Sweaty palms, vice-like grips or the insufferable limp hand may be the least of your hand-shaking worries.
Scientists at Aberystwyth University in Wales have shown that a shake transfers more bacteria than other forms of hand-on-hand action.
They are calling for the widespread adoption of the fist bump instead, especially during flu outbreaks.
Public Health England whimsically suggested a Victorian-age bow or curtsy would be even safer.
The researchers took a pair of sterile rubber gloves and dipped one into a bacterial-broth so the outside was completely coated in E. coli.
They then performed a range of hand manoeuvres including handshakes of varying intensities, fist bumps and high-fives.
The findings, published in the American Journal of Infection Control, showed a handshake transferred 10 times as many bacteria as a meeting of fists, while a palm-to-palm high-five was somewhere in-between.
It is thought the smaller area of contact and shorter duration in the bump reduced the spread of bacteria.
Dr Dave Whitworth told the BBC News website: "There is definitely a serious side to this story, superficially it is very whimsical, but there is a serious message underneath.
"If there's a flu pandemic then handshaking might be something you want to think about or in a hospital with the spread of superbugs."
It is not the first time the argument has been raised. There have been calls in the Journal of the American Medical Association to ban handshakes from hospitals.
"There's a lot of inertia into changing this, a handshake is a badge of office and medics are trained to have a firm handshake to infuse patients with confidence, but you've got to ask is that appropriate behaviour," Dr Whitworth added.
However, Dr Whitworth admitted he was no good at bumping knuckles and repeatedly got the angle wrong.
"My hand greeting of choice remains the handshake, but I do it as little as possible."
Peter Hoffman, an expert in infection control at Public Health England, told the BBC: "Fist bumping may be one small way of avoiding getting nasty germs on your hands but there are lots of others that more than make up for it.
"E.coli bacteria are found in the gut and so if someone has these bugs on their hands then basically their skin is covered in poo.
"If we washed our hands thoroughly and consistently after going to the toilet then we could substantially reduce the spread of harmful bugs and reduce illness.
"The ultimate approach to avoiding germs would be if we went back to the Victorian age when on meeting someone you would bow or curtsy from a respectful distance - no germs there!"