The Cleanliness Conundrum

What is going on here?  Over the last century plus, people in “civilized countries”, especially those who live in cities, have improved their hygiene to the point that many people have very limited exposure to germs at all.

Then why are the numbers of people with certain diseases on the increase?

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After the onset of the industrial revolution, public health officials increasingly instigated measures to protect the health of the average citizen.  “These measures comprised decontamination of the water supply, pasteurization and sterilization of milk and other food products, respect of the cold chain procedure, vaccination against common childhood infections and the wide use of antibiotics.”

This was a good thing.

Well, there is a well-recognized phenomenon that, as far as I know, has been given no name.  Basically, some people have the idea that, “If a little is good, more is better.”

Over the years, store shelves have gradually filled more and more with disinfectant wipes, hand sanitizers, etc.  Advertizing professes that these products offer protection from infectious diseases.

And that is true…up to a point.

As people bought-in to the idea that all germs were bad, the incidence of germophobia grew.  With the increased availability of disinfectants and their advertisement, more and people fed-in to the belief that they needed to protect themselves and their children from exposure to germs…all germs.

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In the latter half of the 20^th century, something happened that added to this…the invention of video games, creation of the internet, and the increase of television channels.

When I was a youngster, we had no video games, no internet, and only two television channels.  There were just not that many choices for things to do inside.  If you didn’t want to watch what was on one of those two channels, you could read a book or go outside and play.

By the time I was in high school, Cablevision had come to town.  Cablevision brought more channels.  By the time I attended college there were dozens of channels, offering more and more options to going outside.

Now there are satellite television services and hundreds of channels.  Add the availability of internet and the rabbit hole of adventure it offers, including ordering the home delivery of food and services, and there is no need to go outside…unless you just want to.

In grade school I knew only one boy with asthma, and diseases like allergic rhinitis and atopic dermatitis were practically unheard of.  According to the same study I quoted earlier, “In 1998, about one in five children in industrialized countries suffered from allergic diseases such as asthma, allergic rhinitis or atopic dermatitis. This proportion has tended to increase over the last 10 years, asthma becoming an ‘epidemic’ phenomenon.

“The incidence of inflammatory bowel diseases (IBD), such as Crohn’s disease or ulcerative colitis and primary biliary cirrhosis (an inflammatory disease of the bile ducts.  Sufferers have about a ten year life expectancy.) is also rising.”

The occurrence of these diseases and others has continued to increase in the intervening years.  Interestingly, the number of sufferers of these diseases has not increased nearly as much in less-developed countries, where access to disinfectants has not grown as much.  Likewise, television and internet are not as available so people get outside more than in more developed countries.

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Health care professionals began to notice some interesting studies about immunity, exposure, and the incidence of disease.  One study found that children, especially younger siblings, from large families have a lower incidence of allergies, asthma, etc.  Another study found that people living in the country, especially those who work with livestock, have a lower incidence of many diseases.  The same thing was found for children who attend daycare.  Same for pet owners.

Need I point out that those people should be the ones who are more exposed to germs and should thus be more sick?

In 1989, David Strachan came up with what he called, “the hygiene hypothesis”. He proposed that the rising incidence of allergic disease, such as asthma and allergies, was actually linked to reduced exposure to germs through declining family sizes, more limited exposure to animals, and higher general standards of cleanliness. Strachan thought that repeated exposure to microbes at an early age, for example as a result of having siblings, owning a pet, living on a farm, or attending day care, stimulate our immune systems to adapt so they would not overreact to routine environmental stimuli, such as potential allergens.

This does not suggest that parents should send their children out to play in the sewer or run across the street to wrestle with the kid whose family is in the throes of COVID 19.  Rather, it would seem to indicate that kids need to play with other healthy children, and doing so outside should be encouraged.  Playing with pets is generally good for children too.

I wish I had known, when Mom got onto me for having enough dirt in my ears to start a potato patch, I could have simply said, “But, Mom, I’m just building up my immunity!”

Oh, and bath time is not off the schedule either.

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Note: Obviously, these recommendations are for normal, healthy children and not those with immune systems that are compromised due to disease or genetics.   Also, this is not intended to encourage anyone to avoid accepted precautions to prevent the spread of the current COVID epidemic.  Also, you should follow the recommendations of your health care professionals.

Otherwise, send your kids out to play in the dirt!

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