ArticlePDF Available

Covid-19 and mobile phone hygiene in healthcare settings

Authors:
Sunilkumar Panigrahi at All India Institute of Medical Sciences, Deoghar
Sunilkumar Panigrahi
  • All India Institute of Medical Sciences, Deoghar
Vineet Pathak at All India Institute of Medical Sciences
Vineet Pathak
Mohan Kumar at KMCH Institute of Health Sciences and Research
Mohan Kumar
  • KMCH Institute of Health Sciences and Research
Utsav Raj
Utsav Raj
Show all 5 authorsHide
Download full-text PDF
Read full-text
Download citation

Abstract

Covid-19 is now a global pandemic. There is some evidence to suggest possible fomite transmission. Hence, inanimate objects play a significant role in their transmission. In this commentary, we discuss ‘mobile phones’ as a potential vector of severe acute respiratory syndrome-CoV-2 spread. The use of mobile phones has not been restricted in hospitals and other health�care settings. Hence, mobile phones could be a missing link in controlling the covid-19 pandemic. We recommend, as part of efforts to control the covid-19 pandemic, awareness of ‘mobile phone hygiene, restriction of mobile phone use in healthcare settings; avoiding the sharing of mobile phones, headphones or headsets of any kind; and widely disseminated advice from mobile companies, governments and WHO on how to disinfect mobile phones.
Content uploaded by Vineet Pathak
Author content
All content in this area was uploaded by Vineet Pathak on Apr 23, 2020
Content may be subject to copyright.
1
PanigrahiSK, etal. BMJ Global Health 2020;5:e002505. doi:10.1136/bmjgh-2020-002505
Covid-19 and mobile phone hygiene in
healthcare settings
Sunil Kumar Panigrahi, Vineet Kumar Pathak , M Mohan Kumar, Utsav Raj,
Karpaga Priya P
Commentary
To cite: PanigrahiSK,
PathakVK, KumarMM,
etal. Covid-19 and mobile
phone hygiene in healthcare
settings. BMJ Global Health
2020;5:e002505. doi:10.1136/
bmjgh-2020-002505
Handling editor Seye Abimbola
Received 17 March 2020
Revised 3 April 2020
Accepted 4 April 2020
Community and Family
Medicine, AIIMS Raipur, Raipur,
Chhattisgarh, India
Correspondence to
Dr Vineet Kumar Pathak;
pathakvineet2089@ gmail. com
© Author(s) (or their
employer(s)) 2020. Re- use
permitted under CC BY- NC. No
commercial re- use. See rights
and permissions. Published by
BMJ.
Summary box
►Covid-19 is now a global pandemic. There is some
evidence to suggest possible fomite transmission.
Hence, inanimate objects play a signicant role in
their transmission.
►In this commentary, we discuss ‘mobile phones’
as a potential vector of severe acute respiratory
syndrome- CoV-2 spread. The use of mobile phones
has not been restricted in hospital and other health-
care settings. Hence, mobile phones could be a
missing link in controlling the covid-19 pandemic.
►We recommend, as part of efforts to control the
covid-19 pandemic, awareness of ‘mobile phone
hygiene’; restriction of mobile phone use in health-
care settings; avoiding the sharing of mobile phones,
headphones or headsets of any kind; and widely dis-
seminated advice from mobile companies, govern-
ments and WHO on how to disinfect mobile phones.
MOBILE PHONES IN HEALTHCARE SETTINGS
Hospitals and other healthcare settings can
facilitate the spread of infectious diseases.1
The recent outbreak of covid-19 is the third
documented spillover of animal coronavirus
to humans in the past two decades, after severe
acute respiratory syndrome (SARS) in 2002
and the Middle East respiratory syndrome in
2012. It has brought the focus of disease epide-
miology to the healthcare institutions. The
index case which sets the motion of outbreak
investigations and subsequent control meas-
ures are initiated only after coming in contact
with the healthcare institutions.2
Hospitals without proper infection control
measures are a liability during an epidemic.3
They may become sources of hospital- acquired
infections. They may initiate a vicious cycle
of new disease diagnosis and newly acquired
infections, both simultaneously occurring in
the same hospital. For any infectious disease,
it is the mode of transmission that bridges the
source or reservoir with a susceptible host. It
is this point which needs to be interrupted to
prevent and control further disease transmis-
sion.4 Healthcare professionals are a bridge
between infectious patients in hospitals (core
population) and the general population in
transmitting the disease.
The things they use within the hospital prem-
ises may facilitate such disease transmission.1
These include mobile phones. Globally, there
are 5.07 billion5 mobile phone users. There are
almost 1.2 billion6 users in India alone; 23%
of mobile phone users globally are in India.
Based on mobile phone usage, India is placed
second only next to China.7 It is important for
healthcare professionals to use mobile phones
in the hospital and other health and care
settings, especially for communication.
