Article Text

This article has a correction. Please see:

Sensor recorded changes in rates of hand washing with soap in response to the media reports of the H1N1 pandemic in Britain
  1. Diana S Fleischman1,
  2. Gregory D Webster2,
  3. Gaby Judah1,
  4. Mícheál de Barra1,
  5. Robert Aunger1,
  6. Valerie A Curtis1
  1. 1Hygiene Centre, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Department of Psychology, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Diana S Fleischman; dianafleischman{at}


Objectives To examine how the frequency of information regarding a real disease threat influences hand washing with soap.

Design and setting The authors installed wireless devices in highway service station lavatories in England to record the proportion of individuals washing hands with soap from May 2009 to January 2010.

Participants Participants were users of men's and women's toilets. Combined there was an average of 6800 participant entrances into the lavatories daily.

Primary outcome measure The primary outcome measure is the proportion of soap usage to the number of entries into the lavatories.

Results Hand-washing rates were positively related to both H1NI coverage in blogs and the news; however, these relationships were stronger for men than for women.

Conclusions Hand washing with soap increases proportionally to the frequency of media key words related to H1N1. Women's hand washing was more strongly associated with incidence of media keywords than men's.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

View Full Text

Statistics from

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Files in this Data Supplement:


  • To cite: Fleischman DS, Webster GD, Judah G, et al. Sensor recorded changes in rates of hand washing with soap in response to the media reports of the H1N1 pandemic in Britain. BMJ Open 2011;1:e000127. doi:10.1136/bmjopen-2011-000127

  • Funding Unilever helped fund this research.

  • Competing interests All authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare that (1) DSF, VC, RA, GJ and MdB have support from Unilever Plc for the submitted work; (2) GDW has no relationships with Unilever that might have an interest in the submitted work in the previous 3 years; (3) their spouses, partners or children have no financial relationships that may be relevant to the submitted work and (4) all authors have no non-financial interests that may be relevant to the submitted work.

  • Ethics approval Ethics approval was provided by London School of Hygiene and Tropical Medicine.

  • Contributors VC, RA and GJ conceived the study; VC, RA, DSF and MdB designed this study; RA, GJ and VC designed the data collection system; GJ and DSF collected the data; GDW analysed the data; DSF drafted the manuscript; VC, RA, MdB, GDW and GJ redrafted the manuscript. VC acts as guarantor for the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data Sharing statement Raw sensor data are available upon request from the first author for the months of June 2009 to January 2010.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Miscellaneous
    British Medical Journal Publishing Group