Thursday, August 26, 2010

Alcohol hand rubs in the workplace: A Randomized Trial

Just a quick post because I've got to get the kids to bed.  Researchers in Germany randomized 134 administrative employees at the Ernst-Moritz-Arndt University Greifswald to alcohol hand rub or nothing (n=67 in each group).  Subjects were to use >3ml of hand rub at least 5x/day especially after using the bathroom, blowing their nose, before eating and after contact with an ill person. The study lasted from March 2005 to April 2006.  People who used hand disinfects prior to the study were excluded.  They found significant reductions in common cold symptoms, fever, cough, and fewer days of illness with each symptom. A thing to note is that 111 of the 134 subjects were female, although it is hard to figure how this would hurt the generalizability. Alright, story time...

BMC Infectious Disease article by Hubner et al.


  1. Always nice to have more data backing up hand hygiene! It's a pity they didn't placebo-control it, though, or collect laboratory data in some form.

    On a more philosophical level, why is it that we still feel a need to do this type of hand hygiene study? There are those who would say we've known this sort of thing since Semmelweis, and that the study, nice though it is to have the data, simply proves the obvious. Is the question that they answered really a question we didn't have an answer to? And by extension, what are the questions in hand hygiene that are still in need of an answer?

  2. Good comments. I'm not sure what a good placebo would be in a hand hygiene trial, at least one that didn't impact hand colonization in some way. I suspect laboratory data would have added to the expense. I suspect they would have had to do frequent culturing to find any difference and I doubt they had a large budget. I agree that it would have been nice to have though.

    I agree that we don't need any more data that hand hygiene works. I have a colleague here that likes to remind me that one of my research areas is useless since we already know that bacterial pathogens can show seasonal variation. However, there are other reasons to continue study including exploring the underlying mechanism for subsequent intervention in the seasonal variation example or perhaps to increase awareness and expand use as would be the case in this hand hygiene study.

    In this study, I would have expected that the majority of exposures occurred outside of this administrative workplace, so it is interesting that there was still a measurable benefit. With hand hygiene compliance likely below 60% in hospital settings, despite what people report, we need all the evidence we can get.