Handwashing and hand drying are key elements of infection control. Paper towels are generally accepted as the most hygienic means of drying hands and are often distributed from generic dispensers. Effective dispensing of towels is of importance economically and may influence infection control objectives if hands become contaminated during hand drying. In this study, a method to identify potential exposure routes for hand contamination and evaluate the efficiency of paper-towel dispensing is described and applied to 5 different folded paper towels using a generic wall-mounted dispenser. A total of 18 male and female participants of varying heights participated in pull testing of 400 paper towels each, in controlled hand-drying simulations. All events having the potential for hand contamination, including towel jamming, towels falling onto the floor, and incidental contact of paper exits, were monitored and documented. There was considerable variation in dispensing efficiency between different towel brands. One towel (Z) had significantly (P <.05) superior dispensing properties from the generic dispenser. Participants of a shorter height obtained a lower incidence of dispensing malfunctions using all towel products and type. The results indicated likely contamination exposure routes and wastage levels for each towel type. Environmental service managers and infection control practitioners should carefully consider, for economic and infection control reasons, the siting and design of towel dispensers and the types of towel purchased.