Impact of COVID-19 Pandemic on Hand Washing Process and Water Consumption

Authors: Kaywan Othman Ahmed1 & Shuokr Qarani Aziz2 & Dara Muhammad Hawez3 & Zhir Latif Sabir4
1Department of Civil Engineering, Faculty of Engineering, Tishk International University, Sulaimani, Iraq
2Department of Civil Engineering, College of Engineering, Salahaddin University, Erbil, Iraq
3Department of Civil Engineering, Faculty of Engineering, Koya University, Koya, Iraq
4Independent Researcher

Abstract: World Health Organization suggested many ways to protect from coronavirus disease 2019 (COVID-19), such as maintaining a safe distance from others, wearing a mask, avoiding touching eyes, nose, or mouth, staying at home, cleaning/washing hands often, and using soap and water or an alcohol-based hand rub. Thus, water and alcohol-based handwashing were frequently used since the pandemic. Therefore, this research aimed to compare the amount of water used before and during COVID-19. Similarly, using the alcohol-based cleaning will be evaluated during the COVID-19 and before that. Several questions were prepared and sent to the participants using technology. This study found that the number of handwashing and the duration of the washing hand increased by 85.34% and 101.92% respectively, which means water used for handwashing was doubled after the spread of the coronavirus. Correspondingly, clean and sanitizers like gel and alcohol were used more as well.

Keywords: COVID-19, Detergents, Disinfectants, Handwashing, Sanitizers, Water Consumption

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doi: 10.23918/eajse.v7i1p228


Ahmad, A. R., & Murad, H. R. (2020). The Impact of Social Media on Panic During the COVID-19 Pandemic in Iraqi Kurdistan: Online Questionnaire Study. Journal of Medical Internet Research, 22(5), e19556-e19556. doi:10.2196/19556

Ahmed, W., Angel, N., Edson, J., Bibby, K., Bivins, A., O’Brien, J. W., Choi, P. M., Kitajima, M., Simpson, S. L., & Li, J. (2020). First confirmed detection of SARS-CoV-2 in untreated wastewater in Australia: A proof of concept for the wastewater surveillance of COVID-19 in the community. Science of The Total Environment, 728, 138764. doi:

Aiello, A. E., Perez, V., Coulborn, R. M., Davis, B. M., Uddin, M., & Monto, A. S. (2012). Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial. PLOS ONE, 7(1), e29744. doi:10.1371/journal.pone.0029744

Al-Masri, R. A. (2020). Coronavirus: what might more hand washing mean in countries with water shortages? The Conversation.

Al‐Tawfiq, J. A., & Memish, Z. A. (2017). Religion and Hand Hygiene. In D. Pittet, J. M. Boyce, & B. Allegranzi (Eds.), Hand Hygiene: A Handbook for Medical Professionals (First Edition ed., pp. 216-220). Massachusetts: John Wiley & Sons.

Aledort, J. E., Lurie, N., Wasserman, J., & Bozzette, S. A. (2007). Non-pharmaceutical public health interventions for pandemic influenza: an evaluation of the evidence base. BMC Public Health, 7(1), 208. doi:10.1186/1471-2458-7-208

Asare, A., Enweronu-Laryea, C. C., & Newman, M. J. (2009). Hand hygiene practices in a neonatal intensive care unit in Ghana. Journal of Infection in Developing Countries, 3(5), 352-356. doi:

Aziz, S. Q. (2020). Potential impact of COVID-19 pandemic lockdown on environmental parameters. Recycling and Sustainable Development, 13, 49-61. doi:doi: 10.5937/ror2001049A

Bae, S., Kim, M.-C., Kim, J. Y., Cha, H.-H., Lim, J. S., Jung, J., Kim, M.-J., Oh, D. K., Lee, M.-K., Choi, S. H. (2020). Effectiveness of Surgical and Cotton Masks in Blocking SARS-CoV-2: A Controlled Comparison in 4 Patients. Ann Intern Med, 173(1), W22-W23. doi:10.7326/M20-1342

Bartram, J., & Cairncross, S. (2010). Hygiene, Sanitation, and Water: Forgotten Foundations of Health. PLOS Medicine, 7(11), e1000367. doi:10.1371/journal.pmed.1000367

