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The effect of a comprehensive handwashing program on absenteeism in elementary schools*

https://doi.org/10.1067/mic.2002.120366Get rights and content

Abstract

Handwashing is one of the most important factors in controlling the spread of micro-organisms and in preventing the development of infections. The objective of this study was to determine the effectiveness of a comprehensive handwashing program on absenteeism in elementary grades. Two hundred ninety students from 5 independent schools were enrolled in the study. Each test classroom had a control classroom, and only the test classroom received the intervention (education program and hand sanitizer). Absenteeism data were collected for 3 months. The number of absences was 50.6% lower in the test group (P <.001). The data strongly suggest that a hand hygiene program that combines education and use of a hand sanitizer in the classroom can lower absenteeism and be cost-effective. (Am J Infect Control 2002;30:217-20.)

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Subjects

Five independent elementary schools in Pennsylvania were enrolled in the study. Written permission was obtained from the headmaster/headmistress at each school before student enrollment in the study. Each school was asked to provide 2 test and 2 control classrooms of the same grade. The median class size was 15 (range, 11-20 students). Three schools were coed, one was single sex (boys), and one was single sex (girls). Students in the test group received the intervention of education and hand

Two hundred and ninety students (145 controls and 145 tests)

Table 1 shows the number of episodes of absenteeism by school and month.

. Episodes of absenteeism

SchoolClass sizeGradeMarchAprilMay
ControlTestControlTestControlTest
1171595403
183637251
215Kindergarten
A72141233
20Kindergarten
C145781910
313Kindergarten15593114
1121027254
4183836473
516Kindergarten10162510158
172861610139

Total episodes of absenteeism: control group = 277, test group = 140; % difference = 50.6% (P <.001).

There was lower absenteeism in 23 of the 27 months the test groups (P <.001) compared

Discussion

Schools, like hospitals, have significant predisposing factors for the transmission of micro-organisms and cross-contamination, such as a close environment, inanimate objects serving as vehicles of transmission, and often inadequate supplies for handwashing. The number of lost school days annually among kindergarten through twelfth-grade students is 164 million, with an average of 4.5 days a year per student.10 A report by the Carnegie Foundation11 for education noted that 83% of teachers think

Acknowledgements

The authors wish to thank the headmasters and headmistresses of each school, teachers, and students who participated in the study. We also thank Richard Waterman, PhD, Adjunct Assistant Professor, Wharton School, University of Pennsylvania, for assistance with data analysis and Lois Porten in helping prepare the manuscript. In addition, the authors thank GOJO Industries for supplying the educational materials and hand sanitizer for the study.

References (12)

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    The results from the survey indicated that both the childrens’ and their parents’ awareness of good health behaviors and habits had been raised. In the studies of Talaat18 and Guinan,9 absenteeism decreased, but they did not mention if there was any outbreak of influenza during the research period. It was therefore unclear whether the decrease of absenteeism was owing to reduced incidence of influenza at the time of these studies.

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    2017, American Journal of Infection Control
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    Five studies reported the effect of ABHR use coupled with education.20,24,25,31,36 Similar to the above results regarding ABHR use alone, 3 of 5 studies reported reductions in combined illness-related absenteeism in the intervention group versus the comparison group, ranging from 22.6%-50.6% (P < .05).24,25,31 One reported a 29.5% reduction in AGI-associated absenteeism (P < .001),36 whereas the remaining study20 did not detect a significant reduction in ARI-associated absenteeism between the intervention and comparison groups.

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Reprint requests: Maryanne McGuckin, Dr ScEd, MT (ASCP), University of Pennsylvania School of Medicine, 605A Stellar-Chance Bldg, 422 Curie Blvd, Philadelphia, PA 19104-6021.

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