Fighting classroom germs helps keep kids healthy

NEW YORK (Reuters Health) - Frequent use of alcohol-based hand sanitizers and a daily disinfectant wipe-down of classroom surfaces can help reduce school absences due to gastrointestinal illness, a new study demonstrates.

In classes where these infection control measures were used, 16 percent of the students were out sick for 1 day or more because of stomach problems over the course of 8 weeks, compared with 24 percent of children in classes that didn’t use them, Dr. Thomas J. Sandora of Children’s Hospital Boston and Harvard Medical School and colleagues report in the current issue of Pediatrics.

“These are very simple and relatively low-cost kinds of things,” Sandora told Reuters Health. “Anything a school can do to prevent the exposure to these kinds of germs can really keep kids healthier and in school.”

He and his colleagues randomly assigned 285 third- to fifth-graders in 15 classrooms to an intervention or a comparison, or “control,” group. In the infection-control intervention group teachers were given alcohol-based hand sanitizers and asked the students to use them before and after lunch, after using the restroom (where they were instructed to wash their hands with soap and water), and after being exposed to “potentially infectious secretions,” for example a toy that another student had placed in his or her mouth.

Teachers also wiped down students’ desks with disinfectant wipes containing quaternary ammonium chloride every day after lunch. The control group was asked to follow the usual cleaning and hand-washing practices.

The Clorox Company provided the wipes and hand sanitizer used in the study, as well as funding for the research, but wasn’t involved in analyzing the research or in the study write-up.

In the intervention classrooms, 9 percent of samples taken from the children’s desks came back positive for norovirus, a frequent cause of gastrointestinal infections, compared to 29 percent of samples in the control group classrooms.

In addition to having fewer absences, the infection-control group had a fewer number of total days out of the classroom. The number of days absent in the control group ranged from 0 to 7 days per student over the 8 weeks, compared with 0 to5 days per student in the intervention group.

But there was no difference between the groups in the percentage of students who missed school due to respiratory illness. This is probably because such infections spread more easily than tummy bugs, and would require a level of hand hygiene vigilance difficult to sustain throughout the course of a busy school day, Sandora said.

“The main message for parents is that hand washing is the best way to prevent the spread of infection, that’s been known for a long time,” the researcher said. Hand sanitizers are useful in situations where there’s no access to a sink, he added. And disinfecting household surfaces may also help prevent family members from getting sick, Sandora said, because it’s known that many viruses and bacteria that cause illness can survive on different types of surfaces.

He and his colleagues conclude: “Schools should consider incorporating these simple infection-control interventions in the classroom to reduce the number of days lost caused by common illnesses.”

SOURCE: Pediatrics, June 2008.