Schoolchildren Who Add Hand Sanitizer To Washing Still Get Sick

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Schools can be a great breeding ground for colds, stomach viruses, the flu and other bugs kids (and their parents) would rather not get.

Researchers wanted to know whether the transmission of those baddies could be reduced by telling elementary school children to use hand sanitizer in addition to the usual hand washing. But their study, conducted in 68 primary schools in New Zealand, found putting sanitizer in classrooms might not be worth the money and effort in higher-income countries, where soap and clean water are readily available.

Half the schools were randomly assigned to get the sanitizer. In those schools, the kids had a 30-minute educational session on hand hygiene and were also told to use the hand sanitizer dispensers after coughing or sneezing and when they left the classroom for recess or lunch. (The active ingredient in the hand sanitizer was plain old alcohol, not the antibacterial triclosan, which is controversial for its potential to create antibiotic-resistant bacteria.) Kids in the other schools just got the session on hand hygiene.

After the 20-week study was over, the researchers followed up with caregivers of a randomly selected sample of 2,443 students. The absence rates due to illness in the sanitizer and nonsanitizer groups were similar. Nor was there a difference in absence rates due to a specific illness, say, a gastrointestinal bug. And the family members of those kids in the soap-only group didn't get sick more often either.

The study was conducted in 2009 and began right before the H1N1 flu pandemic began. So the researchers cautioned that kids might have been more careful about hand hygiene in general, thanks to public health efforts aimed at curtailing the spread of the flu. Still, they conclude that this study and others conducted in high-income countries "show that the addition of hand sanitizer to existing hand hygiene facilities does not result in important benefits."

But Dr. Aaron Glatt, executive vice president at Mercy Medical Center in Rockville Centre, N.Y., and a spokesman for the Infectious Diseases Society of America, emphasizes that this doesn't mean there's any harm in using alcohol-based hand sanitizers in schools. It's only that they don't seem to help much there. (Of course, this research can't say anything about the effectiveness of sanitizers in other settings, like the hospital.)

But Glatt notes that schools, like the workplace or other places where people gather together in close proximity, are "absolutely" sites of disease transmission. So whether or not a kid uses sanitizer, basic hand hygiene is essential to cutting back on those sick days.

The findings appear in PLoS Medicine.