Beale, S., Johnson, A., Zambon, M., null, n., Hayward, A., & Fragaszy, E. (2020). Hand Hygiene Practices and the Risk of Human Coronavirus Infections in a UK Community Cohort [version 1; peer review: 1 approved, 1 approved with reservations]. Wellcome Open Research, 5(98). doi:10.12688/wellcomeopenres.15796.1

Berardi, A., Perinelli, D. R., Merchant, H. A., Bisharat, L., Basheti, I. A., Bonacucina, G., Cespi, M., & Palmieri, G. F. (2020). Hand sanitisers amid CoViD-19: A critical review of alcohol-based products on the market and formulation approaches to respond to increasing demand. International Journal of Pharmaceutics, 584, 119431. doi:

Biran, A., Schmidt, W.-P., Zeleke, L., Emukule, H., Khay, H., Parker, J., & Peprah, D. (2012). Hygiene and sanitation practices amongst residents of three long-term refugee camps in Thailand, Ethiopia and Kenya. Tropical Medicine and International Health, 17(9), 1133-1141. doi:10.1111/j.1365-3156.2012.03045.x

Brauer, M., Zhao, J. T., Bennitt, F. B., & Stanaway, J. D. (2020). Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries. Environmental Health Perspectives, 128(5), 057005. doi:doi:10.1289/EHP7200

CDC. (2020a). Frequent Questions About Hand Hygiene. Handwashing: Clean Hands Save Lives. Retrieved from

CDC. (2020b). When and How to Wash Your Hands. Handwashing in Community Settings. Retrieved from

Chen, X., Ran, L., Liu, Q., Hu, Q., Du, X., & Tan, X. (2020). Hand Hygiene, Mask-Wearing Behaviors and Its Associated Factors during the COVID-19 Epidemic: A Cross-Sectional Study among Primary School Students in Wuhan, China. 17(8), 2893.

Connolly, M. A., Gayer, M., Ryan, M. J., Salama, P., Spiegel, P., & Heymann, D. L. (2004). Communicable diseases in complex emergencies: impact and challenges. The Lancet, 364(9449), 1974-1983. doi:10.1016/S0140-6736(04)17481-3

Curtis, V. A., & Cairncross, S. (2003). Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. The Lancet Infectious Diseases, 3(5), 275-281. doi:

Curtis, V. A., Danquah, L. O., & Aunger, R. V. (2009). Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res, 24(4), 655-673. doi:10.1093/her/cyp002

Doebbeling, B. N., Pfaller, M. A., Houston, A. K., & Wenzel, R. P. (1988). Removal of nosocomial pathogens from the contaminated glove. Implications for glove reuse and handwashing. Ann Intern Med, 109(5), 394-398. doi:10.7326/0003-4819-109-5-394

Elizabeth, G. (1999). How to handwash. Nursing & Residential Care, 1(2), 123–125. doi:

Feldman, H. (1969). Learning transfer from programmed instruction to clinical performance. Nurs Res, 18(1), 51-54. doi:

Fleming, A. (2020). Keep it clean: The surprising 130-year history of handwashing. Coronavirus outbreak. Retrieved from

Freeman, M. C., Stocks, M. E., Cumming, O., Jeandron, A., Higgins, J. P. T., Wolf, J., Prüss-Ustün, A., Bonjour, S., Hunter, P. R.,

Fewtrell, L. (2014). Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Tropical Medicine & International Health, 19(8), 906-916. doi:10.1111/tmi.12339

Garner, J. S., & Favero, M. S. (1986). Guideline for handwashing and hospital environmental control, 1985 supersedes guideline for hospital environmental control published in 1981. Am J Infect Control, 14(3), 110-126. doi:

Grayson, M. L., Melvani, S., Druce, J., Barr, I. G., Ballard, S. A., Johnson, P. D. R., Mastorakos, T., & Birch, C. (2009). Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers. Clinical
Infectious Diseases, 48(3), 285-291. doi:10.1086/595845 %J Clinical Infectious Diseases

