Kids and germs. They’re as inseparable as Bert and Ernie or peanut butter and jelly. Throw a daycare center into the mix and you’ve got a microbe’s version of heaven. As it’s commonly observed, even children who won’t share anything else will share a cold —and daycare centers provide the perfect venue for their sudden generosity.

In the United States, more than 7.5 million children younger than five years are enrolled in out-of-home daycare. Studies have shown that children enrolled in daycare centers tend to catch more colds and gastrointestinal (GI) infections than other children. And then they bring those infections home.

One of the best ways to prevent those germs from spreading to other children or adults in the house is hand washing. In fact, studies have shown that vigorous scrubbing for 15 seconds with soap and warm water reduces the spread of infection. But hand washing isn’t always possible. There are numerous situations where a sink with running water is not immediately available, making it impossible to do a proper scrub.

That’s where the new instant hand sanitizers have stepped in. These alcohol-based products kill most bacteria and viruses on contact, and they don’t require any water. But how effective are they at reducing the spread of germs in the home?

In an article published in the September 2005 issue of Pediatrics , researchers studied whether the use of instant hand sanitizers reduced the spread of respiratory and gastrointestinal infections in families who have children enrolled in out-of-home daycare. They found that families who used the hand sanitizers had a significant reduction in the spread of gastrointestinal infections compared to families who did not use the hand sanitizers. Hand sanitizers also reduced the spread of respiratory infections, but not to a statistically significant degree.

About the Study

The researchers recruited 292 families from 26 daycare centers. Each family had at least one child between six months and five years old enrolled in one of these daycare centers for ten or more hours per week. Families who already used instant hand sanitizer in the home at least once a day were excluded from the study.

The families were randomly assigned to either the intervention group or the control group. All families within the same daycare center were assigned to the same group.

The researchers gave the intervention group supplies of an alcohol-based hand sanitizer (Purell Instant Hand Sanitizer) as well as educational materials about hand hygiene. The control group received educational materials about a healthy diet including fruits and vegetables. The control group was told not to use hand sanitizer during the study period.

Over the ensuing five months, families from both groups reported the timing and duration of respiratory and GI illnesses among family members. Families in the intervention group also reported the amount of hand sanitizers used and any adverse reactions to them.

Based on this information, the researchers observed how well the hand sanitizers prevented the spread of infection to other members of the family once one family member became infected. They did this by comparing the number of secondary respiratory and GI illnesses in the intervention and control groups. A secondary infection was one that began two to seven days after the onset of the same type of illness in another member of the household.

The Findings

After taking other relevant factors such as the number of young children in the house and baseline hand-hygiene practices into account, the families in the hand sanitizer group had a 59 percent lower incidence of secondary GI illnesses compared to the control group. This was a significant difference. The hand sanitizer group also had fewer secondary respiratory illnesses, but this difference was not statistically significant.

The hand sanitizer users also did not report significant adverse effects that discouraged their continued use.

One limitation of this study is that because the intervention group received both hand sanitizer and hand hygiene education materials, it is not possible to know whether the hand sanitizers would have been as effective if the families hadn’t been given tips on when and how to use the product.

How Does This Affect You?

This study found that families who used instant hand sanitizers had significantly fewer secondary GI infections compared to families who did not.

Does this mean that hand sanitizers are more effective than hand washing? Although this study was unable to answer that question, hand sanitizers do have their advantages. For one thing, other studies have shown that soap and water does not kill rotavirus, the most common cause of GI infection in a childcare setting. Alcohol, the active ingredient in hand sanitizers, does reliably kill this virus. Furthermore, hand sanitizers, which can be placed in a purse, diaper bag, or car, are also particularly useful when you can’t get to a sink.

With cold and flu season approaching and the threat of GI infections always present, be mindful of your hand hygiene. Remember to clean your hands after using the bathroom, before preparing food, and after changing your child’s diaper. If you prefer soap and water and can get to a sink, then by all means continue to do so. But keep instant hand sanitizer in mind (and in hand) for all other occasions.