Press|year=2002|isbn=978-0-521-52206-9|page=54|quote=...but baths were normally considered therapeutic until the days of Gregory the Great, who understood virtuous bathing to be bathing "on account of the needs of body"...}}</ref> The Church built [[public bathing]] facilities that were separated by sex near [[Christian monasticism|monasteries]] and pilgrimage sites. 

{{Further|Hygiene in Christianity#History}}

====Middle Ages====
Contrary to popular belief,<ref>{{cite web|first=Melissa|last=Snell|url=https://www.thoughtco.com/weddings-and-hygiene-1788715|title=Middle Ages Weddings and Hygiene|website=ThoughtCo.|access-date=2008-03-05|archive-date=2017-01-30|archive-url=https://web.archive.org/web/20170130223521/http://historymedren.about.com/od/dailylifesociety/a/bod_weddings.htm}}</ref> [[bathing]] and [[sanitation]] were not lost in Europe with the collapse of the [[Roman Empire]].<ref>{{cite web|url=http://www.vlib.us/medieval/lectures/black_death.html|title=The Great Famine and the Black Death – 1315–1317, 1346–1351|website=Lectures in Medieval History |first=Lynn H. |last=Nelson}}</ref><ref>{{cite web|url=http://www.middle-ages.org.uk/middle-ages-hygiene.htm|title=Middle Ages Hygiene|work=middle-ages.org.uk}}</ref> Starting in the early Middle Ages, [[popes]] situated baths within church [[basilica]]s and monasteries.<ref name="Mary Thurlkill" /> Pope [[Gregory the Great]] promoted [[bathing]] as a bodily need.<ref name="Paolo Squatriti" /> The [[Anal hygiene|use of water]] in many [[Christian countries]] is partly due to Biblical toilet etiquette which encourages washing after all instances of defecation.<ref name="Clark 2006">{{cite book|last=E. Clark|first=Mary|title=Contemporary Biology: Concepts and Implications|publisher=University of Michigan Press|year=2006|isbn=978-0-7216-2597-3|page=613|quote=Douching is commonly practiced in Catholic countries. The bidet... is still commonly found in France and other Catholic countries.}}</ref> [[Bidet]] and [[bidet shower]]s were used in regions where water was considered essential for [[anal cleansing]].<ref name="Clark 2006" /><ref>{{cite book | last=Forgione | first=Angelo| title=Made in Naples: Come Napoli ha civilizzato l'Europa (e come continua a farlo) | publisher=Addictions-Magenes Editoriale | date=2013 | isbn=978-88-6649-039-5 | language=it|trans-title=Made in Naples. How Naples civilised Europe (And still does it)}}</ref> [[Public bathing|Public bathhouses]] were common in medieval [[Christendom]] larger towns and cities such as [[Constantinople]], [[Paris]], [[Regensburg]], [[Rome]] and [[Naples]].<ref>{{multiref2
|1={{cite book|title=The Middle Ages: Facts and Fictions|first=Winston |last= Black|year= 2019| isbn=  978-1-4408-6232-8| page =61 |publisher=ABC-CLIO|quote=Public baths were common in the larger towns and cities of Europe by the twelfth century.}}
|2={{cite book|title=Perception and Action in Medieval Europe|first=Harald|last=Kleinschmidt|year= 2005| isbn=978-1-84383-146-4| page =61 |publisher=Boydell & Brewer}}</ref> Great bathhouses were built in [[Byzantine Empire|Byzantine centers]] such as [[Constantinople]] and [[Antioch]].<ref>{{citation | editor-first = Alexander | editor-last = Kazhdan|editor-link=Alexander Kazhdan | title = Oxford Dictionary of Byzantium | publisher = Oxford University Press | year = 1991 | isbn = 978-0-19-504652-6}}{{page needed|date=August 2023}}
|3={{cite book |last1=Kourkoutidou-Nikolaidou |first1=E. |last2=Tourta |first2=A.|year=1997 |title=Wandering in Byzantine Thessaloniki |publisher=Kapon Editions |isbn=960-7254-47-3 |page=87}}
}}</ref>

