"Long before it's in the papers"
January 27, 2015


Study: fist-bumping more hygienic than shaking hands

July 28, 2014
Courtesy of Elsevier Health Sciences 
and World Science staff

“Fist bump­ing” trans­mits sig­nif­i­cantly few­er bac­te­ria than ei­ther hand­shak­ing or “high-fiving,” ac­cord­ing to a new stu­dy. 

“Adop­tion of the fist bump as a greet­ing could sub­stanti­ally re­duce the trans­mis­sion of in­fec­tious dis­eases,” said Da­vid Whit­worth of at Ab­er­yst­wyth Uni­vers­ity in the U.K., co-author of a re­port on the find­ings. “For the sa­ke of im­prov­ing pub­lic health we en­cour­age fur­ther adop­tion of the fist bump as a sim­ple, free, and more hy­gien­ic al­ter­na­tive to the hand­shake.”

Whit­worth and col­leagues per­formed ex­pe­ri­ments in­volv­ing the fist-bump, a ges­ture that goes back dec­ades but has been giv­en a pop­u­lar­ity boost by the likes of Pres­ident Obama. In the ex­pe­ri­ments, a greet­er im­mersed a sterile-gloved hand in­to a con­tain­er of germs. Once the glove was dry, the greet­er ex­changed a hand­shake, fist bump, or high-five with a sterile-gloved re­cip­i­ent.

Af­ter the ex­change, the re­ceiv­ing gloves were im­mersed in a so­lu­tion to count the num­ber of bac­te­ria trans­ferred. Nearly twice as many bac­te­ria were trans­ferred dur­ing a hand­shake com­pared to the high-five, and sig­nif­i­cantly few­er bac­te­ria were trans­ferred dur­ing a fist bump than a high-five, the re­search­ers said. In all three forms of greet­ing, a long­er dura­t­ion of con­tact and stronger grips were fur­ther as­so­ci­at­ed with in­creased bac­te­ri­al trans­mis­sion.

The study is pub­lished in the Au­gust is­sue of the Amer­i­can Jour­nal of In­fec­tion Con­trol, the of­fi­cial pub­lica­t­ion of the As­socia­t­ion for Pro­fes­sion­als in In­fec­tion Con­trol and Ep­i­de­mi­ology.

The study al­so ex­pands on a re­cent call from the Jour­nal of the Amer­i­can Med­i­cal As­socia­t­ion to ban hand­shakes hos­pi­tal en­vi­ron­ments.

Doc­tors ar­gued that health­care providers’ hands can spread po­ten­tially harm­ful germs to pa­tients, lead­ing to health­care-as­so­ci­at­ed in­fec­tions, among the lead­ing causes of pre­ventable harm and death in the Un­ited States. The U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion es­ti­mates that one in 25 hos­pi­talized pa­tients de­vel­ops such an in­fec­tion, and 75,000 pa­tients with them die dur­ing their hos­pi­tal­iz­a­tion each year.

Whit­worth and col­leagues ar­gue that it’s un­likely that all greet­ing-as­so­ci­at­ed con­tact will be elim­i­nat­ed en­tire­ly, as it’s a strong “cul­tural ex­pecta­t­ion.” So they sug­gest the fist-bump as an al­ter­na­tive that might gain trac­tion.

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“Fist bumping” transmits significantly fewer bacteria than either handshaking or high-fiving, according to a new study. “Adoption of the fist bump as a greeting could substantially reduce the transmission of infectious diseases between individuals,” said David Whitworth of at Aberystwyth University in the U.K., co-author of a report on the findings. “For the sake of improving public health we encourage further adoption of the fist bump as a simple, free, and more hygienic alternative to the handshake.” Whitworth and colleagues performed experiments involving the fist-bump, a gesture that goes back decades but has been given a popularity boost by the likes of President Obama. In the experiments, a greeter immersed a sterile-gloved hand into a container of germs. Once the glove was dry, the greeter exchanged a handshake, fist bump, or high-five with a sterile-gloved recipient. After the exchange, the receiving gloves were immersed in a solution to count the number of bacteria transferred during contact. Nearly twice as many bacteria were transferred during a handshake compared to the high-five, and significantly fewer bacteria were transferred during a fist bump than a high-five, the researchers said. In all three forms of greeting, a longer duration of contact and stronger grips were further associated with increased bacterial transmission. The study is published in the August issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology. The study also expands on a recent call from the Journal of the American Medical Association to ban handshakes hospital environments. Doctors argued that healthcare providers’ hands can spread potentially harmful germs to patients, leading to healthcare-associated infections, among the leading causes of preventable harm and death in the United States. The U.S. Centers for Disease Control and Prevention estimates that one in 25 hospitalized patients develops such an infection, and 75,000 patients with them die during their hospitalization each year. Whitworth and colleagues argue that it’s unlikely that all greeting-associated contact will be eliminated entirely, as it’s a strong “cultural expectation.” So they suggest the fist-bump as an alternative that might gain traction. hygiene grounds