Hashim, B. M., Al-Naseri, S. K., Al-Maliki, A., & Al-Ansari, N. (2021). Impact of COVID-19 lockdown on NO2, O3, PM2.5 and PM10 concentrations and assessing air quality changes in Baghdad, Iraq. Science of The Total Environment, 754, 141978. doi:

Hsieh, H. F., Chiu, H. H., & Lee, F. P. (2006). Surgical hand scrubs in relation to microbial counts: systematic literature review. J Adv Nurs, 55(1), 68-78. doi:10.1111/j.1365-2648.2006.03876.x

Ibarra-Vega, D. (2020). Lockdown, one, two, none, or smart. Modeling containing covid-19 infection. A conceptual model. Science of The Total Environment, 730, 138917. doi:

Jeffcott, S. A., Evans, S. M., Cameron, P. A., Chin, G. S., & Ibrahim, J. E. (2009). Improving measurement in clinical handover. BMJ Quality & Safety, 18(4), 272-277. doi:10.1136/qshc.2007.024570

Jefferson, T., Del Mar, C., Dooley, L., Ferroni, E., Al-Ansary, L. A., Bawazeer, G. A., van Driel, M. L., Foxlee, R., & Rivetti, A. (2009). Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. Bmj, 339, b3675. doi:10.1136/bmj.b3675

Jenn, N. C. (2006). Designing A Questionnaire. Malaysian family Physician: The official Journal of the Academy of Family Physicians of Malaysia, 1(1), 32-35.

Karabey, S., Ay, P., Derbentli, S., Nakipoglu, Y., & Esen, F. (2002). Handwashing frequencies in an intensive care unit. Journal of Hospital Infection, 50(1), 36-41. doi:

Khoshnaw, S. H. A., Shahzad, M., Ali, M., & Sultan, F. (2020). A quantitative and qualitative analysis of the COVID–19 pandemic model. Chaos, Solitons & Fractals, 138, 109932. doi:

Kouadio, I. K., Aljunid, S., Kamigaki, T., Hammad, K., & Oshitani, H. (2012). Infectious diseases following natural disasters: prevention and control measures. Expert Rev Anti Infect Ther, 10(1), 95-104. doi:10.1586/eri.11.155
Kurdistan Regions Statistics office. (2020). The Measurement. Retrieved from

Larson, E., & Killien, M. (1982). Factors influencing handwashing behavior of patient care personnel. Am J Infect Control, 10(3), 93-99. doi:

Larson, E. L. (1995). APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control, 23(4), 251-269. doi:10.1016/0196-6553(95)90070-5

Lin, Y.-H., Liu, C.-H., & Chiu, Y.C. (2020). Google searches for the keywords of “wash hands” predict the speed of national spread of COVID-19 outbreak among 21 countries. Brain, behavior, and immunity, 87, 30-32. doi:10.1016/j.bbi.2020.04.020

Luby, S. P., Agboatwalla, M., Feikin, D. R., Painter, J., Billhimer, W., Altaf, A., & Hoekstra, R. M. (2005). Effect of handwashing on child health: a randomised controlled trial. The Lancet, 366(9481), 225-233. doi:10.1016/s0140-6736(05)66912-7

Marvin, J. (2019). Do you realise how much water you waste when washing your hands? Retrieved from

Meers, P. D., & Yeo, G. A. (1978). Shedding of bacteria and skin squames after handwashing. The Journal of Hygiene, 81(1), 99-105. doi:10.1017/s0022172400053808

Nazliansyah, N., Wichaikull, S., & Wetasin, K. (2016). Factors Affecting Hand Washing Practice Among Elementary Schools Students in Indonesia. 2016, 2(4), 7.

