Handwashing in Focus: Bradley Survey Highlights Behavior Gaps as World Hand Hygiene Day Marks Global Progress

As the sun rises over a busy container terminal in Rotterdam, Netherlands—symbolizing the constant global movement of people and goods—another invisible exchange is always underway: the spread of microorganisms. In this interconnected world, hand hygiene remains one of the simplest and most powerful tools for infection prevention. Yet, new data from the 2026 Healthy Handwashing Survey by Bradley Company suggests that consistent adherence remains a challenge.

The Bradley Company has tracked American handwashing behaviors since 2009, making 2026 the 17th year of its national survey. This year, 1,020 adults across the US were surveyed to better understand public restroom habits, perceptions, and hygiene behaviors. While awareness of hand hygiene remains high, the findings reveal a troubling gap between knowledge and action.

According to the survey, 77% of respondents reported seeing others leave public restrooms without washing their hands—an increase from 68% in 2024. Even more striking, 1 in 5 Americans admitted they are more likely to skip handwashing when alone, underscoring the influence of social accountability on hygiene practices.

Self-reported adherence is also declining. In 2026, respondents said they wash their hands 76% of the time after using a public restroom, down from 81% the previous year. Barriers such as a lack of soap, empty paper towel dispensers, or nonfunctioning sinks were commonly cited reasons for skipping proper handwashing.

“For many people, the decision to wash their hands in a public restroom is influenced by the environment,” said Jon Dommisse, vice president of business development and strategy for Bradley Company. “If a restroom appears poorly maintained or understocked, it can discourage proper handwashing—at exactly the moment when it matters most for public health.”

The survey also highlights concerning shortcuts. While soap and water remain the gold standard, 44% of Americans admit to rinsing with water only. Gender differences persist: Men are more likely than women to skip soap (50% vs 38%).

Despite these behaviors, awareness of hand hygiene’s importance remains strong. Ninety-three percent of respondents believe handwashing is essential to overall health, and 81% report increasing handwashing during influenza season or viral surges. Of the respondents, 70% say they are concerned about contracting seasonal illnesses such as influenza.

These findings align closely with the goals of World Hand Hygiene Day, observed annually on May 5. Established by the World Health Organization (WHO) in 2009, the same year Bradley began its survey, the campaign has now been promoting hand hygiene for 17 years. The initiative is part of WHO’s broader “Save Lives: Clean Your Hands” campaign, aimed at improving hand hygiene practices in health care and community settings worldwide.

Each year, World Hand Hygiene Day emphasizes the critical role of hand hygiene in preventing infections, particularly in health care environments where patients are most vulnerable. The 2026 campaign continues to reinforce that proper hand hygiene is a shared responsibility across clinicians, patients, and the public.

The Bradley survey also underscores how environmental conditions influence behavior. More than half of respondents (52%) said a clean, well-maintained restroom improves their perception of a business. Conversely, 71% reported that unclean facilities negatively impact their overall impression, and many indicated they are more likely to return and spend more at establishments with clean restrooms.

Touchless technology is another emerging factor. A significant majority of Americans prefer touchless fixtures: 76% believe they are important, and 75% agree they improve the restroom experience. Additionally, 66% said they are more likely to return to businesses that offer touchless restrooms, suggesting that hygiene and customer experience are increasingly intertwined.

Taken together, the 2026 findings paint a clear picture: While Americans understand the importance of handwashing and respond during times of heightened risk, sustaining those behaviors, especially in public settings, remains inconsistent.

For infection prevention professionals, the message is familiar but urgent. Education alone is not enough. Environmental design, accessibility, and behavioral nudges all play a role in improving adherence. As global initiatives like World Hand Hygiene Day continue to promote awareness, translating that awareness into daily practice remains the next critical step.

In a world as connected as the Rotterdam port at sunrise, the smallest actions, like washing hands, can have the largest impact.