COVID-19, MOBILE PHONES AND DISEASE
EPIDEMIOLOGY
There have been recent discussions on
curbing the use of white coats as a way of
preventing hospital- acquired infection.8 9
However, mobile phones are arguably much
more commonly and extensively used by
healthcare professionals compared with
white coats. Apart from social media use,
health professionals use mobile phones to
follow health- related news; communicate with
one another; look up updated guidelines,
drug interactions, adverse events and health
research; for photography, sharing medical
documents, conducting teleconsultations
and patient tracking; all resulting in exten-
sive use of mobile phones.10 The self- reported
use of mobile phones among health workers
ranges from once in every 15 min to once in
2 hours.11
Mobile phones are one of the most highly
touched surfaces according to the Centers for
Disease Control and Prevention (CDC), along
with counters, tabletops, doorknobs, bath-
room fixtures, toilets, keyboards, tablets and
bedside tables.12 During the ongoing covid-19
pandemic, hand hygiene has been recom-
mended as a mainstay of infection control
by all prominent health societies, including
copyright. on April 22, 2020 at India:BMJ-PG Sponsored. Protected byhttp://gh.bmj.com/BMJ Glob Health: first published as 10.1136/bmjgh-2020-002505 on 22 April 2020. Downloaded from
2PanigrahiSK, etal. BMJ Global Health 2020;5:e002505. doi:10.1136/bmjgh-2020-002505
BMJ Global Health
WHO.13 Hand washing not only reduces the individual
risk of transmission but also interrupts the community
transmission of SARS- CoV-2, the virus that causes covid-
19. However, mobile phone surfaces are a peculiar ‘high-
risk’ surface, which can directly come in contact with the
face or mouth, while talking over phone, even if hands
are properly washed and clean.
In their tendency to come in direct contact with the
face, nose or eyes in healthcare settings, mobile phones
are perhaps second only to masks, caps or goggles.
However, they are neither disposable nor washable like
these other three, thus warranting disinfection. Mobile
phones can effectively negate hand hygiene, as there
can often be seemingly compulsive and frequent use of
mobile phones immediately after hand washing or hand
rubbing with alcohol- based sanitizers. There is growing
evidence that mobile phones are a potential vector for
pathogenic organisms.14 15
A recently published literature review showed that
mobile phone contamination rates range from 40% to
60%. Coagulase- negative Staphylococcus and S. aureus
were the most frequent bacteria (10%–90%), and most
of them were methicillin resistant.16 There is evidence
of mobile phones getting contaminated by viruses in
hospital settings. In a study, 10% of phones which were
tested had viral pathogens.17 Studies have also reported
medical students to have four times higher odds of having
heavy growth of microbes on their mobile phones.11
These findings are particularly important, given the
evidence in a recent review, which included 22 studies,
that coronavirus can survive on inanimate surfaces like
metal, glass or plastic surface for 2 hours to 9 days, and
that high temperature such as 30°C or 40°C reduced the
duration of persistence.18
MOBILE PHONE HYGIENE: BETTER SAID THAN DONE
SARS- CoV-2, the virus that causes covid-19, is only 3
months old, and so our understanding of the disease
epidemiology is continuously evolving. However, there
are many significant guidelines from various health
organisations (eg, WHO and CDC) focusing on preven-
tion and control of disease spread. However, there is no
mention of or focus on mobile phones in these guide-
lines, including the WHO infection control and preven-
tion guideline, which recommends the use of hand
washing as being of the highest importance of universal
precautions. It is the need of the hour to address a proper
hygienic use of mobile phones in healthcare settings.12 13
In a study in India, almost 100% of health workers of a
tertiary care hospital used mobile phones in the hospital,
but only 10% of them had at any time wiped their mobile
phones clean.19
There seems to have been some initial agreement
that more than 50% of alcohol damages mobile screen,
whereas many microorganisms, including SARS- CoV-2,
do not respond to concentrations below 55% of alcohol.20
Two of the biggest mobile phone companies (Apple and
Samsung) do not recommend any chemical or spray to
clean the mobile phone screen prior to covid-19.21 22
However, amidst the ongoing pandemic of covid-19, both
Apple and Samsung have revised their user support
guidelines, saying that 70% isopropyl alcohol or Clorox
Disinfecting Wipes can be used to gently wipe the exte-
rior surface of phones in switched- off mode. However, in
doing so, the use of bleach or entry of moisture through
any of the openings must be avoided, and any harsh
chemical may damage the oleophobic screen, leading to
damage in the touch screen sensitivity of the phone.21 22
MOBILE PHONE HYGIENE: THE WAY FORWARD
We recommend mobile phone use restrictions in health-
care institutions especially in hospital wards, operating
theatres and intensive care units. Disposable/washable
transparent polythene mobile phone covers may be
mandated for mobile phones that are brought into and
used in hospital premises. Use of headphones or headsets
(wired/wireless) should be promoted to prevent contact
with the face while talking on mobile phones. There
should be no sharing of mobile phones, headphones or
headsets of any kind. In addition, where available, the use
of interdepartmental intercom facility though telephones
may be promoted as a strategy for reducing excessive use
of personal mobile phones inside hospital premises.
Further, organisations such as the WHO and CDC
should mobilise mobile manufacturing companies to
issue advisory on the choice of disinfectants in view of
product damage. Compulsory hand washing with soap
and water or alcohol- based hand rubs should be prac-
tised after unavoidable mobile phone use. Organisational
research should be promoted through identification of
bacterial or viral flora on mobile phones, and appro-
priate use of disinfectants according to the culture and
sensitivity pattern should be included in hospital infec-
tion control measures.
There has never been any concrete evidence that
mobile phone hygiene has reduced disease transmission.
Having said that, minimising mobile phone use, hand
washing, disinfectant wipes, headphone use and wash-
able covers should be encouraged. Complete mobile
phone restriction in the current situation would be
near impossible and may contribute to a breakdown of
communication in a time when swift and open lines of
communication are crucial. The available recommenda-
tion from the mobile phone industry is to use biocide
(70% isopropyl alcohol or Clorox Disinfecting Wipes) for
cleaning mobile phones routinely, in the following steps:
►Before starting to clean, turn off the phone and
remove the case, accessories and cables, if any.
