Hygiene is a word we are coming across increasingly frequently – whether in relation to infection prevention or in other areas such as sleep hygiene or mental hygiene. But what do we actually understand by hygiene and who decides what is hygienic? Hygiene is often used as a synonym for cleanliness – but this definition does not go far enough. The word hygiene is derived from the Ancient Greek word ὑγιεινή, which roughly translated means ‘art that serves health’. This definition still applies today: All hygiene measures are designed to maintain and improve health. The German government’s healthcare reporting provides a more detailed definition of hygiene “The entirety of all efforts and measures aimed at preventing diseases and damage to health”.
Soap, disinfectant, clean tap water and safe foods: High hygiene standards are now something we take for granted. But what were things like before? In the past, hygiene was not always so strict. The Romans introduced basic hygiene rules in the first century BC and used quarantine to try to control infections. However, there are also some dark chapters in the history of hygiene. Viewed from our current perspective, there were some significant failings in hygiene in the Middle Ages in Europe – in particular, with regard to cleanliness in public areas. Sewage and waste systems were still unknown, people lived alongside animals in very cramped spaces, refuse and faeces were simply channelled into rivers, with this water then used for personal hygiene. As well as resulting in extremely unpleasant odours in cities, this also regularly led to the spread of infections such as plague or cholera.
Even in the early 19th century, compared with our current standards, hygiene conditions in medicine were appalling: Doctors’ clothing and medical equipment were not cleaned or disinfected, women frequently died from childbed fever because practically no doctors washed their hands before assisting at a birth, thus allowing transmission of pathogens. However, various pioneers revolutionised hygiene: Ignaz Semmelweis proved the effectiveness of disinfection in combating disease. In 1865, Max von Pettenkofer held the first German chair for hygiene and researchers such as Robert Koch, Johann Peter Frank and Franz Ballner laid the foundations for modern hygiene. From the middle of the 19th century, governments also began to introduce public healthcare systems, with improved hygiene in cities and technical achievements such as water purification and sewage systems.
Difference between personal and public hygiene
Today, a distinction is often made between personal and public hygiene. Personal hygiene is each individual’s own responsibility and includes aspects such as body hygiene and oral hygiene – i.e., showering, washing hair and brushing teeth. It also encompasses cleaning and cleanliness in the home – for example, washing laundry, wiping floors and vacuum-cleaning. Public hygiene, on the other hand, involves all measures used by governments to protect and maintain citizens’ health. As well as medical institutions and medical care, this also includes supplies of hygienic, safe foods, clean tap water, organised town cleaning and, of course, appropriate sewage systems and purification plants.
Thanks to great advances in infection protection measures and medical innovations such as vaccines and antibiotics, we now enjoy high hygiene standards and far improved public health. However, hygiene in public places is still an important issue. It affects a wide range of areas, including:
- Hygiene in public toilets, for example at train stations or in administration buildings, hygiene in public buildings such as churches, department stores and leisure facilities, hygiene in education establishments such as nursery schools, schools or universities, hygiene in all healthcare facilities such as clinics and hospitals
Hygiene and disinfection in hospitals is a very important issue – according to experts, up to 15,000 people a year die as a result of hospital-acquired infections. This illustrates the vital importance of hygiene procedures, even in our modern age. The coronavirus pandemic has also shown us that hygiene is not something that can be governed by law. In public settings, everyone must play their part in complying with hygiene rules – for example, through social distancing, regular hand washing and sneezing into the crook of their elbow rather than their hand.