[[File:Βυζαντινό λουτρό Άνω Πόλης 1788.jpg|thumb|[[Byzantine Bath (Thessaloniki)|Byzantine Bath]] in [[Thessaloniki]]]]

In the 11th and 12th centuries, bathing was essential to the Western European upper class: the [[Cluniac]] monasteries (popular centers for resorting and retiring) were always equipped with bathhouses. These baths were also used ritually when the monks took full immersion baths at the two Christian festivals of renewal.<ref name=PB>{{cite book|first=Philippe|last=Braunstein|chapter=Solitude: eleventh to the thirteenth century|title=A History of Private Life|volume=II. Revelations of the Medieval World|editor-last=Duby|editor-first=Georges|year=1988|page=525}}</ref> The rules of the [[Augustinians]] and [[Benedictines]] contained references to [[ritual purification]],<ref>{{cite book|title=The English Spa, 1560–1815: A Social History|first=Phyllis|last= Hembry|year= 1990| isbn= 978-0-8386-3391-5|publisher=Fairleigh Dickinson Univ. Press}}</ref> and, inspired by [[Benedict of Nursia]], encouraged the practice of therapeutic bathing. [[Benedictine]] monks also played a role in the development and promotion of [[spa]]s.<ref name=ASpiritualHistory>{{cite book | title = Water: A Spiritual History| first =Ian |last=Bradley| year =2012| isbn= 978-1-4411-6767-5|publisher=Bloomsbury Publishing}}</ref>

On the other hand, bathing also sparked erotic phantasies, played upon by the writers of [[Romance (heroic literature)|romances]] intended for the upper class;{{citation needed|date=May 2024}} in the tale of [[Melusine]] the bath was a crucial element of the plot.
{{Blockquote|text=Bathing and grooming were regarded with suspicion by moralists, however, because they unveiled the attractiveness of the body. Bathing was said to be a prelude to sin, and in the penitential of [[Burchard of Worms]] we find a full catalogue of the sins that ensued when men and women bathed together.{{r|PB}}}} Cities regulated public bathing – the 26 public baths of Paris in the late 13th century were strictly overseen by the civil authorities {{r|PB}} and guild laws banned prostitutes from bathhouse admission.<ref>{{cite book|title=Women's Lives in Medieval Europe: A Sourcebook|chapter=Le Livre des Métiers|first=Etienne|last=de Boileu|publisher=Routledge|page=162|year=1993|editor-last=Amt|editor-first=Emilie}}</ref> 

{{anchor|Dürer}}[[File:Albrecht Durer, "Woman's Bath".jpg|thumb|''Women's Bath'', 1496, by [[Albrecht Dürer]]]]

In 14th century Tuscany, newlywed couples commonly took a bath together and we find an illustration of this custom in a fresco in the town hall of San Gimignano.<ref>Fresco of {{circa|1320}} illustrated in {{cite book|first=Charles|last=de la Roncière|chapter=Tuscan notables on the eve of the Renaissance|title=A History of Private Life|volume=II. Revelations of the Medieval World|editor-last=Duby|editor-first=Georges|year=1988|page=232}}</ref> 
As evident in [[Hans Folz]]' ''Bath Booklet'' (a late 15th century guide on European baths)<ref>{{cite book | title=Bodily and Spiritual Hygiene in Medieval and Early Modern Literature: Explorations of Textual Presentations of Filth and Water|first=Albrecht|last=Classen|year=2017|isbn=978-3-11-052379-9|publisher=de Gruyter|page=535}}</ref> and various artistic depictions such as [[Albrecht Dürer]]'s ''Women's Bath'' {{see above|[[#Dürer|above]]}}, public bathing continued to be a popular past time in the [[Renaissance]]. In Britain, the rise of [[Protestantism]] also played a prominent role in the development of [[spa]] culture.<ref name="ASpiritualHistory"/>

