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community health, hygiene, infection



  1. Larson, Elaine L.
  2. Lin, Susan X.
  3. Gomez-Pichardo, Cabilia


Background: Despite the fact that hygienic practices have been associated with reduced risk of infection for decades, the potential role of specific home hygiene and cleaning practices in reducing risk have not been explicated.


Objective: This study aimed to determine the incidence and predictors of infectious disease symptoms over a 48-week period in inner city households.


Methods: Cleaning and hygiene practices and the incidence of infectious disease symptoms were closely monitored prospectively for 48 months in 238 households. Each household was contacted by trained interviewers weekly via telephone, was visited monthly, and underwent an extensive home interview quarterly.


Results: The incidence of new symptoms in the month before quarterly home visits ranged from 8.9% to 12.4% for individuals and from 32% to 39.7% for households. Four factors were significantly associated with infection. Drinking only bottled water increased risk (relative risk [RR], 2.1; 95% confidence interval [CI], 1.2-3.7). Using hot water (RR, 0.7; 95% CI, .5-.9) and bleach (RR, 0.29; 95% CI, .23-.66) for laundry and reporting that germs were most likely to be picked up in the kitchen (RR, 0.5; 95% CI, .3-.8) were protective. No other hygiene practices, including hand washing, were associated with infection risk.


Conclusions: Further studies of a potential role for bottled water in infections are warranted, as is a renewed appreciation for the potential protective role of laundry practices such as using bleach and hot water.