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Global Worming
There's yet another alarmist report in the press; this time, about men not washing their hands when they leave the bathroom. Hmmm, this is a job for the queen of the parasites (oops, that didn't come out right -- and oops, since this is starting out as a post about bathroom behavior, neither did that)...but I'm talking about Marlene Zuk, a behavioral ecologist (studying the evolution of behavior) who gave a fascinating talk at the Human Behavior and Evolution Society conference two years ago at Penn.

Zuk's point, in brief, is that we co-evolved with parasites, and, as she put it in an e-mail the other day, "we remove all of them (or try to, with anti-bacterial everything) at our peril. This hyper-cleanliness may be behind some of the enormous increase in allergies, asthma, Crohn's disease and some of the other 'diseases of the advantaged.'"

At HBES, Zuk gave details on the downsides of removing our pathogens (put away that Purell, you clean freaks). A few of my notes from her talk:

Asthma, which is more common in industrialized countries, increased 75% from 1980-84 in US. Asthma is less common in rural environments, and families with more children, pets or farm animals. Just having older siblings is likely to be associated with decrease in asthma.

Drinking unpasteurized milk means people are less likely to have allergies (Amy-torial in support of Zuk's point: We idiotic Americans don't allow unpasteurized cheese, except for some hard cheeses at Whole Foods and other such stores. Pasteurized cheese tastes like nothing compared to unpasteurized [and healthier] cheese. What about the danger of listeria?! Come on...all of France isn't coming down with it from unpasteurized cheese, now are they?)

Endotoxin, a component of bacterial cell walls, may be a crucial component of the human body. It's particularly prevalent in rural environments. And higher endotoxin levels in bedding were associated with lower levels of asthma in a study 812 European children.

Zuk also spoke of parasite-based success in treating Crohn's by a researcher named J.V. Weinstock, who gave Crohn's patients (put down your breakfast!) a solution of pig whipworm in Gatorade. And then, in a 2004 double-blind study, 3/4 of the patients showed remission of the disease after six months. (In case you don't know this, that's a pretty amazing success rate.)

More from Marlene Zuk in a moment. But, first, an AP story by Marilynn Marchione, about a study showing that one-third of men (compared to 12 percent of women) didn't wash their hands after using the toilet.

Not surprisingly, a PR dude for soap manufacturers -- those who "co-sponsored" the survey and the related "education campaigns" -- was among the first to chastise all the naughty, naughty men for not washing their hands:

"Guys need to step up to the sink," said Brian Sansoni, spokesman for the Soap and Detergent Association.

But, do they? Granted, there are those guys I really, really want to wash their hands: Those who have done more than urinate, and those who wear a stethoscope to the office. As Lena put it the other day, the latter are in the business of sticking their fingers in places fingers, in day to day doings, are generally not stuck.

Marchione's story continues:

Frequent hand washing is the single best thing people can do to avoid getting sick, from colds and the flu to germs lurking in food, doctors say. And a recent Harris Interactive survey found 92 percent of Americans said they always wash up after using the bathroom.

Oh, great. So "doctors" say it. (There's some great reporting.) Whaddya wanna bet your doctor hasn't read more than 10 studies (if that) since he or she left med school? And, if I want to know whether it really matters if people wash their hands, I'm not going to go on peer pressure ("92 percent of Americans...). And sure, maybe 92 percent said they wash up after using the bathroom. What percent of those people do you think were actually telling the truth about it?

Clearly, this was a question for Marlene Zuk. So, I e-mailed her:

AMY: We all want people to wash their hands after a bowel movement, but it's my impression urine is sterile, and from what I've read, the bacteria, if any, may come from handling the genitals. I see a doctor recommending people wash with (ugh!) sterile wipes. Also, it seems the real danger of picking up bacteria comes from handling faucets. But, you're the expert here!

Here's what she wrote back:

MARLENE ZUK: ...the piece you sent is interesting. I have always wondered about this very issue myself. You are right, urine is more or less sterile when it leaves the body, although it can certainly contain bacteria if a person has a urinary tract infection. Washing hands keeps pathogen transmission down, certainly, but I too have wondered about why highlighting hand-washing after using the toilet is so important.

On general principles, the more you wash your hands, the less likely you are to convey viruses or bacteria. And mucous membranes like those around the genitals carry these microbes. But I'd be willing to bet that no one has done the kind of epidemiological study necessary to confirm that washing after urinating *per se* is important. You'd have to have a group that did so and a group that didn't, and then confirm that the former transmitted fewer diseases. It's hard getting those data for humans without also getting a lot of confounding variables; maybe the hand-washers also have other habits that keep pathogens at bay, for example.

And do include a word about the folly of antibiotic overuse! Honestly, people are way too worried about things that are a very small risk, like shark attacks or Ebola, and not worried enough about things that are much larger risks, like antibiotic-resistant infections in hospitals.

