The use of hand sanitizers or hand rubs for infection control has been evaluated in health care facilities, at home, and in day care centers and schools. Most of these studies showed a significant reduction in the occurrence of infections in general. However, effectiveness of the sanitizers may vary depending on the individual agents, especially viruses. Hand sanitizer products containing alcohol tend to have greater activity against non-enveloped viruses (e.g., respiratory syncytial virus, influenza, parainfluenza viruses, HIV, and herpes simplex virus) than against enveloped viruses (e.g., rhinovirus, enterovirus, adenovirus, rotavirus,7 and caliciviruses).8 Washing one’s hands for an extended time, however, can enhance the antiviral activity of hand sanitizers toward enveloped viruses.

Picornaviruses (e.g., enteroviruses, rhinoviruses, and hepatitis A virus) are particularly difficult to eradicate from hands or environmental surfaces but may be inactivated by high concentrations of alcohol and extended hand-washing time. Nevertheless, for all of these viruses, hand sanitizers have been shown to be more effective than routine hand washing. A number of studies have examined the efficacy of hand sanitizers over traditional hand-washing methods in reducing the incidence of acute illnesses and absenteeism. A systematic review of five published studies on the effectiveness of hand sanitizers in preventing absenteeism due to illness in elementary school children revealed a significant advantage for hand sanitizer use over baseline conditions, which may have included soap and water or no structured hand washing.

However, the quality and heterogeneity of the reports prevented the calculation of pooled estimates. Recently the Centers for Disease Control and Prevention (CDC) revised its guidelines for hand hygiene in health care settings to recommend hand washing to remove visible soiling. Otherwise the use of hand sanitizers is recommended based on their efficacy, the propensity of health care workers to use them, and the low incidence of adverse effects (CDC, 2002).9 The CDC’s recommendations also emphasized that for health care facilities the items necessary for hygiene and cough etiquette must be readily available, including disposable tissues, no-touch waste receptacles, conveniently located dispensers of alcohol-based hand rub solutions, and, wherever sinks are available, supplies for hand washing. Similar measures could be implemented in green schools; ongoing maintenance would be required if such measures are to be effective. The efficacy of the measures contained in these recommendations in reducing respiratory illness and absenteeism has not been proved. The recommendations are based, instead, on the assumption that the measures will disrupt the primary modes of transmission of the agents most frequently causing respiratory and gastrointestinal illnesses. Assuring compliance with these measures is problematic for any age and probably impossible for young children.

However, for older children and staff, constant reminders to follow these measures and ensuring that hand sanitizers and other items are routinely available seem reasonable considering the ways in which infectious agents spread, the low cost of these items, and the absence of significant adverse effects. Learning things is not limited to the scentific area. Instead it also has relations with some other things like speaking a language or using software, including Rosetta Stone Arabic and Rosetta Stone Chinese. If you have a creative mind, you will make all your own differences in the end!