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Access to hand sanitizer in classrooms did not reduce absences
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Addition of hand sanitizer dispensers in primary school classrooms did not reduce sick days from school, according to study findings in PLoS Medicine.
Patricia Priest, MB, ChB, MPH, DPhil, FAFPHM, of the University of Otago in Dunedin, New Zealand, and colleagues randomized 68 primary schools in three cities in New Zealand to receive hand hygiene education and alcohol-based sanitizer dispensers or hand hygiene education alone. Children aged 5 to 11 years in intervention schools received a 30-minute hand hygiene education session and were instructed to use hand sanitizer after coughing/sneezing and when exiting the classroom for morning break and lunch. Children in control schools received the same hand hygiene education session but were not instructed to use hand sanitizer. Dispensers containing alcohol-based sanitizer with less than 60% ethanol were fitted in all intervention classrooms in April 2009. The study was conducted during winter session, from April to September 2009.
There were 5,766 absences among the 2,443 children who followed up. Of these, 5,134 were considered “medical,” “illness,” or “unknown.”
Halfway through the study period, a change was made to hand sanitizer solution in 41 of the 396 classrooms. Children became reluctant to use the initial hand sanitizer before eating lunch because they reported tasting the sanitizer on their fingers or food.
The absence rate due to any illness was similar among the intervention and control groups (1.21 per 100 child-days vs. 1.16 per 100 child-days).
The researchers reported that there was no significant evidence that hand sanitizer reduced rates of respiratory or gastrointestinal illness, the length of illness or illness absence episodes. The rate of same illness occurrence among household members did not differ between intervention and control groups.
“Our study does not address the effectiveness of hand sanitizer for reducing specific infections such as influenza, and we have not shown that hand hygiene itself is not important, nor that hand sanitizer as a method of hand hygiene is not useful. Where clean water is scarce, hand sanitizer could be a useful alternative. However, our results suggest that in a high-income country, putting resources into extra hand hygiene by providing hand sanitizer in classrooms may not be effective in reducing absences,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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Priest P. PLoS Med. 2014; doi:10.1371/journal.pmed.1001700.
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