Infection Prevention & Control

Why you should be concerned about touching any washroom door handle?

Washroom door handles are a focal point for the accumulation of harmful fecal based bacteria, causing the spread of infections such as E-coli, Staphylococcus, Aurea’s, as well as fungal and viral infections such as the Flu virus or Norovirus (winter vomiting bug). Washing your hands regularly is the single most important intervention you can do but on its own, this action is simply not enough to contain the spread of harmful germs.

After you visit the washroom, if you happen to be one of the people who do wash their hands correctly, you then have to touch the door handle to exit and the likely hood is that at this point you will have re-contaminated your hands with harmful bacteria. In doing so, as you continue to come into contact with other people or objects, you now become complicit in the potential spread of harmful germs. Most people are well aware of the risks associated with washroom door handles and surveys show the extent that people will go to, to avoid touching the door handle.

How to exit a washroom

A number of recent studies have articulated the reasons why we all should be more concerned about the potential risk with door handles and specifically, a study by a Dr. Charles Gerba from the University of Arizona demonstrated just how quickly, one single contaminated door handle could infect up to 60% of the occupants of a building within just 4 hours. In his study he placed a harmless virus on one of three door handles at the entrance to an office building. The building had 80 staff and within four hours of the contamination of that single door handle, 60% of the staff had traces of the virus on their hands.

In a second study, 100 swab samples were collected from door knobs from different departments of Al-Shifa hospital (including wards, offices, and rest rooms). All the samples were processed with two hours of collection and the swabs were cultured on routine microbiological media, incubated for 24 hours and analyzed for bacterial identification. Antimicrobial susceptibility of the isolated bacteria was also performed according to CLSI guidelines. The results of this investigation has shown that most of the tested samples contained a variety of pathogenic and nonpathogenic organisms like methicillin-resistant Staphylococcus aureus (MRSA) which is 100% resistant to teicoplanin and 96.5% to penicillin and erythromycin, klebsiella pneumonia which exhibited 50% resistance to meropenem, Aeromonas hydrophila which is 100% resistant to teicoplanin , and Serratia marcescens which is 100% resistant to tetracycline and all of them were sensitive to imipenem.

Studies such as these which highlight the dangers associated with door handles should result in a change of behavior and a re-evaluation of infection control procedures within the whole community. Infection control personnel working in all sections of the community and in particular in the health care industry have a duty of care to the provide the safest possible environment for patients, staff and visitors.

Whats on the door handleApproximately 4 100 000 patients are estimated to acquire a healthcare-associated infection in the EU each year. The number of deaths occurring as a direct consequence of these infections is estimated to be at least 37 000 and these infections are thought to contribute to an additional 110 000 deaths each year – See more at: http://ecdc.europa.eu/en/healthtopics/Healthcare-associated_infections/Pages/index.aspx#sthash.82G5ZxZ3.dpuf

The need for effective door handle sanitisers

In relation to door handle contamination, it is one thing to say there is no answer to the problem where an answer does not exist but when people are aware of a solution to a potentially deadly problem, it is inexcusable not to act.

Whether in an office, healthcare institution, public building or restaurant the most commonly touched hard surface has to be the washroom door handle and given its size, location and its frequency of use, this small surface area presents a disproportionate high risk of contamination for everyone who comes into contact with it.

Many people have mixed views on the level of risk presented by a contaminated door handle. Comments such as “how did our parents survive” and “I haven’t been sick in years” or “we clean our door handles regularly” are common place. This attitude is misplaced through a lack of understanding of how potentially dangerous germs are actually transmitted within the community and the eventual consequences of such transmission can be devastating or indeed, deadly.

The vast majority of the population are indeed healthy and have excellent immune system that are capable of protecting us against most common germs and infections. Minor ailments, such as the flu Virus and Norovirus, although common, are not life threatening to your average healthy individual but may be life threating to young children, the elderly of the infirm.

For most of us these ailments are at worst unpleasant or disconcerting but for employers some of these ailments result in increased costs through absenteeism, presenteeism or loss of productivity and as such, again, the transmission of germs in our institutions or in the workplace should be controlled or avoided where possible. We are all conscious that at certain times of the year some germs can be ubiquitous and most of us believe that the spread of such germs is through the air. This is another common misconception and the facts show that 80% of all germs are in fact transmitted via hard surfaces, such as a door handles. There is also an abundance of evidence that shows that most common germs can survive on a hard surface for several days.

Over the years we have come to understand the importance of hand washing and the role contaminated hands can play in the transmission of germs. This progressive understanding of how germs are transmitted have led to improved hygiene standards and have resulted in an overall healthier community.

Given the known risks associated with all door handles, the installation of effective door handle sanitisers should be an essential and natural progression in the ongoing challenge to continually improve general hygiene standards.

It is not possible to keep a door handle germ free without constant intervention, even if, as claimed by many infection control personnel, the handle is cleaned on a regular basis. Therefor the only permanent solutions to this problem would be to automate the opening and closing of the door, to remove the door all together as seen in airports and large public venues or simply install an effective door handle sanitiser such as the “CANNON TOUCH” or the Handle hygiene system

Our system can greatly reduce or eliminate this potential problem. The door unit itself, is a small neat box that sits about 800mm above the door handle and as the door returns to its closed position a small arm is triggered which results in fine particles of sanitizer being sprayed on the surface of the door handle. The quantity of sanitiser released is about 0.75ml which will equate to approximately 4,000 uses per refill cartridge.

For more information about our door handle sanitizing system, please contact me at;

maurice@handlehygiene.com

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