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Updated: May 15, 2026
A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Hand-to-face touching behaviors by sex differences and putative-fomite use: Exploring routes and risks of
Thomas D Berry1, Rik Chakraborti2, Angela K Fournier3
1Department of Psychology, College of Natural and Behavioral Sciences, Christopher Newport University, Newport News, VA.
Background:
The study investigated face-touching behaviors as a potential self-inoculation event, while examining sex differences and the role of handheld objects as possible fomites. Understanding these factors helps identify non-obvious behavioral routes of infection.
Methods:
A naturalistic field study observed 114 coffeeshop patrons. Observers recorded each instance of face touching as either T-zone touches (eyes, nose, mouth) or P-zone touches (cheeks, chin, ears), and whether handheld objects (putative fomites) were involved. Welch's t-test, multivariate and logistic regression were used to test for significance.
Results:
Nearly all patrons (94.7%) touched their faces at least once, averaging 1.09 touches per minute. Women face touched their P-zone significantly more than men. About 21% of patrons used an object to touch their face, and object-use was significantly associated with increased T-zone touching compared with non-use. After controlling for sex, object-users had 9.1 times the odds of touching their T-zone compared to non-object users.
Discussion:
The findings show the pervasiveness of face-touching behaviors. The results highlight face-touching as a key behavior in self-inoculation and pathogen transmission. Dynamic transmission models indicate increased pathogen dose for object-mediated face touching. Strategies to reduce face touching and increase public awareness are discussed.
Conclusions:
Future research should explore strategies to reduce direct and object-mediated face touching.
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