Relationship between handwashing practices and infectious diseases in Korean students

한국 학생의 손씻기 실천과 감염병 이환과의 관련성

  • Zhang, Dong-Fang (Department of Public Health, The Graduate School of Public Health & Wlefare, Konyang University) ;
  • Lee, Moo-Sik (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Hong, SuJin (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Yang, Nam-Young (Department of Nursing, College of Medicine, Konyang University) ;
  • Hwang, Hae-Jung (Department of Health & Welfare Management, Konyang Cyber University) ;
  • Kim, Byung-Hee (Department of Advertising and Public Relations, School of Communication, Sewon University) ;
  • Kim, Hyun-Soo (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Kim, Eun-Young (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Park, Yun-Jin (Division of Infectious Disease Control, Korea Center for Disease Control and Prevention) ;
  • Lim, Go-Un (Division of Infectious Disease Control, Korea Center for Disease Control and Prevention) ;
  • Kim, Young-Tek (Division of Infectious Disease Control, Korea Center for Disease Control and Prevention)
  • 장동방 (건양대학교 보건복지대학원 보건학과) ;
  • 이무식 (건양대학교 의과대학 예방의학교실) ;
  • 홍수진 (건양대학교 의과대학 예방의학교실) ;
  • 양남영 (건양대학교 간호대학 간호학과) ;
  • 황혜정 (건양사이버대학교 보건복지경영학과) ;
  • 김병희 (서원대학교 광고홍보학과) ;
  • 김현수 (건양대학교 의과대학 예방의학교실) ;
  • 김은영 (건양대학교 의과대학 예방의학교실) ;
  • 박윤진 (질병관리본부 감염병관리과) ;
  • 임고운 (질병관리본부 감염병관리과) ;
  • 김영택 (질병관리본부 감염병관리과)
  • Received : 2015.06.23
  • Accepted : 2015.12.19
  • Published : 2015.12.31


Objectives: The purpose of this study was to investigate the association between practice and infectious diseases in elementary, middle and high school students. Methods: In 16 metropolitan cities and province of the Korea, the students who from fourth grade of elementary school to third grade of high school were surveyed by personal interviews and an web-based online survey from 5 to 25 September, 2014. We analyzed data with chi-square test and logistic regression analysis. Results: Common cold, diarrhea, and eye infections were more prevalent among students in higher grade than lower grade. In particular, common cold was more prevalent among girls than boys, using hand sanitizer than washing with soaps, and students who wash the dorsal side of hand than not wash the dorsal side of hand. Conclusions: Higher-grade students showed low status of hand washing practice. Hand washing was determined as the fact which influences to increase the prevention of communicable disease such as common cold. Considering the fact that youth groups have higher risk of being infected due to their group life, schools are recommended to provide adequate educations regarding proper hand washing practice with soap.


