Male commuters in north and south England: risk factors for the presence of faecal bacteria on hands

Hand swabs from commuters (n = 308) at train stations in 4 cities were tested for the presence of faecal bacteria.The prevalence of hand contamination with faecal bacteria was again higher in cities in the north compared to the south (5% in London, 4% in Birmingham, 10% in Liverpool and 19% in Newcastle). Contamination risk decreased with age and better personal hygiene (self-reported). Soil contact and shaking hands increased contamination with faecal bacteria. However, in multivariable analysis, none of these factors fully explained the variation in contamination across cities.The study confirmed the north-south differences in faecal contamination of hands without finding a clear cause for the trend. Faecal contamination of hands was associated with personal hygiene indicators suggesting that microbiological testing may contribute to evaluating hygiene promotion campaigns.Total morbidity (both reported and the estimated unreported cases) for intestinal infectious disease within England has been estimated at 9.4 million cases per year, which scales to one person in five per year [1]. The Financial Services Authority estimated the cost of this burden to the UK economy at ￡350 million per year [2]. Faecal-oral carriage via the hands is thought to be an important transmission pathway for diarrhoea pathogens. The promotion of improved hand hygiene continues to be a key public health goal both in low and high income countries, in communities and in health care settings. Most previous research has been done into specific populations such as primary carers and healthcare workers [3-6], but little work has been done to investigate the carriage rate of the general population [7-9].Normal bacterial flora of the gastrointestinal tract includes a vast array of anaerobes (organisms that exist in the absence of oxygen), gram negative organisms of the family Enterobacteriaceae as well as gram positive Enterococci. Commonly found species of Enterobacteriaceae are Escherichia coli