Ever put any thought into how much bacteria is transmitted during a handshake? Although the culture of handshaking is seen as a sign of respect and maybe even symbolic to some, it may be making you more prone to sickness.

Surgeons at the West Virginia University compared bacterial transmission between people after they shook hands and after they fist bumped. Turns out the handshake exposed more than three times as much skin and lasted 2, 7 times longer than a fist bump. So is it time to replace the handshake with a fist bump? Lead researcher of the study Tom McClellan suggests it is – they also (not surprisingly) found that more bacteria was transmitted during the handshake. Another study found that men are less likely to wash their hands. As much as hand washing is an important ritual in healthcare settings to reduce disease transmission, they also found that even after cleansing, up to 80% of the participants still had bacteria on their hands.

The best alternative to the handshake is the fist bump in a hospital setting, and may also be useful outside of healthcare settings, say the researchers of the study.