►Use a soft, lint- free, waterproof and dust- proof wipe,
such as a camera lens wipe, to gently wipe the surface
of the device.
►Lightly dampen a corner of a washcloth with a small
amount of biocide and gently wipe the front and back
of the phone.
copyright. on April 22, 2020 at India:BMJ-PG Sponsored. Protected byhttp://gh.bmj.com/BMJ Glob Health: first published as 10.1136/bmjgh-2020-002505 on 22 April 2020. Downloaded from
PanigrahiSK, etal. BMJ Global Health 2020;5:e002505. doi:10.1136/bmjgh-2020-002505 3
BMJ Global Health
►Avoid entry of moisture through any openings and do
not use liquid directly on the phone.
►Do not use the compressor and do not use or spray
bleach or any cleaning solutions directly on phone.
►Do not use bleach.
CONCLUSION
The CDC recommends hand hygiene before and after
contact with every patient, and an estimated one- third
of hospital- acquired infections are caused by lack of
adherence to established infection control practices such
as hand hygiene.13 Although hand hygiene and mobile
phone use by a person are not mutually exclusive, it is
high time to acknowledge the potential role of mobile
phones in disease transmission cascade and to take
evidence- based appropriate actions. This is especially
important, given the ongoing covid-19 pandemic. To
this end, it is necessary for government agencies and the
WHO to generate public awareness and to formulate suit-
able information, education and communication mate-
rial on mobile phone hygiene, especially in healthcare
settings.
Contributors All the authors were involved in the concept, design, literature
search, manuscript preparation, manuscript editing and manuscript review, and
acted as guarantors.
Funding The authors have not declared a specic grant for this research from any
funding agency in the public, commercial or not- for- prot sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement There are no data in this work.
Open access This is an open access article distributed in accordance with the
Creative Commons Attribution Non Commercial (CC BY- NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non- commercially,
and license their derivative works on different terms, provided the original work is
properly cited, appropriate credit is given, any changes made indicated, and the
use is non- commercial. See:http:// creativecommons. org/ licenses/ by- nc/ 4. 0/.
ORCID iD
Vineet KumarPathak http:// orcid. org/ 0000- 0003- 2788- 8399
REFERENCES
1 Collins AS. Chapter 41. Preventing health care–associated
infections. In: Patient safety and quality: an evidence- based
Handbook for nurses, 2020. https://www. ncbi. nlm. nih. gov/ books/
NBK2683/
2 Centers for Disease Control and Prevention. Principles of
epidemiology: lesson 6, section 2, Self- Study course SS1978.
Available: https://www. cdc. gov/ csels/ dsepd/ ss1978/ lesson6/
section2. html [Accessed 19 Mar 2020].
3 World Health Organization. Hospital preparedness for epidemic.
Available: https://www. who. int/ publications- detail/ hospital-
preparedness- for- epidemics [Accessed 19 Mar 2020].
4 Detels R, Gulliford M, Karim QA. Oxford textbook of global
public health. Oxford, UK: Oxford University Press, 2015. https://
oxfordmedicine. com/ view/ 10. 1093/ med/ 9780199661756. 001. 0001/
med- 9780199661756
5 Abdulla MA, Esmaeel AM. Providing information through smart
platforms: an applied study on academic libraries in Saudi
universities. J Educ Soc Behav Sci 2019:1–24.
6 Government of India. Home, Telecom regulatory authority of India.
Available: https:// main. trai. gov. in/ [Accessed 19 Mar 2020].
7 Highlights of Telecom subscription data as on 31st January,
2019. Available: https:// main. trai. gov. in/ sites/ default/ les/ PR_ No.
22of2019_ 0. pdf [Accessed 19 Mar 2020].
8 Banu A, Anand M, Nagi N. White coats as a vehicle for bacterial
dissemination. J Clin Diagn Res 2012;6:1381-4.
9 Fernandes E. Doctors and medical students in India should stop
wearing white coats. BMJ 2015;351:h3855.
10 Jayalakshmi J, Appalaraju B, Usha S. Cellphones as reservoirs of
nosocomial pathogens. J Assoc Physicians India 2008;56:388–9.
11 Chao Foong Y, Green M, Zargari A, etal. Mobile phones as a
potential vehicle of infection in a hospital setting. J Occup Environ
Hyg 2015;12:D232–5.
12 Centers for Disease Control and Prevention. Preventing 2019-
nCoV from spreading to others. Available: https://www. cdc.
gov/ coronavirus/ 2019- ncov/ hcp/ guidance- prevent- spread. html
[Accessed 19 Mar 2020].
13 World Health Organization. Infection prevention and control during
health care when novel coronavirus (nCoV) infection is suspected.
Available: https://www. who. int/ publications- detail/ infection-
prevention- and- control- during- health- care- when- novel- coronavirus-(
ncov)- infection- is- suspected- 20200125
14 Brady RRW, Wasson A, Stirling I, etal. Is your phone bugged?
the incidence of bacteria known to cause nosocomial infection on
healthcare workers' mobile phones. J Hosp Infect 2006;62:123–5.
15 Pal S, Juyal D, Adekhandi S, etal. Mobile phones: reservoirs for
the transmission of nosocomial pathogens. Adv Biomed Res
2015;4:144.
16 Morvai J, Szabó R. [The role of mobile communication devices in the
spread of infections]. Orv Hetil 2015;156:802–7.
