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Effect of Hand Hygiene on Infectious Disease Risk in the Community Setting: A Meta-Analysis


Aiello, Allison E.; Coulborn, Rebecca M.; Perez, Vanessa; & Larson, Elaine L. (2008). Effect of Hand Hygiene on Infectious Disease Risk in the Community Setting: A Meta-Analysis. American Journal of Public Health, 98(8), 1372-1381. PMCID: PMC2446461


To quantify the effect of hand-hygiene interventions on rates of gastrointestinal and respiratory illnesses and to identify interventions that provide the greatest efficacy, we searched 4 electronic databases for hand-hygiene trials published from January 1960 through May 2007 and conducted meta-analyses to generate pooled rate ratios across interventions (N=30 studies). Improvements in hand hygiene resulted in reductions in gastrointestinal illness of 31% (95% confidence intervals [CI]=19%, 42%) and reductions in respiratory illness of 21% (95% CI=5%, 34%). The most beneficial intervention was hand-hygiene education with use of nonantibacterial soap. Use of antibacterial soap showed little added benefit compared with use of nonantibacterial soap. Hand hygiene is clearly effective against gastrointestinal and, to a lesser extent, respiratory infections. Studies examining hygiene practices during respiratory illness and interventions targeting aerosol transmission are needed.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Public Health


Aiello, Allison E.
Coulborn, Rebecca M.
Perez, Vanessa
Larson, Elaine L.