Do hand-washing programs prevent infections?

Hand washing prevents infections. (LOE = 2a)

Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health 2008;98(8):1372-1381.  [PMID:18556606]

Meta-analysis (other)

Unknown/not stated

Various (meta-analysis)

These authors searched multiple databases and reference lists of included articles to identify randomized and quasi-experimental studies of hand washing programs and their effect on gastrointestinal and respiratory illnesses. Two reviewers independently assessed the eligibility of articles and ultimately included 30 studies. The authors do not report whether they assessed the quality of the included studies. The bulk of the studies used educational interventions or education combined with various soaps and antiseptics. Most took place in child-care centers and schools rather than as community-wide campaigns. Unfortunately, the authors don't give us data on the number of participants in the studies or the absolute effects, so we can't estimate the numbers needed to treat to prevent 1 infection. Hand-washing programs reduced gastrointestinal infections by 31% (relative risk (RR) = 0.69; 95% CI, 0.58 - 0.81) and respiratory infections by 21% (RR = 0.79; 0.66 - 0.95). Finally, nonantibacterial soaps worked as well as antibacterial soaps.