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Hand Sanitizer vs. Soap and Water for Optimum Handwashing

During the time of year when occurrences of flu and other respiratory infections increase, public health departments, hospitals, pediatricians and family doctors all beat the handwashing drum – and for good reason. Evidence points to proper hand hygiene as a major deterrent to the spread of respiratory illness, including the influenza virus, or the flu.

Hand Sanitizer in Daycare Centers

Now, a study out of Spain [1] reveals that children under 3 years old who attend daycare centers – a population vulnerable to the quick spread of infectious diseases – may be better served using alcohol-based gel hand sanitizers than soap and water.

The study placed 911 daycare students at 24 daycare centers in Spain into three study groups. One group used only hand sanitizer to clean their hands. Another group was instructed to use only soap and water. A third group – the control group – followed their normal hand hygiene procedure, which may have included a combination of the two methods. Parents and center staff members in the two variable groups attended training sessions about respiratory infections and their treatments and about fever.

Over the eight-month study, researchers also taught children regularly, using stories, songs and posters placed in the classrooms and throughout the common areas of the daycare centers, about hand hygiene and infection prevention.

At the study’s conclusion, researchers found that children in the group who used hand sanitizers had fewer instances of respiratory illness and fewer antibiotic prescriptions, compared with those in the control group. Children in the group that used soap and water had a higher risk of respiratory infections and required more antibiotic prescriptions, compared with those in the hand sanitizer group. Furthermore, the percentage of days absent was significantly lower in the hand sanitizer group than in either the soap-and-water or the control group.

“It’s good to see that there are measures being taken to teach young kids about the importance of hand hygiene in the prevention of spreading illness,” said Barbara Russell, R.N., the director of Infection Prevention and Control at Baptist Hospital of Miami [2]. “I am glad that attention is being paid and hope that others follow suit.”

Hand Sanitizer Convenience

Ms. Russell says that alcohol-based hand sanitizers in the healthcare setting have been common for quite some time and have been shown to be effective. “In healthcare, we prefer the antimicrobial effects of the alcohol and the convenience of being able to clean our hands when soap and water aren’t easily accessible,” she said. Similarly, children and teachers may be more likely to clean their hands more frequently if they don’t have sinks in their classrooms and can use hand sanitizers until they can get to a sink.

Ms. Russell notes that healthcare workers should still use soap and water if their hands are visibly soiled, when they care for patients with diarrhea; after they, themselves, use the restroom; and after several uses of hand sanitizer. Hand sanitizers kill the germs on your hands, but the dead germs remain on your hands until you eventually rinse them down the drain.

“Those dead germs can’t infect you or anyone else, but the process of getting them off your hands with friction and water is why handwashing is still important to truly cleaning your hands,” she said.

Hand Hygiene, Period

While the study clearly points to hand sanitizers as a deterrent to spreading respiratory infections among children in daycare, Ms. Russell warns against taking this information to the extreme and only using hand sanitizer. “We don’t make a decision based on one study,” she said. Yet, she’s happy to see that hand hygiene is being taught and practiced in the daycare setting and notes that parents and teachers need to be good examples for the children in their care.

“Whatever method of hand hygiene you practice, be sure it’s shared with your children and that they see you practice it, especially before and after handling food and after using the bathroom,” she said. “Just do it.”