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Does Hand Sanitizer Beat Hand-Washing When It Comes to Avoiding Sick Days?

Photograph by Twenty20

It's that time of year again—cold and flu season—when the sound of your child sneezing immediately feels you with dread.

We all know how important frequent hand-washing is this time of year (and always), but one study recently published in the journal of Pediatrics shows that when it comes to fewer missed days of school and day care from illness, hand sanitizer might be even more effective than hand-washing for young children.

The study followed 911 children from newborn to 3 years old who attended day care in Spain. The kids, their families and the daycare staff were split into three groups: One group used only hand sanitizer, one used soap and water, and both of these groups were told to follow strict hygiene protocols; the third (control group) followed their usual hand-washing routines.

The results showed that the hand sanitizer group had the fewest sick days (3.25 percent vs. 3.9 percent for the soap and water group, and 4.2 percent for the control group). Although that doesn't appear to be a big difference, the study also found that the soap and water group had a 21 percent higher risk of contracting a respiratory infection and a 31 percent higher risk of being prescribed antibiotics. Frequent antibiotic use can be harmful because it has been linked to helping create bacteria that are harder to kill—or are antibiotic-resistant. Antibiotics also kill the good and helpful bacteria in the body.

It's important to note that the Centers for Disease Control and Prevention still recommends hand-washing as the "best way to reduce the number of microbes in most situations," and they emphasize the importance of teaching proper hand-washing techniques to children. This includes being sure to lather the back of your hands, between your fingers and under your nails and scrubbing for at least 20 seconds. (Children can hum the “Happy Birthday” song from beginning to end twice for reference.) They also point out that sanitizer does not eliminate all types of germs and might not be as effective when hands are visibly dirty or greasy.

This study does seem to show, however, that hand sanitizer can be an important tool for preventing the spread of germs in daycare centers and schools—where we can’t always be sure how often children are washing their hands.

As Dr. Don Goldmann, chief medical and scientific officer emeritus at the Institute for Healthcare Improvement, tells CNN, "I think the main contribution of this paper is its focus on really young children in day care. I think it does build on previous literature to support the notion that you can reduce the spread of respiratory tract infections in really young kids if you use alcohol hand sanitizer."

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