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The case for medical fist bumping, then and now

Last year, 2013, medical researchers at West Virginia University published the study “Reducing pathogen transmission in a hospital setting. Handshake verses fist bump: a pilot study,” P.A. Ghareeb, T. Bourlai, W. Dutton, W.T. McClellan, Journal of Hospital Infection, vol. 85, no. 4, December 2013, pp. 321–323 (epub September 19, 2013). (We mentioned that here then.) That study says:

Handshaking is a known vector for bacterial transmission between individuals…. We have determined that implementing the fist bump in the healthcare setting may further reduce bacterial transmission between healthcare providers by reducing contact time and total surface area exposed when compared with the standard handshake.

This year, 2014, researchers at Aberystwyth University, Ceredigion, UK, published a study: “The fist bump: A more hygienic alternative to the handshake,” Sara Mela, David E. Whitworth, American Journal of Infection Control, vol. 42, 2014, pp. 916-7. The new study says:

We developed an experimental model to assay transfer of bacteria during greeting exchange, and show that transfer is dramatically reduced when engaging in alternative so-called dap greetings known as the high five and fist bump compared with a traditional handshake. Adoption of the fist bump as a greeting could substantially reduce the transmission of infectious disease between individuals.

The 2014 study does not cite the 2013 study. It’s yet another example of how medical knowledge can travel slowly, if at all.

The new study includes some near-poetic language, especially in this passage:

An experimental model and assay for bacterial transmission via physical contact was developed using standard microbiologic methods. A greeting donor immersed a sterile-gloved hand into a dense culture (2.4 109 CFU/mL) of nonpathogenic Escherichia coli and allowed a film of bacteria to dry onto the glove. A greeting was then exchanged with a sterile-gloved recipient.

The two co-authors cooperated in the making of a short educational video:

(Thanks to Ig Nobel Prize winner Mahadevan, and several other investigators, for bringing the new study to our attention.)

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