Friday, January 3, 2014

Is your iPad really a "mobile germ warehouse"?

As I have written before, there is a veritable cottage industry of papers identifying contamination of nearly every inanimate object you can think of. [For my other posts on this topic, click here.]

One of the latest involves contamination of the surfaces of electronic devices and in particular, iPads.

Without giving references, a New York Times article entitled "Cleaning the mobile germ warehouse" says, "Repeated studies show what accumulates [on device surfaces] is germy nastiness worse than what is on the bottom of your shoe." A least it's not a toilet seat comparison.

The Times cites a recent letter to the editor of the American Journal of Infection Control which states that the screens of 20 hospital-provided iPads were cultured looking for Staph aureus, Clostridium difficile, and gram-negative organisms. Three grew Staph, but neither of the other organisms was found.

They then inoculated screens with MRSA and C. diff. to test various disinfection techniques. The use of wipes containing bleach effectively decontaminated all the screens.

The Times piece launched into a long discussion of how screens should be cleaned without any mention of the problem of extrapolating what can be found on a hospital's iPad screens to what might be found on your iPad screen or whether inoculating screens with bacteria is comparable to what might be found with normal home or non-medical office use.

The senior author of the iPad screen study is quoted as saying, “That devices can be a source of disease transmission is not a subject of debate anymore." His study mentions no references to disease transmission by iPads or smart phones.

Excuse me, but I don't see what this research has to do with transmission of disease. The study did not look at disease transmission but merely colonization of surfaces. It showed that hospital-acquired organisms can occasionally be found on a small number of iPad screens in one North Dakota hospital.

I would say the topic is still quite debatable. 

iPads used in hospitals should be cleaned regularly. I have nothing against cleaning the screen of your iPad or any other device you own. If nothing else, cleaning makes it easier to see, and the device looks nicer.

What I have a problem with is the unquestioning endorsement of research like this. 

But what the hell, headlines like "mobile germ warehouse" get clicks, and that's what it's all about.


Bill Reed said...

While I agree that the "mobile germ warehouse" needs better examination, I wonder if Semmelweiss' early observations might likewise have been short on hard evidence.

Anonymous said...

Actually, Semmelweiss had very good hard evidence, based on a comparison of rates of Puerperal fever among his patients (handled with washed hands) and the general obstetrical population (handled without hand washing). His difficulties did not stem from a lack of evidence, but from a lack of the establishment's willingness to accept the evidence.

I don't think the Skeptical Scalpel's skepticism reaches quite the same level of resistance that Semmelweiss had to contend with, and I agree completely with his concern re: the willingness of both the public and the health care professions' willingness to uncritically accept pretty much anything labeled 'research', especially if it conforms to their perceptual biases, or generates clicks.

Skeptical Scalpel said...

While I was contemplating how to respond to Bill, Anonymous showed up with a much better comment than I would have made. Thanks.

Les said...

Never fear, Corning is here to save the day problem or no problem:

Why didn't they think to make toilet levers and seats of this stuff?

Skeptical Scalpel said...

Why not make everything out of it, including scrubs? I wonder how long it will take before the antimicrobial glass induces resistant organisms?

Les said...

Silver has been used as an antimicrobial agent for many years in creams for burns and coatings on stents for example. Silver ion's charge is +1 so I think it sneaks into the cells via sodium pumps causing oxidative stress or interfering with translation. Silver ion resistant bacterial strains have been isolated. I suppose silver will become the new triclosan marketed to a germophobic public.

Skeptical Scalpel said...

Yes, and everyone will wring their hands and worry about the fact that the bacteria are winning.

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