Allison E. Aiello, PhD, MS, Assistant Professor of Epidemiology, University of Michigan School of Public Health, Center for Social Epidemiology and Population Health, Ann Arbor
Recorded at 9th annual Evidence Based Practice, sponsored by the University of Michigan Health System, Saint Joseph Mercy Health System, and Department of Veterans Affairs Health Center, and held March 16, 2007 in Ann Arbor, MI
Hand Hygiene in the Community
A variety of products are marketed for personal hygiene and preventing cross-contamination in the community setting (eg, households, restaurants, and daycare centers). These products include antiseptic hand washes (active ingredients include triclosan and triclocarban), antiseptic body washes (also with triclosan or triclocarban), and consumer hand sanitizers (alcohol or benzalkonium chloride).
What are the Benefits?
To assess the benefits of hand hygiene in the community setting, a large, comprehensive literature review was performed. It began with a PubMed search of journal articles published between 1980 and 2006. The interventions of interest were hand-hygiene education and the use of regular soap, antibacterial soap, or waterless hand sanitizers. A keyword search was conducted, using various keywords and combinations associated with hygiene, infection, soap, and hand washing in the community setting (241 search combinations were used).
To be included in the meta-analysis, studies had to include an outcome of gastrointestinal (GI) illness or upper respiratory infections (URIs).
Risk Reduction: GI Illnesses
The following are the relative reductions in risk associated with each intervention:
- Alcohol plus education: -23.6%
- Benzalkonium chloride: -42%
- Education alone: -30%
- Plain soap: -39%
Risk Reduction: URIs
Hand-hygiene interventions don't seem to be as effective against URIs as against GI infections. The following are the relative reductions in risk for each intervention:
- Alcohol plus education: -7%;
- Benzalkonium chloride: -39.9% (significant)
- Education alone: -14.5%
- Plain soap: (no published studies compared plain soap to no intervention)
Increasingly the most popular Benzalkonium Chloride-based product