Americans still don’t know how and when to wash their hands

By Kristen Rogers, CNN

(CNN) — Some Americans are still not doing their due diligence when it comes to washing their hands.

That’s according to a new survey that found nearly half of its respondents forget or choose not to wash their hands at key times, such as after visiting grocery stores, restaurants, coffee shops and health care settings including a doctor’s office or hospital.

For some of us, the hygiene lessons of the Covid-19 pandemic apparently have not sunk in — although the survey, funded by the National Foundation for Infectious Diseases, did find that 33% of participants wash their hands more now than they did during the crisis.

“We have been talking about handwashing probably back to the days when all of us were in preschool or even kindergarten,” said Dr. Robert Hopkins, the foundation’s medical director. “I would have hoped that we would think of that as a core way of keeping ourselves healthy regardless of our other health behaviors.

“It’s a nonspecific way that we can reduce risk for exposure to infectious diseases, along with dirt, grime [and] all of the other things we don’t like to see on our hands.”

Released Monday, on World Hand Hygiene Day, the survey is part of the National Foundation for Infectious Diseases’ Hands in for Handwashing Campaign, which raises awareness of the importance of handwashing to help stop the spread of infectious diseases. The research was conducted by NORC (formerly called the National Opinion Research Center) at the University of Chicago.

The report highlights when, where and why nearly 3,600 adults surveyed between December and March were most likely to wash or not wash their hands, and how some of those habits differed between age groups and genders.

Varied handwashing habits

Sixty-two percent of participants correctly answered that washing hands with soap and water for 20 seconds is the method that most effectively reduces the spread of germs, while 13% thought less time would be enough and 24% believed more time is needed.

The top three situations that prompted respondents to wash their hands were using the bathroom, handling food and handling human or animal waste.

“This is good news, given that a single gram of human feces can contain 1 trillion germs — including Salmonella, E. coli, and norovirus — that can cause disease,” the report stated.

But only 30% of participants said they were most likely to wash their hands after sneezing or coughing, “which is concerning given how easily respiratory diseases such as influenza … can spread,” the report added.

Among the nearly half of adults who didn’t wash their hands at important times, forgetting was the most common reason why. But 20% actively chose to not wash their hands, with some thinking that the practice wasn’t necessary, that they didn’t have time or that they didn’t want to dry out their hands.

Men were more likely than women to not wash their hands at important times and to think handwashing requires less time.

Adults older than 60 were most diligent in their handwashing habits, with 74% doing so after using the bathroom or handling food. The greater likelihood in this age group may be due to awareness of the fact that older adults have a higher risk of getting sick, according to the report.

Or the trend could be caused by a longer lifetime of habits, said Dr. Georges Benjamin, executive director of the American Public Health Association, who wasn’t involved in the research.

“Older folks, we didn’t have the hand sanitizers when we were younger,” Benjamin said. “When I went outside to play, when I came back in, I was supposed to wash my hands. So I think that you’re looking at behaviors that may have changed from a generation to another generation.”

Some participants’ handwashing habits depended on the season, with 26% reporting washing their hands more frequently in the fall and winter. The variance makes sense given that some respiratory illnesses peak during colder weather, the report stated. Public health messaging is also more prevalent during this season, Benjamin said.

“However, other germs — like those that cause colds, norovirus, and other infectious diseases — can spread throughout the year,” according to the survey. “It is important to maintain proper hand hygiene all year round to help stay healthy.”

How to remember to wash your hands

Most adults surveyed said they wash their hands to protect their own health, feel clean, avoid spreading germs to others, and avoid getting sick and missing work or school.

Handwashing can make a big difference. “Since about 80% of infectious diseases are spread by dirty hands, routine, proper handwashing throughout the year can significantly help prevent the spread of infectious diseases,” according to the report. “In just 20 seconds, handwashing can help prevent the spread of diseases like flu, COVID-19, and norovirus.”

The habit can also prevent 1 in 3 people from getting diarrhea and 1 in 5 people from developing a respiratory illness, Dr. Vincent Hill, adjunct associate professor of environmental health at Emory University’s Rollins School of Public Health in Atlanta, told CNN in 2020.

For people who often forget to wash their hands, an increase in public health signage in public — or in do-it-yourself signage at home — reminding people to do so could be worthwhile, Benjamin said.

And if you’re one of those people who doesn’t wash their hands after using the restroom because they “only went pee,” Hopkins urged people to remember that in public restrooms especially, there are at least millions of bacteria on every surface you’re touching, from the many people going in and out of that bathroom all day. Even if your urine is sterile, it doesn’t mean everything else is.

Hand sanitizer is great to have when you absolutely can’t wash your hands, but you shouldn’t depend on it, given its inability to kill certain bacteria or viruses such as C. diff and norovirus, Hopkins said.

If you’re worried about your hands being too dry after washing or sanitizing, you can carry a small bottle of lotion in your bag or car, experts said. Applying lotion when your hands are still slightly damp helps your skin lock in moisture.

“Proper handwashing puts the power of health in our own hands,” said Patricia A. Stinchfield, immediate past president of the National Foundation for Infectious Diseases.

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