Restroom Hygiene & Hand Care

Flu Season Runs October to May

Although scientists are unable to predict how severe or when a flu season will peak until data beings rolling in, one thing is certain. There will be an influenza outbreak. For some it will be serious, for many it will cost work or school days, and in every building throughout the United States, custodial staffs can have an impact on how many are affected, and to some degree the severity of infections.

That is right, studies of practices like daily desktop disinfection have shown that not only how many students are absent, but the length of absence (an indicator of severity) can both be reduced. In businesses, treatment of shared surfaces from October through May may even reduce colds, and have been shown to reduce the norovirus which causes a very severe form of abdominal and stomach sickness.

Handwashing Helps

Breaking the infection cycle starts with reminding everyone to wash their hands thoroughly. Hands are part of the cross-contamination cycle. Yet we all short-change hand washing from time to time, and many report having seen co-workers not wash at all after activities like using the restroom.

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Hidden Hygiene and Cleaning Costs; Who is Blowing Hot Air?

Restroom users sometimes have to think twice about "dip in your hands" air blowers. When visible growth and deterioration occurs, fewer users may be inclined to dry.Air drying of hands is not as effective in providing hygiene as paper towels. 

Not only do air blowers take longer than restroom users are willing to invest to achieve hands that feel dry and don't pass germs. At the same time, aerosols and sprays created by the forced air (and water shaken from hands) create increased cleaning costs to keep up with the splatters onto walls and floors. That same dispersal of water, sprays and germs is a threat to hygiene, providing a means for germs to cross-contaminate throughout large sections of the restroom and even onto clothes of nearby restroom users.

This need for additional cleaning is one of the considerable hidden costs not only to budgets, but to restroom imagery that forced-air dryers cause.

Because 95% of cleaning expense is in people, and 5% in supplies[1], increases in restroom cleaning labor are significant, even before electrical and initial investments in equipment and remodeling are considered. Basically, people - a part of the 95% - cost well more than paper - a part of the 5%. When you add to cleaning requirements by making things dirtier, you increase your people costs which are the lion's share of your budget. (Like Mom said, don't be penny wise, pound foolish. Mom must have been from England.) 

But there is even a more fundamental problem with blowing moisture off your hands. The moisture getting blasted into the air and onto walls, floors and people has germs in it. Laboratory experiments have shown even standard blow dryers distribute bacteria onto users and throughout a 3-foot range of the dryer. Paper towels on the other hand, are part of the cleaning process and are shown to help reduce bacteria counts on hands and do not re-distribute bacteria, but instead help to contain and dispose of safely. [D]

"The dispersal of bacteria...was found within a radius of approximately 3 ft from hot air dryers and to the investigator's laboratory coat. When paper towels were used for hand drying, no dispersal of bacteria was found."  - Mayo Clinic in reference to Ngeow, et al, study. [D]

Study finds Paper Towels More Effective in Removing Bacteria

From PUR-O-ZONE's observations and experience - and keeping in mind that we carry a wide range of air drying devices - air dryers of all kinds are messy and contribute to dirty conditions. And, not to put too fine a point on it, hardly anyone who uses your restrooms is going to be pleased.[3] That means you will have a reduction in handwashing. Why? Restroom users - that's all of us - dislike the thought of using even the most advanced new dryers.[4] 

