Hand hygiene in day-care centres: washing or disinfecting?

New study shows advantages of hand disinfection for infection protection in educational institutions

Running noses and long-lasting, irritable cough: pathogens are quickly and easily transmitted through both direct and indirect contact, especially in day-care centres, often leading to reoccurring outbreaks of disease. Simple hygiene measures, including thorough handwashing with soap and water and proper drying of hands after washing, can effectively prevent the spread of infections in day-care facilities.

There is a more effective measure

A study conducted by Spanish scientists recently investigated whether the use of hand disinfectants could make hand hygiene in day-care centres even more effective. The study findings: yes.

In an eight month study conducted in Almería, Spain, 24 educational institutions with children aged 0 to three years were selected to examine the effects of introducing hand disinfectant on infection prevention.  In the study, three groups were defined: two intervention groups with strict hygiene procedures and a control group without intervention.  In first intervention group, a group of 274 children were instructed to wash their hands with water and soap for regular hand hygiene.  The second intervention group included 339 children, who were instructed to exclusively use alcohol-based hand disinfectant for regular hand hygiene.  The control group continued with its usual hand washing procedures.

The results were clear: when comparing the two intervention groups over the eight month study period, significantly more infections occurred in the first intervention group – who were instructed to wash their hands with soap and water (3.90% days absent), in contrast to the second intervention group who were instructed to disinfect their hands their hands using alcohol-based disinfectant (3.25% days absent).

Careful observation during disinfection

While the results of the study are encouraging, it is important to emphasize that the use of alcohol-based hand disinfectants in day-care centres must only be carried out under the strict supervision of educators. The practical implementation of alcohol-based disinfectant may therefore prove challenging. Considering the safety aspects associated with children in educational facilities, thorough hand washing with soap and water may remain the preferred measure for infection prevention.

Source: Azor-Martinez  et al. Effectiveness of a Hand Hygiene Program at Child Care Centers: A Cluster Randomized Trial, AAP News & Journals (2018)