Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis

Am J Public Health. 2008 Aug;98(8):1372-81. doi: 10.2105/AJPH.2007.124610. Epub 2008 Jun 12.


To quantify the effect of hand-hygiene interventions on rates of gastrointestinal and respiratory illnesses and to identify interventions that provide the greatest efficacy, we searched 4 electronic databases for hand-hygiene trials published from January 1960 through May 2007 and conducted meta-analyses to generate pooled rate ratios across interventions (N=30 studies). Improvements in hand hygiene resulted in reductions in gastrointestinal illness of 31% (95% confidence intervals [CI]=19%, 42%) and reductions in respiratory illness of 21% (95% CI=5%, 34%). The most beneficial intervention was hand-hygiene education with use of nonantibacterial soap. Use of antibacterial soap showed little added benefit compared with use of nonantibacterial soap. Hand hygiene is clearly effective against gastrointestinal and, to a lesser extent, respiratory infections. Studies examining hygiene practices during respiratory illness and interventions targeting aerosol transmission are needed.

Publication types

  • Meta-Analysis

MeSH terms

  • Communicable Disease Control / methods
  • Communicable Diseases / transmission
  • Community-Acquired Infections / prevention & control
  • Databases, Bibliographic
  • Gastrointestinal Diseases / prevention & control*
  • Hand Disinfection / methods*
  • Hand Disinfection / standards
  • Humans
  • Respiratory Tract Infections / prevention & control*
  • Risk Assessment
  • Skin Care / methods*
  • Skin Care / standards
  • Surface-Active Agents


  • Surface-Active Agents