Basic Health Habit No.11: Hygiene

Hygiene is two thirds of health

Hygiene refers to conditions and practices that help to maintain health and prevent the spread of disease. 

Hygiene is also the branch of science concerned with the promotion and preservation of health.

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Health is the level of functional or metabolic efficiency of a living organism. 

Metabolism is the set of life-sustaining chemical transformations within the cells of living organisms. The three main purposes of metabolism are the conversion of food to energy to run cellular processes; the conversion of food to building blocks for proteins, lipids, nucleic acids, and some carbohydrates for the maintenance of health and structural integrity; the elimination of waste byproducts for the reduction of disease risk. 

These enzyme-catalyzed reactions allow organisms to grow and reproduce, maintain their structures, and respond to their environments.

This means that the principle life, and health-supporting physiological functions are involved in: 

  • cellular function
  • cellular building and repair
  • elimination of waste by-products
  • maintenance of health
  • structural integrity

The necessary elements for the physiological functions of health are dependent on and supplied by your Basic Health Habits.

The human body is an ecosystem of complementary, co-dependent, and cooperative systems, functioning together to maintain health, and designed to heal itself. Neglect of basic health habits leads to physical deterioration, malfunction, a cascade effect of health complications, and finally, to disease. Physiological health relates only to an intact, fully functional, flesh and blood body. 

In humans, health is also the ability of individuals or communities to adapt and self-manage when facing physical, mental, or social challenges. 

Hygiene and Health History
From the onset of the industrial revolution until fairly recently, it was something of an accomplishment to live through childhood. Even when people made it through the deadly childhood years, there were a host of infectious diseases waiting to strike them down. In the last 150 years or so, there has been a remarkable transformation in both the life expectancy of the population of the industrialized world and the manner in which people die.    
The conventional understanding of this transformation is one of biomedical triumph.   
A popular explanation of the epidemiological transition is that the germs that caused infectious disease mortality were defeated by the magic bullets of mainstream medicine (pasteurization, antibiotics, surgery, and pharmaceuticals) over the course of the 20th century, permitting the population to get old enough to get the chronic diseases of heart disease and cancer.   
This explanation is false. 

Politics, Economy, and Health
The most important causes of infectious disease were the political and economic structures that favoured capital at the expense of labour so blatantly that it left a large portion of the working population virtually at death's door. This was remedied only when resistance by labour created a more livable workday, child labour laws, and a higher wage, resulting in improvements in nutrition, housing, and subsequent advances in hygiene.  
Chronic disease increased as industries transformed the production process by introducing more mechanized and chemically intensive production procedures. This has transformed our food, water, air, and work conditions in unprecedented ways and helped to create a historically unique, chronic disease pattern. To Live and Die in America by Robert Chernomas and Ian Hudson

Health Literacy
We are not born with the knowledge of health. That education is not available presently to individuals, or for health and medical professionals in Canada. We are illiterate because there is no definitive, coherent language for us to use to communicate with each other about health; to educate ourselves; nor does a comprehensive system exist for the evaluation of health, and for practical application.

Canadians are health illiterate, and to be fair, we are uneducated. We are on our own when learning about health. The result is that we depend on a healthcare system of medical and pharmaceutical treatment that would get a failing grade for health. Doctors do not have the education or the training to help you with your health. 

What is a Health Trend?
The world of health is dominated by trends and business, and the world of medicine, which we name healthcare, would get a failing grade for health. Extreme fitness, specialized diets, and weight loss have developed to fill the void. 

The current aggressive marketing and mass popularity of idealized body image, weight-loss, and extreme fitness is unique, but it is not about health. 

Canada has two new eating disorders related to health dieting trends, and a new psychological disorder, Body Dismorphic Disorder (BDD), that now includes a growing number of young boys and men, as well as girls and women; engaging in extreme fitness, health dieting, drug use, surgery, augmentation, and supplementation behaviours. 

Unfortunately, most people that I treat have extreme fitness habits, unsupported by basic health habits - with effects compounded by unhealthy habits. I have been charting the short and long term damage of this behaviour for more than 25 years.

While the goal of basic health habits is the creation and support of health, the purpose of a health trend is focused on a specific result such as weight loss, detoxification, or physical fitness. Health trends are temporary measures for achieving a limited outcome - often at a cost to our health, while basic health habits are essential, sustainable, and fundamental for the health of all humans.

When health is the goal, rather than weight loss or an increase in body size, better choices are made, the health benefits are more comprehensive and sustainable, and include: beauty, weight management, muscle development, and healthy aging.

