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Four graduate students from ����ֱ�� State University's College of Public Health recently completed a research project focused on hand hygiene among economically disadvantaged populations for Akron's GOJO Industries Inc., a leading global producer and marketer of skin health and hygiene solutions for away-from-home settings and inventor of PURELL® hand sanitizer.

During Spring Semester 2012, a multidisciplinary team of two doctoral students, Diana Kingsbury and Julie Schaefer, along with two Master of Public Health students, Lorriane Odhiambo and Sunita Shakya, collaborated on a social sustainability initiative to improve the lives of children in water-restricted communities.  The students explored which regions of the world would be most appropriate for GOJO outreach, assessed the current state of hand hygiene in those regions and explained the complexity of interrelated health factors that, when combined, determine childhood mortality and illness outcomes.

Context for the project was a 2008 study conducted in 42 child care centers with limited clean tap water in six towns in Colombia.  Authors were Juan C. Correa, Diana Pinto, Lucas A. Salas, Juan C. Camacho, Martín Rondón and Juliana Quintero.  The study evaluated the effectiveness of alcohol-based hand rubs in reducing acute diarrheal diseases and acute respiratory infections, which are among the leading causes of death in Colombian children ages one to five. The study employed PURELL® hand sanitizer, the use of which reduced diarrhea by 36 percent, and respiratory ailments by more than 18 percent.

The history for collaboration with ����ֱ�� State dates back to the early days of GOJO in the 1940s, when its founders sought expertise from Chemistry Professor Clarence Cooke. He assisted in the formulation of a hand cleaner that cut through, safely removed and easily rinsed tough soils from the hands of rubber workers.  Throughout the years, numerous ����ֱ�� State faculty members have collaborated with GOJO, and the company has frequently sponsored internships that draw students from across the university.

The public health team worked under the direction of  Madhav Bhatta, Ph.D., assistant professor of epidemiology; Ken Slenkovich, assistant dean, operations and community relations; and Mark James, executive director of global health programs. Their GOJO project sponsors were Nicole Koharik, global sustainability marketing director, and Carrie Anne Zapka, microbiology scientist.

"Each team member played a different role," explains Bhatta, the faculty advisor.  "The epidemiologist examined the epidemiology of water- and sanitation-related diseases and the contribution of hand hygiene to the disease burden globally.  The environmental health scholar researched issues regarding lack of water and sanitation, which plays an important role in infectious disease transmission.

"Our prevention science expert investigated behavioral and sociocultural practices associated with hand sanitization. With a multidisciplinary team approaching the issue of hand hygiene and its impact on infectious disease transmission from epidemiological, environmental, sociocultural and behavioral perspectives, the recommendations based upon their findings were particularly robust.”

"Two students were from Kenya and Nepal, and their global perspectives really helped," says Slenkovich. 

Koharik and Zapka agree. 

"They went way beyond the data and statistics to bring in real-life stories to enhance the project," says Koharik.  "All of the students challenged and learned a lot from each other," adds Zapka.

The Correa child care center study concluded that the country's disease-prevention policies should include use of alcohol-based hand rubs, especially in settings where hand washing with soap and water is limited by water availability.  Findings were published in the June 2012 issue of the Pan American Journal of Public Health. "It's clear that hand sanitizers play a significant role in health and well-being," says Zapka.  "We're making a difference in people's lives." 

GOJO considers sustainability from three perspectives:  social, environmental and economic. "It's about living and working in ways that enhance life today, while taking into account the needs of future generations," Zapka says.  "We're creating products, programs and services that are beneficial to life and producing them to help individuals and society in safe ways.”

Members of the ����ֱ�� State team returned to GOJO on Aug. 2 to present their report. "We don't think twice about clean water coming out of taps here, but almost a billion people worldwide don't have access to clean water," says Bhatta.  "And every 20 seconds a child dies from water-related illness.”

This story first appeared in Public Health Quarterly, the ����ֱ�� State College of Public Health newsletter.