• Wendy A Harrison, Christopher J Griffith, Troy Ayers, and Barry Michaels.
• School of Applied Sciences, University of Wales Institute, Cardiff, United Kingdom.
• Am J Infect Control. 2003 Nov 1; 31 (7): 387-91.

BackgroundThe role of hands in disease transmission is well established, and the importance of handwashing is recognized. However, the exits of paper-towel dispensers used in hand drying may be contaminated, and the functionality of handwashing equipment increasingly is being questioned.ObjectivesWe sought to study the transfer and cross-contamination potential between hands, towels, and dispenser exits if one or more is contaminated using bacteria representative of the skin's flora.Materials And MethodA generic wall-mounted paper-towel dispenser and a range of different paper towels were used. Volunteers with either clean or contaminated hands were asked to remove, using a range of protocols, towels from dispensers which themselves were either clean or contaminated. Previously clean surfaces were then microbiologically tested.ResultsRecoverable bacterial transfer rates from a contaminated hand to clean dispenser exits ranged from 0.01% to 0.64% depending on the bacteria used with an even higher transfer rate for clean towels. The reverse transfer (ie, from contaminated exits to clean hands) was between 12.4% and 13.1%.ConclusionsThe results indicate that zig-zag transfer of bacteria between paper-towel dispensers and hands can take place if either one is contaminated. This potential should be considered in the design, construction, and use of paper-towel dispensers.

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