Park, J. H., Cheong, H. K., Son, D. Y., Kim, S. U., & Ha, C. M. (2010). Perceptions and behaviors related to hand hygiene for the prevention of H1N1 influenza transmission among Korean university students during the peak pandemic period. BMC Infect Dis, 10, 222. doi:10.1186/1471-2334-10-222

Parker-Pope, T., O’Neill, S., Kessel, J., & DeSantis, A. (2020). How to Wash Your Hands. The Coronavirus Outbreaks. Retrieved from

Patel, H. R., & Joseph, J. M. (2016). Questionnaire Designing Process: A Review. Journal of Clinical Trials, 6(2), 1-7. doi:DOI: 10.4172/2167-0870.1000255

Pittet, D., Allegranzi, B., Storr, J., Nejad, S. B., Dziekan, G., Leotsakos, A., & Donaldson, L. (2008). Infection control as a major World Health Organization priority for developing countries. Journal of Hospital Infection, 68(4), 285-292. doi:

Preston, G. A., Larson, E. L., & Stamm, W. E. (1981). The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. The American Journal of Medicine, 70(3), 641-645. doi:

Rana, M., Sayem, A., Karim, R., Islam, N., Islam, R., Zaman, T. K., & Hossain, G. (2015). Assessment of knowledge regarding tuberculosis among non-medical university students in Bangladesh: a cross-sectional study. BMC Public Health, 15(1), 716. doi:10.1186/s12889-015-2071-0

Ray, I. (2020). Viewpoint – Handwashing and COVID-19: Simple, right there…? World Development, 135, 105086. doi:

Rennie-Meyer, K. (2007). Preventing the spread of infection. In Foundations of Nursing Practice: Fundamentals of Holistic Care (pp. 391-423). Edinburgh Elsevier Mosby.

Rohilla, S. K. (2020). COVID-19 outbreak: More hand washing can increase India’s water woes. Down To Earth.

Rose-Innes, O. (2017, 07-02-2018). SEE: How much water do you use per day? Environmental Health. Retrieved from

Ryan, M. A. K., Christian, R. S., & Wohlrabe, J. (2001). Handwashing and respiratory illness among young adults in military training1 1The full text of this article is available via AJPM Online at American Journal of Preventive Medicine, 21(2), 79-83. doi:

Sackey, A. H. (2019). Conservation of Water During Handwashing. SN Comprehensive Clinical Medicine, 1(1), 47-48. doi:10.1007/s42399-018-0015-6

Sayeed, A., Ahmed, F., Tariq, M. R., Rahman, F., Joy, M. T. I., Abid, M. T., & Rahman, M. H. (2020). Water Loss During the Handwashing During Covid-19 Pandemic in Bangladesh. Retrieved from

Smith, S. M. (2009). A review of hand-washing techniques in primary care and community settings. J Clin Nurs, 18(6), 786-790. doi:10.1111/j.1365-2702.2008.02546.x

Soesanto, D. (2018). The influence of nurse’s knowledge level on behaviour changes, attitude and 5 moments of hand hygiene compliance. Indian Journal of Public Health Research & Development, 9(11), 6. doi:10.5958/0976-5506.2018.01708.4

Timby, B. K. (2009). Fundamental nursing skills and concepts (9th ed ed.). Philadelphia: Wolters Kluwer Health.

UNICEF. (2020). Washing your hands can protect you and your loved ones. Everything you need to know about washing your hands to protect against coronavirus (COVID-19). Retrieved from

Wadood, M. A., Mamun, A., Rafi, M. A., Islam, M. k., Mohd, S., Lee Lee, L., & Hossain, M. G. (2020). Knowledge, attitude, practice and perception regarding COVID-19 among students in Bangladesh: Survey in Rajshahi University. Retrieved from

Ward, D. (2000). Handwashing facilities in the clinical area: a literature review. British Journal of Nursing, 9(2), 82-86. doi:10.12968/bjon.2000.9.2.6396

WHO. (2009). WHO Guidelines on Hand Hygiene in Health Care. Geneva: WHO Library Cataloguing-in-Publication Data.

WHO. (2020a). Coronavirus disease (COVID-19) advice for the public. Diseases. Retrieved from

WHO. (2020b). Hand Hygiene in the Community. Who save lives: clean your hands in the context of covid-19. Retrieved from

WHO. (2020c, 30 January 2020). Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Retrieved from

Zimakoff, J., Kjelsberg, A. B., Larsen, S. O., & Holstein, B. (1992). A multicenter questionnaire investigation of attitudes toward hand hygiene, assessed by the staff in fifteen hospitals in Denmark and Norway. Am J Infect Control, 20(2), 58-64. doi:10.1016/s0196-6553(05)80002-1