====Modernity====
Until the late 19th century, only the elite in Western cities typically possessed indoor facilities for relieving bodily functions. The poorer majority used communal facilities built above [[cesspool]]s in backyards and courtyards. This changed after Dr. [[John Snow (physician)|John Snow]] discovered that [[cholera]] was [[Fecal–oral route|transmitted by the fecal contamination]] of water. Though it took decades for his findings to gain wide acceptance, governments and sanitary reformers were eventually convinced of the health benefits of using [[Sewerage|sewers]] to keep human waste from contaminating the water. This encouraged the widespread adoption of both the [[flush toilet]] and the moral imperative that bathrooms should be indoors and as private as possible.<ref>{{Cite web|year=2001|title=Water Sanitation and Hygiene|url=https://www.gatesfoundation.org/our-work/programs/global-growth-and-opportunity/water-sanitation-and-hygiene|access-date=2020-10-04|website=Bill & Melinda Gates foundation|language=en}}</ref>{{Verify source|reason=page doesn't seem to say anything about the topics in the paragraph|date=August 2023}}

Modern sanitation was not widely adopted until the 19th and 20th centuries. According to medieval historian Lynn Thorndike, people in [[Middle Ages|Medieval Europe]] probably bathed more than people did in the 19th century.<ref>{{cite web |url=http://www.godecookery.com/mtales/mtales08.htm |last=Matterer|first=James L.|title=Daily Life|website=Gode Cookery: Tales of the Middle Ages|access-date=22 February 2017}}</ref>{{better source needed|date=August 2023}} Some time after [[Louis Pasteur]]'s experiments proved the [[germ theory of disease]] and [[Joseph Lister, 1st Baron Lister|Joseph Lister]] and others put this into practice in [[sanitation]], hygienic practices came to be regarded as synonymous with [[health]], as they are in modern times.

The importance of hand washing for human health{{snd}}particularly for people in vulnerable circumstances like mothers who had just given birth or wounded soldiers in hospitals{{snd}}was first recognized in the mid 19th century by two pioneers of hand hygiene: the Hungarian physician [[Ignaz Semmelweis]] who worked in Vienna, Austria, and [[Florence Nightingale]], the English "founder of modern nursing".<ref name="GPPH">{{Cite web|website = Global Handwashing Partnership|title=History |url = https://globalhandwashing.org/about-handwashing/history-of-handwashing/|date = 19 March 2015|access-date = 18 April 2015}}</ref> At that time most people still believed that infections were caused by foul odors called [[miasma theory|miasmas]].

===Middle East===
[[File:Ali Gholi Agha hammam, Isfahan, Iran.jpg|thumb|[[Ali Gholi Agha hammam]], [[Isfahan]], Iran]]
[[Islam]] stresses the importance of cleanliness and personal hygiene.<ref>{{cite journal |last1=Majeed |first1=Azeem|title=How Islam changed medicine |journal=BMJ |date=22 December 2005 |volume=331 |issue=7531 |pages=1486–1487 |doi=10.1136/bmj.331.7531.1486 |pmid=16373721 |pmc=1322233 |language=en |issn=0959-8138}}</ref> [[Islamic hygienical jurisprudence]], which dates back to the 7th century, has a number of elaborate rules. {{transliteration|ar|[[Islam|Taharah]]}} (ritual purity) involves performing {{transliteration|ar|[[wudu]]}} (ablution) for the five daily {{transliteration|ar|[[salah]]}} (prayers), as well as regularly performing {{transliteration|ar|[[ghusl]]}} (bathing), which led to [[Turkish bath|bathhouses]] being built across the [[Islamic world]].<ref>{{Cite web|url=https://www.britannica.com/topic/tahara-Islam|title=Ṭahāra &#124; Islam|website=Britannica}}</ref> [[Islamic toilet etiquette|Islamic toilet hygiene]] also requires [[Anal cleansing|washing with water]] after using the toilet, for purity and to minimize pathogens.<ref>{{citation |first=Israr |last=Hasan|year=2006 |title=Muslims in America |url=https://books.google.com/books?id=k5J493fDF38C |isbn=978-1-4259-4243-4 |page=[https://books.google.com/books?id=k5J493fDF38C&pg=PA144 144]|publisher=AuthorHouse }}</ref>

