Jet-air hand dryers should not be used in hospital toilets as they spread more germs than disposable paper towels, a study warns.
Published in the Journal of Hospital Infection, the study looked at bacterial spread in a real world setting -- in two toilets in each of three hospitals, which were in the UK, France and Italy.
Each of the toilets had paper towel dispensers and jet-air dryers, but only one of these was in use on any given day.
"The problem starts because some people do not wash their hands properly," said Mark Wilcox, a professor at University of Leeds in the UK.
"When people use a jet-air dryer, the microbes get blown off and spread around the toilet room," said Wilcox.
"In effect, the dryer creates an aerosol that contaminates the toilet room, including the dryer itself and potentially the sinks, floor and other surfaces, depending on the dryer design and where it is sited," he said.
"If people touch those surfaces, they risk becoming contaminated by bacteria or viruses," he added.
Jet-air dryers often rely on no-touch technology to initiate hand drying. However, paper towels absorb the water and microbes left on the hands and if they are disposed of properly, there is less potential for cross-contamination, researchers said.
The research follows a previous laboratory-based study led by the same team, which found that jet-air dryers were much worse than paper towels or traditional warm air hand dryers when it came to spreading germs.
On each day, over 12 weeks, levels of bacterial contamination in the toilets were measured, allowing comparisons to be made when either paper towels or jet-air dryers were in use.
Samples were taken from the floors, air and surfaces in each of the toilets.
The main target bacteria included Staphylococcus aureus, Enterococci, and Enterobacteria, including Escherichia coli.
Staphylococcus aureus is responsible for a range of conditions from minor skin and wound infections to life-threatening septicaemia. Enterococci can cause difficult-to-treat infections. Enterobacteria cause a wide range of infections, including gastroenteritis, pneumonia and septicaemia.
Across the three hospitals, bacterial counts were significantly higher in the toilets on the days that jet-air dryers were in use.
"We found multiple examples of greater bacterial contamination on surfaces, including by faecal and antibiotic-resistant bacteria, when jet-air dryers rather than paper towels were in use," said Wilcox.
"Choice of hand drying method affects how likely microbes can spread, and so possibly the risk of infection," he said.
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