  • Even the strongest hot air drying units only damp-dry hands in 10-12 seconds, 40 seconds is likely.[4] Jet-dryer manufacturers have claimed their electrically powered units are equivalent to towels. Studies done in response found most users did not feel their hands were dry after 10-12 seconds under the jet blower and in fact averaged over 20 seconds, at which time, they still felt damp. The same study (as well as those conducted by an Australian university study) showed paper does the job needed in just 10 seconds. [C]
  • Single-serve towels reduce hand moisture to only 4% in 10 seconds.[4]
  • Dryers create longer lines in busy restrooms, because only one person can dry per blower at once. With paper, users take their towel and generally step back, allowing others to dry. 
  • Research shows hygiene factors are in favor of paper, [5] which provides part of the cleaning process. Dry hands are more germ-free. Damp hands support and pass more diseases.[6]
  • Because of dryer avoidance, more users walk away from restrooms without washing their hands at all than when paper towels are available.
  • People have learned to open doors with the towel and then toss the towel in the trash. Opening the door with a handle wet from semi-dry hands gives most people the heebie-geebies.
  • Pathogens (germs) can become aerosolized by air-blasting methods. [8] Aerosolized droplets can be spread throughout the restroom, something also proven to occur in toilet-flushing studies. [9]
  • Pathogens can grow inside parts of air dryers (see picture above).
  • Users often shake wet hands to improve their chances dryer hands. The messes from splattering increase restroom labor, the biggest cost in any cleaning budget.
  • Increased drips onto flooring equates to increased slip and fall risks [A].
  • Restroom imagery suffers. Users consider air dryers an inconvenience for them designed to save money for the building operator.

Studies regarding the green footprint of paper vs. air drying have been released advising in both directions. Unfortunately, most of these studies are funded by parties already positive toward one method of drying or the other. According to Sierra Club's Ask Mr. Green, "MIT’s recent cradle-to-grave comparison of drying methods gives paper towels a slightly better grade than dryers," except for the two most efficient dryers.[2] A Dutch study found basic parity between hand dryers and paper towels when all factors were taken into consideration. [7]


Cost factors blower manufacturers sometimes omit

Finally: Honest hand dryer instructions (GIZMODO)

Those Ancient Handshakers Knew Their Stuff

Monument of KalhuAssyrian King Shalmaneser III and Marduk-zakir-šumi I of Babylon - those two guys, they had it going on.

Their grasp of hands in friendship in the 8th century BC was memorialized in stone and stands at the first documented case of a handshake. Humans were probably shaking hands long before then and have long since continued in what may have started as a ritual to show no weapons were being carried in the right hand. Today, almost every country has some form of handshaking ritual deeply embedded in its culture.


Today, amidst concerns about transmission of germs from person to person, the handshake has been taking hits. Naysayers - from Donald Trump to U.K. biochemist David Whitworth - concern over the unhealthy aspects of this show of trust and friendship are being voiced. 

Whitworth conducted tests released in the American Journal of Infection Control comparing the handshake, fist bump and high five as greetings. The e. coli bacteria applied to gloves on hands in the handshaking tests was transferred 10 times more readily than the fist bump and twice that of the high five. (Low, too slow, didn't seem to get much serious consideration.)


Gojo Industries has suggested the handshake is not likely to go away, nor perhaps should it. In fact, their light-hearted Shake Your Way to $5K contest challenges college students to make a 15-second video of their creative or secret handshake.  


Like other facets of life that require some hygiene responses or adaptions, handshaking risks can be taken care of pretty well with good hygiene habits: 

  • Handwashing or hand sanitizing before activities like eating
  • Periodic, thorough handwashing for 20 seconds or more several times throughout the day
  • Sanitizing opportunities made available in areas where people meet and greet or should otherwise care for their hands:

Meeting rooms
Restaurant lines
Dining halls 

Restroom Paper Towel Types; a Visual Reference Guide


Many types of paper towels are used in restrooms. It is easy to get them confused, or forget their names. Here is a quick summary of the main types of restroom paper towels.

DOWNLOAD: Paper Towel Types


An older style of paper towel, singlefolds are not often found in restrooms today. Sheets are folded in half and dispensed from a shoe-box sized container. Approximate folded size: 5.63" x 9.25".


Modern dispensers allow multifold towels to dispense one at a time with a "touch-free" tail exposed. Multifold dispensers can be "topped off" when a custodian visits the restroom. Standard dispensers hold two to two and a half sleeves. Approximate folded size: 9.50" x 3.25". 


A variation on the multifold towel is the interleaved towel. The last folded third of one towel is inserted into the next towel in the stack. Towels like the Optifold(R) from Wausau, are often somewhat wider than standard multifolds, providing more drying area. Sizes vary somewhat depending on manufacturer. These subtle differences make it important to pair the right dispenser with the right towel for better dispensing.   


