PURELL Education Classroom

Schools Can Play an Important Role in Educating Children about Handwashing

David Berendes


By David Berendes, PhD, MSPH

Waterborne Disease Prevention Branch, Centers for Disease Control and Prevention*

Anyone who has spent significant time around children knows that germs spread quickly in school settings and can make children sick. Handwashing education in schools is a low-cost way to keep children healthy and help improve school attendance. Our team at the Centers for Disease Control and Prevention (CDC) recently published an article in CDC’s Morbidity and Mortality Weekly Report that highlights the links between income, illness, and missing school and the need for handwashing education in schools.

Links Between Income, Illness, and School Attendance

Our team analyzed data from 2010 to 2016 collected through the U.S. National Health Interview Survey,1 the country’s largest in-person household health survey. We examined how rates of missed school days, respiratory illness, and gastrointestinal illness among children 5 to 17 years old varied with income to identify associations among income, illness, and school attendance.

Low-income parents were more likely than higher-income parents to report that their children had been sick, but were less likely to report that their children missed school. However, when children from low-income households did miss school, they missed more school days.

A Call for Improved Handwashing Education in Schools

We know that not every parent can keep their children home from school when they are sick. This is especially true for low-income parents, who are less likely to have paid sick leave that would allow them to stay home with a sick child. Because some children may attend school while sick, and because hygiene habits form during childhood, schools are an ideal location for handwashing education. School-based hand hygiene programs can help children miss fewer school days by limiting the spread of germs,2 which is important because missing lots of school days can be associated with lower grades and test scores, not graduating on time, and dropping out.3

The benefits of increased handwashing education in schools extend beyond the classroom. Children who have been taught handwashing at school bring that knowledge home to parents and siblings and encourage them to also wash their hands.4,5 This can help family members get sick less often and miss less work and school.  

Our findings highlight the importance of handwashing education in schools and at home to keep children healthy. Teachers and parents play a critical role in teaching children how to properly wash hands and make sure that children wash hands during key times. School administrators can also make sure that students have access to clean bathroom sinks that are stocked with soap. By making handwashing accessible, easy, and fun, teachers, parents, and school administrators can help children make handwashing a healthy habit for life.

*Posting of this commentary does not imply endorsement by CDC of other blogs or commercial products, services, or companies affiliated with this website.

1. National Center for Health Statistics, CDC. NHIS—National Health Interview Survey. Atlanta, GA: US Department of Health and Human Services, CDC; 2019.https://www.cdc.gov/nchs/nhis/index.htm
2. Wang Z, Lapinski M, Quilliam E, Jaykus LA, Fraser A. The effect of hand-hygiene interventions on infectious disease-associated absenteeism in elementary schools: a systematic literature review. Am J Infect Control 2017;45:682–9.
3. Balfanz R, Byrnes V. The importance of being in school: a report on absenteeism in the nation’s public schools. Baltimore, MD: Johns Hopkins University Center for Social Organization of Schools; 2012.http://new.every1graduates.org/wp-content/uploads/2012/05/FINALChronicAbsenteeismReport_May16.pdf
4. Blanton E, Ombeki S, Oluoch GO, Mwaki A, Wannemuehler K, Quick R. Evaluation of the role of school children in the promotion of point-of-use water treatment and handwashing in schools and households–Nyanza Province, Western Kenya, 2007.External Am J Trop Med Hyg. 2010;82(4):664-71. 5. O’Reilly CE, Freeman MC, Ravani M, Migele J, Mwaki A, Ayalo M, Ombeki S, Hoekstra RM, Quick R. The impact of a school-based safe water and hygiene programme on knowledge and practices of students and their parents: Nyanza Province, western Kenya, 2006. Epidemiol Infect. 2008;136(1):80-91.

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