I truly appreciate the mention (and have been enjoying your column and blog). On the other hand, with my first book on sex/gender and animal behavior, I got a lot of weird emails about orgasms. I am a little worried that this one will get me people telling me all about their bowel problems, what with the stuff on worms and Crohn's. Such is a writer's life, I guess.

Best, Marlene

This seems a good time to mention that Zuk has written a very interesting book -- Riddled with Life: Friendly Worms, Ladybug Sex, and the Parasites That Make Us Who We Are -- which I have read and recommend. It's well-written, and an easy read, and, considering her subject matter, filled with unexpected bits of wit: her confession that she feels like "the Anne Rice of crickets"; the way she starts a section, "I came to a fondness for chickens late in life"; and her title for another, "Lice, Hair, and Getting Dates."

(Presumably, with hair and without lice.)

Oh yeah, and don't miss the section on bedbug sex. Seriously.

Posted by aalkon at September 24, 2007 11:36 AM

Comments

I always thought the issue wasn't washing per se, but what you wash with. From what I've read, plain old handwashing with warm water and regular soap is plenty good enough; it's the carpet-bombing with "sanitizers" and other alcohol-based products that only makes the bugs stronger.

At this point, let me put in a word for the bathroom-keepers of the world:Stock your facilities with mild, UNSCENTED soaps, perhaps with a sign on the dispenser, and you'll see handwashing go way up. Oh, and a little warm water wouldn't kill you either. Nothing puts me off doing my duty faster than icy water and that vile pearly-pink lotion soap that smells like urinal cakes.

Posted by: Nance at September 24, 2007 5:41 AM

People washing with sanitizers makes Marlene Zuk crazy. My point here is that we're a little too crazy about all of it.

Posted by: Amy Alkon at September 24, 2007 5:53 AM

My wife and I often laugh about the thought that, after touching my penis during my pre-bedtime bathroom visit, I must wash my hands. A few minutes later, we are making love, including oral sex.

Posted by: Steamer at September 24, 2007 8:20 AM

TMI, Steamer,but I know where you're coming from. My great-gramma used to say that you (meaning everybody) eat about a peck of dirt before you die. Which isn't a lot. Which was probably her way of saying, what's the big deal? Kids get dirty, it's a fact of life. I can't recall anyone dying just from getting dirty.

Posted by: Flynne at September 24, 2007 9:14 AM

Speaking of UTI's and overuse of antibiotic. I get alot of them, and doctors don't really seem to know what causes them, or anything to do about it but antibiotics. Which is fine if you have them occasionally. But when you get them often, no joke, I've been to no fewer than three specialists who suggested putting me on a daily dose of antibiotics....for life. Seriously! There are actually non-antibiotic ways of getting rid of UTI's, D-Mannose is a really effective one.

Unnecessary antibiotics, and those who don't finish all of the pills when on antibiotics, kill off the weakest germs first, then they leave the toughtest bugs alive to pass on their resistance to the next germ generation. Drug-resistant staph infections ought to scare us all a hella lot more than global warming, but you know the media- they seem to like to distract us with irrelevant stuff so we don't notice the more important issues.

Posted by: Allison at September 24, 2007 9:14 AM

Cranberry juice, Allison. I don't know what it is about cranberry juice, but get that stuff flushing through your system and you'll see a dramatic decrease in UTI's. It works for me! o_O

Posted by: Flynne at September 24, 2007 9:17 AM

And if you live in NYC long enough, you're going to eat about two pounds of cockroach parts.

Posted by: Amy Alkon at September 24, 2007 9:23 AM

I forgot to put this in as I was writing the blog item, but Marlene Zuk is the bug world's Barry Glassner (he wrote "Culture of Fear" -- http://www.amazon.com/gp/product/0465014909?ie=UTF8&tag=advicegoddess-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0465014909--- about how we're afraid of all the wrong things, and tells a story about a woman who, in light of a terrible rainstorm, cancelled her flight to LA, rented a car, and drove 10 hours through the rain. Of course, statistically, you're much, much more likely to die in a car crash! And I'll take my chances with a professional pilot any day over driving on roads filled with drunks, teenagers, drunken teenagers, and drunken, text-messaging teenagers!)

Posted by: Amy Alkon at September 24, 2007 9:30 AM

My local market now supplies anti-bacterial wipes so you can sanitize the grocery cart handle before you touch it. From what I can tell, the grocery cart was invented in 1937. HOW did we survive all those years with dirty cart handles?!

Posted by: Darry at September 24, 2007 9:51 AM

Maybe that's why we're all not like fragile little flowers.

Posted by: Amy Alkon at September 24, 2007 10:30 AM

Visit a farm in the Spring when the newly born animals are still nursing and you will see the mothers liking the rear ends of their newborns. The reason they instinctively do this is to ingest any potentially harmful organisms in their offspring's system. The mother will (hopefully) develop an immunity to the organism and pass that immunity to her young through her milk.