In the [[Abbasid Caliphate]] (8th–13th centuries), its capital city of [[Baghdad]] (Iraq) had 65,000 baths, along with a sewer system.<ref>{{cite book |first1=Judith |last1=Kidd |first2=Rosemary |last2=Rees |first3=Ruth|last3= Tudor|year=2000 |title=Life in Medieval Times |publisher=Heinemann |isbn=0-435-32594-9 |page=[https://books.google.com/books?id=J5wtyi4-GsgC&pg=PA165 165] |url=https://books.google.com/books?id=J5wtyi4-GsgC}}</ref> Cities and towns of the [[medieval Islamic world]] had [[water supply system]]s powered by [[hydraulic]] technology that supplied [[drinking water]] along with much greater quantities of water for ritual washing, mainly in [[mosques]] and [[Turkish bath|hammams]] (baths). Bathing establishments in various cities were rated by Arabic writers in [[travel guide]]s. Medieval Islamic cities such as Baghdad, [[Córdoba, Spain|Córdoba]] ([[Islamic Spain]]), [[Fez, Morocco|Fez]] (Morocco), and [[Fustat]] (Egypt) also had sophisticated [[waste disposal]] and [[sewage system]]s with interconnected networks of sewers. The city of Fustat also had multi-storey [[tenement]] buildings (with up to six floors) with [[flush toilet]]s, which were connected to a water supply system, and [[flue]]s on each floor carrying waste to underground channels.<ref>{{cite book |first1=Colin |last1=Chant|first2= David|last2= Goodman|title=Pre-Industrial Cities and Technology |year=2005 |publisher=Routledge |isbn=1-134-63620-2 |pages=[https://books.google.com/books?id=hK-EAgAAQBAJ&pg=PA136 136]–38 |url=https://books.google.com/books?id=hK-EAgAAQBAJ}}</ref>

A basic form of [[Infection|contagion]] theory dates back to the Persian medicine in the medieval, where it was proposed by Persian physician [[Ibn Sina]] (also known as Avicenna) in ''[[The Canon of Medicine]]'' (1025), the most authoritative medical textbook of the Middle Ages. He mentioned that people can transmit disease to others by breath, noted contagion with [[tuberculosis]], and discussed the transmission of disease through water and dirt.<ref>{{cite book |last1=Byrne |first1=Joseph Patrick |title=Encyclopedia of the Black Death |year=2012 |publisher=[[ABC-CLIO]] |isbn=978-1-59884-253-1 |page=[https://books.google.com/books?id=5KtDfvlSrDAC&pg=PA29 29] |url=https://books.google.com/books?id=5KtDfvlSrDAC}}</ref> The concept of invisible contagion was eventually widely accepted by [[Islamic scholars]]. In the [[Ayyubid Sultanate]], they referred to them as {{transliteration|ar|[[najasat]]}} ("impure substances"). The {{transliteration|ar|[[fiqh]]}} scholar [[Ibn al-Haj al-Abdari]] ({{c.|1250–1336}}), while discussing [[Islamic dietary laws|Islamic diet]] and hygiene, gave advice and warnings about how contagion can contaminate water, food, and garments, and could spread through the water supply.<ref>{{cite book |last1=Reid |first1=Megan H. |title=Law and Piety in Medieval Islam |year=2013 |publisher=[[Cambridge University Press]] |isbn=978-1-107-06711-0 |pages=106, 114, 189–190 |url=https://books.google.com/books?id=5fJ4AAAAQBAJ}}</ref>

In the 9th century, [[Ziryab]] invented a type of [[deodorant]].<ref name="Menocal">{{cite book|title=The Literature of Al-Andalus|editor-last1=Menocal|editor-first1=María Rosa|editor-first2=Raymond P.|editor-last2=Scheindlin|editor-first3=Michael Anthony|editor-last3=Sells|publisher=Cambridge University Press|year=2000}}</ref> He also promoted morning and evening baths, and emphasized the maintenance of personal hygiene. Ziryab is thought to have invented a type of [[toothpaste]], which he popularized throughout [[Al-Andalus|Islamic Iberia]].<ref name="Sertima">{{cite book|last=van Sertima|first=Ivan|author-link=Ivan van Sertima|year=1992|title=The Golden Age of the Moor|page=[https://archive.org/details/goldenageofmoor00vans/page/267 267]|publisher=[[Transaction Publishers]]|isbn=978-1-56000-581-0|url=https://archive.org/details/goldenageofmoor00vans}}</ref> The exact ingredients of this toothpaste are not known,<ref name="Lebling">{{cite journal|last=Lebling|first=Robert W. Jr.|title=Flight of the Blackbird|journal=[[Saudi Aramco World]]|date=July–August 2003|pages=24–33|url=http://www.islamicspain.tv/Arts-and-Science/flight_of_the_blackbird.htm|archive-url=https://web.archive.org/web/20071214171154/http://www.islamicspain.tv/Arts-and-Science/flight_of_the_blackbird.htm|archive-date=2007-12-14|access-date=28 January 2008}}</ref> but it was reported to have been both "functional and pleasant to taste."<ref name="Sertima" />

=== Sub-Saharan Africa ===
In [[West Africa]], various ethnic groups such as the [[Yoruba people|Yoruba]] have used [[African black soap|black soap]] to treat skin diseases.<ref>{{Cite journal |last1=Ikpoh |first1=I.S |last2=Lennox |first2=J.A. |last3=Agbo |first3=B.E. |last4=Udoekong |first4=N.S. |last5=Ekpo |first5=I.A. |last6=Iyam |first6=S.O. |date=January 2012 |title=Comparative studies on the effect of locally made black soap and conventional medicated soaps on isolated human skin microflora |url=https://www.researchgate.net/publication/303544065 |journal=Journal of Microbiology and Biotechnology Research |volume=2 |issue=4 |pages=533–537 |via=[[ResearchGate]]}}</ref>

In [[Southern Africa]], the [[Zulu people]] conducted methods of sanitation by using water stored in pottery at [[Ulundi]].<ref>{{cite web | url=https://www.academia.edu/26731539 | title=99 Zulu Indigenous Practices in Water and Sanitation: Preliminary Field Research on Indigenous Practices in Water and Sanitation Conducted at Ulundi | last1=Mbatha | first1=Sandile }}</ref> The [[Himba people]] of [[Namibia]] and [[Angola]] also utilized mixtures of smoke and [[Otjize|otjitze]] to treat skin diseases in regions where water is scarce.

=== Soap and soap makers ===
{{Main|Soap#History}}
[[File:Marseiller Seife.jpg|thumb|[[Marseille soap]] in blocks of {{cvt|600|g}}]]
Hard toilet [[soap]] with a pleasant smell was invented in the [[Middle East]] during the [[Islamic Golden Age]] when soap-making became an established industry. Recipes for soap-making are described by [[Muhammad ibn Zakariya al-Razi]] ({{circa|865–925}}), who also gave a recipe for producing [[glycerine]] from [[olive oil]]. In the Middle East, soap was produced from the interaction of fatty oils and [[fat]]s with [[alkali]]. In [[Syria]], soap was produced using olive oil together with alkali and [[Lime (material)|lime]]. Soap was exported from Syria to other parts of the [[Muslim world]] and to Europe.<ref>{{cite book|editor-first=Ahmad Y.|editor-last=al-Hassan|editor-link=Ahmad Y. al-Hassan|year=2001|pages=[https://books.google.com/books?id=h2g1qte4iegC&pg=PA73 73]–74|title=Science and Technology in Islam: Technology and applied sciences|series=The Different Aspects of Islamic Culture|volume=4|publisher=[[UNESCO]]}}</ref> Two key Islamic innovations in [[soapmaking]] was the invention of [[bar soap]], described by al-Razi, and the addition of [[scent]]s using [[perfume]] technology perfected in the Islamic world.<ref>{{cite book|last1=Kalın|first1=İbrahim|url=https://books.google.com/books?id=or-6BwAAQBAJ|title=The Oxford Encyclopedia of Philosophy, Science, and Technology in Islam|year=2014|publisher=[[Oxford University Press]]|isbn=978-0-19-981257-8|page=[https://books.google.com/books?id=or-6BwAAQBAJ&pg=PA137 137]}}</ref>

