What Has More Germs Than a Toilet Seat, But We Use It Constantly?

Last week was Handwashing Awareness Week. It appears to have been started by infection prevention specialist Dr. Will Sawyer, and is now being picked up by hospitals and organizations around country. (There is also a Global Handwashing Day, promoted by the Centers for Disease Control.)

The benefits of hand washing to curb the spread of disease is not a new concept—it’s been a published topic since the early 1800s. However, the knowledge of how to wash hands correctly is still fighting to become general knowledge. Hint: a little sprinkle of water falls very short of acceptable.

When I worked at a hospital in Maine we launched a full hand washing training program for all hospital employees, not just the clinical staff. I was the designated trainer for our Community Relations team and am proud to say that even today, 10 years later, people sometimes ask me if I’m a nurse because of how I wash my hands. Nope, I’m just well trained.

Hospitals use all kinds of metrics to estimate and encourage handwashing compliance, from direct observations and measuring hand sanitizer usage, to sinks that beep if hands are not washed for the requisite 20 seconds. Of course, there’s even now a digital monitor in the form of a smart watch that turns red if a provider fails to wash his or her hands between patients.

All of these efforts are fantastic, and I hope proper handwashing becomes expected social etiquette, but are we overlooking something else that should be given equal attention as a surface in need of washing?

Take a tangent with me for a moment and recall the story of Golgafrincham. Golgafrincham is a planet described by Douglas Adams in The HitchHiker’s Guide to the Galaxy. Unfortunately, the inhabitants were short-sighted and shipped much of their population, including all cleaning staff, off into space. Those who remained behind then perished after contracting a virulent disease from a dirty telephone. Published in 1979, the book was, of course, talking about the old-fashioned desk phone, or perhaps a public pay phone. But bring the idea forward, and what do nearly all of us carry everywhere, from the cafeteria to the bathroom (and back again…)? While they may be personal devices, our smartphones can be very public colonizing grounds for any number of nasty microbes.

The British publication Which? swabbed tablets, phones, and toilet seats and found that where we sit is far cleaner than the devices we carry around. The prevalence of microbes on the mobile, hand-held devices would be a lot less, I suspect, if everyone washed their hands properly. Even so, it’s a surface we touch a lot and can’t always have clean hands when we need to use it. Colonized phones can later transfer microbes back to our hands, which we then use to touch other surfaces—it’s not just a personal problem.

So what are even the most diligent hand washers among us to do? Device manufacturers caution against alcohol-based cleaners because they can damage the device—most cleaning How-To guides suggest dry-wiping with a microfiber cloth. Does dry-wiping do enough? And how often can we realistically wipe our phones? Is there a protocol somewhere for the cleaning of our mobile devices like there are protocols for cleaning patient rooms and equipment? Since I have yet to find a best-practices solution I use little alcohol prep pads to wipe my screen protector and external case, but even this is merely once a week. What do you do to keep your devices clean? What do you think should be a solution for the future? Copper exteriors? How about UV treatment boxes specially designed for mobile devices? I’d love to hear your ideas.