Estimating the effect of hand hygiene compliance and surface cleaning timing on infection risk reductions with a mathematical modeling approach

Am J Infect Control. 2019 Dec;47(12):1453-1459. doi: 10.1016/j.ajic.2019.05.023. Epub 2019 Jul 19.


Background: Quantitative tools are needed to relate infection control interventions to infection risk reductions.

Methods: A model for predicting virus concentrations on hands was used to predict rotavirus, rhinovirus, and influenza A virus doses. Variability in behaviors, transfer efficiencies for various contact types, and surface areas of contact were included. Dose-response curves were used to relate estimated doses to infection risks. Percent reductions from baseline in average rotavirus, rhinovirus, and influenza A virus dose and infection risk were calculated for interventions.

Results: Baseline average infection risks for rotavirus, rhinovirus, and influenza A virus were 0.43, 0.20, and 5.51 × 10-6, respectively. One and 2 cleaning events decreased average viral infection risks by 6.98%-17.06% and 13.95%-34.66%, respectively. A 15% increase in hand compliance decreased average infection risks by 6.98%-20.51%. A 15% increase in hand hygiene compliance paired with 2 cleaning events decreased average infection risks by 20.93%-47.55%.

Discussion: This study demonstrates the infection risk benefits of combined interventions.

Conclusions: Models such as the one in this study could be used to optimize timing and frequency of cleaning events and to create hand hygiene compliance goals to achieve infection risk targets.

Keywords: Infection control; Intervention efficacy; QMRA; Virus.

MeSH terms

  • Computer Simulation
  • Cross Infection / prevention & control*
  • Equipment Contamination
  • Fomites / virology
  • Guideline Adherence / statistics & numerical data*
  • Hand Hygiene / statistics & numerical data*
  • Humans
  • Infection Control / methods
  • Infectious Disease Transmission, Professional-to-Patient / prevention & control*
  • Influenza A virus / isolation & purification
  • Models, Statistical*
  • Nurses
  • Rhinovirus / isolation & purification
  • Rotavirus / isolation & purification
  • Time Factors