| dc.description.abstract | Background:
Frequent hand-washing is standard advice for avoidance of respiratory tract infections, but the
evidence for a preventive effect in a general community setting is sparse. We therefore set out to quantify, in a
population-based adult general population cohort, the possible protection against acute respiratory tract infections
(ARIs) conferred by a person’s self-perceived hand-washing frequency.
Methods:
During the pandemic influenza season from September 2009 through May 2010, a cohort of 4365 adult
residents of Stockholm County, Sweden, reported respiratory illnesses in real-time. A questionnaire about typical
contact and hand-washing behaviour was administered at the end of the period (response rate 70%).
Results:
There was no significant decrease in ARI rates among adults with increased daily hand-washing frequency:
Compared to 2–4 times/day, 5–9 times was associated with an adjusted ARI rate ratio (RR) of 1.08 (95% confidence
interval [CI] 0.87-1.33), 10–19 times with RR = 1.22 (CI 0.97-1.53), and ≥20 times with RR = 1.03 (CI 0.81-1.32). A similar
lack of effect was seen for influenza-like illness, and in all investigated subgroups. We found no clear effect modification
by contact behaviour. Health care workers exhibited rate ratio point estimates below unity, but no dose-risk trend.
Conclusions:
Our results suggest that increases in what adult laymen perceive as being adequate hand-washing may
not significantly reduce the risk of ARIs. This might have implications for the design of public health campaigns in the
face of threatening outbreaks of respiratory infections. However, the generalizability of our results to non-pandemic
circumstances should be further explored. | en_US |
