Elaine L. Larson, PhD; Susan X. Lin, DrPH; Cabilia Gomez-Pichardo, MD; Phyllis Della-Latta, PhD
Acknowledgments: The authors thank Ms. Delmy Miranda and Dr. Angela Lopez, who served as interviewers in the research team.
Grant Support: By the National Institute for Nursing Research, National Institutes of Health (grant 1 RO1 NR05251). Procter & Gamble, Cincinnati, Ohio, provided products packaged in a blinded fashion.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Elaine Larson, PhD, Columbia University School of Nursing, 630 West 168th Street, New York, NY 10032; e-mail, ELL23@Columbia.edu.
Current Author Addresses: Drs. Larson and Lin: Columbia University School of Nursing, 630 West 168th Street, New York, NY 10032.
Dr. Gomez-Pichardo: Center for Liver Disease and Transplantation, 622 West 168 Street PH14, P&S 9-501, New York, NY 10032.
Dr. Della-Latta: Clinical Microbiology Laboratory, Children's Hospital of New York, 3S Room 325, 622 West 168th Street, New York, NY 10032.
Author Contributions: Conception and design: E.L. Larson.
Analysis and interpretation of the data: E.L. Larson, S.X. Lin.
Drafting of the article: E.L. Larson, S.X. Lin, P. Della-Latta.
Critical revision of the article for important intellectual content: E.L. Larson, S.X. Lin, P. Della-Latta.
Final approval of the article: E.L. Larson, S.X. Lin, C. Gomez-Pichardo, P. Della-Latta.
Provision of study materials or patients: P. Della-Latta.
Statistical expertise: S.X. Lin.
Obtaining of funding: E.L. Larson.
Administrative, technical, or logistic support: P. Della-Latta.
Collection and assembly of data: E.L. Larson, S.X. Lin, C. Gomez-Pichardo.
Despite the widespread household use of cleaning and personal hygiene products containing antibacterial ingredients, their effects on the incidence of infectious disease symptoms have not been studied.
To evaluate the effect of antibacterial cleaning and handwashing products for consumers on the occurrence of infectious disease symptoms in households.
Randomized, double-blind clinical trial.
Northern Manhattan inner-city neighborhood, New York.
238 primarily Hispanic households (1178 persons) that included at least one preschool-age child.
Households were randomly assigned to use either antibacterial or nonantibacterial products for general cleaning, laundry, and handwashing. All products were commercially available, but the packaging was blinded and the products were provided free to participants.
Hygiene practices and infectious disease symptoms were monitored by weekly telephone calls, monthly home visits, and quarterly interviews for 48 weeks.
Symptoms were primarily respiratory: During 26.2% (717 of 2736) of household-months, 23.3% (640 of 2737) of household-months, and 10.2% (278 of 2737) of household-months, one or more members of the household had a runny nose, cough, or sore throat, respectively. Fever was present during 11% (301 of 2737) of household-months, vomiting was present in 2.2% (61 of 2737), diarrhea was present in 2.5% (69 of 2737), and boils or conjunctivitis were present in 0.77% (21 of 2737). Differences between intervention and control groups were not significant for any symptoms (all unadjusted and adjusted relative risks included 1.0) or for numbers of symptoms (overall incidence density ratio, 0.96 [95% CI, 0.82 to 1.12]).
The tested antibacterial products did not reduce the risk for symptoms of viral infectious diseases in households that included essentially healthy persons. This does not preclude the potential contribution of these products to reducing symptoms of bacterial diseases in the home.
Household cleaning products containing antibacterial ingredients are widely available and popular. Although manufacturers use claims of health benefits to market these products, evidence linking the use of antibacterial products to health outcomes has been lacking.
This innovative trial found no difference in episodes of infectious disease symptoms over one year in 228 inner-city households randomly assigned to use antibacterial household cleaning products or identically packaged products without antibacterial ingredients.
These findings highlight the need to better educate consumers about the use and limitations of household antibacterial cleaning products.
Profile of randomized, clinical trial.
Table 1. Characteristics of Household Members
Table 2. Rates of at Least One Infectious Disease Symptom for Each Household-Month by Group
Percentage of households with infectious disease symptoms for each household-month.
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Larson EL, Lin SX, Gomez-Pichardo C, et al. Effect of Antibacterial Home Cleaning and Handwashing Products on Infectious Disease Symptoms: A Randomized, Double-Blind Trial. Ann Intern Med. 2004;140:321–329. doi: 10.7326/0003-4819-140-5-200403020-00007
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Published: Ann Intern Med. 2004;140(5):321-329.
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