17 Cavari Y, Kaplan O, Zander A, etal. Healthcare workers mobile
phone usage: a potential risk for viral contamination. surveillance
pilot study. Infect Dis 2016;48:432–5.
18 Kampf G, Todt D, Pfaender S, etal. Persistence of coronaviruses
on inanimate surfaces and their inactivation with biocidal agents. J
Hosp Infect 2020;104:246–51.
19 Shakthivel PCG, G. Sucilathangam GV, Revathy C. Mobile phones
in healthcare setting: potential threat in infection control. Int J Curr
Microbiol Appl Sci 2017;6:706–11.
20 The Wall Street Journal. Should you clean your phone to combat
coronavirus? Denitely. Maybe. Available: https://www. wsj. com/
articles/ should- you- clean- your- phone- to- combat- coronavirus-
denitely- maybe- 11584018237 [Accessed 19 Mar 2020].
21 Apple Support. Cleaning your iPhone. Available: https:// support.
apple. com/ en- in/ HT207123 [Accessed 19 Mar 2020].
22 Samsung Support NZ. Galaxy note 8: how to clean dirty glass/
screen? Available: https://www. samsung. com/ nz/ support/ mobile-
devices/ galaxy- note- 8- how- to- clean- dirty- glass- screen/ [Accessed
19 Mar 2020].
copyright. on April 22, 2020 at India:BMJ-PG Sponsored. Protected byhttp://gh.bmj.com/BMJ Glob Health: first published as 10.1136/bmjgh-2020-002505 on 22 April 2020. Downloaded from
... 10 Healthcare workers, including medical and dental students, require the use of a mobile device for a number of diverse situations: viewing health-related news, communication with colleagues, to peruse medical guidelines and drug interactions, checking adverse events and health research, for medical or dental photography and radiology, sharing of medical documents, and of particular importance during the Covid-19 pandemic was through conducting patient teleconsultations. 1,10,12 It was also recommended as a tracking device during the pandemic and advised by governments to use in alerting people of other Covid positive cases in their vicinity and so ensure the safety of all in the prevention and spread of infections. 12 Thus, it has become an essential part of our work and lifestyle and has proven to change and enhance the lives of those who use it. ...
... Evidence suggested that SARS-CoV-2 may remain viable for hours and/or even days on a variety of materials. [1][2]15 The presence of the coronavirus is known to be more stable on plastic and stainless steel than on copper and cardboard and may be detected for up to 72 hours on these surfaces. [15][16] As MPs are neither disposable nor washable, it is a reservoir for microbes and the more time spent with the device, the greater the chances of microbial cross-contamination. 12,15 Similarly, mobile devices are stored in pockets and handbags and are used in different locations eg the toilet, gym, while dining out, and within healthcare settings, allowing contamination and creating an environment for cross-infection. ...
... After searching all relevant databases, 646 articles were obtained following criteria set for inclusion and using a three-step screening process (titles, abstracts and full text) for eligibility and a final number of 20 articles were included ( Figure 1). [1][2]7,9,11,[16][17][23][24][25][26][27][28][29][30][31][32][33][34][35] Data were meticulously and independently extracted by the two reviewers (SK and QI) focusing on the outcomes set for this review. ...
Mobile phone hygiene practices in healthcare settings: A mapping review
Article
Full-text available
  • Feb 2025
The aim of this review was to map the evidence related to knowledge, attitude, and hygiene practices of healthcare workers regarding mobile phones in a healthcare setting.
View
... In the healthcare environment, professionals use these for work-related activities such as: following healthrelated news; communicating with colleagues and patients; searching databases for updated guidelines, drug interactions, adverse events and health research; taking pictures of patients oral health conditions; sharing of medical documents; conducting tele-consultations as well as patient-tracking and creating appointments. 3 The self-reported use of mobile phones among healthcare workers ranges from once in every 15min to once every 2hours. 3 Due to its continuous daily use, these devices may be considered as 'hotspots' for carrying and transmission of pathogens, such as corona virus (SARS-COV2).4-6 ...
... 3 The self-reported use of mobile phones among healthcare workers ranges from once in every 15min to once every 2hours. 3 Due to its continuous daily use, these devices may be considered as 'hotspots' for carrying and transmission of pathogens, such as corona virus (SARS-COV2).4-6 Mobile phones are thus highly touched surfaces and should be cleansed daily to avoid transmission of identified and unidentified pathogens. ...
... 9 Transmission of microbes could be from other surfaces, the environment, different dental procedures they busy with, from patients on whom they work and from each other or just the extended time of using their mobile phones. [3][4][5][6]9 These outcomes are no different to other studies published on this matter, though a difference was expected due to the strict protocols that most healthcare facilities included during the COVID-19 pandemic the world was experiencing. 6,17 It was also recommended that the COVID-19 protocols should be strictly adhered to within these healthcare settings especially, because that would ensure the safety of all patients, staff and students. ...