  1. Ko IS. A Study on the Preventive Health Behavior of Teachers in Seoul [dissertation]. Seoul, Korea National University, 1995 (Korean)
  2. Young GS. The history of infectious diseases is now 'under way'. Korean Journal of Medicine 2005;68(2):127-128 (Korean)
  3. Jang YJ, Lee SW, Youn SK. Revision of Epidemiological Investigation Guideline for Water & Foodborne Diseases. Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention. 2013 (Korean)
  4. Jeong JS, Choi JK, Joeng IS, Pack KR, In HK, Park KD. A nationwide survey on the hand washing behavior and awareness. Journal of Preventive Medicine and Public Health 2007;40(3):197-204 (Korean)
  5. Hyundae Research Institute. A research for people's recognition level and actual condition about hand washing at 2006. Korea Centers for Disease Control and Prevention(KCDC). 2006, p7-35 (Korean)
  6. Yang NY, Lee MS, Hong JY, Kim BH, Kim HS, Hong SJ, Kim EY, Kim YT, Park YJ. Related Factors of Handwashing with Soap and its Practices by Students in South Korea. Journal of Korean Public Health Nursing 2014;28(2):372-386 (Korean)
  7. Korea Centers for Disease Control and Prevention. Epidemiological Investigation of Infectious Diseases in Korea Annual Report 2013. 2014 (Korean)
  8. Jang YJ, Lee MS, Na BJ, Kim KY, Bae SH, Kim CW, Kim EY. A Study on the Knowledge, Attitude and Practice of Handwashing of Middle School Students. Journal of Korean Society for Health Education and Promotion 2007;24(4):1-22 (Korean)
  9. Jeong JS, Choi JH, Lee SH, Kim YS. Hand hygiene effects measured by hand culture in intensive care unit. Journal of Preventive Medicine and Public Health 2003;5(2):21-30 (Korean)
  10. Kim YJ. A Study on the Subjectivity about Nursing Student's Attitude after Hand Washing Education. The Journal of Digital Policy & Management 2013;11(12):621-630 (Korean)
  11. Park JS, Kim DB, Min HG. Comparison of Desiccation Methods after Hand Washing for Removing Bacteria. Journal of Biological Nursing Science 2011;13(1):8-15 (Korean)
  12. Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. International Journal of Environmental Research and Public Health 2011;8(1):97-104
  13. Korea Centers for Disease Control and Prevention. Korea Youth Risk Behavior Web-based Survey 2012. 2012 (Korean)
  14. Kim YW. The epidemiology and economic burden of pandemic influenza a(H1N1) 2009. [dissertation]. Seoul, Korea University. 2012 (Korean)
  15. Yang WJ. Survey of 1,852 middle school students of common infectious diseases, Inner Mongolia Medical College. Acta Acadmed Neimongol 2006;28(S1):214-216
  16. Choi JK. Spatio-temporal analysis of initial phase of A(H1N1) pandemic 2009 in Korea, [dissertation]. Seoul, Hanyang University. 2014 (Korean)
  17. Niffenegger JP. Proper handwashing promotes wellness in child care. Journal Of Pediatric Health Care 1997;11(1):26-31 (Korean).
  18. Seo SH. Analysis of factors related to occurrence of influenza A(H1N1) among junior high students [dissertation]. Seoul, Hanyang University. 2011 (Korean)
  19. Min YS, Lim HS, Lee K, Lim SH, Lee BS. Epidemiologic Investigation on an Outbreak of Shigellosis in Seongju-gun, Korea, 2003. Journal of Preventive Medicine and Public Health 2005;38(2):189-196 (Korean)
  20. Ansari SA, Springthorpe VS, Sattar SA, Tostowaryk W, Wells GA. Comparison of cloth, paper, and warm air drying in eliminating viruses and bacteria from washed hands. American Journal of Infection Control 1991;19(5):243-249
  21. Bartlett AV, Jarvis BA, Ross V, Katz TM, Dalia MA, Englender SJ, Anderson LJ. Diarrheal illness among infants and toddlers in day care centers: effects of active surveillance and staff training without subsequent monitoring. American Journal of Epidemiology 1988;127(4):808-817
  22. Korea Centers for Disease Control and Prevention. School-based Infectious Disease Surveillance Annual Report. 2012 (Korean)
  23. Cho KS, Choi SH, Kim SJ, Han NS, Kim HC, Lee YS, Park SM. Isolation and Characterization of Causing Viruses from Acute Conjunctivitis Patients During Year 2001 to 2003. Journal of Life Science 2004;14(4):620-626 (Korean)
  24. Kim HH, Lim HS, Min YS. Epidemiologic Investigation into the Outbreak of Acute Hemorrhagic Conjunctivitis in Gyeongju-City, South Korea, in 2002. Journal of Preventive Medicine and Public Health 2004;37(4): 312-320 (Korean)
  25. Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of Hand Hygiene on Infectious Disease Risk in the Community Setting: A Meta-Analysis. American Journal of Public Health 2008; 98(8):1372-1381
  26. Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM. Effect of handwashing on child health: a randomised controlled trial. Lancet 2005; 366(9481):225-233
  27. Uhari M, Mottonen M. An open randomized controlled trial of infection prevention in child day-care centers. Pediatric Infectious Disease Journal 1999;18(8):672-677
  28. Black RE, Dykes AC, Anderson KE, Wells JG, Sinclair SP, Gary GW, Hatch MH, Gangarosa EJ. Handwashing to prevent diarrhea in day-care centers. American Journal of Epidemiology 1981;113(4):445-451
  29. Master D, Hess Longe SH, Dickson H. Scheduled hand washing in an elementary school population. Fam Med 1997;29(5): 336-339
  30. Roberts L, Jorm L, Patel M, Smith W, Douglas RM, McGilchrist C. Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomized, controlled trial. Pediatrics 2000;105(4):743-746
  31. Curtis V, Caimcross S. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 2003;3(5):275-281