Infections at home can be a fact of life for healthcare workers. At the 2020 iClean conference, Managing Director of the water purification company Medentech, Michael Gately, spoke to the topic of healthcare workers (HCW) and their families. In 2015, he and his colleagues performed a meta-analysis of all available studies on HCW and their families, and came to a rather compelling conclusion (paraphrased): “There is no measure of healthcare workers’ family members who die… however there are significantly higher numbers of infection observed in family members of healthcare workers than in the family members of those who are sick.”  

Pathogens do not travel alone. They require a host to transport them to a new environment, completing the chain of infection. Gately explores the following scenario, which is familiar to every healthcare worker. Exhausted, at the end of a shift and ready to go home to their loved ones and their bed, the last thing they are thinking of is infection control for themselves. They are more inclined to think let’s get out of here. Tiredness lowers our immune system, our concentration and attitudes, which in turn increases the risk of infection transmission. Our attention to detail decreases when we are tired. We may not take care to consider how we handle our uniform, shoes, car keys, handbags and phones — all of which act as vehicles to transport infection into our home environments. This in turn puts everyone in our home at risk of infections.

Bringing your work home with you

Picture this. One healthcare worker took MRSA home, and as a matter of course her husband and son developed chest infections. Interestingly, these infections were traced back to toothbrushes in a shared toothbrush holder. The toothbrushes may have been infected by plumes from the nearby toilet. Every time you flush the toilet, a gust or plume of germs is generated. Every time you brush your teeth, germs are introduced directly to the gums and into the bloodstream. 

HOT TIP: Close the toilet lid when flushing, and change toothbrushes regularly: disinfect and store them well away from the toilet.

The risk to family members depends on the situation. The message is to be alert for vulnerabilities. Those most at risk include babies, the elderly, diabetics, those on antibiotics, the already ill (immunocompromised), the pregnant, those on chemo or antacids (decreasing immunity) or dialysis, and people with open wounds/cuts/acne.

Attitudes to infections

Healthcare attitudes to infection remain inconsistent, even in the current climate, where we have seen an increase in awareness of the need for infection prevention and control. While on the floor, our Bug Control consultants have noted that attitudes and understanding of IPC vary greatly depending on the leadership received and the support provided by management for IPC measures.   

A study on HCWs working in operating theatres show that 95% of their phones were contaminated with different pathogens. 

Floors are underappreciated hot spots for bacteria: items placed on the floor or in contact the floor pick up germs which eventually find their way to our benchtops, hands or mouths. Think of handbags, cell phones, call bells, shoes, carpets, wheelchairs, walking sticks, kids’ toys — all of these can carry germs from the floor to higher surfaces. This shows how easily germs from the floor can wind up on our hands, without ever even touching the floor.

How can I keep my home safe?

Ask yourself: What am I bringing into the healthcare environment that I am taking home? 

You already know how to stop transporting infection: by paying attention to personal terminal cleaning:

  • Change clothing before transporting home from work.
  • Remove uniform and shoes before walking into the home.
  • Shower directly after work.
  • Wash uniform between shifts with an antibacterial disinfectant, followed by a clothing dryer on hot. Note: To reduce bacteria in washing machines sumps or drums, run a high temperature or chemical wash between a uniform wash and a family wash.
  • Ensure that your relevant vaccines are up to date.
  • Stop touching your T-zone (mouth, eyes and nose).

You could also:

  • Wipe down your keys and phone with 2-1 cleaning wipes at the end of a shift.
  • Consider using a protective phone case or placing your phone into a snap lock bag while at work.
  • Always refer to manufacturer’s instruction on appropriate cleaning products for surfaces.
  • Close the gap between cleaning with detergent (moving the germs) and disinfectant (killing the germs).

Key points for home cleaning:  

  • Gately highly recommended something we could do in our busy home to stop infections — put the dishcloth in the dishwasher before soaking it in bleach and water in the sink. Alternatively, place cloth in the dishwasher followed by two minutes in the microwave. 
  • Try to avoid antibiotic treatments unless recommended.
  • Keep toothbrushes away from toilets, preferably in a cupboard, and disinfect regularly. Colgate recommends that you dilute 1 teaspoon of 3 percent strength hydrogen peroxide in 1 cup of water and swish the toothbrush bristles in the solution before brushing. The American Dentistry Association (2019) suggests sanitising a toothbrush in 3 percent hydrogen peroxide or Listerine mouthwash to reduce bacterial load.
  • Close the toilet lid when flushing.
  • Hand wash, hand wash, hand wash. 
  • A final point from Gately: toilet paper is very porous. Please fold it

Sometimes it’s hard to know whether you or your facility are doing enough to keep workers (and their families) safe. If you have any questions about infection prevention and control, contact Bug Control for obligation-free, best practice advice.