Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis.
To quantify the effect of hand-hygiene interventions on rates of gastrointestinal and respiratory illnesses and to identify interventions that provide the greatest efficacy, we searched 4 electronic databases for hand-hygiene trials published from January 1960 through May 2007 and conducted meta-analyses to generate pooled rate ratios across interventions (N=30 studies). Improvements in hand hygiene resulted in reductions in gastrointestinal illness of 31% (95% confidence intervals [CI]=19%, 42%) and reductions in respiratory illness of 21% (95% CI=5%, 34%). The most beneficial intervention was hand-hygiene education with use of nonantibacterial soap. Use of antibacterial soap showed little added benefit compared with use of nonantibacterial soap. Hand hygiene is clearly effective against gastrointestinal and, to a lesser extent, respiratory infections. Studies examining hygiene practices during respiratory illness and interventions targeting aerosol transmission are needed.
Department of Epidemiology, Center for Social Epidemiology & Population Health, University of Michigan-School of Public Health, 3659 SPH Tower, 109 Observatory, Ann Arbor, MI 48109-2029, USA. aielloa@umich.edu
Allison E
AE
Aiello
Rebecca M
RM
Coulborn
Vanessa
V
Perez
Elaine L
EL
Larson
D003140:Communicable Disease Control / Q000379:methods; D003141:Communicable Diseases / Q000635:transmission; D017714:Community-Acquired Infections / Q000517:prevention & control; D016206:Databases, Bibliographic; D005767:Gastrointestinal Diseases / Q000517:prevention & control*; D006235:Hand Disinfection / Q000379:methods* / Q000592:standards; D006801:Humans; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D018570:Risk Assessment; D017592:Skin Care / Q000379:methods* / Q000592:standards; D013501:Surface-Active Agents
D013501:Surface-Active Agents