By the 15th century, the manufacture of soap in Christendom had become virtually industrialized, with sources in [[Antwerp]], [[Castile (historical region)|Castile]], [[Marseille]], [[Naples]], and [[Venice]].<ref>{{cite book|chapter=Anionic and Related Lime Soap Dispersants|first=Raymond G. Jr. | last=Bistline | editor-last=Stache | editor-first=Helmut W.| title=Anionic Surfactants: Organic Chemistry | series=Surfactant science series|volume=56|publisher=CRC Press | year=1996 | isbn=0-8247-9394-3|page=632}}</ref> In the 17th century the Spanish [[Catholicism|Catholic]] manufacturers purchased the [[monopoly]] on [[Castile soap]] from the cash-strapped [[Charles I of England|Carolinian]] government.<ref>{{Cite book|last=Gregg|first=Pauline|url=https://books.google.com/books?id=h2v69fUCDxYC|title=King Charles I|publisher=Dent|year=1981|isbn=978-0-460-04437-0|location=London|page=[https://books.google.com/books?id=h2v69fUCDxYC&pg=PA218 218]|oclc=9944510|author-link=Pauline Gregg}}</ref> Industrially-manufactured bar soaps became available in the late 18th century, as advertising campaigns in Europe and America promoted popular awareness of the relationship between cleanliness and health.<ref>{{cite book|last=McNeil|first=Ian|url=https://books.google.com/books?id=uxsOAAAAQAAJ|title=An Encyclopaedia of the History of Technology|publisher=Taylor & Francis|year=1990|isbn=978-0-415-01306-2|pages=[https://books.google.com/books?id=uxsOAAAAQAAJ&pg=PA203 203]–205|archive-url=https://web.archive.org/web/20160505145316/https://books.google.com/books?id=uxsOAAAAQAAJ&pg=PA203|archive-date=2016-05-05|url-status=live}}</ref>

