The Effect of a School Based Hand Sanitizer Program on Asthma

描述（由申请人提供）：在美国，儿童哮喘是一个有据可查的公共卫生问题。儿童哮喘的影响可以通过卫生保健费用和发病率来衡量。哮喘的发病率是季节性的，秋季发病率最高，仲夏发病率最低。与年龄有关的季节变化很大，小学生最容易受到季节变化的影响。此外，儿童哮喘发病率的年度高峰已被证明与学年开始有关。最近的研究表明，儿童的这种季节性主要与病毒性呼吸道感染有关。经常洗手已被广泛认为是对抗包括病毒在内的传染病传播的最有效手段。然而，学龄儿童的有效洗手充其量是不一致的。学校环境为有效洗手提供了多种障碍，例如时间限制，经常缺乏肥皂，毛巾和战略位置的水槽。用于防止过度使用水的弹簧加载的水龙头无意中对彻底的手部清洁造成额外的障碍。在这样的环境中，手消毒可以通过抗微生物免冲洗手消毒剂有效地完成。因此，我们建议与单一学区合作，以实现以下具体目标：1.开发一个简单的学校为基础的干预使用洗手液，以减少哮喘儿童哮喘急性发作。2.在活动组和安慰剂组中实施以学校为基础的互联网监测系统，以记录哮喘症状，峰值流量计读数，学校缺勤和在学校使用急救药物。3.随机选择26所学校，使用活性或安慰剂洗手液。4.采用交叉设计比较活性药物组和安慰剂组每月至少发生一次急性发作的哮喘儿童的时间平均比例。改善学校环境中的手部卫生可能是一种相对简单但有效的降低哮喘恶化风险的方法。通过实现这些具体目标，本研究将提供有关洗手液在学校环境中的有效性的有价值的信息。

DESCRIPTION (provided by applicant): Pediatric asthma is a well documented public health issue in the United States. The impact of pediatric asthma can be measured by both health care costs and morbidity. Asthma morbidity is seasonal with the greatest number of exacerbations occurring in autumn and the fewest in mid-summer. There is a strong age-related seasonal variability with grade school children being the most vulnerable to seasonal changes. Furthermore, the annual peak asthma morbidity for children has been shown to be associated with the start of the school year. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular handwashing has been widely recognized as the most effective means to combat the spread of infectious illness, including viruses. However, effective handwashing among school-age children is inconsistent at best. The school setting provides multiple barriers to effective handwashing such as time constraints, and frequent lack of soap, towels, and strategically located sinks. Spring loaded faucets which serve to prevent overuse of water inadvertently pose an additional barrier to thorough hand cleansing. Hand sanitization in such settings may be effectively accomplished by antimicrobial rinse-free hand sanitizers. Therefore, we propose to collaborate with a single school district to achieve the following specific aims: 1. Develop a simple school based intervention using hand sanitizers to decrease asthma exacerbations in children with asthma. 2. Implement a school based internet monitoring system within both the active and placebo groups to record asthma symptoms, peak flow meter readings, school absences, and use of rescue medications at school. 3. Randomize 26 schools to either active or placebo hand sanitizer. 4. Use a cross-over design to compare the active and placebo groups with regard to time-averaged proportion of children with asthma who have at least one exacerbation per month. Improving hand hygiene in the school environment may be a relatively simple, yet effective way to reduce the risk of asthma exacerbations. By achieving these specific aims, this study will provide valuable information on the effectiveness of hand sanitizers in the school setting.