Hygiene and health - the need for a holistic approach

The holistic principles of hygiene and public health have contributed subst antially to an increase in life expectancy by more than 30 years and in lif e quality since the beginning of the 20th century. Frank, Pettenkofer, Nigh tingale, Pasteur, Lister, and Koch have been pioneering protagonists of the holistic approach to hygiene and public health. Socioeconomic development and related factors such as nutrition status and food hygiene, housing cond itions, water supply and sewage systems, and education (including motivatio n for personal hygiene) have obviously been of more importance for life exp ectancy and life quality than progress in curative medicine. Such as availa bility of microbial diagnosis. vaccination. and antibiotics. Today, new ris k factors for infectious diseases arise, even in developed countries. These risk factors arise from emerging pathogens, antibiotic-resistant microorga nisms, changing demographic patterns, an increasing amount of ambulatory an d home care. Socioeconomic and environmental changes, technical environment s. worldwide distribution of food, and changing human behavior with a decre ased awareness of microbial threats. These new challenges worldwide make a renewal of the holistic approach of hygiene and public health both urgent a nd necessary. On the basis of historic experience, policies that focus on s urveillance and control, diagnosis, and therapy only can be assumed to be b oth insufficient and inefficient in controlling the new challenges in infec tious diseases. Experiences in Germany with a holistic hospital hygiene str ategy since 1976 provide encouragement for the promotion of holistic health concepts. Risk assessment, risk management. and risk communication are bas ic steps of a modern holistic strategy. Hygiene has the potential to act as a moderator of diverging positions of different disciplines within this re newed approach.