Leading European microbiologists and hospital hygienists* have produced a scientific consensus statement upholding evidence that hand drying using paper towels is associated with lower numbers of microbes on the hands and in the washroom environment than using warm air dryers or high-velocity air dryers.
The six experts, working in hospitals and universities in Belgium, Germany, Italy, Sweden and the UK have signed an eight-point statement, Hand drying: an important part of hand hygiene, which highlights the importance of hand drying after thorough hand washing and notes that air drying blows water containing microbes off the hands, which can contaminate others in the washroom environment.
The experts examined scientific literature and studies sponsored by the European Tissue Symposium – in particular those undertaken by Eurofins-Inlab in Germany and the University of Westminster in the UK before compiling their statement.
There may be a greater risk of exposure to microbes associated with some types of hand driers
The eight main points of the statement are that:
- The importance of hand washing to prevent spread of infection is widely accepted by scientists. However, hand drying has received much less attention.
- Some microbes remain on the hands after washing, and these are more easily spread around if hands are not dried adequately.
- Proper hand drying completes the hand washing process by reducing the risk of transmission of microbes.
- Generally available hand drying methods in public washrooms are based on either water absorption (single use paper and textile towels) or water dispersal by several ways (warm air dryers, high velocity air dryers).
- There is evidence that hand drying using towels is associated with lower numbers of microbes both on the hands and in the washroom environment than using warm air dryers or high velocity air dryers.
- Warm air dryers are less efficient than other methods at drying the hands. Damp hands are more likely to transfer microbes.
- High velocity air dryers are particularly likely to spread microbes because they blow water that contains microbes off the hands. These microbes could contaminate the user, other persons and the washroom environment.
- These points have implications for the prevention of spread of microbes and potential infection, especially in settings where hygiene is very important. Therefore, the choice of hand drying methods should take into account the risk of contaminating the hands, other individuals or the environment.
Roberto Berardi
'From the results we have examined, it appears that there may be a greater risk of exposure to microbes associated with some types of hand driers. There was an increased level of microbial contamination on and beneath air driers, particularly jet air driers. These findings have implications for the prevention of the spread of microbes and infections and could result in reduced illness and time off sick and so ultimately provide economic benefit too,' said Marc Van Ranst, Professor in virology and Chairman of the Department of Microbiology and Immunology at the University of Leuven in Belgium. 'We urge that they be explored further by companies, cleaning and facilities' managers and beyond.'
The consensus statement will hopefully prompt further research and steer policy guidance in all workplace washrooms
Hand hygiene is recognised as the most important standard measure to prevent cross contamination or transmission of nosocomial hospital acquired infections. The World Health Organisation (WHO) recommends the use of paper towels in its poster on hand washing.
'The consensus statement will hopefully prompt further research and steer policy guidance in all workplace washrooms – particularly those where workers are involved in the preparation of food,' the experts said.
'Paper tissue absorbs water and microorganisms,' said Roberto Berardi, Chairman of the European Tissue Symposium. 'It is crucial that washrooms offer a method of hand drying that minimises the risk of re-contaminating the hands and blowing microbes onto yourself, others or surfaces around you.'
* Professor Silvio Brusaferro, Professor of public health, University of Udine, Italy; Professor Bertil Kaijser, Professor and Senior Consultant clinical bacteriology, Sahlgrens University, Sweden; Dr Ralf Kämmerer, Senior expert at TUV Rhineland, Germany; Keith Redway, Senior academic in microbiology, department of biomedical sciences, University of Westminster, UK; Professor Dr Marc Van Ranst, Professor of Virology and chairman of the Department of Microbiology and Immunology at the University of Leuven in Belgium; Professor Mark Wilcox, Consultant microbiologist, Leeds Teaching hospitals, UK and Professor of Medical Microbiology at the University of Leeds (Leeds Institute of Molecular Medicine), and Lead on Clostridium difficile for Public Health England (PHE).
