Hand sanitizer gels reduce spread of GI infections

October 2005

Using an alcohol-based hand sanitizer gel significantly reduces the spread of gastrointestinal (GI) infections in the home, according to a study.

In a study of 292 greater Boston families – half of whom were given hand sanitizer – those that used the gel had a 59% reduction in the spread of GI illnesses.

“This is the first randomized trial to show that hand sanitizer reduces the spread of germs in the home,” Thomas J. Sandora, MD, physician in the division of infectious diseases at Children’s Hospital Boston and lead author of the study, said in a statement.

Researchers recruited the families through day care centers. They randomly assigned half the families to receive hand sanitizer and educational materials on hand hygiene. They were told to place bottles of the gel around the house, including the bathroom, kitchen and baby’s room, and to apply it to their hands after using the toilet, before preparing food, and after changing diapers. The remaining families, serving as controls, received only materials about nutrition, and were asked not to use hand sanitizer. The two groups reported similar rates of hand washing on an initial questionnaire.

For five months, researchers tracked the families and phoned every other week to record how much hand sanitizer had been used, whether someone had developed a respiratory or GI infection and whether the illness had spread to others in the home.

The families given hand sanitizer had a 59% lower incidence of secondary GI illnesses compared with the control group, after adjusting for other factors. In addition, families reporting higher amounts of sanitizer use (more than 2 oz in two weeks, indicating four to five uses per day) were about 20% less likely to transmit respiratory illnesses, but this effect did not reach statistical significance.

“We think that’s probably because people were more diligent about using the sanitizer after a GI-related incident, such as using the bathroom or vomiting, than after a respiratory incident, such as nose-wiping or sneezing,” said Sandora, also an instructor at Harvard Medical School.

A related study from Harvard Medical School and Children’s Hospital Boston demonstrated that hand sanitizing gels have a protective effect against respiratory illness among families who used the products at their own initiative.

The alcohol-based gels, widely available in stores, do not require water and rapidly kill most bacteria and viruses.

At risk for infections

According to the U.S. Census Bureau, more than 7.5 million children younger than 5 are enrolled in day care, placing them at high risk for respiratory and GI infections.

Although hand washing with soap and water is effective in reducing the spread of most infections, it requires access to a sink. In addition, there is evidence that rotavirus, the most common GI infection in the child-care setting, is not removed effectively by soap and water but is reliably killed by alcohol.

The study was published recently in Pediatrics.

For more information:

• Sandora T, Taveras E, Shih M, et al. A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home. Pediatrics. 2005;116:287-294.