It is a natural defense strategy against infectious disease and it works better than chemical sanitizers or antibiotics.

Posted by: martin at September 24, 2007 10:53 AM

Doh! "liking" s/b "licking" .

Preview is my friend but I don't always take his advice.

Posted by: martin at September 24, 2007 10:55 AM

Liking the rear ends of other animals is more of a bonobo thing, I'd imagine.

Posted by: Amy Alkon at September 24, 2007 11:01 AM

"Really sheriff, I was just trying to help that sheep over the fence."

Posted by: ex-farmboy martin at September 24, 2007 11:13 AM

Urine is sterile . . . but if you think urine is the reason you should wash your hands, you have missed the point completely. As Cecil Adams puts it, your entire boxer-shorts region (from navel to mid-thigh) is crawling with coliform bacteria. Touch anything in that region and you now have those bacteria on your hands.

Posted by: Pat at September 24, 2007 11:40 AM

Offtopic internet sports!

Reconcile this story from early Saturday:

http://urltea.com/1kku

....


[dodging spamfilter]

Posted by: Crid at September 24, 2007 11:57 AM

... with this one from this afternoon (east coast time):

http://urltea.com/1kkt

Posted by: Crid at September 24, 2007 11:59 AM

Ah, is there an Advice Goddess pet topic not covered by my latest favorite most brutally overwatched movie?

Posted by: Paul Hrissikopoulos at September 24, 2007 1:31 PM

Which movie?

Posted by: Amy Alkon at September 24, 2007 1:34 PM

Sorry, I forget not everyone has my superhuman mindreading powers. That would be 2 Days in Paris. Bad health through over-cleanliness, "France [as] a muslim country", boyfriends who can't handle details about girlfriends' past(s?), etc.

Posted by: Paul Hrissikopoulos at September 24, 2007 3:51 PM

Does it include scenes in Café de Flore or similar islands of America within Paris?

Posted by: Stu "El Inglés" Harris at September 24, 2007 5:17 PM

Not everyone is equally healthy. Spreading your personal culture of microbes could be very harmful to someone whose immune system is depressed, whether by anti-rejection drugs or by other diseases. You and your spouse have time to develop mutual immunities; strangers in restaurants who will touch the same counters, mints, etc, do not.

Posted by: njcommuter at September 24, 2007 5:23 PM

If my immune system were depressed, I would wear gloves and a mask, and probably not leave the house to often. I don't wear perfume on airplanes or to the movies lest I bother somebody with allergies, but I'm not going to live like a germphobe because somebody I come into contact with somewhere might be ill.

Posted by: Amy Alkon at September 24, 2007 6:15 PM

A whiff of perfume, a single lung-puff, is heavenly. To be in that same air for more than two minutes is like wearing plastic-colored lenses all night.., Who but a child would be amused by the coarsely distorted perception?

I have energy about this, and have reason to believe there's a genetic predisposition.

Posted by: Crid at September 25, 2007 12:47 AM

I make sure to only use soap. Liquid shower gel and the crap they have in the dispensers in washrooms is actually detergent, which is way too harsh.

Allison, I would recommend using extremely mild soap for the cleaning of your 'lady parts', and see if that helps keep the UTIs away. It's just a thought...

I let my cat sleep on a pillow right next to mine, mostly because she is an apartment cat so won't bring fleas or germs from other animals from outside, so it's pretty low risk. I also figure that I should get some exposure to cooties to keep my immune system sharp.

I haven't used antibiotics for at least 15 years, mostly because I want to make sure that my body doesn't get used to them, so that when I really need them, they will work.

Posted by: Chrissy at September 25, 2007 11:52 AM

I was under the impression that soap and other cleaners are not particularly effective at killing bacteria on your hands - you need alocohol or carbolic for that. Instead, washing works by dislodging the bacteria and flushing them down the drain. Water alone is probably just as effective. And neither water nor soap will get them out from the deeper skin crevices anyway.

But the point is to not be scared of the wrong things. Drinking cholera- or e-coli- infected water is dangerous, but pretty rare.

Posted by: Norman at September 26, 2007 1:12 AM

Here is my take, its been siting in my pants all day long, meanwhile my hands have come into contact with god knows what throught the course of the day.

I wash my hands BEFORE using the toilet. ANd when you think about it, after you have washed your hands you grab the same door handle that people who didnt wash their hads have touched - ever think of that?

Posted by: lujlp at September 26, 2007 1:53 AM

And when you wash your hands, you're touching the hot & cold fixtures after you wash your hands, that you had just touched with your dirty hands, thus recontaminating yourself.

Posted by: Chrissy at September 26, 2007 6:56 AM

I wrote a little something on hand washing and am getting the word out.
www.washfirst.org

Guys have got it backwards

Posted by: cory at October 1, 2007 5:06 PM

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