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Objectives. We assessed hand-washing behaviors and intentions among school children in Bogota, Colombia, to help identify and overcome barriers to proper hygiene practices. Methods. Data on hand-washing behavior and intentions and individual and contextual factors were collected from 2042 sixth- through eighth-grade students in 25 schools in Bogota via anonymous questionnaires. A member of the school administration or teaching staff completed a questionnaire about the school environment. Site inspections of bathroom facilities were conducted. Results. Only 33.6% of the sample reported always or very often washing hands with soap and clean water before eating and after using the toilet. About 7% of students reported regular access to soap and clean water at school. A high level of perceived control was the strongest predictor of positive hand-washing intentions (adjusted odds ratio [AOR]=6.0; 95% confidence interval [CI]=4.8, 7.5). Students with proper hand-washing behavior were less likely to report previous-month gastrointestinal symptoms (OR=0.8, 95% CI=0.6, 0.9) or previous-year school absenteeism (OR=0.7; 95% CI=0.6, 0.9). Conclusions. Scarcity of adequate facilities in most schools in Bogota prevents children from adopting proper hygienic behavior and thwarts health promotion efforts. The current renovation program of public schools in Bogota provides a unique opportunity to meet the challenges of providing a supportive environment for adoption of healthy behaviors. doi:10.2105/AJPH.2007.129759)

Handwashing after using the restroom is generally poor across the population, and one common method used to increase the frequency of handwashing is to place signs reminding individuals to wash their hands. The current study examined the association between the absence and presence of signs reminding one to wash their hands and handwashing in public restrooms. Signs prompting handwashing behavior remind restroom patrons of acceptable behavior, and the presence of these signs is hypothesized to be associated with an increase in handwashing. Observation of 175 individuals (95 women and 80 men) using public restrooms on a university campus indicated that 61% of the women and 37% of the men observed washed their hands, e.g., washing hands with soap, in the absence of the sign, and 97% of the women and 35% of the men observed washed their hands in the presence of the sign. Further, 53% of the men and 38% of the women observed rinsed their hands, e.g., washing hands without soap, in the absence of the sign, and 55% of the men and 2% of the women observed rinsed their hands in the presence of the sign. Results are discussed in terms of possible factors associated with sex differences in handwashing and the absence and presence of visual prompts for handwashing behavior.

Little is known about effects of public use of antimicrobial handwashing soap. A double-blinded, randomized clinical trial of hands of primary caretakers in 238 inner city households was conducted in which effects of plain or antimicrobial (containing 0.2% triclosan) handwashing soap on bacterial counts of the hands were compared before and after a single wash and before and after handwashing following a year of product use. The randomly assigned product was provided without cost to each household during monthly home visits, and compliance with product use was monitored. Households were contacted by telephone weekly and with a home visit monthly for 11 months. Hand cultures were obtained before and after handwashing at baseline and after 11 months, using a modified glove juice technique. Overall, there were no significant differences in pre-to-post handwashing counts at baseline (p = 0.41), but by the end of one year, post-wash counts were significantly lower than pre-wash (p = 0.000) for those using either antimicrobial or plain soap. There were no significant differences in mean log counts either before or after handwashing between those using the antimicrobial or plain soap at baseline or after a year of use (all p values >0.28). For the group using antimicrobial soap, higher counts were observed post-handwashing in 31.3% of paired samples at baseline and 26.7% after one year (p = 0.03). A single handwash had minimal effect on quantity of hand flora, but there were significant effects over time, regardless of whether antimicrobial or plain soap was used. In the absence of more definitive evidence, the risk-benefit ratio argues in favor of targeted rather than ubiquitous, general household use of antimicrobial soap. KEY WORDS: handwashing; sanitation.

Community-based epidemiologic studies have shown that hand sanitizers have beneficial effects. Hand sanitizers have been found to be effective in reducing gastrointestinal illnesses in households (Sandora et al., 2004), in [...]

'Frequent handwashing is one of the best ways to help prevent the spread of disease' according to the Centers for Disease Control and Prevention (CDC). Research has shown that hand washing helps prevent absenteeism in schools. Health fairs, after-school programs and activities in child care facilities, preschools, and elementary schools are ideal settings in which to promote hand washing. The purpose of this project was to develop an educational activity for educators to use with younger children in these locations. In 'Sink Those Germs' children 'sink germs' by tossing bean bag 'germs' into a container ('sink').The game uses 6 bean bags, corresponding with 6 times to wash hands. The game materials include (1) a poster showing when to wash hands; (2) a 'Sink Those Germs' label for 'sink;' and (3) a take-home coloring sheet on hand washing. Members of the Society for Nutrition Education SNEEZE listserv were invited to review the materials during development; 96% of respondents (n = 48) felt that the materials would be helpful. After incorporating suggestions from SNEEZE members and from using the activity with children, we notified educators on several listservs about downloading these materials from the Web. During the first 3 months, the 'Sink Germs' homepage received 7000+ hits. In an on-line evaluation, 96% (n = 201) responded the materials were helpful to them; 95.5% felt 'inspired to try something new as a result of these materials.' A sample comment: 'This site was really helpful for our handwashing display and the children loved the games and coloring sheets.' Regular operating funds funded this project.