Just to follow up on our discussion about handwashing--it's known that handwashing in child care centers helps to decrease illness/absenteeism, but this was a RCT (randomly controlled trial) to look at children in child care and the effect of good hand hygiene (and alcohol-based sanitizers) at home.
A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home.
Sandora TJ, Taveras EM, Shih MC, Resnick EA, Lee GM, Ross-Degnan D, Goldmann DA.
Division of Infectious Diseases, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA. thomas.sandora@childrens.harvard.edu
OBJECTIVE: Good hand hygiene may reduce the spread of infections in families with children who are in out-of-home child care. Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections. The objective of this study was to determine whether a multifactorial campaign centered on increasing alcohol-based hand sanitizer use and hand-hygiene education reduces illness transmission in the home. METHODS: A cluster randomized, controlled trial was conducted of homes of 292 families with children who were enrolled in out-of-home child care in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5 years of age and in child care for > or =10 hours/week. Intervention families received a supply of hand sanitizer and biweekly hand-hygiene educational materials for 5 months; control families received only materials promoting good nutrition. Primary caregivers were phoned biweekly and reported respiratory and GI illnesses in family members. Respiratory and GI-illness-transmission rates (measured as secondary illnesses per susceptible person-month) were compared between groups, adjusting for demographic variables, hand-hygiene practices, and previous experience using hand sanitizers. RESULTS: Baseline demographics were similar in the 2 groups. A total of 1802 respiratory illnesses occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI illnesses occurred during the study; 28 (11%) were secondary illnesses. The secondary GI-illness rate was significantly lower in intervention families compared with control families (incidence rate ratio [IRR]: 0.41; 95% confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-1.30). However, families with higher sanitizer usage had a marginally lower secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI: 0.65-1.09). CONCLUSIONS: A multifactorial intervention emphasizing alcohol-based hand sanitizer use in the home reduced transmission of GI illnesses within families with children in child care. Hand sanitizers and multifaceted educational messages may have a role in improving hand-hygiene practices within the home setting.
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My child came home from pre-school the other day saying that they learned to cough and sneeze into their elbow with Germy Wormie, and I was totally taken aback. I always covered with my hands. But I went to the website and now I get it, hands touch, elbows don't!! Kids can touch 300 surfaces in 1/2 hour and they hate to wash their hands. This is a simple thing that can make a huge difference. Also, there is a DVD the kids love, and it teaches them in a fun way other necessary hygiene habits, as well as the elbow cough.
ReplyDeleteI do like the point that elbows don't touch, I never thought of that too, I'll have to start covering my coughs and sneeze with my elbow from now on.
ReplyDeleteQuestions about the experiment: Did the author say what these certain types of illnesses were beside it being either respiratory/ GI and secondary illnesses? Just wondering if one certain type was more prevalent then other?
I am wondering if these researchers are finding a decrease in GI illness due to safer practices of food handling and food preparation (and educational message that needs to be further implemented here) rather than the hand to hand contact and its relationship to GI illness?
ReplyDeleteJill, can you add the actual reference for this abstract?
ReplyDeleteSorry--I didn't realize that I left out the journal.
ReplyDeletePEDIATRICS Vol. 116 No. 3 September 2005, pp. 587-594
I read that medical doctors are following a trend of not shaking hands or giving high-fives and greeting each other with the “doctor bump” where they bump shoulders to say hello. When I volunteered in an ER I tried it with the EMTs but apparently they were oblivious to the gesture.
ReplyDeleteI realize that this is purely anecdotal, but as a kid I played in the dirt and horse poop constantly and my mom always said that I was rarely sick. My niece and nephew (1½ and 3) are told to wash their hands religiously yet they always have some sort of bug between the two of them. However I will admit to washing my hands a lot when I am working at the hospital these days.
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