Physical interventions to interrupt or reduce the spread of respiratory viruses. Part 2 - Hand hygiene and other hygiene measures: systematic review and meta-analysis.

Lubna A Al-Ansary; Ghada A Bawazeer; Elaine Beller; Justin Clark; John Conly; Chris Del Mar; Elizabeth Dooley; Eliana Ferroni; Paul Glasziou; Tammy Hoffman; Tom Jefferson; Sarah Thorning; Mieke van Driel; Mark Jones

The composite outcome of 'ARI or ILI or influenza", the outcome of ARI alone and the outcome of absenteeism showed a significant benefit from hand hygiene. A non-significant benefit in favour of hand hygiene for laboratory-confirmed influenza may reflect less effect for this specific virus or sample size issues for a more rigourous outcome measure. We did not find an effect of combined hand hygiene and masks interventions, although there were few trials, mostly small in size, so CIs are wide. Similarly, we did not find a benefit for the addition of masks to hand hygiene, again CIs are wide, and it is difficult to draw a conclusion from these data. There were too few trials comparing different types of hand hygiene interventions to be certain of any differences between soap and water, alcohol-based hand sanitisers, or other types of interventions.