Surveillance of specific pathogens on mobile phones in aerosol and non-aerosol generating dental clinics during the COVID pandemic
Article
Full-text available
  • Feb 2023
Following COVID-19 protocols implemented globally, it is prudent to extend this to mobile phones, regarded as carriers of microbes, as these are used extensively in clinical settings for learning and patient care. AIM: Was to determine types of microbes harbored on mobile phones and related hygiene practices whilst using these in aerosol and non-aerosol generating dental settings METHODOLOGY: This cross-sectional study was conducted in two parts: A laboratory study to determine the prevalence of microbes on mobile phones and a questionnaire survey to determine the related knowledge and behavior of phone users in both aerosol and non-aerosol generating dental clinics. All proper protocols (consent, ethics) were adhered to RESULTS: A small percentage (27.2%) of swabs of mobile phones yielded a positive bacterial culture, of these 72% were from the AGP dental setting. Gram positive and negative microorganisms were distinguishable, indicating a diverse group of microbes. Students and staff indicated good mobile phone hygiene practices, but there is place for improvement. Their related knowledge of disinfectants and use were acceptable, but not having mobile phone coverings was problematic CONCLUSION: Faculty protocols for disinfecting mobile phones and standardized guidelines for its use in aerosol or non-aerosol clinics is recommended
View
... Most people have at least one symptom during the first 12 days of exposure, on average (11). For the great majority of persons, the acute phase of the disease is short-lived. ...
... Chronic COVID is a condition that affects more than half of home-isolated young people. It causes tiredness for months after recovery and long-term organ damage (11,12). To better understand the disease's long-term impacts, researchers are conducting long-term studies (13). ...
Effect of pulmonary rehabilitation on functional status dyspnea and quality of life among post COVID-19 patients
Article
Full-text available
Objectives To determine the Effect of pulmonary rehabilitation on functional status dyspnea and quality of life among post-COVID-19 patients. Methods The study utilized an experimental study designwith a total of 120 participantsto examine the effects of pulmonary rehabilitation. The participants were divided into two groups: Group A (experimental group) and Group B (control group). Demographic variables such as age, weight, and height were collected. Health-related quality of life (HRQL), post-COVID-19 functional status, and perceived exertion were assessed before and after the intervention. Results Group A demonstrated a higher mean age than Group B, indicating a significant age difference between the two groups, with no significant difference observed in weight and height. Following the intervention, Group A exhibited significant improvement in HRQL, post-COVID-19 functional status, and perceived exertion compared to Group B. Conclusion Pulmonary rehabilitation had positive effects on health-related quality of life, post-COVID-19 functional status, and perceived exertion. The experimental group benefited from improved HRQL, suggesting an overall enhancement in their well-being. The study provides preliminary evidence supporting the effectiveness of pulmonary rehabilitation as an intervention for improving outcomes in individuals post-COVID-19.
View
... Panigrahi et al. (2020) point out that mobile phones have one of the most touched surfaces thus may constitute a serious hygiene problem during the pandemic. Also we preferred the iPhone instead of Apple because we observed that the iPhone as a brand has a more powerful position than Apple considering that other Apple products (Apple TV, Apple Watch, etc.) are not as popular as iPhone in Turkey.3 ...
HYGIENE ANXIETY AND BRAND LOVE OF CONSUMERS: LESSONS FROM COVID-19 PANDEMICHYGIENE ANXIETY AND BRAND LOVE OF CONSUMERS: LESSONS FROM COVID-19 PANDEMIC
Article
Full-text available
  • Dec 2023
The current study analyzed the hygiene anxiety of consumers within the context of the COVID-19 pandemic. Hygiene anxiety means the state of being worried about the cleanliness of purchased or to-be-purchased products/services that may cause illness. It is hypothesized that the hygiene anxiety experienced by consumers with strong emotional bonds with their brands - consumers who love the brand - would not reduce their purchasing intentions. In the first study, unexpectedly, it was found that the purchase intention of consumers with higher brand love significantly decreased when their hygiene anxiety was triggered. In the second study, what can reduce the hygiene anxiety of consumers is qualitatively inquired. Direct and indirect anxiolytic efforts were discovered. Indirect efforts are the brand's hygienic image, brand trust, and country of origin. Direct efforts are categorized under a hygienic 3P (product, promotion, and place) concept inspired by the classical marketing mix (4P).
View
... The questionnaire was developed and modified from previous studies conducted in Bangladesh [41] and China [46], and several other relevant literatures were considered [63][64][65][66][67][68][69][70]. The questionnaire was first developed in the English language, translated to Nepali language and back translated to English language. ...
Knowledge, attitudes and practices (KAP) on COVID-19 among the general population in most affected districts of Nepal
Article
Full-text available
  • Jul 2023
The COVID-19 pandemic has become one of the global health challenges in the current context. In Nepal, the first confirmed case was reported on 23 January 2020, and since then, it has resulted in several negative impacts, including economic disruption and deterioration of physical and mental health. In such a pandemic, it is indispensable to understand the knowledge and behavioral patterns of the general population regarding COVID-19. Therefore, our study aimed to assess the knowledge, attitudes and practices on COVID-19 among the general population in most affected districts and its relationship with socio-demographic conditions. The cross-sectional study was conducted among the general population above the age of 18 years from eight districts of Nepal including Kathmandu, Bhaktapur, Lalitpur, Morang, Sunsari, Rupandehi, Chitwan, and Kaski. A convenient non-probability sampling method was considered with total sample size of 702. The questionnaire survey was conducted to collect data. Descriptive statistics, non-parametric statistical tests, and a logistic regression model were used for analysis. The study showed that 93.3% of respondents had knowledge of overall preventive practices, whereas only 32% had knowledge of overall symptoms of COVID-19. Regarding attitudes, only 14.3% strongly believed that the COVID-19 pandemic would end soon. The preventive practice was reduced after the lockdown compared to that of during the lockdown. The respondents with white-collar occupations, high-income, and unmarried were good at KAP. Similarly, highly educated and those residing in urban areas had good knowledge and practice. The study findings will help in the development of targeted programs to improve the general population’s knowledge, attitudes and practices on COVID-19, which is paramount to dealing with the existing pandemic and also such possible future waves of the pandemic.
