Intended for healthcare professionals

Rapid response to:


Hand washing

BMJ 1999; 318 doi: (Published 13 March 1999) Cite this as: BMJ 1999;318:686

Rapid Response:


Dear Editor

The importance of handwashing covered in your Editorial[1] may only
be the tip of the iceberg. During the last 20 years of full time research
into the benefits of higher techniques of hygiene specifically designed to
clean the thumb/fingernails, hands, eyes and front of the nasal
passageway, the results have been truly spectacular. The benefits
demonstrated in thousands of volunteers and clients. Not only does
advanced hand washing and hygiene profoundly reduce all respiratory
diseases to a level never before thought possible (>90%), it has an
astonishing effect on reducing allergies, even headaches.[2]

Yet, these remarkable benefits pale into insignificance when one
realizes that the concentration of serum albumin and the albumin/globulin
ratio are influenced by the standard of hygiene far more than the amount
of ratio are influenced by the standard of hygiene far more than the
amount of protein in the diet.[3] Consider that the concentration of
albumin has emerged as perhaps the single-most important factor in
determining mortality and morbidity in numerous studies.[4] [5]

Perhaps the single greatest misunderstanding in medical history is
the erroneous belief that serum albumin concentrations are a measure of
dietary protein status.[6] Attempts to raise albumin by high protein diets
or infusion, particularly in the elderly and critically ill, have been
termed by eminent albumin researchers as the "Ultimate in metabolic
misunderstanding." Great harm can come from this ignorance. Undeniably,
albumin concentration, particularly in a modern society, is deeply
associated with infectious status and stress on the immune system. This
usually is evident in the level of globulins influencing osmotic pressure,
which to a large degree determines the concentration of albumin via
transducer mechanism. A major influence in all this is the level of
Interleukin 6 and Tumor Necrosis Factor, all associated with the acute-
phase reaction. The globulin concentration is also influenced by antibody
levels. High hygiene can reduce the need for antibody levels from an
average of 17g/L to In conclusion; the motivation for proper hand washing and personal
hygiene, that emerged from my study, may revolutionize hospital care. A
stronger, more selfish motive arises for health-care workers to wash their
hands frequently and properly to maintain a very low personal infectious
status and super-high albumin profiles (50-60g/L, A/G ratio 3.0 - 4.0).
The very difference between people may be the standard of personal
hygiene, not genetic factors. Hygiene via albumin levels may also be the
single-most important factor in slowing the aging process.

Kenneth Seaton

National Hygiene Foundation,
1712 8th Avenue,
WV 25703,

1 Handwashing Liaison Group, BMJ, 1999;318:688 ( 13 March).

2 Hall H. An Intergrative Approach to Headache & Pain Management for
Physicians & Health-care Providers, Case Western Reserve University,
Cleveland Ohio), May 1st 1999.

3 Seaton K, Micozzi M. Is Cortisol the Aging Hormone? J Adv. Med.
1998;11:73 -94.

4 Phillips A. Shaper AG. Wincup PH. Association between Serum Albumin and
Mortality from Cardiovascular Disease, Cancer and Other Causes.

5 Corfi MC. Guranik JM. Salive ME. Sorkin JD. Serum Albumin Level and
Physical disability as Predictors of Mortality in Older Persons. JAMA,

6 Klein S. The Myth of Serum Albumin as a measure of Nutritional Status.
Gastroenterolgy, 1990;99:1845-1851.

7 Seaton K. Health, Wealth & Hygiene (letter) JNMA 1994;86:327, 356,

8 Seaton K. Has Cancer been Solved? J Adv. Med. 1999; 12:73 -77.

Competing interests: No competing interests

02 November 1999
Kenneth Seaton