A major contribution of the [[Christian missionaries]] in [[Africa]],<ref>{{cite book |last= Newell|first= Stephanie|title=International Encyclopaedia of Tribal Religion: Christianity and tribal religions|year=2006|publisher=Ohio University Press|isbn=978-0-8214-1709-6|page=40}}</ref> [[China]],<ref>{{cite book |last= Grypma |first=Sonya|title=Healing Henan: Canadian Nurses at the North China Mission, 1888–1947|year=2008|publisher=University of British Columbia Press|quote=the Gospel of Christ was central to the 'missionary' aspect of missionary nursing, the gospel of soap and water was central to 'nursing' aspect of their works.|isbn=978-0-7748-5821-2|page=27}}</ref> [[Guatemala]],<ref>{{cite book |last=Thomas |first=Kedron|title=Securing the City: Neoliberalism, Space, and Insecurity in Postwar Guatemala|year=2011|publisher=Duke University Press|quote=Christian hygiene existed (and still exists) as one small but ever important part of this modernization project. Hygiene provides an incredibly mundane, deeply routinized, marker of Christian civility ...Identifying the rural poor as 'The Great Unwashed,' Haymaker published Christian pamphlets on health and hygiene,... of personal hygiene' (filled with soap, toothpaste, and floss), attempt to shape Christian Outreach and Ethnicity.|isbn= 978-0-8223-4958-7|pages=180–181}}</ref> [[India]],<ref>{{multiref2
|1={{cite book |last= Bauman |first=Chad M.|title=Christian Identity and Dalit Religion in Hindu India, 1868–1947|year=2008|publisher=Wm. B. Eerdmans Publishing|quote=Along with the use of allopathic medicine, greater hygiene was one of the most frequently mobilized markers of the boundary between Christians and other communities of Chhattisgarh... The missionaries had made no secret of preaching 'soap; along with 'salvation'...|isbn=978-0-8028-6276-1|page=160}}
|2={{cite book |last=Baral|first= K. C.|title=Between Ethnography and Fiction: Verrier Elwin and the Tribal Question in India|year=2005|publisher=North Eastern Hill University Press|quote=where slavery was in vogue Christianity advocated its end and personal hygiene was encouraged|isbn=978-81-250-2812-3|page=151}}
}}</ref> [[Indonesia]],<ref>{{cite book |last=Taylor |first= J. Gelman|title=Cleanliness and Culture: Indonesian Histories|year=2011 |publisher=Royal Netherlands Institute of Southeast Asian and Caribbean Studies|quote=Cleanliness and Godliness: These examples indicate that real cleanliness was becoming the preserve of Europeans, and, it has to be added, of Christianity. Soap became an attribute of God — or rather the Protestant|isbn=978-90-04-25361-2|pages=22–23}}</ref> [[Korea]],<ref>{{cite book |last=Choi|first=Hyaeweol|title=Gender and Mission Encounters in Korea: New Women, Old Ways: Seoul-California Series in Korean Studies|volume=1|year=2009|publisher=University of California Press|quote=In this way, Western forms of hygiene, health care and child rearing became an important part of creating the modern Christian in Korea.|isbn=978-0-520-09869-5|page=83}}</ref> and other places was better [[health care]] through hygiene and introducing and distributing soap,<ref>{{cite book |last= Channa|first=Subhadra|title=The Forger's Tale: The Search for Odeziaku|year=2009|publisher= Indiana University Press|quote=A major contribution of the Christian missionaries was better health care of the people through hygiene. Soap, tooth-powder and brushes came to be used increasingly in urban areas.|isbn=978-81-7755-050-4|page=284}}</ref> and "cleanliness and hygiene became an important marker of being identified as a Christian".<ref>{{cite book |last= Thomas|first=John|title=Evangelising the Nation: Religion and the Formation of Naga Political Identity|year=2015|publisher=Routledge|quote=cleanliness and hygiene became an important marker of being identified as a Christian|isbn=978-1-317-41398-1|page=284}}</ref>

==Society and culture==
===Religious hygienic customs===
{{Main|Ritual purification}}
{{Further|Ablution in Christianity|Hygiene in Christianity|Islamic hygienical jurisprudence|Ritual washing in Judaism|Islamic toilet etiquette}}

Many religions require or encourage ritual purification via bathing or immersing the hands in water. In [[Islam]], washing oneself via {{transliteration|ar|[[wudu]]}} or {{transliteration|ar|[[ghusl]]}} is necessary for performing [[Salat|prayer]]. [[Hadith|Islamic tradition]] also lists a variety of rules concerning proper hygiene after using the bathroom. The [[Baháʼí Faith]] mandates the washing of the hands and face prior to the [[obligatory Baháʼí prayers]]. [[Orthodox Judaism]] requires a {{transliteration|he|[[mikveh]]}} bath following menstruation and childbirth, while [[Handwashing in Judaism|washing the hands]] is performed upon waking up and before eating bread. [[Water]] plays a role in Christian rituals as well,<ref name="Z. Wahrman 2016 46–48">{{cite book|title=The Hand Book: Surviving in a Germ-Filled World|first=Miryam |last=Z. Wahrman|year= 2016| isbn=978-1-61168-955-6| pages =46–48 |publisher=University Press of New England|quote=Water plays a role in other Christian rituals as well.... In the early days of Christianity, two to three centuries after Christ, the lavabo (Latin for "I wash myself"), a ritual handwashing vessel and bowl, was introduced as part of Church service.}}</ref> and in certain [[Christian denomination|denominations of Christianity]] such as the [[Ethiopian Orthodox Tewahedo Church]] which prescribes several kinds of [[hand washing]] for example after leaving the latrine, lavatory, or bathhouse, or before prayer, or after eating a meal, or ritual handwashing.<ref>{{Cite journal |first=Kirsten Stoffregen|last=Pedersen|year=1999|url=http://pwtw.pl/wp-content/uploads/wst/12-2/Pedersen.pdf |title=Is the Church of Ethiopia a Judaic Church? |access-date=2020-05-29 |archive-date=2016-03-04 |archive-url=https://web.archive.org/web/20160304115645/http://pwtw.pl/wp-content/uploads/wst/12-2/Pedersen.pdf |journal=Warszawskie Studia Teologiczne|volume=12|number=2|pages=203–216 }}</ref><ref name="Z. Wahrman 2016 46–48"/>

