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Cited by 556Pediatric health and respiratory diseasesInfection Control in HealthcareRespiratory viral infections research

Handwashing and risk of respiratory infections: a quantitative systematic review

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Rabie, Tamer, Curtis, Valerie·2006·Tropical Medicine & International Health
DOI 10.1111/j.1365-3156.2006.01568.xPMC PMC7169664
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Abstract

Summary: 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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  • The earliest review in 2006 included eight studies, three of which were RCTs.

    “The earliest review in 2006 included eight studies, three of which were RCTs (Rabie 2006).”

    From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Rabie 2006

    The Screening process section says the review selected eight papers, and the Discussion describes eight intervention studies. But the Discussion explicitly says only two of the eight were RCTs, not three. The paper does not establish whether this was the earliest review. (LLM, conf=0.93)

    Experimental — accuracy not yet measured

  • Handwashing can reduce respiratory infection by 16% according to one review.

    “Handwashing can also reduce other infections; one review suggested it could reduce respiratory infection by 16%,13”

    From Hygiene: new hopes, new horizons (2011) · cites this paper as [13]

  • The pooled estimate of seven studies in Rabie 2006 was described as 'indicative' of the effect of hand hygiene, but the studies were of poor quality.

    “The pooled estimate of seven studies was described as “indicative” of the effect of hand hygiene, but the studies were of poor quality.”

    From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Rabie 2006

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Research works printed but not linked: 5

  1. [13]13. Curtis V, Kanki B, Cousens S et al. (2001) Evidence for beha- viour change following a hygiene promotion programme in West Africa. Bulletin of the World Health Organization 79, 518-526.
  2. [19]19. Fulginiti VA, Eller JJ, Sieber OF, Joyner JW, Minamitani M & Meiklejohn G (1969) Respiratroy virus immunization. 1. A field trial of two inactivated respiratory virus vaccines: an aqueous trivalent parainfluenza virus vaccine and an alum-precipitated respiratory syncytial virus vaccine. American Journal of Epi- demiology 89, 435.
  3. [35]35. Khan MU (1982) Interruption of shigellosis by handwashing. Transactions of the Royal Society of Tropical Medicine and Hygiene 76, 164-168.
  4. [53]53. Ryan MAK, Christian RS & Wohlrabe J (2001) Handwashing and respiratory illness among young adults in military training. American Journal of Preventive Medicine 21, 79-83.
  5. [64]64. artı ´culos, ocho estudios de intervencio ´n tenı ´an los criterios para ser elegidos. resultados Los ocho estudios elegibles reportaban que el lavado de manos disminuı ´a el riesgo de infecciones respiratorias, con reduccio ´n del riesgo de entre un 6 a un 44% (valor combinado 24% (95% IC 6%-40%). Agrupando los resultados de los sete estudios homoge ´neos se obtenı ´a un riesgo relativo del 1.19 (95% IC 1.12 -1.26, lo cual implica que el lavado de manos puede disminuir el riesgo de infeccio ´n respiratoria en un 16% (95% IC 11 a 21%). El lavado de manos esta ´asociado con una disminucio ´n de la infeccio ´n respiratoria. Sin embargo, los estudios analizados eran de baja calidad, ninguno relacionado con paı ´ses de baja renta, y solo uno de ellos con enfermedad severa. Se requieren con urgencia ensayos rigurosos sobre el impacto del lavado de manos en la morbilidad y mortalidad por infecciones respiratorias, especialmente en paı ´ses de baja renta. palabras clave lavado de manos, infecciones respiratorias, revisio ´n sistema ´tica, meta-ana ´lisis Tropical Medicine and International Health volume 11 no 3 pp 258-267 march 2006

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Authors
Rabie, T., & Curtis, V.
Affiliations
London School of Hygiene & Tropical Medicine (GB)
Corresponding author
Curtis, Valerie
ORCID
Venue
Tropical Medicine & International Health
Publisher
Wiley
Published
2006-03
Volume
11
Issue
3
Pages
258-267
ISSN
  • 1360-2276 (ISSN-L)
  • 1365-3156
DOI
10.1111/j.1365-3156.2006.01568.x
PMC
PMC7169664
OpenAlex
W2130779321
Semantic Scholar
5902ddf049eec27ca80dc848efaccade856b4fc3
Cited by
556
References
62
Citations by year
2026: 9 · 2025: 18 · 2024: 25 · 2023: 40 · 2022: 48 · 2021: 65 · 2020: 60 · 2019: 35 · 2018: 23 · 2017: 21 · 2016: 29 · 2015: 26 · 2014: 23 · 2013: 28 · 2012: 17
FWCI
3.15
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6 d)
Locations
  • Tropical Medicine & International Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • World Bank Group
  • Unilever
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
Keywords
hand washing, hand hygiene, respiratory infections, acute respiratory infections, infection control, risk mitigation, developing countries
MeSH terms
Hand Disinfection, Humans, Respiratory Tract Infections, Risk Factors

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