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Hygiene and Atopic Disease
The hygiene hypothesis was first formulated in 1989 by an epidemiologist, Dr Strachan, who observed that there was an inverse relationship between family size and development of atopic allergic disorders - the more children in a family, the less likely they were to develop these allergies. From this, he hypothesized that lack of exposure to infections in early childhood transmitted by contact with older siblings could be a cause of the rapid rise in atopic disorders over the last thirty to forty years. Strachan further proposed that the reason why this exposure no longer occurs is, not only because of the trend towards smaller families, but also improved household amenities and higher standards of personal cleanliness.

Although there is substantial evidence that some microbial exposures in early childhood can protect against allergies by conditioning the immune system, there is no evidence that we need exposure to harmful microbes (infection) or that we need to suffer a clinical infection. Nor is there evidence that hygiene measures such as hand washing, food hygiene etc. are linked to increased susceptibility to 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 lifestyle that have led to decreased exposure to certain microbial or other species, such as helminths, that are important for development of immuno-regulatory mechanisms.

chain of infection transmission
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A strong collective mindset has become established that dirt is healthy and hygiene somehow unnatural. This has caused concern that everyday life hygiene behaviours, which are the foundation of public health, are being undermined. In response to the need for effective codes of hygiene in home and everyday life settings the International Scientific Forum on Home Hygiene has developed a risk-based approach, based on Hazard Analysis Critical Control Point (HACCP), which has come to be known as targeted hygiene. Targeted hygiene is based on identifying the routes of spread of pathogens in the home, and applying hygiene procedures at critical points at appropriate times to break the chain of infection.

Natasha Sturm: A cultured handprint (left) on a large TSA plate from my 8 1/2 year old son after playing outside.

The big blob in the lower right is most likely a Bacillus species which is commonly found in dirt. The white is staphylococcus bacteria and the coloured colonies are probably yeast.

Human Biology
For every human cell in your body, there are ten non-human cells. They weigh approximately three pounds - the average weight of an adult brain. These micro-organisms are composed of millions of genes compared to the 20,000 identified genes that form the human genome. The term human being is being replaced with the term human organism by microbiologists to reflect the reality that the human genome is one of a myriad genomes dictating the human experience in both health and disease.

The human body is an ecosystem of complimentary, co-dependent, and cooperative systems, functioning together to maintain health and designed to heal itself. Regarding our personal health care, our primary behaviour should involve the support of these natural functions with the practise of basic health habits. 

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Neglect of basic health habits leads to physical deterioration, malfunction, a cascade effect of health complications, and finally, to disease. 

As long as we are made of flesh and blood, we are bound by natural laws. If your present system of health care is not built on a foundation of understanding and support of the natural functions of your body, then it is a faulty system.

The Skin and Sweat Glands

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Our skin is an anatomical barrier that protects us from pathogens and damage. It is an ecosystem of cells which are a part of our adaptive immune system and a balance of millions of bacterial floral microorganisms needed for health. It contains cells for pigmentation, blood and lymph vessels, hair follicles, sebaceous oil glands and tubular coiled sweat glands. It has a variety of nerve endings  which react to heat and cold, touch, pressure and injury. 

The skin is the largest organ of the body and is often called the third kidney because of its important role in elimination. It is more complex than the kidneys or any other organ, except the brain.

Our modern lifestyle makes most people's skin inactive. Many of us don't sweat, especially during the winter months. Modern synthetic fibres or tight clothing that don't allow the skin to breathe, can damage our skin and our natural ability for elimination, as does excessive prolonged sun exposure. A sedentary lifestyle also inactivates the skin.

Antiperspirants, artificial environments, pollution, inactivity, diet, stress, synthetic clothing, and poor skin hygiene to remove dirt, dead skin; and oil and sweat secretions - affect skin health. 

The Acid Mantle is a protective, slightly acidic (pH 4.5-5.5), micro-flora, hydro-lipid film on the surface of skin that prevents the growth of fungi and bacteria

Your skin’s acid mantle is made up of the following:
  • Water
  • Lactic acid
  • Urocanic acid
  • Fatty acids
  • Pyrrolidine carboxylic acid
  • Eccrine glands which secrete amino acids. 

These friendly secretions help with the the metabolism of your skin:
  • Protect against environmental assaults
  • Secrete enzymes, that break down excess sebum in the skin
  • Prevent bad bacteria and viruses from entering the blood stream
  • Keep your skin soft and supple, so it stays free from cracks and abrasions
  • Boost the immune system, which produces antigens close to the skins surface; these antigens retard the growth of bad bacteria, known as pathogens

Skin is an important part of temperature regulation with a blood supply that allows precise control of energy loss by radiation, convection and conduction. Our skin is a semipermeable barrier and controls the evaporation of fluid. Loss of this function contributes to massive fluid loss, such as in the case of severe burns. 

Our skin is also water resistant and acts as a barrier so that essential nutrients aren't washed out of the body.  It is an important storage area for lipids and water and for the synthesis of vitamin D. Aesthetically, others see our skin and assess our mood, physical state and attractiveness.

