An observational study of frequency of provider hand contacts in child care facilities in North Carolina and South Carolina

• Published in: American journal of infection control Vol. 43; no. 2; pp. 107 - 111
• Main Authors: Fraser, Angela, PhD, Wohlgenant, Kelly, MS, Cates, Sheryl, BA, Chen, Xi, MS, Jaykus, Lee-Ann, PhD, Li, You, PhD, Chapman, Benjamin, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2015; Mosby-Year Book, Inc
• Subjects: Child; Child care; Child care providers; Child Day Care Centers; Child, Preschool; Children & youth; Classroom observation; Environmental Exposure; Evidence-based medicine; Fomites; Gastrointestinal diseases; Hand contact; Hand Disinfection; Humans; Infant; Infection Control; Infection Control - methods; Infectious Disease; Nonporous surfaces; North Carolina; Observational study; Play and Playthings; Porous surfaces; Sanitation - methods; South Carolina; North Carolina; South Carolina; Child care providers; Observational study; Nonporous surfaces; Hand contact; Porous surfaces
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2014.10.017

Background Children enrolled in child care are 2.3-3.5 times more likely to experience acute gastrointestinal illness than children cared for in their own homes. The purpose of this study was to determine the frequency surfaces were touched by child care providers to identify surfaces that should be cleaned and sanitized. Methods Observation data from a convenience sample of 37 child care facilities in North Carolina and South Carolina were analyzed. Trained data collectors used iPods (Apple, Cupertino, CA) to record hand touch events of 1 child care provider for 45 minutes in up to 2 classrooms in each facility. Results Across the 37 facilities, 10,134 hand contacts were observed in 51 classrooms. Most (4,536) were contacts with porous surfaces, with an average of 88.9 events per classroom observation. The most frequently touched porous surface was children's clothing. The most frequently touched nonporous surface was food contact surfaces (18.6 contacts/observation). Surfaces commonly identified as high-touch surfaces (ie, light switches, handrails, doorknobs) were touched the least. Conclusion General cleaning and sanitizing guidelines should include detailed procedures for cleaning and sanitizing high-touch surfaces (ie, clothes, furniture, soft toys). Guidelines are available for nonporous surfaces but not for porous surfaces (eg, clothing, carpeting). Additional research is needed to inform the development of evidence-based practices to effectively treat porous surfaces.