Silent Risk: Nearly Half of Hospital Visitors Skip Handwashing, Study Finds

Oct 9, 2025 - 09:55 Updated: Oct 8, 2025 - 12:35

Silent Risk: Nearly Half of Hospital Visitors Skip Handwashing, Study Finds

A study published this year by the University of Surrey in the UK has found that almost half of hospital restroom users do not wash their hands, a behavior that directly threatens patient safety.

Researchers used sensors installed on hospital toilets and sink pipes to discreetly monitor handwashing behavior. Their analysis of 2,636 flushes showed that 43.7 percent of users left restrooms without washing their hands. During certain weeks, this rate of noncompliance soared to 61.8 percent.

The study identified specific patterns in this concerning behavior, with poor handwashing habits most prevalent during mornings, evenings, and around mealtimes.

“People may assume handwashing is second nature by now—especially in hospitals post-COVID-19—but our data paints a different picture,” Dr. Pablo Pereira-Doel, lead author of the study and co-director of the Human Insight Lab at the University of Surrey Business School, stated in the press release.

Neglecting handwashing in hospitals can have profound consequences for patients and the public health care system, added Carrie Newlands, head of clinical skills at the University of Surrey’s Medical School.

The Hidden Dangers: Pathogens on Hospital Surfaces

“Hospitals are full of germs, and handwashing is always recommended when entering and leaving the hospital,” Li Shang, attending physician at Shuanghe Hospital under the Ministry of Health and Welfare in Taiwan, told The Epoch Times.

A 2024 study published in the American Journal of Infection Control found that despite frequent disinfection, numerous health care surfaces still harbored pathogens, identifying mannequins, bedrails, and mobile workstations as particularly contaminated.

Similarly, a 2020 study published in Nature Communications found that when testing viral loads in hospital wards during the COVID-19 pandemic, viruses were detected on more than half of the surfaces in the wards, including bedrails and chairs.

Unlike bacteria that can be killed by alcohol-based hand sanitizers, many viruses cannot be eliminated by them. Therefore, frequent handwashing is considered the best practice to prevent infectious diseases.

Why Handwashing Matters

More than a simple habit, proper handwashing is a critical public health practice with proven benefits for preventing the spread of dangerous pathogens.

Preventing Acute Respiratory Infections

A 2023 meta-analysis published in The Lancet covering more than 160,000 people in 26 studies showed that promoting handwashing reduced the risk of acute respiratory infections by 17 percent, respiratory tract infections by 22 percent, and upper respiratory tract infections by 26 percent.

Dr. Zheng Yuanyu, an infectious disease physician at the Shangwen Clinic in Taiwan, explained the transmission mechanism. Hands and other parts of the body can be exposed to droplets from infected people or come into contact with infected items left behind by patients, Yuanyu told The Epoch Times. When our eyes, nose, or mouth touch these infected areas, the virus can enter the body.

Preventing Norovirus Infection

Norovirus is highly contagious and causes 58 percent of foodborne illnesses in the United States. The virus triggers an average of 465,000 emergency room visits each year, most of them among young children, and more than 100,000 hospitalizations. Norovirus can cause acute gastroenteritis, with symptoms such as nausea, vomiting, diarrhea, and abdominal cramps.

Dr. Huang Xuan, a thoracic and critical care physician in Taiwan, described the transmission routes: direct contact with infected people, consumption of contaminated food or water, and contact with contaminated surfaces.

The key to prevention is to wash your hands with soap and water for at least 20 seconds after using the toilet, before eating, and before and after touching your phone, focusing on cleaning between your fingers and nail grooves. Alcohol cannot kill norovirus, so bleach should be used for disinfection.

Research shows that increasing hand hygiene compliance to 60 percent among nursing home staff can reduce norovirus cases by about 75 percent.

Preventing Influenza

While handwashing effectively prevents influenza, technique and duration matter. A study of 3,000 people showed that washing hands with soap for only five to 10 seconds increased the likelihood of influenza-like symptoms by 37 percent. Conversely, proper handwashing after social contact reduced symptoms by 41 percent.

Preventing Pink Eye

Adenovirus is one of the main viruses that cause conjunctivitis, or pink eye. It spreads through direct contact with infected eyes or upper respiratory tract secretions and contaminated objects such as clothes, eye makeup, towels, or topical ophthalmic medications.

Studies have shown that 46 percent of conjunctivitis patients have viruses on their hands, making frequent handwashing crucial for preventing transmission.

Preventing Hand, Foot, and Mouth Disease

Coxsackievirus causes hand, foot, and mouth disease, and children are particularly susceptible. A 2019 study in the Journal of Infection found that after kindergartens reinforced children’s hand washing measures, the probability of children contracting the virus decreased by 60 percent to 70 percent, and the length of sick leave also dropped significantly.

Proper Handwashing Technique and Timing

Correct hand washing is crucial to preventing disease. Proper handwashing involves three critical elements: knowing when to wash, scrubbing for adequate duration, and targeting commonly overlooked areas such as between the fingers.

When to wash hands:

After returning from public places
Before and after entering hospitals
After using restrooms
Before and after meals

Xuan advises washing hands and wearing a mask before holding infants and young children. Their weaker immune systems make them more vulnerable to viruses that may not significantly affect adults.

Addressing Common Blind Spots

A study of 664 university students analyzing handwashing procedures and residual bacteria found that people often overlooked rubbing between and the backs of the fingers. It also found that the wrists and fingertips harbored the most residual contaminants.

Yuanyu advises carefully scrubbing the palms, backs of the hands, between the fingers, and fingertips, especially the base of the thumb and the area extending from the thumb to the base of the palm. The entire handwashing process should take at least 30 seconds.

Zheng recommends scrubbing with soap and water for at least 20 seconds. Soap itself may not kill the viruses, but it can wash them off the hands, reducing the number of pathogens and effectively lowering the risk of infection.

The Limitations of Alcohol-Based Sanitizers

Xuan cautions against overreliance on alcohol for disinfection and neglecting the importance of hand hygiene. “Many people are accustomed to spraying alcohol for disinfection in public places,” he said. Viruses on surfaces typically spread through the hands, which pick them up from objects like doorknobs and tables, and then enter the body when people touch their mouths or noses, Xuan added.

Alcohol kills bacteria but not all viruses, yet many people use hand sanitizer for convenience without realizing its limits. “Washing your hands with soap is a better way to prevent you from bringing enterovirus, rhinovirus, foot-and-mouth virus, and norovirus home to your children and family.”