Is the outer layer of skin and does not contain blood vessels but is nourished by capillaries in the upper layers of the dermis. Layers (strata) of cells are formed and move up the strata, changing shape and composition, a process that takes weeks to occur. The epidermis has 25 - 30 layers of dead skin.

Lies beneath the epidermis and consists of connective tissue that supports and cushions the body from stress and strain. It has a rich supply of blood and lymphatic vessels, nerve endings, hair follicles and sweat and oil glands. It is here that a pattern of ridges forms finger prints that make us genetically unique and this is where tattoo ink is held and stretch marks form. Collagen, elastin and protein fibers give strength, extensibility and elastic integrity to our skin. The hyperdermis is the subcutaneous tissue that attaches the skin to muscle and bone and contains 50% of the body's fat.

SEM (Scanning Electron Micrograph) 
of a human sweat pore, opening onto the surface of human skin

Sweat Glands
We have two types of sweat glands located in the dermal layer of the skin. Apocrine sweat glands  are more superficial (closer to the surface), respond to emotional stimulus and are located in the groin and around the nipples and secrete into hair follicles. Apocrine sweat gland activity starts at puberty and contains pheromones which are chemicals that respond to and communicate information to other individuals. These glands are controlled by the Autonomic Nervous System and by circulating hormones. 

Merocrine, also known as Eccrine sweat glands, are more numerous, smaller and more widespread than apocrine sweat glands. We have 2.6-3 million eccrine sweat glands and they do not extend as far into the dermis as the apocrine glands and they discharge directly onto the surface of the skin through pores. We have the highest number on the palms of our hands and the soles of our feet to cause friction and to give us grip. Body heat stimulates the part of the brain called the hypothalamus which controls body temperature and is located above the brain stem. The hypothalamus connects the nervous system to the endocrine system via the pituitary gland and neural and hormonal responses stimulate eccrine sweat gland activity.

Sweat contains mostly water derived from blood plasma along with electrolytes and urea and may also contain lactic acid and other wastes and toxins. As well as regulating body temperature and excretion, sweating gives us protection from environmental hazards by diluting harmful chemicals and discouraging the growth of infectious microorganisms. Sweat is odourless. It is the contact with bacteria which causes odour and this is influenced by hygiene, diet, lifestyle, genetics, medication, health and gender.

Death by accumulated poisons occurs in a matter of hours if sweat gland activity is blocked. Properly cared for skin is better able to resist infection, protect our body and regulate body temperature.

In a systematic review, published in the Journal of Environmental and Public Health, regarding toxic levels of arsenic, cadmium, lead, and mercury in sweat,  heat regulatory mechanisms of the autonomic nervous system are often affected, resulting in a failure to sweat readily. With toxic elements ubiquitous in our air, water, food, and the physical environment, as well as in many consumer products, prudent avoidance is not always possible. The study also stated that the signs and symptoms of chronic disease are consistent with effects of arsenic, cadmium, lead, and/or mercury. All four elements are confirmed carcinogens, and they exhibit wide-ranging toxic effects on many bodily systems, including the nervous, endocrine, renal, musculoskeletal, immunological, and cardiovascular systems, and need to be included as probable cause in diagnosis by physicians in clinical practice. The study concluded that sweating, with sauna or steam bath use, with the aid of hydration, nutrition, and exercise is the most effective heavy metal detox.

A Practical Guide
for healthy hygiene 

before/after public outings
before/after social interactions

Coming soon:
  • The HEALTH COACH Personal Hygiene Test coming soon
  • Greening Your Hygiene coming soon
  • What Is Your Body Trying To Tell You? How To Listen To Your Body ... stay tuned for more


Hazard analysis and critical control points (HACCP) is a systematic preventive approach to food safety from biological, chemical, and physical hazards in production processes that can cause the finished product to be unsafe, and designs measurements to reduce these risks to a safe level.

Sternutation: is the semi-autonomous, convulsive expulsion of air from the lungs through the nose and mouth, usually caused by foreign particles irritating the nasal mucosa - also known as a sneeze. It is an important part of the first line of immune defence. The sneeze reflex involves various nerves in the brainstem that control muscles in the throat and lungs. During a sneeze, the soft palate and palatine uvula are lowered while the back of the tongue rises to partially close the passage to the mouth so that air expelled by the lungs can exit the nose. Because the mouth closes only partially, much of this air is also expelled through it.

The air can be expelled by the nose at high speeds - up to 160 kilometres per hour. The force of a sneeze can send 100,000 germs across a distance of 5 to 32 feet. 

How Far Do Sneezes and Vomit Travel?
Gross Science

The difference between allergic sneezing and infectious sneezes is that the latter involves a rise in body temperature. When the ethmoidal nerve on the sides of the inside of the nose is stimulated by mild electricity, one almost inevitably sneezes at least once, while photic sneezes are triggered by light and solar sneezes by exposure to the sun. Here, it is not the nose but the iris in the eye that reacts to trigger a sneeze.

