Abstract
BackgroundThe economical impact of absenteeism and reduced productivity due to acute infectious respiratory and gastrointestinal disease is normally not in the focus of surveillance systems and may therefore be underestimated. However, large community studies in Europe and USA have shown that communicable diseases have a great impact on morbidity and lead to millions of lost days at work, school and university each year. Hand disinfection is acknowledged as key element for infection control, but its effect in open, work place settings is unclear.MethodsOur study involved a prospective, controlled, intervention-control group design to assess the epidemiological and economical impact of alcohol-based hand disinfectants use at work place. Volunteers in public administrations in the municipality of the city of Greifswald were randomized in two groups. Participants in the intervention group were provided with alcoholic hand disinfection, the control group was unchanged. Respiratory and gastrointestinal symptoms and days of work were recorded based on a monthly questionnaire over one year. On the whole, 1230 person months were evaluated.ResultsHand disinfection reduced the number of episodes of illness for the majority of the registered symptoms. This effect became statistically significant for common cold (OR = 0.35 [0.17 - 0.71], p = 0.003), fever (OR = 0.38 [0.14-0.99], p = 0.035) and coughing (OR = 0.45 [0.22 - 0.91], p = 0.02). Participants in the intervention group reported less days ill for most symptoms assessed, e.g. colds (2.07 vs. 2.78%, p = 0.008), fever (0.25 vs. 0.31%, p = 0.037) and cough (1.85 vs. 2.00%, p = 0.024). For diarrhoea, the odds ratio for being absent became statistically significant too (0.11 (CI 0.01 - 0.93).ConclusionHand disinfection can easily be introduced and maintained outside clinical settings as part of the daily hand hygiene. Therefore it appears as an interesting, cost-efficient method within the scope of company health support programmes.Trial registration numberISRCTN96340690
Highlights
The economical impact of absenteeism and reduced productivity due to acute infectious respiratory and gastrointestinal disease is normally not in the focus of surveillance systems and may be underestimated
Our study provides an initial investigation of the impact of alcohol-based hand disinfectant use at work place by assessing illness rates due to common cold and diarrhoea
Mean hand disinfection frequency reported was more than 5 times daily in 19%, 3-5 times daily in sex female male mean age
Summary
The economical impact of absenteeism and reduced productivity due to acute infectious respiratory and gastrointestinal disease is normally not in the focus of surveillance systems and may be underestimated. Large community studies in Europe and USA have shown that communicable diseases have a great impact on morbidity and lead to millions of lost days at work, school and university each year. For example, estimated the total economic impact of noninfluenza-related viral respiratory tract infections in the USA with $40 billion annually. Due to their high prevalence in working-age groups they have the potential to cause substantial health-related productivity losses [7]. This results in missed work time and caregiver absenteeism, but in high on-the-job productivity loss due to impaired work performance, too [7]. Economical investigations have proven that besides direct illness costs, indirect costs due to missed work time (absenteeism), caregiver absenteeism and on-the-job productivity loss, accounts for the biggest part of expenses caused by acute communicable illness [7]
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