The public hand hygiene practices of New Zealanders: a national survey.

Aim: To survey hand hygiene practices of the New Zealand public.
Method: Hand hygiene practices of subjects after they had used the toilet were observed in the washrooms of shopping malls in the cities of Auckland, Hamilton, Wellington, and Christchurch. The frequency and duration of hand hygiene were recorded by gender-appropriate observers.
Results: A total of 1200 subjects were observed. The overall frequency of hand washing was 86.7% (95% Confidence Interval [CI] 84.6-88.5). Significant (p<0.0001) gender differences were found with males (81.0%, 95% CI 77.6-84.0) having a lower frequency of hand hygiene than females (92.4%, 95% CI 89.9-94.4). Soap was used by 71.6% (95% CI 68.7-74.3) of subjects but less frequently by males (66.2%) than females (76.5%). Nine out of ten (91.2%, 95% CI 89.3-92.9) subjects who washed their hands, dried them. Males washed (median 8.0 seconds) and dried (median 7.0 seconds) their hands for a shorter period of time than females who washed and dried for medians of 8.8 and 8.0 seconds respectively. The median duration of handwashing (8.6 seconds) and drying with paper towels (7.9 seconds) was well below current recommendations of 20 seconds for each practice. The median duration of use of air towels at 16 seconds was far short of the recommended time of 45 seconds.
Conclusion: The New Zealand public appear to practise suboptimal hand hygiene in public washrooms. Future hand hygiene promotion should focus on males; on achieving adequate hand washing (using soap) and drying times; and on promoting drying times appropriate to the chosen method.