View
... In fact, two of the biggest mobile phone companies (Apple and Samsung) did not recommend the use of any chemical substances or sprays for cleaning the mobile phone screen. However, during the COVID-19 pandemic, both Apple and Samsung have revised their user support guidelines, stating that 70% isopropyl alcohol, or disinfectant wipes, can be used to wipe the exterior of mobile phones when powered off [5]. ...
How Did the COVID-19 Pandemic Change the Hand and Mobile Phone Hygiene Behaviors of Greek Undergraduate Students?
Article
Full-text available
  • Feb 2023
The aim of this study is to assess the influence of the COVID-19 pandemic on undergraduate students’ knowledge, attitudes, and behaviors on hand and mobile phone hygiene. An anonymous self-reported questionnaire was distributed among 100 Greek male and female undergraduate students of all academic years who attended healthcare as well as non-healthcare curriculums. Descriptive statistics and statistical tests (chi-squared and Wilcoxon signed-rank test) were used (α = 5%). Students provided better responses during COVID-19, compared to the period before the COVID-19 pandemic, concerning their hand washing frequency (p < 0.001), hand washing circumstances, certain hand washing procedures, as well as their mobile phones’ cleaning/disinfection methods and frequency (p < 0.001). Statistically significant differences were observed between males and females in their knowledge, attitudes, and behaviors on hand and mobile phone hygiene, followed by faculty and year of studies. Overall, being a final-year female undergraduate student of health sciences has a positive influence on correct knowledge, attitudes, and behaviors on hand and mobile phone hygiene.
View
... Our findings of limited S. aureus contamination are like studies showing bacterial surface contamination of items used repeatedly in healthcare. Many studies have cited high frequencies of HCW cell phone bacterial contamination, commonly by S. aureus (Kalra et al., 2021;Malhotra et al., 2020;Panigrahi et al., 2020). Furthermore, some data suggest that even disinfected stethoscopes maintain significant rates of bacterial contamination (Kalra et al., 2021). ...
Surface Contamination of Reusable Respirators and Face Shields During Care of Critically Ill COVID-19 Patients
Article
  • Dec 2022
Background: With the emergence of SARS-CoV-2, healthcare workers (HCW) have relied on reusable personal protective equipment (PPE), including respirators and face shields (FSs). The effectiveness of decontamination procedures outside experimental settings is unclear. We examined the prevalence of surface contamination on reusable PPE used by HCWs at a hospital incorporating daily centralized decontamination and post-use wiping by sampling for common pathogens. Method: Samples were collected from HCWs' CleanSpace Halo respirator face masks (FMs) and FSs at the start of shift, immediately after use, and after cleaning with disinfecting wipes. Samples were analyzed for pathogens using the Applied Biosystems™ TaqPath™ COVID-19 Combo Kit and ThermoFisher TaqMan Array Card. Patient charts were reviewed for clinical correlation. Findings: Of the 89 samples, 51 from FMs and 38 from FSs, none tested positive for SARS-CoV-2, despite 58 being obtained from PPE used in the care of patients with COVID-19, many with recent aerosol-generating procedures. Four samples tested positive (4.5%) for Staphylococcus aureus, two each from FMs and FSs. FMs that tested positive were not worn concurrently with FSs that tested positive. The FM and FS samples testing positive were worn in the care of patients without diagnosed S. aureus infection. No FMs tested positive following wipe-based disinfection, but both positive FS samples were found after disinfection wiping. Conclusion/application to practice: Contamination of reusable PPE appears uncommon, especially with SARS-CoV-2, when regular decontamination programs are in place. The rare presence of S. aureus highlights the importance of doffing procedures and hand hygiene by HCW to prevent surface contamination.
View
Cell Phones in the OR : A Cross‐Sectional Study of Norwegian Perioperative Nurses’ Knowledge, Practice, and Attitudes
Article
  • Apr 2024
Few studies have focused on the use of cell phones in the OR. In Norway, researchers sought to assess perioperative nurses’ knowledge, practice, and attitudes associated with cell phone use in the OR and distributed a nationwide questionnaire via a social media platform. More than 80% of the 332 respondents thought that cell phones were contaminated and that pathogens could contaminate hands. Almost all respondents brought their phone to work; approximately 61% of respondents carried it in their pocket in the OR. Responses to questions about phone cleaning showed that 39 (11.7%) of the respondents routinely cleaned their phone before entering the OR and 33 (9.9%) of the respondents cleaned it when leaving the OR. Less than 20% of respondents indicated their facility had guidelines for cleaning personal cell phones. Opportunities for improvement in cell phone cleaning in ORs exist and additional research involving all perioperative team members is needed.
View
Creating anti-viral high-touch surfaces using photocatalytic transparent films
Article
  • Mar 2023
  • CHEMOSPHERE
Antimicrobial and self-cleaning surface coatings are promising tools to combat the growing global threat of infectious diseases and related healthcare-associated infections (HAIs). Although many engineered TiO2-based coating technologies are reporting antibacterial performance, the antiviral performance of these coatings has not been explored. Furthermore, previous studies have underscored the importance of the "transparency" of the coating for surfaces such as the touch screens of medical devices. Hence, in this study, we fabricated a variety of nanoscale TiO2-based transparent thin films (anatase TiO2, anatase/rutile mixed phase TiO2, silver-anatase TiO2 composite, and carbon nanotube-anatase TiO2 composite) via dipping and airbrush spray coating technologies and evaluated their antiviral performance (Bacteriophage MS2 as the model) under dark and illuminated conditions. The thin films showed high surface coverage (ranging from 40 to 85%), low surface roughness (maximum average roughness 70 nm), super-hydrophilicity (water contact angle 6-38.4°), and high transparency (70-80% transmittance under visible light). Antiviral performance of the coatings revealed that silver-anatase TiO2 composite (nAg/nTiO2) coated samples achieved the highest antiviral efficacy (5-6 log reduction) while the other TiO2 coated samples showed fair antiviral results (1.5-3.5 log reduction) after 90 min LED irradiation at 365 nm. Those findings indicate that TiO2-based composite coatings are effective in creating antiviral high-touch surfaces with the potential to control infectious diseases and HAIs.
