Hand washing and adolescents. A study from seven schools in Konya, Turkey

The aim of the study was to evaluate how and when adolescent students washed their hands and to detect the conditions that affect hand washing in schools. Seven schools were selected in Konya, Turkey. A questionnaire assessing the answers of 'how long', 'when' (frequency of hand-washing in six conditions with a Likert scale; after toilet, before eating, after eating, entering the home, cleaning a room, when sneezed or coughed), 'how' (hand-washing techniques) and 'why' was given to students. According to self report, person who washed his hands more than or equal to 20 sec and had adequate washing techniques (with soap and water) and had washing frequency score more than 20 was defined as having 'proper basic handwash'. Of a total of 1074 students, 1021 responded. According to self reported behaviours and attitudes, soap and water were used in 99.2% of hand washes, and an alcohol preparation was used in 0.2% of cases and wet paper was used in the remaining 0.6% in the schools. The average duration of soap and water washes was 41.8 +/- 39.1 sec. Overall, 42.4% of adolescents had a proper basic handwash. In multivariate analysis female sex, living at home, high knowledge level and urban school were associated with high proper basic handwash. In addition to this, the presence of some complaints about toilets in school affected proper basic hand wash in univariate analysis. Contrary to what had been expected, a factor such as type of school (health trade school) was not found to be associated with high proper basic handwash in both multivariate and univariate analysis. As a result, adolescents have limited knowledge about indications of hand-washing and some problems adversely influenced hand-washing. To increase compliance, problems should be solved and lessons about hand-washing and communicable disease should be given.