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Regular hand-washing can cut the rate of respiratory illnesses such as flu by almost half, according to a new study.

In a bid to cut absenteeism, U.S. Navy researchers ordered recruits to wash their hands at least five times a day. The researchers found that the rate of illness plummeted by 45 per cent.

Margaret Ryan of the Health Naval Research Center in San Diego said the Navy's research amounts to the largest hand-washing study ever conducted, and one of the few done outside a health-care setting. She said it demonstrates that promoting clean hands could have dramatic public-health and economic benefits.

Respiratory illnesses are the most common cause of absenteeism in the military, and severe outbreaks can compromise military readiness, Dr. Ryan said. Over the years, the U.S. military has implemented a number of programs to tackle the problem, including dust suppression, ultraviolet radiation, disinfectant vapours and widespread antibiotic prescription. None has proved anywhere near as effective as hand-washing, Dr. Ryan wrote in today's edition of the American Journal of Preventive Medicine.

According to the U.S. Centers for Disease Control, hand-washing is the single most important means of preventing the spread of infection. Eighty per cent of common infections, such as chest colds, strep throat and stomach flu, are spread directly by hands and touching, not through the air, as many people believe. Thousands of infectious microbes can live on surfaces such as doorknobs, telephones and steering wheels for up to three hours.

The American Society for Microbiology, with thousands of members across the United States, has launched a public-education campaign called Clean Hands. The campaign promotes washing your hands before they come in contact with food, contact lenses, wounds, sick or injured people and animals, and after going to the bathroom.

Joel Gaydos, head of global emerging-infections surveillance with the U.S. Defense Department, said that a growing number of resistant strains of bacteria and the relative lack of vaccines to protect people from common illnesses should underscore the importance of hand-washing.

Most people, however, erroneously believe that everything around them is germ free.

"Re-emphasizing hand-washing in our daily lives may provide significant benefits with little effort or cost, especially during the respiratory-disease season," Dr. Gaydos said.

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