== Etymology ==
First attested in English in 1676, the word ''hygiene'' comes from the [[French language|French]] {{lang|fr|hygiène}}, the [[Latinisation (literature)|latinisation]] of the [[Greek language|Greek]] {{lang|grc|ὑγιεινή}} ({{lang|grc|τέχνη}}) {{transliteration|grc|hygieinē technē}}, meaning "(art) of health", from {{lang|grc|ὑγιεινός}} {{transliteration|grc|hygieinos}}, "good for the health, healthy",<ref>{{cite book|chapter-url=https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Du%28gieino%2Fs|chapter=ὑγιεινός|first1=Henry George|last1=Liddell|first2=Robert|last2=Scott|title=A Greek-English Lexicon|publisher=Perseus}}</ref> in turn from {{lang|grc|ὑγιής}} ({{transliteration|grc|hygiēs}}), "healthful, sound, salutary, wholesome".<ref>{{cite book|chapter-url=https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Du%28gih%2Fs|chapter=ὑγιής|first1=Henry George|last1=Liddell|first2=Robert|last2=Scott|title=A Greek-English Lexicon|publisher=Perseus}}</ref> In [[Religion in ancient Greece|ancient Greek religion]], [[Hygeia]] ({{lang|grc|Ὑγίεια}}) was the personification of health, cleanliness, and hygiene.<ref>{{cite book|chapter-url=https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Du%28gi%2Feia^|chapter=ὑγίεια|first1=Henry George|last1=Liddell|first2=Robert|last2=Scott|title=A Greek-English Lexicon|publisher=Perseus}}</ref>

==See also==
* {{annotated link|[[Cleaning station]]}}
* {{annotated link|[[Contamination control]]}}
* {{annotated link|[[Human decontamination]]}}
* {{annotated link|[[Hygiene program]]}}
* {{annotated link|[[Hygiene theater]]}}
* {{annotated link|[[Mysophobia]]}}
* {{annotated link|[[School hygiene]]}}
* {{annotated link|[[Waterborne diseases]]}}

==References==
{{reflist}}

==External links==
{{offline|med}}
{{Wiktionary}}
{{NIE Poster|Sanitary Science}}
* [https://www.cdc.gov/hygiene/index.html Hygiene] at the [[Centers for Disease Control and Prevention]]
* [https://www.ecdc.europa.eu/en/publications-data/directory-guidance-prevention-and-control/core-requirements-healthcare-settings-0 Hand hygiene] at the [[European Centre for Disease Prevention and Control]]
* [https://web.archive.org/web/20151018041219/http://www.who.int/neglected_diseases/water-sanitation/en/ Water, Sanitation and Hygiene] at the [[World Health Organization]]

{{Public health}}
{{Activities of daily living}}
{{Concepts in infectious disease}}
{{Virtues}}

{{Authority control}}

[[Category:Hygiene| ]]

[[Category:Bathrooms]]
[[Category:Medical hygiene|Hygiene]]
[[Category:Sanitation|Hygiene]]