WASH YOUR DAMN HANDS!…And Clean Your Stuff

No, not that stuff (well, actually, yes, that stuff too, but I definitely don’t want to know about it). One of the important tools in fighting infectious disease is disinfecting surfaces. Which brings me to a recent paper about cruise ships and cleanliness. In June 2006, 43 norovirus outbreaks occurred on thirteen vessels. Noroviruses can cause severe vomitting and diarrhea, and in children, particularly infants, can be deadly (also see Aetiology). In the paper, the authors decided to examine how often bathroom surfaces on cruise ships are cleaned:

Methods. Trained health care professionals covertly evaluated the thoroughness of disinfection cleaning (TDC) of 6 standardized objects (toilet seat, flush handle or button, toilet stall inner handhold, stall inner door handle, restroom inner door handle, and baby changing table surfaces) with high potential for fecal contamination in cruise ship public restrooms, by means of a previously validated novel targeting method.

Results. Fifty‐six cruise ships (30% of 180 vessels operated by 9 large cruise lines) were evaluated from July 2005 through August 2008. Overall, 37% (range, 4%-100%; 95% confidence interval, 29.2%-45.4%) of 8344 objects in 273 randomly selected public restrooms were cleaned daily. The TDC did not differ by cruise line and did not correlate with the Centers for Disease Control and Prevention (CDC) Vessel Sanitation Program inspection scores (r2 = .002; p = .75). More than half the vessels had overall TDC scores <30%, although several of these low‐scoring ships had near‐perfect CDC sanitation scores. The mean TDC of the 3 ships evaluated within 4 months before a NoVO [norovirus outbreak] (10.3%) was substantially less than the mean TDC of the 40 ships that did not experience NoVOs (40.4%) (p = 0.004 ).

An objective evaluation of public restroom environmental hygiene on 56 cruise ships found that only 37% of selected toilet area objects were cleaned on a daily basis. Low TDC scores may predict subsequent NoVO‐prone vessels. Enhanced public restroom cleaning may prevent or moderate NoVOs on cruise ships.

The very short summary:


So how did the researchers determine this? In the most sneakiest contact assessment method EVAH! (until the next sneakiest contact assessment method EVAH!, anyway), they put droplets of a clear sticky compound that lights up when a UV light is shone on it. This way they could determine what surfaces in bathrooms are actually cleaned (bathrooms and unwashed hands are probably the primary vectors of transmission because this is a diarrheal disease).

I don’t know why, but this methodology greatly amuses me.

Even though the findings are really gross.

Cited article: Carling et al. 2009. Cruise Ship Environmental Hygiene and the Risk of Norovirus Infection Outbreaks: An Objective Assessment of 56 Vessels over 3 Years. Clinical Infectious Diseases 49:1312-1317. DOI: 10.1086/606058

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5 Responses to WASH YOUR DAMN HANDS!…And Clean Your Stuff

  1. Anon says:

    So… they prolly got a grant to go on lots of cruises to do research, no?
    Of course, following their research, a cruise ship may be the last place they might want to be.

  2. Aaron Golas says:

    One of the important tools in fighting infectious disease is disinfecting surfaces.

    I know a few school administrators who could stand to be smacked upside the head a few times with this sentence.
    My mom teaches 7th grade biology, and her district appears to be getting hit pretty hard by the swine flu. She and the other teachers asked for disinfectant wipes so they could wipe down the desks between class periods, but the administration refused. Their excuse: kids might have an allergic reaction to the wipes, for which the school would be held liable. A secretary got fed up and brought in her own wipes just to use at her own desk, and they were confiscated. It’s insane.

  3. katydid13 says:

    So does this mean that the people in my office who dry their hands, turn off the water with a paper towel, then use that paper towel to open the bathroom door, and then get a squirt of hand sanitizer from the dispenser are smart? I have to say they are acting a lot like people I know who have been diagnosed with OCD act.

  4. Jack H says:

    Did you read the one about COWS? It’s just as amusing but gross.
    Dangerous cows: An analysis of disinfection cleaning of computer keyboards on wheels.
    American Journal of Infection Control, Volume 37, Issue 9, Pages 778-780 (November 2009)

  5. llewelly says:

    You’ll pry my filthy keyboard from my COLD DEAD HANDS.

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