1. Prepared by Wirthlin Worldwide A Survey of Handwashing Behavior Prepared for: American Society for Microbiology September 2000 #6649

2. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 2 Research Objectives The American Society for Microbiology is interested in replicating an observational study and telephone study that Wirthlin Worldwide conducted in 1996. The objectives of the research are to observe adults in public restrooms to determine the proportion who wash their hands, and also to poll the American public to determine how frequently they say they wash their hands in several situations: –After petting a dog or cat –Before handling or eating food –After coughing or sneezing –After using a public restroom –After handling money –After changing a diaper –After using the bathroom in their home The purpose of this research is to increase public awareness of the importance of handwashing.

3. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 3 Methodology – Observed Behavior Wirthlin Worldwide observed the behavior of 7,836 individuals in public restrooms and recorded whether or not they washed their hands after using the facilities. The research was conducted in 5 different cities: Observers discreetly watched and recorded whether or not adults using public restrooms washed their hands. Observers were instructed to groom themselves (comb their hair, put on make-up, etc.) while observing and to rotate bathrooms every hour or so to avoid counting repeat users more than once. Observers were also instructed to wash their hands no more than 10% of the time. City & SiteDate(s)MalesFemalesTotal Chicago, Navy Pier8-26106115362597 New Orleans, Treasure Chest Casino8-24, 8-278476661513 San Francisco, Golden Gate Park8-24, 9-2259294553 Atlanta, Braves Baseball Game8-27365525890 New York City, Grand Central Station & Penn Station 8-24, 8-28105712262283

4. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 4 Methodology – Telephone Poll Wirthlin Worldwide also interviewed a total of 1,021 U.S. adults via telephone about their handwashing behavior in several situations. Interviewing was conducted during the period of Sept. 1-4, 2000. Results are weighted by age, gender, geographic region, and ethnicity to ensure reliable and accurate representation of the 18+ population in continental U.S. Margin of error for a sample of this size is + 3% at a 95% confidence level, meaning that in 95 out of 100 cases a survey of this size will produce responses with + 3% of the result that would have been obtained had the entire universe of adults in the continental U.S. been interviewed.

5. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 5 Executive Summary There is a huge gap between self-reported handwashing behavior after using public restrooms and actual handwashing behavior – people are less likely to wash their hands after using public restrooms than they say they are. This is consistent with trend data collected four years ago. –More than nine in ten (95%) say they always wash their hands after using public restrooms. However, only slightly more than two-thirds (67%) are observed washing their hands after using public facilities. Among males, nine in ten (92%) report that they always wash their hands after using public restrooms, but only 58% of those observed actually did. This represents a gap of 34%. –Interestingly, compared to actual handwashing behavior in 1996, men nowadays are significantly less likely to wash their hands after using public restrooms (58% actually washed their hands in Aug. 2000 vs. 61% in Aug. 1996). Nearly all women (97%) surveyed report that they always wash their hands after using public restrooms, but only 75% observed actually did. This represents a gap of 22%. Similar to 1996, women continue to be significantly more likely than men to say that they always wash their hands after using public facilities (97% vs. 92%).

6. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 6 Executive Summary When asked about their handwashing behavior for a list of activities, women were also significantly more likely than men to indicate that they always wash their hands for the following activities: –after using the bathroom at home (90% women vs. 81% men) –after changing a diaper (86% women vs. 70% men) –before handling or eating food (84% women vs. 69% men) –after petting a dog or cat (54% women vs. 36% men) –after coughing or sneezing (40% women vs. 22% men) –after handling money (28% women vs. 12% men) The less affluent appear to have more stringent handwashing behavior than their more affluent peers – this is consistent with results from 1996. Those with incomes of $35,000 or less are significantly more likely than those with incomes of more than $35,000 to say they always wash their hands… –Before handling or eating food (82% vs. 73%) –After petting a dog or cat (51% vs. 40%) –After coughing or sneezing (37% vs. 26%) –After handling money (26% vs. 15%)

7. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 7 Executive Summary The less educated appear to be more hygienic than their counterparts in some respects – this is consistent with results from 1996. Those with high school or less education indicate that they are significantly more likely than those with some college/college education to always wash their hands… –Before handling or eating food (83% vs. 73%) –After petting a dog or cat (55% vs. 38%) –After coughing or sneezing (40% vs. 26%)

8. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 8 Detailed Findings

9. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 9 Actual handwashing behavior after using public restrooms is lower than reported - Among U.S. Adults, Aug. 2000 -

10. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 10 1996: Actual handwashing behavior after using public restrooms vs. reported handwashing behavior - Among U.S. Adults -

11. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 11 There are no significant changes from 1996 in the percent of people who say they always wash their hands - Among U.S. Adults* - * National telephone study (n=1,021)

12. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 12 Women are significantly more likely than men to report that they always wash their hands - Among U.S. Adults* - Statistically significant at the 95% confidence level * National telephone study (n=1,021)

13. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 13 Men are less likely than they did four years ago to say they always wash their hands before handling or eating food - Among Males* - Statistically significant at the 95% confidence level * National telephone study (n=1,021)

14. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 14 Among women, there are no significant changes from 1996 in the percent who say they always wash their hands - Among Females* - Statistically significant at the 95% confidence level * National telephone study (n=1,021)

15. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 15 The less affluent are more likely than the affluent to report that they always wash their hands - Among U.S. Adult by Income* - Statistically significant at the 95% confidence level * National telephone study (n=1,021)

16. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 16 The less educated are more likely than the educated to report that they always wash their hands - Among U.S. Adult by Education* - Statistically significant at the 95% confidence level * National telephone study (n=1,021)

17. WIRTHLIN WORLDWIDE American Society for Microbiology Handwashing Study September 2000 17 Demographics - Among U.S. Adults* - * Unweighted data, National telephone study (n=1,021) Gender 50%Male 50%Female Household Income 6%Less than $15,000 12%$15,000 to $25,000 15%$25,000 to $35,000 17%$35,000 to $50,000 30%$50,000 or more Age 30%Younger than 35 42%35-54 28%55 or older Education 8%Some high school 31%High school grad 22%Some College 34%College grad