Handwashing Reduces Rates of Respiratory Illness

Aug. 1, 2001
An experiment revealed that Navy recruits had 45 percent fewer bouts of respiratory illness after being ordered to wash their hands frequently.

A little soap and water go a long way toward preventing illness, a piece of common sense dramatically demonstrated by an experiment with Navy recruits who had 45 percent fewer bouts of respiratory illnesses after being ordered to wash their hands frequently.

Respiratory illnesses are the most common cause of lost time from duty among young adults in the military, and a large outbreak can compromise military readiness, according to Dr. Margaret A. K. Ryan, with the Naval Health Research Center in San Diego.

Handwashing has been recommended for more than 150 years as a simple but effective way of thwarting the spread of illnesses, but military personnel, as well as people outside the military, often don''t follow the advice.

Ryan''s findings are published in the August issue of the Journal of Preventive Medicine.

The study describes a program called Operation Stop Cough, implemented at the Great Lakes Recruit Training Command Center in Illinois.

Health officials devised the program as a low-tech response to the impending lack of a vaccine the military uses to reduce the incidence of respiratory illness.

In the past century, the military has tried everything from dust suppression, ultraviolet radiation, disinfectant vapors and widespread antibiotics to prevent infections, according to Ryan.

As part of the handwashing program, commanding officers told recruits to wash their hands at least five times a day. Other changes were made to facilitate frequent handwashing, including allowing "wet sinks" (rather than dry) to be acceptable for inspection purposes, installation of liquid soap dispensers at all sinks in training spaces and monthly barracks inspection "to include assessment of sink and soap availability."

Ryan and her colleagues tracked illness among Navy recruits who participated in Operation Stop Cough from 1997 to 1998 by reviewing weekly illness rates, based on trips to the medical clinic that serves the training center and visits to naval hospitals. They compared this information to rates in 1996, a year before the program went into effect.

"The overall rate of illness in 1997 and 1998 was 45 percent lower than the average rate in the preceding year," says Ryan. "Although there may have

been other factors that affected illness rates, this work augments the growing literature assessing handwashing outside of healthcare settings, and evaluates such an intervention in the largest population described to date."

Operation Stop Cough produced no reduction in hospitalization rates, which may indicate that handwashing works best in preventing less virulent illnesses. However, handwashing may have mitigated, but did not prevent, an outbreak of adenoviral illness in the fall of 1997, according to Ryan.

Despite the success of the program, the researchers were unable to continue collecting data after 1998 because the emphasis on the handwashing program waxed and waned with staff turnover and competing pressures inherent to a military training center. Additionally, a survey found that close to half the recruits said keeping up the five-times-a-day washing schedule was difficult, Ryan writes.

"Increasing and sustaining compliance with handwashing may be best accomplished through a multifaceted organizational commitment," she says.

Though not a substitute for vaccines, handwashing is especially valuable, according to Dr. Joel C. Gaydos, with the Defense Department''s Global Emerging Infections Surveillance and Response System.

"My impression is that in settings where visible soiling of hands is unusual, such as in offices, people are not inclined to wash their hands even before eating," says Gaydos. "Re-emphasizing handwashing in our daily lives may provide significant benefits with little effort or cost, especially during the respiratory disease season."

by Virginia Foran

About the Author

EHS Today Staff

EHS Today's editorial staff includes:

Dave Blanchard, Editor-in-Chief: During his career Dave has led the editorial management of many of Endeavor Business Media's best-known brands, including IndustryWeekEHS Today, Material Handling & LogisticsLogistics Today, Supply Chain Technology News, and Business Finance. In addition, he serves as senior content director of the annual Safety Leadership Conference. With over 30 years of B2B media experience, Dave literally wrote the book on supply chain management, Supply Chain Management Best Practices (John Wiley & Sons, 2021), which has been translated into several languages and is currently in its third edition. He is a frequent speaker and moderator at major trade shows and conferences, and has won numerous awards for writing and editing. He is a voting member of the jury of the Logistics Hall of Fame, and is a graduate of Northern Illinois University.

Adrienne Selko, Senior Editor: In addition to her roles with EHS Today and the Safety Leadership Conference, Adrienne is also a senior editor at IndustryWeek and has written about many topics, with her current focus on workforce development strategies. She is also a senior editor at Material Handling & Logistics. Previously she was in corporate communications at a medical manufacturing company as well as a large regional bank. She is the author of Do I Have to Wear Garlic Around My Neck?, which made the Cleveland Plain Dealer's best sellers list.

Nicole Stempak, Managing Editor:  Nicole Stempak is managing editor of EHS Today and conference content manager of the Safety Leadership Conference.

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