This Cochrane Review (published April 2020) had two objectives:
- to assess the effectiveness of rinse-free hand washing for reducing absenteeism due to illness in preschool and school children compared to no hand washing, conventional hand washing with soap and water or other hand hygiene strategies; and
- to determine which rinse-free hand washing products are the most effective (if head-to-head comparisons exist), and what effect additional strategies in combination with rinse-free hand washing have of the outcomes of interest.
It includes 19 studies with 30,747 participants. Six studies were conducted in preschools or day-care centres (children aged from birth to < five years), with the remaining 13 conducted in elementary or primary schools (children aged five to 14 years).
In terms of the first objective, the review authors found that, compared to the 'no rinse-free' group, rinse-free hand wash may reduce absenteeism for any illness (very low-certainty evidence) and acute respiratory (very low-certainty evidence) and gastrointestinal (low-certainty evidence) illnesses, but not absenteeism for any reason (very low-certainty evidence). There may be little to no difference between rinse-free hand washing and the 'no rinse-free' group for adverse skin reactions (very low-certainty evidence). Compliance with the intervention varied between moderate and high, and teachers and students perceived it positively and were willing to continue its use (very low-certainty evidence). They were unable to addresse their second objective due to a lack of data.
The review authors concluded that rinse-free hand washing regimes may have a small, potentially beneficial effect on illness-related absenteeism. However, the certainty of the evidence that contributed to this conclusion was low or very low according to the GRADE approach and is therefore uncertain.
Read the full review on the Cochrane Library.