Mandatory handwashing in elementary schools reduces absenteeism due to infectious illness among pupils: A pilot intervention study

Background

The objective of this study was to determine the effect of mandatory, scheduled handwashing on actual absenteeism due to infectious illness in elementary school pupils in Denmark.

Methods

A 3-month pilot intervention study, randomized between 2 schools, was performed on 652 pupils age 5 to 15 years. The pupils at the intervention school (IS; n=290) were required to wash their hands before the first lesson, before lunch, and before going home. Those at the control school (CS; n=362) continued their usual handwashing practices. All absences due to illness were recorded, and data were analyzed statistically.

Results

Multivariate analysis demonstrated a significantly reduced rate of absenteeism for the IS compared with the CS (P=.002). For girls, the rate was 1.05 periods (95% confidence interval [CI]=0.90 to 1.22) for the IS versus 1.35 (95% CI=1.26 to 1.44) for the CS. For boys, these rates were 0.87 (95% CI=0.72 to 1.05) and 1.12 (95% CI=0.92 to 1.36). An alternative approach demonstrated that the odds ratio for absence was 0.69 (95% CI=0.52 to 0.92) for the IS compared with the CS.

Conclusion

This study suggests that handwashing could be an effective tool to reduce absences due to infectious illness in elementary school pupils. A school policy regarding hand hygiene and teaching of hand hygiene is warranted.

Key Words: Hand washing, mandatory, pupils, infectious illness absenteeism, intervention, elementary school