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No nit policy is a treatment system recommended by health authorities in the USA, Canada and Australia to assist in the elimination of "head lice infestation". The "no nit" policy requires the sending home and barring of all children who have head lice, eggs and/or nits on their hair from controlled settings such as school, summer camp or day care facilities.〔(Head louse infestations: the "no nit" policy and its consequences ), KY Mumcuoglu, TA Meinking, CN Burkhart, CG Burkhart, Int J Dermatol. 2006 Aug;45(8):891-6.〕 The no nit policy involves a number of issues, such as the circumstances under which children will be inspected, the criteria to infer infestation, the procedures for dealing with infested children upon discovery, and the criteria to permit previously infested children to return to school. These issues are controversial. In particular, a number of health researchers and organizations object to the required removal of nits.〔〔 〕〔 〕〔 〕 Opponents to the no-nit policy point out that nits, being empty eggshells, have no clinical importance.〔 Time-consuming nit removal, therefore, has no direct effect on transmission. This has led to the perception that the no-nit policy serves only to ease the workload of school nurses.〔 Proponents of the no-nit policy counter that only a consistently nit-free child can be reliably shown to be infestation-free.〔 〕 That is, the presence of nits serves as a proxy for infestation status. Proponents argue that such a proxy is necessary because lice screening is prone to false negative conclusions (i.e., failure to find lice present on actively infested children).〔〔 〕 〔 〕 Contributing to the controversial nature of school head lice policies is a lack of available data on their importance and efficacy. For example, , the transmissibility of head lice in school settings is largely unknown.〔 Further, control-matched studies of the effect of specific school policies on head lice incidence are also lacking.〔 Schools in developed countries such as the United States, Canada, and Australia commonly exclude infested students, and prevent return of those students until all lice, eggs, and nits are removed.〔 Policies in the United Kingdom extend to legal action against parents of infested students.〔 〕 Attitudes in developing countries are often quite different. Many societies consider head louse infestation to be normal, if even remarked upon at all.〔〔 〕 ==Inspection== A 1991 survey of American nurses reported that 27% have regular inspection programs in place at their schools.〔 85% reported inspection on an "as-needed" basis.〔〔 Routine inspection of children is advocated by a variety of nurses, researchers, organizations, and governments.〔〔〔 Head lice cannot live more than a day or two away from a host.〔 Any remaining eggs will hatch in one to two weeks,〔〔 〕 and absent a host, the emerging nymphs will die within hours.〔 Thus, simply leaving the school vacant for a week or two is sufficient to disinfect all fomite sources of head louse infection. The return of children to this now-clean environment is an ideal time to check for infestations and attempt to keep the environment lice-free.〔 The California Department of Public Health encourages inspections to be performed on Fridays.〔 Some health researchers oppose regular inspections.〔〔 This opposition to school inspections coincides with opposition to no-nit policies, and is based on similar reasoning (i.e., that they are ineffective).〔 Lice infestation is not a reportable disease, so data on head lice incidence are sparse.〔〔 〕〔 〕 , no control-matched study exists on the effect of school screening programs on head lice prevalence.〔 Further, although some authors note a stubborn prevalence of head lice during the latter half of the 20th century, this has occurred in an environment of rather lax screening efforts. For example, a 1991 survey of American nurses reported that only 27% had regular screening programs in place at their schools.〔 Anecdotal evidence suggests that school screening programs ''can'' reduce head lice prevalence.〔〔〔 〕 Certainly, the effectiveness of these programs must be determined before their ''cost effectiveness'' can be evaluated. Barbara Frankowski, a critic of school screenings, argues that time spent screening children by school nurses is better spent on other tasks.〔 This attitude reflects those held by some American school nurses themselves, 27% of whom believe that eliminating lice infestations in ''not'' an important role of school nursing.〔 Even more telling, only 11% of American school nurses find treating head lice to be professionally gratifying.〔 Similar attitudes exist among Canadian school nurses.〔 〕 School inspections are often short—about one minute per child.〔〔 Frankowski argues that such inspections are not thorough enough to be accurate, and so may lead to a false sense of security.〔 Indeed, a 1998 study of Israeli children found that live lice took an average of 57 – 116 seconds to detect depending on the technique used. L. Keoki Williams and others acknowledge this shortcoming of school screening, and suggest that children found to have nits undergo an additional 5- to 10-minute examination to exclude the presence of live lice.〔 In contrast, the American Academy of Pediatrics (AAP) argues not for increased inspection time, but elimination of the school screenings altogether, with parents being educated and encouraged to inspect their own children at home.〔 This attitude, coupled with the AAP's opposition to the no-nit policy,〔 would essentially absolve school administrators of responsibility to directly manage pediculosis in their student body. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「No nit policy」の詳細全文を読む スポンサード リンク
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