title: Effectiveness of alcohol-based hand disinfectants in a public administration: impact on health and work performance related to acute respiratory symptoms and diarrhoea.
abstract: BACKGROUND
  The economical impact of absenteeism and reduced productivity due to acute infectious respiratory and gastrointestinal disease is normally not in the focus of surveillance systems and may therefore be underestimated. However, large community studies in Europe and USA have shown that communicable diseases have a great impact on morbidity and lead to millions of lost days at work, school and university each year. Hand disinfection is acknowledged as key element for infection control, but its effect in open, work place settings is unclear.
  
  
  METHODS
  Our study involved a prospective, controlled, intervention-control group design to assess the epidemiological and economical impact of alcohol-based hand disinfectants use at work place. Volunteers in public administrations in the municipality of the city of Greifswald were randomized in two groups. Participants in the intervention group were provided with alcoholic hand disinfection, the control group was unchanged. Respiratory and gastrointestinal symptoms and days of work were recorded based on a monthly questionnaire over one year. On the whole, 1230 person months were evaluated.
  
  
  RESULTS
  Hand disinfection reduced the number of episodes of illness for the majority of the registered symptoms. This effect became statistically significant for common cold (OR = 0.35 [0.17 - 0.71], p = 0.003), fever (OR = 0.38 [0.14-0.99], p = 0.035) and coughing (OR = 0.45 [0.22 - 0.91], p = 0.02). Participants in the intervention group reported less days ill for most symptoms assessed, e.g. colds (2.07 vs. 2.78%, p = 0.008), fever (0.25 vs. 0.31%, p = 0.037) and cough (1.85 vs. 2.00%, p = 0.024). For diarrhoea, the odds ratio for being absent became statistically significant too (0.11 (CI 0.01 - 0.93).
  
  
  CONCLUSIONS
  Hand disinfection can easily be introduced and maintained outside clinical settings as part of the daily hand hygiene. Therefore it appears as an interesting, cost-efficient method within the scope of company health support programmes.
  
  
  BACKGROUND
  ISRCTN96340690.
authors.affiliation: Institute of Hygiene and Environmental Medicine, Walter-Rathenau-Strasse 49 A 17487 Greifswald, Germany. nhuebner@uni-greifswald.de
authors.forename: Nils-Olaf
authors.initials: NO
authors.lastname: Hübner
authors.forename: Claudia
authors.initials: C
authors.lastname: Hübner
authors.forename: Michael
authors.initials: M
authors.lastname: Wodny
authors.forename: Günter
authors.initials: G
authors.lastname: Kampf
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000438:Alcohols / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004202:Disinfectants / Q000008:administration & dosage*; D004203:Disinfection / Q000706:statistics & numerical data*; D005260:Female; D005759:Gastroenteritis / Q000517:prevention & control*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control*; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000517:prevention & control*
chemical_list: D000438:Alcohols; D004202:Disinfectants