Thermal Comfort: 
According to official national and international Government Occupational Safety and Health Standards, to have thermal comfort means that a person wearing a normal amount of clothing feels neither too cold nor too warm. Thermal comfort is important both for one's well-being and for productivity. It can be achieved only when the air temperature, humidity and air movement are within the specified range often referred to as the comfort zone.

When the conditions affecting thermal comfort are not in the recommended ranges, productivity, health, and safety are affected. 

The factors that affect thermal comfort are:
Air temperature
Radiant heat
Air speed
Physical activity

Thermal comfort for people in sedentary occupations:
Summer: 19-24 degrees Celsius 
Winter: 18-22 degrees Celsius
Humidity: 40-70%
Air speed: 0.1-0.2 m/s
Radiant Heat: No direct exposure to a radiant heat source

Thermal comfort for people in active occupations:
Summer: 16-21degrees Celsius
Winter: 16-19 degrees Celsius
Humidity: 40-70%
Air speed: 0.2 m/s
Radiant Heat: No direct exposure to a radiant heat source

Hyperhidrosis: Excessive sweating, called hyperhidrosis, can be affected by poor basic health habits, systemic illness, medications, infection, fever, stress, high emotional states, poor physical fitness, hot climate, hot internal environments, alcohol, diabetes, insulin, unhealthy menopause, hormonal imbalance, lymphoma, thyroid disease, nervous system or hypothalamic disorders, Parkinson's disease, adrenal or pituitary tumours, tuberculosis, or drug withdrawal.

McClintock Effect: Apocrine sweat gland secretions of women can alter the menstrual timing of other women.

Second Skin: A silicone-based polymer that can be applied on the skin as a thin, imperceptible coating, mimics the mechanical and elastic properties of healthy, youthful skin. In tests with human subjects, the researchers found that the material was able to reshape puffiness under the lower eyelids and also enhance skin hydration. With further development, second skin could also be used to deliver drugs to help treat skin conditions such as eczema and other types of dermatitis, and adapted to provide long-lasting ultraviolet protection, the researchers say.

Tattoo Inoculation Hypothesis: Saliva taken before and after getting new ink was tested for levels of immunoglobulin A, an antibody known to fight infections, and cortisol, a stress hormone that suppresses the immune response. The study found that getting your first tattoo causes a big drop in immunoglobulin A caused by a rise in cortisol levels. As the number of tattoos received increased, the immunoglobulin A levels decreased less, meaning the immune system had been strengthened by getting the previous ones.

Occupational or Industrial Hygiene is the anticipation, recognition, evaluation, control and prevention of hazards from work that may result in injury, illness, or affect the well being of workers. These hazards or stressors are typically divided into the categories biological, chemical, physical, ergonomic and psychosocial.

A Professional Anecdotal Experience 
Imagine my surprise, as an employee of a world-class spa,  to discover some of the most pertinent examples of health illiteracy involving the guests and my health professional colleagues.

It was the lack of guest hygiene that resulted in a skin infection that lasted four months. It took that long to heal the infection, not because of a lack of effective treatment, but due to my continued exposure to unhygienic bodies. 

Some of the contributing factors to the poor state of guest hygiene involved: mouth breathing; neglect of basic health habits - resulting in a cascade effect of health complications; unhealthy habits; extreme fitness, weight-loss, detox, and supplementation behaviours; medications; surgery; disease; and often more dangerous to the therapist - the disease treatment itself; as well as poor personal hygiene. 

When a fellow employee inadvertently saw my skin infection, she cried out in alarm, asking had I been attacked by an animal? 

I witnessed a continual plague of infection among my colleagues, and when I tested their ability to resolve these health issues, not one could offer any practical knowledge or meaningful understanding. 

Thermal Comfort in the Workplace
I had to educate myself about thermal comfort after suffering through months of prolonged, extreme thermal conditions at the spa. Even though the spa is equipped with a sophisticated system, it was a lack of knowledge among the health professional employees and the guests, and an inequality of power, that had the greatest influence on the situation. 

Despite ongoing complaints from the guests, we worked in massage and aesthetic treatment rooms as hot as 30°C (86°F), with multiple sources of radiant heat, and high humidity; soaked for 36 hours a week through to our undergarments, and dripping wet on the guests. 

I do not meet individuals, health, or medical professionals that understand what health is or can identify what is unhealthy; it is uncommon knowledge. Working at a world-class spa was the most unhealthy, unsafe experience of my 40 year career as a health professional. excerpt from Massage Confidential: A Professional Memoir 

In the DO YOU KNOW? section above, you will find useful information about thermal comfort standards for health. 




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