Alcohol-Based Hand Disinfectants May Reduce Workplace Illness and Absenteeism

Laurie Barclay, MD

August 24, 2010

August 24, 2010 — Use of alcohol-based hand disinfectants in the workplace is a cost-efficient method to reduce illness and absenteeism among employees, according to the results of a prospective, intervention-controlled study reported online August 23 in BMC Infectious Diseases.

"Our study found that hand disinfection reduced the number of episodes of illness for the majority of the investigated symptoms," lead author Nils-Olaf Hübner, MD, from the Institute of Hygiene and Environmental Medicine in Greifswald, Germany, said in a news release.

In the municipality of the city of Greifswald, volunteers in public administrations were randomly assigned to a group receiving alcohol-based hand disinfection or to a control group receiving no intervention. The intervention group was supplied with hand disinfectant and instructed to use it 5 times or more during the workday, especially after activities such as toilet use and nose blowing that would likely facilitate bacterial or viral transfer. Monthly questionnaires for 1 year determined respiratory and gastrointestinal symptoms and days of work for a total of 1230 person-months.

For most of the evaluated symptoms, the number of illness episodes was lower in the hand-disinfection group, with statistically significant reductions for the common cold (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17 - 0.71; P = .003), fever (OR, 0.38; 95% CI, 0.14 - 0.99; P = .035), and coughing (OR, 0.45; 95% CI, 0.22 - 0.91; P = .02). In the intervention group, there were fewer days missed from work because of illness for most symptoms evaluated, including colds (2.07% vs 2.78%; P = .008), fever (0.25% vs 0.31%; P = .037), and cough (1.85% vs 2.00%; P = .024).

The OR for work absence because of diarrhea was also statistically significant (0.11; 95% CI, 0.01 - 0.93; P = .017). In addition, symptoms of illness were reduced during times when participants were not absent from work, suggesting that hand disinfectant use may improve overall job productivity.

"Hand disinfection can easily be introduced and maintained outside clinical settings as part of the daily hand hygiene," the study authors write. "Therefore it appears as an interesting, cost-efficient method within the scope of company health support programmes."

Limitations of this study include participation of only 16% of invited persons, and questionnaires administered monthly rather than more frequently.

"Further research should be focused on the question how on-the-job productivity losses could be assessed more clearly, allowing exact calculations on the cost-effectiveness of hand hygiene programmes and on the relationship between the frequency of hand hygiene and symptoms," the study authors conclude. "Still, our data [support] the results from other studies, that hands play a key role in the transfer of community-acquired viral and bacterial infection."

Bode Chemie GmbH employs one of the authors and has provided financial support for research to 2 other study authors.

BMC Infect Dis. Published online August 23, 2010.

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