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AJPH First Look, published online ahead of print Jun 12, 2008
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American Journal of Public Health, 10.2105/AJPH.2007.124610

Framing Health Matters

Effect of Hand Hygiene on Infectious Disease Risk in the Community Setting: A Meta-Analysis

Allison E. Aiello 1*, Rebecca M. Coulborn 1, Vanessa Perez 1, Elaine L. Larson 2

1 University of Michigan-School of Public Health
2 Columbia University- Mailman School of Public Health and School of Nursing

* To whom correspondence should be addressed. E-mail: aielloa{at}umich.edu.


  Abstract

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.

Key Words: Community Health, Infections




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