View
Raman imaging to capture microplastics and nanoplastics carried by smartphones
Article
  • Dec 2022
  • SCI TOTAL ENVIRON
The sources of microplastics and nanoplastics can be found almost everywhere, including being released from the activities of our daily lives. Unfortunately, the process for determining the sources of microplastics and nanoplastics is hampered by the limited techniques available for characterisation. Herewith, we advance Raman imaging by combining it with logic-based, algebra-based, PCA-based algorithms and their hybrid, which can significantly increase the signal-noise ratio and the imaging certainty, to enable the characterisation of microplastics. Consequently, we can capture and identify the microplastics carried by our smartphones. That is because, due to the friction and fragmentation etc., our clothes and the decoration trinkets that might be made of plastic fibres can release microplastics. The released microplastics stick on the phone surface, or are trapped in the charging port, speaker ports etc., towards accumulation. We estimate hundreds or thousands of microplastics can be captured and carried by a smartphone, depending on the clothing materials, pocketing styles, user habits etc. This study did not unequivocally detect nanoplastics due to the complexity of the samples (which shields the weak signals emitted from nanoplastics). To address this, further methodological improvements are required, such as optimisation of sample preparation (for better isolation of nano-sized plastics), refinement of data processing algorithms and combined use of Raman microscopy and scanning electron microscopy.
View
Providing Information through Smart Platforms: An Applied Study on Academic Libraries in Saudi Universities
Article
Full-text available
  • Jun 2019
Information services using smart platforms have become one of the demands of this era since the much of information centres' users prefer using them for their speed and simplicity, capacity and efficiency in collecting vast amounts of information that meets the user's needs. Smartphones have spread out globally in a dramatic form, which means that libraries and information centres are now facing tremendous challenges to meet the needs of its users. This study aims at highlighting the efforts of the Library Information Services Specialists' of providing information services by the use of smart platforms that have been applied in Saudi Academic Libraries and Centres, which have delivered the said services. The main requirements for offering information services via smart platforms in the academic libraries and Information Centers were considered the subject of the study (Saudi academic Library and Resource centres at Saudi Universities). However, the significance of the study relies on empowering the researchers and students to have the means of free access to the research, studies, and all sources of digital information via their smartphones. The study consists of two parts, applied and theoretical fields in its methodology. The implementation of the applied research involved conducting a survey among the information services providers at the Saudi academic Libraries and Resource centres at Saudi Universities. Several users of the said libraries have conducted well-planned interviews with 156 information professionals and researchers to identify their views, insights, and opinions on the benefits of offering information services via smart platforms. The theoretical part took from the resources’, references and websites that discussed the aforementioned topic. Also addressed were its obstacles facing the said services in the era of information technology as the study sought to find out the answer.
View
Mobile Phones: Reservoirs for the Transmission of Nosocomial Pathogens
Article
Full-text available
  • Aug 2015
Global burden of hospital-associated infection (HAI) is on the rise and contributes significantly to morbidity and mortality of the patients. Mobile phones are indispensible part of communication among doctors and other health care workers (HCWs) in hospitals. Hands of HCWs play an important role in transmission of HAI and mobile phones which are seldom cleaned and often touched during or after the examination of patients without hand washing can act as a reservoir for transmission of potent pathogens. This study aimed to investigate the rate of bacterial contamination of mobile phones among HCWs in our tertiary care hospital and to compare it with personal mobile phones of non-HCWs (control group). The mobile phones and dominant hands of 386 participants were sampled from four different groups, hospital doctors and staff (132), college faculty and staff (54), medical students (100) and control group (100). Informed consent and questionnaire was duly signed by all the participants. Samples were processed according to standard guidelines. 316 mobile phones (81.8%) and 309 hand swab samples (80%) showed growth of bacterial pathogens. The most predominant isolates were Coagulase-negative Staphylococcus, Staphylococcus aureus, Acinetobacter species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and Enterococcus species. Hundred percent contamination was found in mobile phones and hands of HCWs indicating mobile phones can be the potential source of nosocomial pathogens. Our study results suggest that use of mobile phones in health care setup should be restricted only for emergency calls. Strict adherence to infection control policies such as proper hand hygiene practices should be followed.
