Hygiene: What Is It and Where Does It Need to Go?
There are different approaches to hygiene that impact the development of allergies.
Hygiene is "conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness."
Interestingly, not everyone shares the same vision of proper hygiene.
Modern-day hygiene
Modern-day hygiene focuses on sterilization and removing microbes irrespective of their roles.59 This approach to hygiene has only gotten more extreme with the COVID-19 pandemic.
The Good:
- Prevents exposure to pathogens: Pathogenic organisms such as RSV are associated with an increased risk of asthma.18
The Bad:
- Prevents exposure to healthy microbes: Exposure to healthy microbes helps to repopulate and sustain diversity in the microbiome, which is a critical factor in preventing allergies.
The "Hygiene Hypothesis"
In 1989, David Strachan, a medical researcher, reported observations of a relationship between a decline in microbial exposure and rises in allergies. These findings led to a hygiene hypothesis, which emphasizes the effect of microbes in educating an infant's immune system.60
Further studies have shown that farm children and larger families have a much lower incidence of allergies, presumably caused by higher and more diverse microbial exposure. (61, 62, 63)
The Good:
- Promotes exposure to healthy microbes
The Bad:
- Promotes exposure to pathogens: Is associated with the idea that "humans have become too clean," which often leads to the archaic practice of seeking out microbial exposure of any kind.64
Targeted hygiene: the best of both worlds
Targeted hygiene is a risk assessment approach to hygiene where one maximizes their protection against pathogens while allowing the spread of healthy microbes. (64, 65)
The Good:
- Promotes exposure to healthy microbes
- Prevents exposure to pathogens
The Bad:
- Requires risk assessment which is prone to human error