title: Handwashing and respiratory illness among young adults in military training.
abstract: OBJECTIVE
  In response to increasing concerns about respiratory illness in military recruits, a simple handwashing program was developed and evaluated at a large Navy training center.
  
  
  METHODS
  Clinical records from 1996 through 1998 were reviewed to determine weekly rates of respiratory illness before and after program implementation (1,089,800 person-weeks reviewed). A supplemental survey was given to a sample of recruits to assess self-reported respiratory illness and compliance with the handwashing program.
  
  
  RESULTS
  A 45% reduction in total outpatient visits for respiratory illness was observed after implementation of the handwashing program. No change was noted in hospitalization rates for respiratory illness, which remained low during the observation period. Survey data supported clinical observations, as frequent handwashers self-reported fewer respiratory illness episodes when compared to infrequent handwashers. Surveys also revealed challenges with handwashing compliance.
  
  
  CONCLUSIONS
  Implementation of a handwashing program in this population of healthy young adults was associated with a marked reduction in outpatient visits for respiratory illness. Despite its success, maintenance of the handwashing program has been challenging in the time-constrained setting of military training.
authors.affiliation: Naval Health Research Center, San Diego, California 92186-5122, USA. ryan@nhrc.navy.mil
authors.forename: M A
authors.initials: MA
authors.lastname: Ryan
authors.forename: R S
authors.initials: RS
authors.lastname: Christian
authors.forename: J
authors.initials: J
authors.lastname: Wohlrabe
mesh_terms: D000328:Adult; D005260:Female; D006235:Hand Disinfection; D006801:Humans; D008297:Male; D008889:Military Personnel; D016017:Odds Ratio; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology