Healthcare workers who know more about hand hygiene are less likely to transmit infections at work, U.S. researchers say. Anne McLaughlin, assistant professor of psychology at North Carolina State University, says the study involved 71 nurses, infection preventionists and hospital environmental services managers, who participated in a national survey gauging hand hygiene knowledge and beliefs. Each healthcare worker assessed 16 real-life simulations designed to test their perceived risk of infection, based on their level of hygiene knowledge as well as their internal health locus of control -- a measurement of how much influence they perceive themselves having over the spread of infection. The study, published in the American Journal of Infection Control, finds that across all knowledge and health locus of control-levels, healthcare workers perceived surfaces as safer to touch than patient skin. Research has proven touching one contaminated surface -- known as a fomite -- can spread bacteria to up to the next seven surfaces touched, the study says. "Despite the dangers that fomites present, this knowledge may not be common enough among healthcare workers for them to understand the level of risk when touching surfaces and then touching patients," the study authors say in a statement.