title: Hand Hygiene Program Decreases School Absenteeism Due to Upper Respiratory Infections.
abstract: We assessed the effectiveness of a handwashing program using hand sanitizer to prevent school absenteeism due to upper respiratory infections (URIs).
  
  
  
  This was a randomized, controlled, and open study on a sample of 1341 children 4-12 years old, attending 5 state schools in Almería (Spain), with an 8-month follow-up. The experimental group (EG) washed their hands with soap and water, together with using hand sanitizer, and the control group followed their usual handwashing procedures. Absenteeism rates due to URIs were compared between the 2 groups through a multivariate Poisson regression analysis. The percent of days missed in both groups were compared with a z test.
  
  
  
  Overall, 1271 cases of school absenteeism due to URIs were registered. Schoolchildren from the EG had a 38% lower risk of absenteeism due to URIs, incidence rate ratio: 0.62, 95% confidence interval: 0.55-0.70, and a decrease in absenteeism of 0.45 episodes/child/academic year, p < .001. Pupils missed 2734 school days due to URIs and the percentage of days absent was significantly lower in the EG, p < .001.
  
  
  
  Use of hand sanitizer plus handwashing with soap accompanied by educational support is an effective measure to reduce absenteeism due to URIs.
authors.affiliation: Distrito Sanitario, Atención Primaria Almería, España, C) Haza de Acosta S/N 04009, Almería, Spain.
authors.forename: Ernestina
authors.initials: E
authors.lastname: Azor-Martinez
authors.affiliation: Servicio de Pediatría, Hospital Torrecárdenas, Almería, España, C) Ramon y Cajal N° 11 Villanueva Mesia 18369, Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Cobos-Carrascosa
authors.affiliation: Distrito Sanitario, Atención Primaria Almería, España, C) Haza de Acosta S/N 04009, Almería, Spain.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Seijas-Vazquez
authors.affiliation: Servicio de Farmacia Hospital Torrecardenas, C) Hermandad de Donantes de Sangre S/N, CP 04009, Almería, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Fernández-Sánchez
authors.affiliation: Roger Williams University, 1 Old Ferry Rd, Bristol, RI 02809.
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Strizzi
authors.affiliation: Unidad de Formación, e Investigación Distrito Almería España, C) Pablo Neruda 2, portal 12, 6° 1, 04009, Almería, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Torres-Alegre
authors.affiliation: Universidad de Almería, España C) Paseo de los Sauces N°2 8°D Aguadulce 04720, Almería, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Santisteban-Martínez
authors.affiliation: Servicio de Pediatría, Hospital Torrecárdenas, Almería, España, C) Pepe Isbert 55, 04007, Almería. Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Gimenez-Sanchez
mesh_terms: D000041:Absenteeism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006235:Hand Disinfection / Q000379:methods; D063373:Hand Hygiene / Q000379:methods* / Q000706:statistics & numerical data*; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D012574:Schools; D012959:Socioeconomic Factors; D013030:Spain
keywords: hand sanitizer; handwashing; respiratory infections; school absenteeism