Hand hygiene clearly impacts the wellness of any community. Keeping hands clean at home, in schools and elsewhere makes a significant difference in keeping folks healthy. The impact of poor hand hygiene habits is linked to increased occurrences of illness, absences, and their associated costs. A renewed commitment to “shared responsibility” in our homes and classrooms may be one of our most important infection prevention strategies.
Hand Hygiene at Home and School, written by Patrick Boshell at Infection Control Tips, says “studies demonstrate that poor hand hygiene practices can contribute to an increase in community-based infections including gastrointestinal, skin and respiratory infections. Additionally, there has been a steady increase in the global burden of infectious diseases, resulting in an reported 13 million deaths annually. Between 1980 and 1992, deaths attributed to infectious disease increased by 22%, according to reports. This is a cause for concern as we continue to see a decline in hand hygiene promotion and education.”
Hand Sanitizer Alert draws attention to the fact that “efficacy experiments reported here reinforce what has been known for more than 50 years: 40% ethanol is a less effective bacterial antiseptic than 60% ethanol. Consumers should be alerted to check the alcohol concentration in hand sanitizers because substandard products may be marketed to the public.”
Effects of Hand Hygiene Campaigns on Incidence of Laboratory-confirmed Influenza and Absenteeism in Schoolchildren, Cairo, Egypt: Elementary schoolchildren are important vectors for spreading infectious diseases between themselves, their families, and their communities, especially in developing countries where public schools are extremely overcrowded. Aiello et al. noted that infectious agents that children contract in schools can result in infections in up to 50% of household members.
Previously, at our blog:
School children are at a higher risk for infection because of their immature immune systems and more frequent social mixing. Gastrointestinal and respiratory infections are the most commonly occurring illnesses among schoolchildren because of their poor hand hygiene.
The American Journal of Infection Control published a study (Comparative efficacy of a simplified hand washing program for improvement in hand hygiene and reduction of school absenteeism among children with intellectual disability.) The setting was a Hong Kong school for children with special needs. A simplified, five-step hand washing technique used was modified from the seven-step version put forth by the World Health Organization.
The simplified 5-step technique combines steps 1 and 3, rubbing palms and fingers together (palm-to-palm and palm-to-palm with fingers interlaced steps), and omits the wrist-rubbing procedure. The simplified 5-step technique is as follows: (1) between fingers, (2) backs of hands, (3) backs of fingers, (4) finger tips, and (5) thumbs. This reduces the spread of microorganisms because water can wet children’s clothes, especially when they are wearing long-sleeved shirts in winter. Wet sleeves serve as a reservoir for microbes that can be transferred to the hands by direct contact, therefore providing a habitat for infectious disease transmission.
The intervention group experienced a significant increase in the rating of their hand washing quality in both hands from pre- to post-test: left dorsum (+1.05, P < .001); right dorsum (+1.00, P < .001); left palm (+0.98, P < .001); and right palm (+1.09, P < .001). The pre- to post-test difference in the intervention group (+1.03, P < .001) was significantly greater than the difference in the control group (+0.34, P = .001). There were no differences between the post-test and the sustainability assessment in the intervention group. The intervention school experienced a significantly lower absenteeism rate (0.0167) than the control group in the same year (0.028, P = .04). Students in this study showed better performance in simplified hand washing techniques and experienced lower absenteeism than those using usual practice in special education school settings.
The researchers concluded: It is very important in the public health agenda to standardize a hand washing program for school teachers and school nurses to teach vulnerable high-risk groups about hand washing procedures and ultimately to prevent the spread of germs in the school community. Therefore, it is hoped that these simplified 5-step hand washing techniques will be adopted by the Centre for Health Protection and Ministry of Health through collaboration and wide adoption by school nurses and school teachers in both special education schools and mainstream schools because the world has been moving toward the integration of children with special education needs into mainstream schools.