View
Mobile Phones as a Potential Vehicle of Infection in a Hospital Setting
Article
Full-text available
To investigate the potential role of mobile phones as a reservoir for bacterial colonization and the risk factors for bacterial colonisation in a hospital setting. We screened 226 staff members at a regional Australian hospital (146 doctors and 80 medical students) between January 2013 and March 2014. The main outcomes of interest were the types of microorganisms and the amount of contamination of the mobile phones. This study found a high level of bacterial contamination (n=168/226, 74%) on the mobile phones of staff members in a tertiary hospital, with similar organisms isolated from the staff member's dominant hand and mobile phones. While most of the isolated organisms were normal skin flora, a small percentage were potentially pathogenic (n=12/226, 5%). Being a junior medical staff was found to be a risk factor for heavy microbial growth (OR 4.00, 95% CI 1.54, 10.37). Only 31% (70/226) of our participants reported cleaning their phones routinely, and only 21% (47/226) reported using alcohol containing wipes on their phones. This study demonstrates that mobile phones are potentially vehicles for pathogenic bacteria in a hospital setting. Only a minority of our participants reported cleaning their phones routinely. Disinfection guidelines utilizing alcohol wipes should be developed and implemented.
View
White Coats as a Vehicle for Bacterial Dissemination
Article
Full-text available
  • Oct 2012
White coats are known to be potential transmitting agents of multi-drug resistant organisms. This study was conducted to determine the level and type of microbial contamination present on the white coats of medical students in order to assess the risk of transmission of pathogenic micro-organisms by this route in a hospital setting. A cross sectional survey of the bacterial contamination of white coats in a tertiary care hospital. 100 medical students working in various specialties were included in the study. Swabs were taken from 4 different areas of the white coat - collar, pocket, side and lapel and processed in the Microbiology department according to standard procedures. Although most of the white coats had been washed within the past 2 weeks, the sides of the coats were the most highly contaminated areas followed closely by the collar and pockets. Staphylococcus aureus was the most common isolate followed by coagulase negative Staphylococci and Gram negative non fermenters. Most of the Gram positive cocci were resistant to Penicillin, Erythromycin and Clindamycin. White coats have been shown to harbor potential contaminants and may have a role in the nosocomial transmission of pathogenic microorganisms. Thus, a yearly purchase of white coats and the possession of two or more white coats at any point in time should be made compulsory. There is pressing need to promote scrupulous hand washing before and after attending patients and alternatives to white coats, including universal use of protective gowns, should be considered.
View
Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents
Article
  • Feb 2020
  • J HOSP INFECT
Currently, the emergence of a novel human coronavirus, temporary named 2019-nCoV, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for 2019-nCoV, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread. FREE ACCESS ON JOURNAL HOMEPAGE
View
View
View
Healthcare workers mobile phone usage: A potential risk for viral contamination. Surveillance pilot study
Article
  • Feb 2016
Background: Mobile phones are commonly used by healthcare workers (HCW) in the working environment, as they allow instant communication and endless resource utilisation. Studies suggest that mobile phones have been implicated as reservoirs of bacterial pathogens, with the potential to cause nosocomial infection. This study aimed to investigate the presence of Respiratory Syncytial Virus, Adenovirus and Influenza Virus on HCWs mobile phones and to identify risk factors implied by HCWs practice of mobile phones in a clinical paediatric environment. Methods: Fifty HCWs' mobile phones were swabbed over both sides of the mobile phone, for testing of viral contamination during 8 days in January 2015. During the same period, a questionnaire investigating usage of mobile phones was given to 101 HCWs. Results: Ten per cent of sampled phones were contaminated with viral pathogens tested for. A total of 91% of sampled individuals by questionnaire used their mobile phone within the workplace, where 37% used their phone at least every hour. Eighty-nine (88%) responders were aware that mobile phones could be a source of contamination, yet only 13 (13%) disinfect their cell phone regularly. Conclusion: Mobile phones in clinical practice may be contaminated with viral pathogenic viruses. HCWs use their mobile phone regularly while working and, although the majority are aware of contamination, they do not disinfect their phones.
View
Doctors and medical students in India should stop wearing white coats
Article
  • Jul 2015
  • Br Med J
Evidence shows that long sleeved coats facilitate the transmission of infection in hospitals, leading to avoidable harm and cost to patients, says Edmond Fernandes Although emphasis on evidence based medicine is increasing, we still selectively tackle issues that we like and collectively ignore the ones that we don’t—such as doctors wearing white coats. Historically, long sleeved coats, popularly called aprons, were worn by laboratory scientists. But in the 19th century, after scientists showed that many doctors’ remedies were useless, doctors started wearing them. They adopted the colour white to symbolise purity and goodness, hoping to improve their damaged reputation.1 In 1975 Joseph P Kriss, former professor of medicine and radiology at Stanford University, wrote in the New England Journal of Medicine , “The physician’s dress should convey to even his most anxious patient a sense of seriousness of purpose that helps to provide reassurance and confidence that his or her complaints will be dealt with competently. “True, the white coat is only a symbol of this attitude, but it has also the additional practical virtues of …
View
[In Process Citation].
Article
  • May 2015
Mobile communication devices have an invaluable feature of communication within hospital, and they may support certain aspects of clinical diagnosis and education. However, there may be a risk for contamination of these devices with various pathogens. The aim of the authors was to perform a systematic review on the potential role of mobile communication devices in the dissemination of pathogens and to identify effective prevention measures. A detailed literature search was conducted using PubMed and ScienceDirect databases for papers published in English between January, 2004 and August, 2014. With the use of specific search term combinations 30 of the 216 articles met the inclusion criteria. It was found that only 8% of healthcare workers routinely cleaned their mobile communication devices resulting in a high rate of contamination (40-100%). Coagulase-negative Staphylococci and Staphylococcus aureus were the most commonly identified bacteria and most of them were methicillin resistant (10-95.3%). This systematic review identified effective interventions to reduce bacterial contamination risks including staff education, hand hygiene and regular decontamination of mobile communication devices. Orv. Hetil., 2015, 156(20), 802-807.
View