Epidemic viruses contaminate healthcare workers’ mobile phones

As if bacterial contamination of cell phones wasn’t enough of a problem, a new paper finds that viral RNA can also be found on the devices. But before you put your phone in the autoclave, read on.

The study was conducted in France and involved 114 healthcare workers (35 senior physicians, 30 residents, 32 nurses, 27 nurse assistants) who used both mobile and cordless phones in a university hospital.

Phones were swabbed and tested for viral RNA, and the subjects answered anonymized questionnaires regarding their behavior.

Viral RNA was recovered from 38.5% of the phones with rotavirus RNA on 93% of the virus-contaminated phones.

About two-thirds of the healthcare workers used their mobile phones while caring for patients, and 28% of them said they never wash their hands before using the phones, 37% never used hand hygiene after using the phone, and 21% said they never performed hand hygiene either before or after using a phone. This held true for personnel who interrupted caring for patients to answer their phone.

In an article about the study, one of the authors said, “It was surprising that 20% of them admitted never carrying out any hand hygiene procedures, either before or after using their phone, even though all said they knew phones could harbor pathogens.”

Problem with my blog. I need your help

I have a big problem.

For the last 10 days, Twitter has been blocking me from tweeting any links to my blog.

This is the message I get whenever I try to send a tweet with "skepticalscalpel.blogspot.com" in it.

I have tried to contact Twitter through @twitter and @support four times and have received no reply, nor have they replied to numerous ticket requests through the Twitter Help Center.

I discovered a site called virustotal.com which compiles reports from 63 different programs that detect viruses, worms, trojans, and malware.

Originally a site called BitDefender claimed my site was malicious. The next day, BitDefender declared my site was clean, but AutoShun, which previously had no problem with my site, said it was malicious. The following day, AutoShun said my site was unrated and Clean MX said "malicious." But the day after, AutoShun went back to calling it malicious and Clean MX said my blog was clean. At no time, did more than one of the 63 detection programs identify my blogsite is being malicious.

You would think that if my blog contained any suspicious programs, more than one of the 63 virus detection organizations would have come up with a positive result on the same day.

None of the programs saying my blog was malicious gave me any clue as to what part of my site was supposedly creating the problem.

I attempted to get some help from Blogger, which hosts my blog. Although one person on a forum responded with some advice, it wasn't enough for me to solve the problem.

My blog is averaging 1600 page views per day. Not one person has contacted me to complain that I am harboring viruses or any other malicious software. That is because, to the best of my knowledge, no such malicious software exists on my blog.

Maybe it would help if you would go to the results section of the virustotal website and cast your vote in favor of my site as not being malicious. In the upper right-hand corner of the site you will see this cartoon.



 Please click on the green face to support my blog.

Meanwhile, I have discovered an interesting workaround which enables me to tweet links to my blog, but visitors to the site will still be blocked by Twitter from tweeting links.

If you consider yourself computer-savvy, maybe you can figure out how I did it. If you think you know the answer, please submit a comment.

I also would welcome any comments or suggestions that could help to resolve my problem. If anyone knows a way to contact a human at Twitter, please let me know.

Thanks.

Surgical smoke: Is it dangerous to your health?

An operating room nurse from the UK has asked me to comment on the burning issue of surgical smoke. [Pun intended.] I don’t think she’s going to like what I have to say.

For several years, studies have found that all kinds of chemicals and organic bits can be found in smoke plumes generated by electrocautery and lasers in the operating room. Some of the chemicals are said to be carcinogens and the organic material reportedly contains intact viral genetic material.

Many organizations have called for the establishment of government regulations regarding the amount of stuff that should be allowable in OR smoke. However, OSHA has been surprisingly reluctant to do anything and has not officially commented on the subject since 1996. The OSHA website does say that about half of the states have various regulations in place.

Some groups, particularly nursing organizations, are calling for the placement of smoke evacuators in all operating rooms. As you might suspect, these efforts are being vigorously supported by the manufacturers of smoke evacuators.

I attempted to find some real evidence about all this, but it is hard to come by. There have been no randomized trials involving surgical smoke.

A very interesting presentation by a group from the Centre Hospitalier Universitaire de Québec (CHUQ) at the 2011 Cochrane Canada Symposium addressed the subject in a health technology assessment.

For biologic and chemical substances, the CHUQ health technology assessment said the risks of transmission of diseases were unclear.

They measured the air in operating rooms and said, “[A]mbient air concentrations of carbon monoxide, volatile organic compounds, and particulate matter are very low and far below the occupational exposure limits.”

They concluded, “There is no clear evidence that surgical smoke may represent health hazard,” but hedged by saying that smoke evacuators should be restricted to specific types of cases such as breast surgery. They offered no evidence to support that recommendation.

There are only two case reports in the literature claiming transmission of viruses in surgical smoke from patients to healthcare workers. These case reports are frequently cited by advocates of smoke evacuation devices.

The first case report, cited in PubMed 16 times but many more times in other documents, is from Norway. Here is the complete abstract. I added emphasis in bold.

A 44-year-old laser surgeon presented with laryngeal papillomatosis. In situ DNA hybridization of tissue from these tumors revealed human papillomavirus DNA types 6 and 11. Past history revealed that the surgeon had given laser therapy to patients with anogenital condylomas, which are known to harbor the same viral types. These findings suggest that the papillomas in our patient may have been caused by inhaled virus particles present in the laser plume.

The second case report, cited 3 times, is from Germany. Here is its abstract.

A 28-year-old gynecological operating room nurse, who assisted repeatedly in electrosurgical and laser surgical excisions of anogenital condylomas, developed a recurrent and histologically proven laryngeal papillomatosis. The expert opinion of a virological institute confirmed a high probability of correlation between the occupational exposition and the laryngeal papillomatosis so that it was accepted as occupational disease. HPV-DNA has been repeatedly detected in laser-plume after excision of papillomas and condylomas. As of the present an exact proof that these particles are infectious has not been brought forward.

There are other ways to acquire HPV virus in one’s throat.

The CDC reports that 48 million inpatient operations were performed in the United States in 2009. In the last 25 years, not a single case of proven (or unproven) transmission of any disease by surgical smoke has been diagnosed. Had such a case been found, it no doubt would have made headlines.

The Anesthesia Quality Institute estimates that there are 35,000-45,000 operating rooms in the United States. A smoke evacuation machine costs a minimum of $1000, not including the costs of disposable tubing for every case and filters which need periodic replacement.

Let’s say 40,000 ORs X $1000/smoke evacuator = $40,000,000 to prevent exactly zero cases of disease. This does not take into account the costs of disposable tubing.

In these economic times, can anyone think of a better place to spend $40,000,000?