America's dirty little secret: second handwashing survey reveals Americans still don't get it

September 17, 2000

Despite an ever increasing threat from antibiotic resistant "superbugs" and emerging new microbial illnesses, at least one third of Americans appear to have forgotten the single best piece of infection control advice Mom ever gave them - always wash your hands after you go to the bathroom. While 95 percent of men and women surveyed say they wash their hands after using a public restroom, only 67 percent of people actually do wash before leaving the restroom, according to the results of a new survey and observational study conducted for the American Society of Microbiology's Clean Hands Campaign released here today at the ASM's Interscience Conference on Antimicrobial Agents and Chemotherapy meeting (ICAAC).

Despite increased publicity over the past several years about the importance of basic handwashing in limiting the spread of infectious disease, men and women in several American cities are even less likely to wash today than they were four years ago.

"While it may seem amusing at first, this is really a very serious issue. We really need to help the public understand the significance of these findings and the importance of handwashing," said Judy Daly, Ph.D., Secretary of the American Society of Microbiology (ASM). "The more people do their part to control the spread of infections, the less we have to use antibiotics, which lose their potency over time as bacteria develop resistance to them."

ASM's Clean Hands Campaign is designed to remind Americans that "Mom was right" - it is important to wash one's hands before and after handling food products, after handling pets, before eating, and whenever one is sick, or is around people who are. Despite the generally held belief that cold germs are spread through sneezing and coughing, the majority of transmission comes from hand-to-hand contact and transfer of germs.

"Hand washing is the simplest, most effective thing people can do to reduce the spread of infectious diseases," according to Julie Gerberding, M.D., Director of the Hospital Infections Program, Centers for Disease Control and Prevention.

Clean Hands Campaign Survey Results
The new findings about hand washing come from a national telephone survey of 1,021 adults and observations of 7,836 persons made in public restrooms in New York, Atlanta, New Orleans, Chicago and San Francisco. Observers found that those least likely to wash in public restrooms were men in Atlanta, while those most likely to wash were women in Chicago.

1996 - 2000/ 1996 - 2000/ 1996 - 2000

Chicago - 60% - 78% / 93% - 86% / 78% - 83%

Atlanta - 46% - 36% / 89% - 84% / 64% - 64%

NYC - 62% - 43% / 58% - 54% / 60% - 49%

New Orleans - 73% - 55% / 70% - 74% / 71% - 64%

San Francisco- 62% - 71% / 78% - 89% / 69% -80%

Women surveyed were significantly more likely than men to at least say they wash their hands after various activities or events. For instance, 40 percent of women reported washing after sneezing or coughing, compared to 22 percent of men; 54 percent of women say they wash after petting a dog or cat, while only 36 percent of men say they do so; and 86 percent of women, compared to 70 percent of men, say they wash their hands after handling a diaper.

Clean Hands Campaign

The Clean Hands Campaign is a key component of ASM's ongoing efforts designed to spread the "importance of handwashing" message. The campaign will consist of educational materials designed for healthcare professionals and consumers including posters, a brochure, stickers and a Web site destination, for downloading information and educational materials.

ASM's initial survey and educational efforts began in 1996 with Operation Clean Hands. "Obviously Americans haven't picked up or retained the message. We believe the situation might be worse that it appears to be because some people may have spotted the observers and worried that 'mom was watching.' In the absence of other people, the numbers may even have been dramatically less," said Daly.

"ASM will continue to educate the public and monitor results over time. Just as it's taken time to convince Americans to see the life-saving value of using their seat belts, we know this equally important effort will take time and we're in it for the long haul."
This research was released at the ASM's ICAAC meeting in Toronto. Information on other presentations at the ICAAC meeting can be found online at

The American Society for Microbiology (ASM), headquartered in Washington, D.C., is the world's largest single life science society, with more than 42,000 members worldwide. ASM's mission is to enhance the science of microbiology to gain a better understanding of basic life processes and to promote the application of this knowledge for improved health, and for economic and environmental well-being. More information is available at

American Society for Microbiology

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