Handwashing and Risk of Respiratory Infections: a Quantitative Systematic Review

Overview

Journal Trop Med Int Health

Specialties Public Health
Tropical Medicine

Date 2006 Mar 24

PMID 16553905

Citations 207

Authors

Tamer Rabie

Valerie Curtis

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the effect of handwashing on the risk of respiratory infection.

Methods: We searched PubMed, CAB Abstracts, Embase, Web of Science, and the Cochrane library for articles published before June 2004 in all languages. We had searched reference lists of all primary and review articles. Studies were included in the review if they reported the impact of an intervention to promote hand cleansing on respiratory infections. Studies relating to hospital-acquired infections, long-term care facilities, immuno-compromised and elderly people were excluded. We independently evaluated all studies, and inclusion decisions were reached by consensus. From a primary list of 410 articles, eight interventional studies met the eligibility criteria.

Results: All eight eligible studies reported that handwashing lowered risks of respiratory infection, with risk reductions ranging from 6% to 44% [pooled value 24% (95% CI 6-40%)]. Pooling the results of only the seven homogenous studies gave a relative risk of 1.19 (95% CI 1.12%-1.26%), implying that hand cleansing can cut the risk of respiratory infection by 16% (95% CI 11-21%).

Conclusions: Handwashing is associated with lowered respiratory infection. However, studies were of poor quality, none related to developing countries, and only one to severe disease. Rigorous trials of the impact of handwashing on acute respiratory tract infection morbidity and mortality are urgently needed, especially in developing countries.

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References

Isaacs D, Dickson H, OCallaghan C, Sheaves R, Winter A, Moxon E . Handwashing and cohorting in prevention of hospital acquired infections with respiratory syncytial virus. Arch Dis Child. 1991; 66(2):227-31. PMC: 1792812. DOI: 10.1136/adc.66.2.227. View

Curtis V, Cairncross S . Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis. 2003; 3(5):275-81. DOI: 10.1016/s1473-3099(03)00606-6. View

White C, Kolble R, Carlson R, Lipson N, Dolan M, Ali Y . The effect of hand hygiene on illness rate among students in university residence halls. Am J Infect Control. 2003; 31(6):364-70. DOI: 10.1016/s0196-6553(03)00041-5. View

Niffenegger J . Proper handwashing promotes wellness in child care. J Pediatr Health Care. 1997; 11(1):26-31. DOI: 10.1016/s0891-5245(97)90141-3. View

Curtin F, Elbourne D, Altman D . Meta-analysis combining parallel and cross-over clinical trials. III: The issue of carry-over. Stat Med. 2002; 21(15):2161-73. DOI: 10.1002/sim.1207. View

Gibson L, Rose J, Haas C, Gerba C, Rusin P . Quantitative assessment of risk reduction from hand washing with antibacterial soaps. J Appl Microbiol. 2002; 92 Suppl:136S-43S. View

Jones G, Steketee R, Black R, Bhutta Z, Morris S . How many child deaths can we prevent this year?. Lancet. 2003; 362(9377):65-71. DOI: 10.1016/S0140-6736(03)13811-1. View

Gwaltney Jr J, Moskalski P, Hendley J . Interruption of experimental rhinovirus transmission. J Infect Dis. 1980; 142(6):811-5. DOI: 10.1093/infdis/142.6.811. View

Guinan M, McGuckin M, Ali Y . The effect of a comprehensive handwashing program on absenteeism in elementary schools. Am J Infect Control. 2002; 30(4):217-20. DOI: 10.1067/mic.2002.120366. View

10.

Ansari S, Sattar S, Springthorpe V, Wells G, Tostowaryk W . In vivo protocol for testing efficacy of hand-washing agents against viruses and bacteria: experiments with rotavirus and Escherichia coli. Appl Environ Microbiol. 1989; 55(12):3113-8. PMC: 203232. DOI: 10.1128/aem.55.12.3113-3118.1989. View

11.

Hoque B, Briend A . A comparison of local handwashing agents in Bangladesh. J Trop Med Hyg. 1991; 94(1):61-4. View

12.

Falsey A, Criddle M, Kolassa J, McCann R, Brower C, Hall W . Evaluation of a handwashing intervention to reduce respiratory illness rates in senior day-care centers. Infect Control Hosp Epidemiol. 1999; 20(3):200-2. DOI: 10.1086/501612. View

13.

FULGINITI V, Eller J, Sieber O, JOYNER J, Minamitani M, MEIKLEJOHN G . Respiratory virus immunization. I. A field trial of two inactivated respiratory virus vaccines; an aqueous trivalent parainfluenza virus vaccine and an alum-precipitated respiratory syncytial virus vaccine. Am J Epidemiol. 1969; 89(4):435-48. DOI: 10.1093/oxfordjournals.aje.a120956. View

14.

Kotch J, Weigle K, Weber D, Clifford R, Harms T, Loda F . Evaluation of an hygienic intervention in child day-care centers. Pediatrics. 1994; 94(6 Pt 2):991-4. View

15.

Egger M, Smith G, Phillips A . Meta-analysis: principles and procedures. BMJ. 1998; 315(7121):1533-7. PMC: 2127925. DOI: 10.1136/bmj.315.7121.1533. View

16.

Khan M . Interruption of shigellosis by hand washing. Trans R Soc Trop Med Hyg. 1982; 76(2):164-8. DOI: 10.1016/0035-9203(82)90266-8. View

17.

St Sauver J, Khurana M, Kao A, Foxman B . Hygienic practices and acute respiratory illness in family and group day care homes. Public Health Rep. 1998; 113(6):544-51. PMC: 1308439. View

18.

Black R, Morris S, Bryce J . Where and why are 10 million children dying every year?. Lancet. 2003; 361(9376):2226-34. DOI: 10.1016/S0140-6736(03)13779-8. View

19.

Faix R . Comparative efficacy of handwashing agents against cytomegalovirus. Infect Control. 1987; 8(4):158-62. DOI: 10.1017/s0195941700065826. View

20.

Larson E, Aiello A, Lee L, Della-Latta P, Gomez-Duarte C, Lin S . Short- and long-term effects of handwashing with antimicrobial or plain soap in the community. J Community Health. 2003; 28(2):139-50. DOI: 10.1023/a:1022699514610. View