Hand hygiene and your home
Most infections spread by hand. That is why good hand hygiene is the simplest and most effective way to protect yourself during leukemia treatment. This topic explains how and when to wash your hands, how to keep your home safe, and what to watch out for with pets, plants, building work and personal hygiene.
01Short answer
02Simple explanation
During the day our hands touch door handles, phones, money and tables, and pick up germs. These germs can then pass to the eyes, nose, mouth, food or a catheter. Clean hands break this chain.
Soap does not so much kill germs as “lift” them off the skin, and water rinses them away. That is why time and technique matter: about 20 seconds — roughly singing “Happy Birthday” twice — rubbing every part of the hands.
When you leave the house, always carry a small alcohol hand rub. It is handy when there is no soap and water. But if your hands are visibly dirty, or certain germs are suspected (for example some that cause diarrhea), soap and water are better.
Your home is your safe base. It does not need to be sterile — that is impossible anyway. It is enough for it to be clean and well aired, with frequently touched places wiped regularly and family members who are ill keeping their distance where possible.
Some jobs should be handed to someone else during neutropenia: emptying the cat’s litter tray, cleaning a bird cage or aquarium, working with soil and fertiliser, and building work or dusty jobs. This does not mean giving up things you love — just being careful during the most vulnerable period.
03Scientific explanation
Hand hygiene is regarded as the main measure for preventing infection in healthcare. Using the WHO technique, washing with soap takes about 40–60 seconds in total and an alcohol hand rub 20–30 seconds; the CDC advises rubbing hands with soap for at least 20 seconds at home. Alcohol hand rubs should contain at least 60% alcohol. They work against many bacteria and viruses but are weaker against Clostridioides difficile spores, norovirus and some parasites — in those situations soap and water are preferred.
The home environment: regularly cleaning frequently touched surfaces (door handles, light switches, remote controls, phones, taps and the toilet) with an ordinary cleaner is enough; bleach and disinfectants are used according to the manufacturer’s instructions and with good ventilation. Humidifiers and air conditioners need regular cleaning, because germs and mould can grow in moisture. If there are patches of mould at home, someone else should clean them.
Fungal spores: moulds such as Aspergillus are common in soil, rotting plants and building or renovation dust. In people with prolonged deep neutropenia (for example, during induction treatment for acute leukemia or after a transplant), breathing in spores can cause a serious lung infection. That is why during this period it is advised to keep away from soil, compost, hay, renovation dust and building sites; some centres also restrict fresh flowers and potted plants on the ward.
Pets are valuable for emotional support and can usually be kept. But cat faeces (toxoplasma), bird droppings, reptiles and amphibians (salmonella) and aquarium water (mycobacteria) are sources of risk. The CDC advises people with weakened immune systems to avoid direct contact with rodents, reptiles, amphibians and backyard poultry, and to wash their hands after contact with other animals.
04What happens in the body?
When should you seek urgent help?
Infection can happen despite good hand and home hygiene. Call straight away if: your temperature is 38 °C or higher; there is redness, swelling, pain or discharge around your catheter; you have had an animal bite or a deep scratch (especially during neutropenia); redness is spreading quickly on your skin, or a wound or pus appears; you develop diarrhea, vomiting or painful mouth sores.
How to wash your hands properly
Wet your hands under running water → apply soap → rub palm to palm → rub the back of each hand with the other palm, fingers interlaced → between the fingers → the backs of the fingers → the thumbs with a rotating movement → the fingertips and nails against the palm → the wrists → rinse well → dry with a clean personal towel or a paper towel → turn off the tap with the towel if you can. The whole process, including about 20 seconds of rubbing, takes 40–60 seconds.
What to pay attention to at home
Wipe frequently touched surfaces regularly. Everyone should have their own towel, toothbrush and cup. Wash bedding and towels regularly in hot water. Air the room. Family members who are ill should stay in a separate room and wear a mask where possible. Keep the fridge and kitchen clean. Deal with mould and damp. Plan any building work before or after treatment if you can.
Pets, plants and gardening
You can keep your pet, but: have someone else clean the litter tray, bird cage and aquarium; do not let the animal lick you, especially your face or any wounds; keep your pet’s vaccinations and vet checks up to date; do not get a new animal, especially a young one, during treatment. If you work with soil, wear gloves and wash your hands afterwards; during neutropenia avoid gardening and compost.
Personal hygiene: mouth, skin, catheter
Brush your teeth several times a day with a soft toothbrush and use an alcohol-free mouthwash. Shower daily, moisturise your skin and protect it from cracks. Use an electric razor for shaving. Take care when cutting nails and do not cut the skin around them. Touch your catheter only with clean hands and follow the care instructions. Avoid tampons, rectal thermometers and suppositories.
