Worse than toilets: hospital elevator buttons a hidden source of bacteria

Elevator buttons are more likely to be colonized by bacteria than toilet surfaces, a new study of three large urban hospitals has found.

“Elevators are a component of modern hospital care, and are used by multiple people with ungloved hands who will later go on to make contact with patients,” said University of Toronto professor, Dr. Donald Redelmeier, co-author of the study and staff physician, division of general internal medicine at Sunnybrook Health Sciences Centre and researcher with the Institute for Clinical Evaluative Sciences (ICES).

At each hospital, 120 randomly selected interior and exterior elevator buttons were swabbed over a ten-day period. These were compared against swabs of toilet surfaces in men’s washrooms, including exterior and interior entry-door handles, the privacy latch and the toilet flusher.

Sixty-one percent of the elevator button samples showed microbiological growth, compared to only 43% of the toilet surface samples. Bacteria cultured from the elevator buttons and toilet surfaces included Staphylococcus, Streptococcus, coliform (or bowel) bacteria, Enterococcus and Pseudomonas, though they are unlikely to cause specific diseases in most cases. (Infographic at right courtesy Sunnybrook Health Sciences Centre.)

“We were surprised by the frequency of bacterial colonization on the elevator buttons, but we were also struck by how easily it could be avoided, specifically by the use of good hand washing or hand hygiene,” said co-author Dr. Andrew Simor, a professor of Medicine and of Laboratory Medicine and Pathobiology at U of T  and chief, department of microbiology and infectious diseases at Sunnybrook.

The authors suggest several strategies for reducing the frequency of bacterial colonization on commonly touched surfaces.

“Use alcohol-based hand sanitizer before and after touching the buttons, or avoid touching them altogether by using the tip of a pen or your elbow,” said lead author Dr. Christopher Kandel, a fellow, department of infectious diseases, at U of T.

“Educating the public about the importance of hand hygiene when in a hospital may also help reduce the rate of colonization.”

The study was published today in Open Medicine Journal.

Sybil Edmonds is a writer with Sunnybrook Health Sciences Centre, a partner hospital of the University of Toronto.