Hand Washing Catching On in U.S.

In Major Cities, 85% of Adults Are Washing Their Hands After Using Public Facilities, Study Shows

Medically Reviewed by Laura J. Martin, MD on September 14, 2010
From the WebMD Archives

Sept. 14, 2010 -- Researchers who observed hand washing in restrooms in major cities say 85% of adults are washing their hands after using public facilities, a new observational study shows.

The American Society for Microbiology (ASM) and the American Cleaning Institute (ACI) sent observers into restrooms in six locations in four major cities in 2010 to monitor hand-washing trends after use of facilities.

The observers, who took steps to disguise their jobs, say they saw 85% of restroom users wash their hands, compared to 77% in 2007. It was the highest rate since such studies began in 1996. No such studies were done in 2008 or 2009.

Results of Hand-Washing Study

The results were announced in Boston at the Interscience Conference on Antimicrobial Agents and Chemotherapy, a meeting sponsored by the American Society for Microbiology. The American Cleaning Institute was formerly known as the Soap and Detergent Association.

The groups’ findings were at odds with a separate telephone survey that found that 96% of adults claimed to have washed their hands after using public restrooms.

Harris Interactive, on behalf of the ASM and the ACI, “discreetly” observed 6,028 adults in public restrooms at Turner Field in Atlanta, the Museum of Science and Industry and the Shedd Aquarium in Chicago, Grand Central Station and Penn Station in New York, and the Ferry Terminal Farmers Market in San Francisco.

Among the findings:

  • 77% of men washed their hands after public restroom use, compared to 66% in 2007.
  • 93% of women were observed washing their hands in the same locations in 2010, up from 88% in 2007.
  • Only 65% of men observed at Turner Field washed their hands, up from a mere 57% in 2007. But 98% of women at that Atlanta sports venue were observed washing their hands.
  • The highest percentages for hand washing were seen in Chicago and San Francisco, with 89% of adults soaping up. Atlanta came in next at 82%, followed by 79% in New York.

Phone Survey About Hand Washing

A 2010 Harris Interactive phone survey of 1,006 people found that most people, 89%, claim they always wash their hands after using the restroom at home. That survey also found that:

  • 82% of people say they always wash their hands after changing a diaper, up from 73% in 2007. And women seem more concerned about this activity than men, the survey says, with 88% of women and only 76% of men claiming to soap up after changing diapers.
  • 77% of Americans told surveyors they always wash their hands before handling or eating food, about the same as 78% in 2007. Women also get the cleanliness nod here, with 83% saying they wash up before touching their food, compared to 71% of men who gave the same answer.
  • 39% of people polled said they always wash their hands after sneezing or coughing.

“We are really pleased to see these results, which suggest that our campaign is being effective,” says Judy Daly, PhD, a spokeswoman for the ASM and professor of pathology at the University of Utah, in a news release. “Although the venues were different, our first observational study in 1996 found only 68% overall washing up in public restrooms, and that declined to an all-time low of 67% when we repeated the study in 2000.”

Media Coverage Has Helped Improve Behaviors

Daly also says increased public awareness of infectious diseases, in part because of media coverage, has helped change behavior toward better cleanliness.

“The message is that people are getting the message,” says Nancy Bock, vice president of consumer education for ASI. “Between mom’s common-sense advice and the recent pandemic scare, people now seem to realize the importance of when and how you wash your hands.”

Daly says that although progress has been made, much work still needs to be done to make Americans more conscious of the need to wash their hands. She says that only 39% of people surveyed said they washed their hands after coughing or sneezing, and improvement could reduce respiratory and gastrointestinal illnesses transmitted by germ-filled hands, which spread bugs to mucous membranes of the eyes, nose, and mouth.

“Whether it’s cold and flu season or baseball season, hand washing is a no-brainer,” Bock says. “Washing with soap and water for 20 seconds or more is a simple way to stay healthy. And if you’re out and about, hand sanitizers or hand wipes are good alternatives for keeping your hands clean.”

A report that details findings recommends that people wash their hands:

  • After using the restroom.
  • Before, during, and after preparing food, especially poultry, raw meat, or seafood.
  • Before and after meals and snacks.
  • Before inserting or removing contact lenses.
  • After touching animals or handling their waste.
  • After changing a diaper.
  • Before and after caring for someone who’s sick or injured.
  • After blowing your nose, coughing, or sneezing.
  • More frequently than usual when someone at home is sick.
  • Anytime your hands are dirty.

Show Sources


News release, American Cleaning Institute.

"A Survey of Hand-Washing Behavior," August 2010.

Brian Sansoni, spokesman, American Cleaning Institute, email interview.

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