Significant implications
The findings have important implications for minimising the risk of cross-infection in toilets. They underline the importance of proper consultation between infection control teams and procurement and facilities managers when taking decisions about which type of hand drying method to offer.
Single use towels – for example, paper towels – have long been recognised as offering a sustainable solution in washrooms; evidence suggests that they also represent the most hygienic option for drying hands while minimising the spread of bacteria following a visit to the toilet/washroom.
Some common findings and differences
In general, bacterial contamination was found to be lower in toilets using paper towels (PT) than in those using jet air dryers (JAD). Total bacterial recovery from the JAD outer surface was also significantly greater. There were differences between the three locations, and while contamination in France and UK was similar, it was markedly lower in Italian toilets – thought to be due to a combination of a lower number of visitors and different cleaning practices. Significantly, more bacteria were recovered from the floors of JAD toilets in the UK and France.
In the UK, footfall was markedly higher than in France and Italy, and overall recovery of MSSA was three times more common and six-fold higher from JAD versus PT surfaces. MRSA was recovered three times more often from the JAD outer surface or floor beneath, and significantly more ESBL- producing bacteria were recovered from floors during JAD vs PT use.
In France, significant differences in bacterial contamination between the two types of hand drying
method were found. Higher numbers of bacteria were recovered from the floors and drier surfaces in the JAD setting than when using PT. In particular, faecal bacteria – including enterobacteria – were recovered from dust twice as often during JAD use than during PT use. In some cases, bacteria such as Staphylococcus aureus were found, which can be transmitted via the hands of carers.
In Italy the levels of microorganisms were more than 25 times greater with JADs than with PT. Indeed, Italian infection control personnel traditionally avoid the use of jet air dryers in hospitals.
www.tomorrowscleaning.com COVER STORY | 27
Single use towels, such as paper towels, are already the recommended choice in German hospitals due to their superior hygiene properties. In the light of this new evidence, health authorities and those responsible for public health and hygiene across Europe and beyond will now need to consider whether they should issue specific guidance on optimal hand drying methods in a healthcare setting.
The independent 2017 study was supported by a grant from ETS and can be viewed here.
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