Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis
Open accessAbstract
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.
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The latest published meta-analysis to include any ARI as an outcome was reported in 2008 by Aiello and colleagues.
“the latest published meta-analysis to include any ARI as an outcome was reported in 2008 by Aiello and colleagues”
Aiello and colleagues estimated that hand hygiene improvements reduced ARIs by 21% (95% CI 5-34).
“who estimated that hand hygiene improvements reduced ARIs by 21% (95% CI 5-34)”
The existing systematic review evidence for the effect of handwashing with soap on ARIs is out of date.
“First, the evidence base is out of date.”
This study is the first meta-analysis of the effect of handwashing with soap interventions on any ARI since the 2008 study by Aiello and colleagues.
“To our knowledge, this study is the first meta-analysis of the effect of handwashing with soap interventions on any ARI since the 2008 study by Aiello and colleagues.14”
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- Authors
- Aiello, A. E., Coulborn, R. M., Perez, V., & Larson, E. L.
- Affiliations
- University of Michigan (US)
- Allison E. Aiello, Rebecca M. Coulborn, and Vanessa Perez are with the Department of Epidemiology and Center for Social Epidemiology & Population Health, School of Public Health, University of Michigan, Ann Arbor. Elaine L. Larson is with the School of Nursing and the Mailman School of Public Health, Columbia University, New York, NY.
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2008-08
- Volume
- 98
- Issue
- 8
- Pages
- 1372-1381
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC2446461
- OpenAlex
- W2109881331
- Cited by
- 796
- References
- 75
- Citations by year
- 2026: 21 · 2025: 44 · 2024: 49 · 2023: 57 · 2022: 78 · 2021: 91 · 2020: 83 · 2019: 40 · 2018: 39 · 2017: 40 · 2016: 31 · 2015: 48 · 2014: 36 · 2013: 39 · 2012: 31
- FWCI
- 2.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Michigan
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Keywords
- hand hygiene, gastrointestinal diseases, respiratory diseases, infectious disease prevention, community settings, hand hygiene education, antibacterial soap, infection transmission
- MeSH terms
- Communicable Disease Control, Communicable Diseases, Gastrointestinal Diseases, Hand Disinfection, Humans, Respiratory Tract Infections, Surface-Active Agents, Databases, Bibliographic, Skin Care, Community-Acquired Infections, Risk Assessment
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