ICAAC: Hand Hygiene Slipping in Public Washrooms

CHICAGO, Sept. 17 -- Americans are even less conscientious about washing up after visiting public washrooms than they were two years ago, according to a study released here.

And men are leading the retreat, according to an observational study of more than 6,000 people conducted this year by the American Society of Microbiology and the Soap and Detergent Association, a Washington-based trade association.

Overall, the study found, 77% of men and women washed their hands after using public washrooms in six locations in four major cities - New York, Chicago, Atlanta, and San Francisco.

That's down from 83% when the survey was conducted in the same locations two years ago, spokesmen for the two groups told attendees at the Interscience Conference on Anti-Microbial Agents and Chemotherapy.

Findings from the survey, which was conducted by Harris Interactive on behalf of the two groups, include a sharp difference between men and women.

In 2007, men washed their hands just 66% of the time, down from 75% in the previous survey in 2005. In contrast, 88% of women washed, although that's still down 2% from 2005.

"Your hands are great distributors" of pathogens, said Judy Daly, Ph.D., of the University of Utah, a spokesman for the microbiology society. "The single most important thing we can all do to keep from getting infectious diseases and spreading them to others is to clean our hands."

Dr. Daly said the increased emphasis on hand hygiene in hospitals - with cleaning posts set up outside each room - is having an effect in that setting. But she said family doctors also need to set an example of regular hand-washing, as well as counseling patients on the benefits of what she called "this marvelous intervention."

The benefits of good hand hygiene are most easily seen in a hospital setting, "because that's where the sickest people are," said Lindsay Grayson, M.D., of Austin Health in Melbourne, Australia.

Dr. Grayson, vice-chairman of the conference's program committee, said he and colleagues have shown that proper hand hygiene in a hospital can reduce the incidence of bacteremia associated with methicillin-resistant Staphylococcus aureus by 50%.

But he said it's a "good message" to try to persuade the general public to increase their personal hygiene.

The survey, which has been performed periodically since 1996, included observers who discreetly watched hand-washing behavior in washrooms, combined with a telephone survey that asked Americans to say how often they washed their hands in various situations.

Interestingly, 92% of adults in the phone survey said they washed their hands after using a public washroom.

"There's clearly a disconnect," said Brian Sansoni of the soap makers association.

The cleanest city in the survey was Chicago, the survey found, with 81% of people washing up, followed by New York at 79%, Atlanta at 75%, and San Francisco at 73%.

The worst place for men was also the best for women - at Atlanta's Turner field, just 57% of men washed up, compared with 95% of women. The best place for men was Chicago's Shedd Aquarium, where 81% lathered up.

The observational part of the study took place at Chicago's Museum of Science and Industry and Shedd Aquarium, at Grand Central and Penn stations in New York, at Turner Field, and at the Ferry Terminal Farmers Market in San Francisco.

All told, 6,076 adults were observed in the six locations, including 3,065 men and 3,011 women. Telephone interviews were conducted with 1,001 adults.