Questions you can ask your doctor
What extra restrictions do I need at home during my neutropenia? Can I keep my pet, and what should I watch out for? Can we do building work at home? Can I garden, and when? How should I care for my catheter? Which mouthwash suits me? Which rules matter most for my family?
05Breaking the chain of germs
Germs usually spread in a few steps. The chain can be broken at every step.
06Everyday jobs at home: what is fine and what to watch
| Activity | During neutropenia | Advice |
|---|---|---|
| Cleaning a cat litter tray | Do not do it | Someone else should do it; if impossible — gloves, a mask and hand washing |
| Bird cage, aquarium | Do not do it | Someone else should clean them |
| Gardening, soil, compost | Avoid | Later — with gloves and hand washing |
| Building work, dust, construction | Keep away | Plan before or after treatment if possible |
| Housework | Light cleaning is fine | Hand over mould, rubbish and dusty jobs to others |
| Kitchen work | Fine | Follow food safety rules |
| Fresh flowers and potted plants | Ask your team | Someone else should change the water; some centres restrict them |
* This table is general information. Your hematology team decides which restrictions you need.
07Key terms
- Hand hygiene
- Washing hands with soap and water or cleaning them with an alcohol hand rub.
- Alcohol hand rub
- A hand cleaner containing at least 60% alcohol.
- Frequently touched surfaces
- Door handles, light switches, phones, taps and other places everyone touches.
- Aspergillus
- A mould common in soil, dust and rotting plants.
- Toxoplasmosis
- A parasitic infection that can spread through cat faeces or raw meat.
- Salmonella
- A bacterium spread by reptiles, birds and raw food.
- Catheter
- A tube in a vein for medicines and blood tests; a place vulnerable to infection.
- Mucositis
- Damage to the lining of the mouth; mouth care is especially important.
- Zoonosis
- An infection that passes from animals to people.
- Neutropenia
- A fall in neutrophils; the main reason for vulnerability to infection.
08Key points
- Hand hygiene is the simplest and most effective protection.
- Rub your hands with soap for at least 20 seconds.
- A hand rub should contain at least 60% alcohol.
- Family and visitors should wash their hands too.
- Your home does not need to be sterile, just clean.
- Someone else should clean litter trays, cages and aquariums.
- During neutropenia, keep away from soil and building dust.
- Your hematology team will tell you about specific restrictions.
09Frequently asked questions
Is antibacterial soap better than ordinary soap?
For home use, antibacterial soap has not been shown to be better than ordinary soap. What matters is good technique and enough time.
My hands get dry and cracked from frequent washing. What can I do?
Use an unscented moisturiser, especially in the evening. Cracks can become doors for germs, so protecting your skin matters. If cracks are painful or red, tell your team.
Do I need to disinfect everything at home?
No. Ordinary cleaning and regularly wiping frequently touched surfaces are enough. Too many chemicals can irritate the airways. Air your home well.
I have a cat. Do I need to give it away?
Usually not. Just have someone else clean the litter tray, do not let the cat scratch or bite you, do not feed it raw meat and try to keep it indoors. Wash any scratches or bites straight away and tell your team.
We had planned building work. Should we postpone it?
Major building work and dusty jobs are risky because of fungal spores, especially during neutropenia. Plan them before or after treatment if possible. If the work cannot be avoided, discuss with your team whether to stay somewhere else while it is done.
Should family members wear masks at home?
Healthy family members usually do not need to wear a mask at home all the time. But if they have a cough, a runny nose or a fever, wearing a mask, washing their hands often and keeping their distance are important.
10Questions for your doctor
Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.
Which hygiene rules at home matter most?
What should I be careful about with my pets?
What should we do when someone in the family gets ill?
Which household tasks should I hand over to others for now?
12Sources
- World Health Organization (WHO). World Hand Hygiene Day
- World Health Organization (WHO). Hand hygiene
- Centers for Disease Control and Prevention (CDC). Hand Sanitizer Guidelines and Recommendations
- NHS. How to wash your hands
- Centers for Disease Control and Prevention (CDC). Preventing Infections in Cancer Patients
- Centers for Disease Control and Prevention (CDC). Information for Patients Who Are Getting Chemotherapy
- American Cancer Society. Preventing Infections in People with Cancer
- Blood Cancer UK. Preventing infection
- Centers for Disease Control and Prevention (CDC). People at Increased Risk for Illness from Animals
- MedlinePlus (U.S. National Library of Medicine). Pets and the immunocompromised person
- Centers for Disease Control and Prevention (CDC). Aspergillosis Basics
- Macmillan Cancer Support. Infection