Too Clean or Not Too Clean?

Making the case for targeted hygiene in the home and everyday life, as the most effective framework for preventing the spread of infection and supporting a healthy microbiome.

Hygiene in the home and everyday life is vital for protecting the public’s health by preventing the spread of harmful microbes and hence reducing the risks of contracting infectious diseases. This report outlines a more focused approach to hygiene – Targeted Hygiene – whereby the spread of infection is prevented by intervening at critical points to break the chain of infection. 

Hygiene is inextricably linked with our microbiome, the array of many micro-organisms hosted by our bodies in the gut and respiratory tract. On the one hand, the media has been known to promote a narrative that good hygiene itself can be problematic for childhood health because it is responsible for reducing contact with important microbes and thereby harming the microbiome – a now discredited proposition known as the ‘Hygiene Hypothesis’.

However, failing to implement proper hygiene at the appropriate moment is far more likely to actually have a negative impact on our microbiome: an infection, and the need to use antibiotics, can destroy the good bacteria in our gut. 

RSPH surveys conducted as part of this report reveal that, while there is a general understanding among the public about the importance of a healthy microbiome, there is much public confusion about the relationship between dirt, germs, cleanliness and hygiene. Moreover, although the importance of hygiene is well understood, the times and situations where it is most necessary are not.

A worrying one in four (23%) of those surveyed believed hygiene in the home was not important, thinking children need to be exposed to harmful germs to build their immune system. The best way to be hygienic and allow our good bacteria to thrive is to practise Targeted Hygiene – implementing the correct cleaning techniques at the most crucial moments.

If the understanding of the importance of targeted hygiene can be communicated more widely, it has the potential to reduce the burden on the NHS, promote healthy microbiomes, and reduce the spread of antimicrobial resistance. 


One in four

believe hygiene in the home is not important

Men are more than twice as likely as women to think there’s

low or no risk

associated with not washing hands with soap after using the toilet

Three in five

believe dirty hands from outdoor play are likely to spread harmful germs


  • The school PSHE curriculum should include ensuring an understanding of the chain of infection and the need for Targeted Hygiene
  • Manufacturers of cleaning and hygiene products should recognise their role in promoting hygiene best practice by developing clearer labelling and simple information leaflets to be issued with their hygiene products
  • Action needs to be taken to educate those working in the media about key issues relating to the importance of Targeted Hygiene to help ensure they do not give confusing and counter-productive messages


Related RSPH policy

Antibiotic resistance

Antibiotic resistance is a ‘major threat’ says the WHO, with over 25,000 dying annually from drug-resistant infections

Skins and Needles

The regulatory environment for ‘special procedures’ – tattoos, piercing, electrolysis and acupuncture – is patchy across the UK