TORONTO — During last spring's lengthy SARS outbreak, public health officials relentlessly pushed the message that frequent hand washing could protect against spread of the disease.

It appears those efforts may have paid off. A study released Monday suggests people in Toronto are much more likely to wash their hands after going to the bathroom than people in major American centres like Miami, Chicago and New York.

The study, conducted for the American Society of Microbiology, found that 95 per cent of men and 97 per cent of women observed in washrooms at Toronto's Pearson Airport in August washed their hands after going to the bathroom.

Those figures are significantly higher than those recorded in five major American airports, where statistics ranged from a low of 59 per cent of women in San Francisco to 63 per cent of men in New York's John F. Kennedy Airport to 92 per cent of women in Dallas-Fort Worth.

The reason Toronto's numbers are so high? The experts point directly at SARS.

"That's all it has to do with. Absolutely. And it's going to go back," said Dr. Donald Low, a leading SARS expert and an avid supporter of hand washing.

"Memories get short very quickly."

The study was conducted by Wirthlin Worldwide, which compared observed behaviour of 7,541 people to the findings of a telephone poll of 1,000 Americans taken during the same month.

Experts know that when it comes to hand washing, people say one thing and do another and that was confirmed yet again with this phone survey.

While 95 per cent of respondents said they wash their hands in public washrooms, the observed average - which was bolstered by Toronto's high numbers - showed that only 74 per cent of men and 83 per cent of women did so.

Similar surveys conducted in 1996 and in 2000 showed virtually the same percentage of people claiming they always wash after using a washroom, but only 68 per cent and 67 per cent respectively doing so. This year was the first time Toronto was included in the survey.

The 2003 phone survey found that only 58 per cent of people said they washed their hands after sneezing or coughing into them and only 77 per cent said they washed their hands after changing a diaper.

Consider that in the context of this medical fact: most of the infectious diseases we suffer from in the course of a year are transmitted via the hand-to-mouth route.

Infectious disease experts says we could all reduce our risk of catching colds and nasty bugs like the Norwalk virus if we washed our hands more frequently. But like Mom's entreaties, the message generally seems to fall on deaf ears.

"It takes something like SARS to make us wash our hands," Low said, chief microbiologist at Toronto's Mount Sinai Hospital.

And it's not just the general public that is lax on this front. Hospital workers are notorious for not washing their hands frequently enough - a fact that contributes to the spread of hard-to-shed antibiotic-resistant infections.

"Where you'd expect to see it done consistently is in a hospital but it's not done any better there than it is out in the general public," Low said. "All the studies show compliance is terrible."

Low acknowledged hand washing among hospital staff in Toronto may likewise have spiked since SARS, which infected frightening numbers of health-care workers. Two nurses and a family physician were among the 44 people in the Toronto area who died from SARS.

The hand washing survey was presented at the Interscience Conference of Antimicrobial Agents and Chemotherapy - the annual gathering of North American microbiologists and infectious disease specialists - in Chicago.