Interfolded towels are an SCA innovation. Some designs are continuous folded sheets with periodic perforations so towels can be pulled from the top of a dispenser. As the towel is pulled against the edge of the opening, tension breaks it at the perforation. Another of the SCA towels achieves this top dispensing by being interfolded. The leading edge of the next towel is left at the opening ready to be pulled.


C-Folds open from the center. They are often made extra thick for upscale applications. The C-fold design is harder to pull from a dispenser, so sometimes they are stacked in baskets on counters. With this uncontrolled method, users often drop some towels and which can be wasteful. Approximate folded size: 10.25" x 3.25". 


Kitchen towels are the least appropriate for restrooms, and can be expensive in-use. Dispensers are generally completely open and exposed to wet hands, creating hygiene issues. Kitchen roll towels have a tendency to be pulled off the pegs of the dispenser, and because they can be used anywhere may end up doing other tasks, leaving the restroom with no towels. Roll are relatively short and must be replaced frequently. Their main advantage would be absorbency, although many hard wound rolls now offer similar wicking capabilities. Kitchen rolls vary widely in thickness, sheet size and length.


Also known as "hardwound," roll towels have improved over the past decade. Many are soft and absorbent. Economy in-use is an important advantage roll towels provide. Some of the dispensers for roll towels control the length and timing of paper release. Bay West and SCA have excellent roll towel systems. You may trial a roll-towel dispenser through PUR-O-ZONE on your own restroom, breakroom or kitchen walls. (In most areas of Kansas and western Missouri.) Sizes: Most roll towels are 8" in width. Common lengths include 325', 600' and 800'. Each towel is cut to length by the dispenser according to factory or user-set choices.


Pulled from the center of the roll instead of being unrolled from the outside, center pull towels are perforated. The towels break by tension applied against the perfs as they are pulled out. Performance depends on dispenser "nozzle" condition. Length of towel perforation varies, but is often between 9" and12". This length is set at the factory by the machine applying the perforations.  In-use, center pull towels tend to be more expensive than roll and sheet alternatives. Sizes: Many center pull towels are 8" x 600', although lengths vary.  

Seriously, Did You Just Walk Away Without Washing?

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Here are five things you can do to improve health in your building this fall:

TIP 1 - Incorporate a Cleaning for Health focus into your daily cleaning routines. Make a list of common touchpoints that your staff will clean and treat with a specialized disinfectant cleaner, like Envirox Critical Care, that provides residual effectiveness.

TIP 2 - Utilize a desktop cleaning system, like Kaifly, that allows janitors to quickly clean and disinfect the desks in your offices or school. Many studies have shown special attention to desktops pays dividends that well exceed the cost of incorporating them into the routine. Video demonstration.

TIP 3 - Remind people about healthy hands through your newsletter and posters. This type of behavior modification can improve on the surprisingly high percentage of persons who use restrooms without washing their hands.

TIP 4 - Install hand sanitizer stations, like Purell with skin conditioners, outside restrooms, near breakroom facilities, inside conference rooms and at the front entryway to your building. A corporate culture of hand hygiene is signalled by these opportunities to reduce cross contamination between workers or students.

TIP 5 - Use a rapid restroom cleaning system, like Kaivac, to leave more surfaces 99.9% free of bacteria with just water. The Rapid Restroom Sanitizing system is lab proven more effective and 40% faster than normal methods. By focusing on restrooms your staff can break a major source of cross-contamination in buildings.

Download items from our Healthy Hands Toolkit

Medical center increases hand washing, dramatically reduces infections

A medical center in Cleveland, Ohio, has found that the simple act of washing hands by hospital staff has reduced the infection rates at the hospital. What may be surprising, though, is just how much a difference it makes.

The hospital, Cleveland MetroHealth Medical Center, hired four employees in 2010 to monitor compliance with hand washing standards, as well as post their results by department. The effort is paying off, as bloodstream infections have dropped by two-thirds, and compliance is now averaging 98% among all medical units.

Compare that to the average across the United States: amazingly enough, hospitals average less than 50% compliance with hand washing standards.

The hospital used both soap and water, as well as hand sanitizer, to achieve their goal of greater compliance with hand washing among staff.