Recent Handwashing Study Shows Gap between Knowing and Doing

In the most recent of ASM's periodic surveys of handwashing behavior among the public, 91% of American adults said they always wash their hands after using public restrooms.  But just 83% actually did so, according to a separate observational study.

            These results were among those released by ASM and The Soap and Detergent Association (SDA), during a press conference on 21 September 2005 highlighting National Clean Hands Week.  Both groups have used surveys over the years to help highlight a vital public health message from the Centers for Disease Control and Prevention (CDC): The single most important thing we can do to keep from getting sick and spreading illness to others is to clean our hands.

            “The American Society for Microbiology has been focusing on increasing public awareness of clean hands in periodic campaigns since 1996, and this message remains one of our most important priorities,” according to Judy Daly, Secretary of the Society. She is Director of the Microbiology Laboratories, Primary Children’s Medical Center, Salt Lake City, Utah and Professor in the Department of Pathology, University of Utah School of Medicine.

            An August 2005 study conducted for ASM and SDA by Harris Interactive® observed 6,336 individuals wash their hands—or not—at six public attractions in four major cities: Atlanta (Turner Field), Chicago (Museum of Science and Industry, Shedd Aquarium), New York City (Grand Central Station, Penn Station), and San Francisco (Ferry Terminal Farmers Market). 

            Observers discreetly watched and recorded whether or not adults using public restrooms washed their hands.  Observers were instructed to groom themselves (comb their hair, put on make-up, etc.) while observing and to rotate bathrooms every hour or so to avoid counting repeat users more than once.  Observers were also instructed to wash their hands no more than 10% of the time.

            Ninety percent of the women observed washed their hands, compared to 75% of men.  By contrast, in an August 2005 telephone survey of 1,013 American adults also conducted by Harris Interactive®, 97% of women and 96% of men say they always or usually wash their hands after using a public restroom.

            “Good health is within reach,” said Brian Sansoni, Vice President of Communication at The Soap and Detergent Association. “Washing with soap and water is still the gold standard when it comes to removing dirt and grime from our hands.  But if soap and water are out of reach, hand sanitizers and wipes are great hygiene tools to have on hand.”

            Among those observed, fans at Atlanta’s Turner Field had the worst hand hygiene habits.  Approximately a quarter (26%) did not wash their hands after using the facilities (84% of the women washed their hands; 37% of the guys didn’t).

            The greatest gender disparity observed between women and men handwashers was in New York’s Penn Station: 92% of the women washed their hands, compared to only 64% of the men.

            Those traveling through San Francisco’s Ferry Terminal Farmers Market and Chicago's Shedd Aquarium and Museum of Science and Industry fared best in the observed handwashing study.  In both cities, 88% were observed washing their hands.

            The telephone survey questioned a nationally representative sample of 1,013 American adults.  Large majorities answered they always wash their hands after such activities as using a public restroom (91%), using the bathroom at home (83%), before handling or eating food (77%), and changing a diaper (73%).  

            Much poorer habits were revealed as fewer indicated they always washed their hands after petting a dog or cat (42%), after handling money (21%), and, most shockingly, after coughing or sneezing (32%). 

            “Only 24% of men and 39% of women say they always wash their hands after coughing or sneezing,” said the SDA’s Brian Sansoni.  “We have to do a better job here in stopping the spread of the germs that make us sick.”

            Contrary to what many people believe, cold and influenza viruses are spread much more often by hands than through airborne transmission from sneezing, according to Daly. “We unconsciously touch our mouths, noses, and eyes many, many times each day,” she said.  “These mucous membranes are welcome mats for cold and flu viruses, which are readily transferred from unclean hands.”

            Survey respondents may be more forthcoming about their hygiene habits than in the past—or else their habits are getting worse.  Over the last seven years, men’s admitted handwashing habits have declined slightly when it comes to washing their hands after using the bathroom at home, changing a diaper and before handling food.

            Meanwhile, in 2005, slightly fewer women admit to washing their hands after using a public restroom (97% of women said they did in an August 2003 Wirthlin Worldwide survey for ASM, 94% said so in the 2005 Harris Interactive survey).

            “Although many Americans are beginning to recognize the importance of washing their hands, we still need to reach many others,” Daly says.  “Our message is clear: one of the most effective tools in preventing the spread of infection is literally at our fingertips.”

            The ASM site has information about current and past surveys as well as downloadable educational resources in English and in Spanish. SDA also has hand hygiene educational resources available online at its website, – click on the “Hand Hygiene” button. ASM and SDA are both members of the Clean Hands Coalition, a national alliance of public and private partners working to create and support coordinated, sustained initiatives to significantly improve health and save lives through clean hands.  The Coalition’s website is