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We used a survey to assess knowledge, attitudes, and practices of environmental service workers (ESWs) at 3 hospitals.The level of ESWs' knowledge regarding cleaning practices was passable.The awareness of occupational safety and health in ESWs was weak.A positive correlation was found between service year and knowledge score.We conducted a study using a face-to-face survey to assess knowledge, attitudes, and practices of environmental service workers (ESWs) concerning routine cleaning and disinfection at 3 tertiary hospitals in China. There were 115 (89.1%) respondents who agreed that environmental cleaning can contribute to keep patients safe, whereas 63 (48.8%) reported they were very willing to make cleaning practices better. Only 15 (11.6%) ESWs agreed they were in risk of nosocomial infections during daily cleaning. Our findings suggest that the level of ESWs' knowledge regarding cleaning practices was passable, but the awareness of occupational safety and health was weak. There is a need to introduce sustained education and training aimed at ESWs.