Hygiene measures to prevent transmission of infectious diseases (multiple reviews)

Added November 23, 2020

What is this? Hygiene measures (such as hand washing) are among the non-pharmaceutical interventions being used to minimise transmission of COVID-19. Several reviews are summarised here, with more details, including citations and links to the full reviews, available further down this page.

What was found: The Jefferson review (search done in April 2020) found that hand hygiene has a modest effect as a physical intervention to interrupt the spread of respiratory viruses. Similar findings were reported in the Xiao review (search done in August 2018), which did not find evidence of a major effect of hand hygiene measures, or of surface or object cleaning, on transmission rates of influenza.

The Teasdale review (search done in February 2013) found that people viewed hand hygiene, as well as respiratory hygiene, as familiar and socially responsible actions.

The Smith review (search done in February 2014) found that gargling povidone-iodine lowered overall upper respiratory tract infection rates but did not lower the risk of influenza.

The Baharoon review (search done before October 2019) reported that lapses in infection control measures within healthcare facilities were an important factor in relation to the transmission of MERS.

None of these reviews provided evidence on respiratory hygiene interventions.

What are the reviews:

Citation: Baharoon S, Memish ZA. MERS-CoV as an emerging respiratory illness: a review of prevention methods. Travel Medicine and Infectious Disease. 2019;32:101520.

In this narrative review, the authors searched for studies of prevention or infection control for MERS-CoV. The review was submitted for publication in October 2019 but it is unclear when the authors did their search, whether they restricted it in any way or how many studies they included.

Citation: Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, Driel ML, Jones MA, Thorning S, Beller EM, Clark J, Hoffmann TC, Glasziou PP, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database of Systematic Reviews. 2020;(11):CD006207.

In this Cochrane Review, the authors searched for randomized trials of the effects of physical interventions on respiratory virus transmission. They did not restrict their searches by language of publication and did the search on 1 April 2020. They included 67 studies, none of which were conducted during the COVID-19 pandemic. These studies assessed a variety of interventions, including masks (15 studies), hand hygiene (25), masks and hand hygiene (7), hand hygiene and disinfection (7) and quarantining workers (1). There were no randomized trials on eye protection, gowns and gloves, or screening at entry ports. The authors also identified 6 ongoing studies, one of which was published on 18 November 2020, just before this review was published.

Citation: Saunders-Hastings P, Reisman J, Krewski D. Assessing the state of knowledge regarding the effectiveness of interventions to contain pandemic influenza transmission: a systematic review and narrative synthesis. PLOS ONE. 2016;11(12):e0168262.

In this systematic overview and narrative syntheses, the authors searched for systematic reviews and meta-analyses of the effects of pharmaceutical and non-pharmaceutical interventions in containing pandemic influenza transmission. They did not restrict their searches by date or language of publication and did the search in July 2016. They included 17 reviews.

Citation: Smith SM, Sonego S, Wallen GR, et al. Use of non‐pharmaceutical interventions to reduce the transmission of influenza in adults: A systematic review. Respirology. 2015;20(6):896-903.

In this systematic review, the authors searched for randomized trials of non-pharmaceutical interventions against influenza infection in community settings across five countries. They restricted their searches to articles published in English but did not restrict by date of publication and searched up to February 2014. They included 7 randomized trials that examined the effects of disinfection, hygiene, and/or barriers (e.g. masks) on risk of influenza.

Citation: Teasdale E, Santer M, Geraghty AWA, et al. Public perceptions of non-pharmaceutical interventions for reducing transmission of respiratory infection: systematic review and synthesis of qualitative studies. BMC Public Health. 2014;14:589

In this systematic review, the authors searched for qualitative research on public perceptions of physical interventions for reducing transmission of respiratory infection. They did not restrict their searches by date or language of publication and did the search in February 2013. They included 16 studies (total: 1022 participants).

Citation: Xiao J, Shiu EY, Gao H, et al. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings: Personal Protective and Environmental Measures. Emerging Infectious Diseases. 2020;26(5):967-975.

In this systematic review, the authors searched for studies of the effects of non-pharmaceutical measures for reducing influenza transmission in community settings. They did not restrict their searches by language of publication and did the search in August 2018. They included studies on hand hygiene (7 randomized trials), face masks (7 randomized trials) or both (6 randomized trials), and surface/object cleaning (2 randomized trials and 1 observational study).

Other Evidence Aid summaries:

Face masks in the community setting, as a protection against respiratory viruses (multiple reviews).

Face masks to stop the transmission of respiratory viruses from infected people (multiple reviews).

N95 respirators and surgical masks for preventing transmission of respiratory infections to healthcare workers (multiple reviews) 


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