Sneeze/Cough Etiquette: Why Tissues Beat Clothing

Why Clothing Is Poor Respiratory Hygiene

• No filtration: Fabric pores >> droplet size; particles pass through or settle on surface.
• Fomite creation: Contaminated clothing transfers pathogens to hands, surfaces, others.
• Self-inoculation: Touching soiled sleeve → face → mucosal entry.
• Moisture retention: Damp fabric prolongs viral/bacterial viability.
• Social signal: Visible soiling signals poor hygiene.

Tissue Advantages

• Disposable, single-use.
• Traps droplets in fibrous matrix.
• Immediate disposal breaks transmission chain.
• Can be followed by hand hygiene.

Best Practice (CDC/WHO)

1. Cover cough/sneeze with tissue (or elbow if none).
2. Discard tissue immediately.
3. Perform hand hygiene (soap/water or ABHR ≥60% alcohol).

Clothing is a last resort; always carry tissues or use elbow.