Fomite Contamination

Fomite contamination is a major route of pathogen and pathogenic bacterial transmission between humans and a major concern for housekeeping and custodial staff.

The Role of Fomites in the Transmission of Pathogenic Bacteria and Pathogens

Fomites--commonly touched inanimate objects--are primary vehicles for the transmission of viral and bacterial infection.

Fomites are contaminated in several ways, including:

• Being touched by people who have not washed their hands.
• Toilet plumes.
• Droplets from people coughing and sneezing, and even;
• Air-blown hand dryers.

According to VeryWell Health;

There are many ways that fomites can end up on surfaces where they will pose a risk to others.

Sneezing and coughing can disperse pathogens directly onto surfaces.

Flushing a toilet may aerosolize them and lead to their presence on other surfaces.

Even hand driers can spread bacteria around a room. However, the most important way that surfaces get infected is from hands.

People who don't wash their hands after sneezing or coughing.

People who don't wash their hands after going to the bathroom.

People who don't wash their hands after touching other, potentially contaminated surfaces.

These can all lead to fomite transmission to surfaces and then to others. [1]

Microbial-types found on fomites range widely but routinely host pathogenic bacteria, such as:

• E. coli.
• Staph.
• Klebsiella, and;
• Salmonella.

According to a recent study conducted at Gombe State University in Nigeria that examined door handles throughout the complex;

A total of one hundred and fifteen (115) colonies were isolated in this study based on cultural, morphological and biochemical characteristics.

Frequency distribution of the isolates showed that Staphylococcus aureus were 26(22.0%), Staphylococcus epidermidis 14(12.6%), Escherichia coli 21(18%), Klebsiella spp. 15(13%), Proteus mirabilis 15(13%) and Salmonelle spp. 13(11%), and Pseudomonas aeruginosa 11(9.6%).

The level of contamination varies depending on the traffic exposure and the environment. [2]

Additional studies have found viable influenza strains resident on fomites that could easily be transmitted to facility occupants.

Uncertainty analysis found that despite the relatively fast inactivation of influenza virus on hands and surfaces, contact transmission remains a viable transmission route, in part due to the vast volumetric majority (99.99%) of cough excretions being so large that they settle from the air rapidly. [3]

 

 

Intervention Methods to Address Fomite Contamination

Intervention methods involving:

• Handwashing campaigns.
• Targeted disinfection services, and;
• Increased cleaning frequencies;

Have been shown in clinical studies to reduce the detectable levels of pathogenic bacteria and viral pathogens on fomites in public facilities, thereby reducing the transmission of illness and infection.

Understanding the types of germs and bacteria your facility is combatting will help your organization decide which type of disinfectant and cleaning products are appropriate for use.

In many cases, hospital-grade disinfectants and commercial-grade cleaning products are recommended for use by the U.S. Centers for Disease Control and Prevention.

However, the U.S. Environmental Protection Agency lists several less toxic products that make claims against common pathogens and pathogenic bacteria.

It is critical to observe these products' dwell time in respect to the virus or bacteria being combatted.

Additionally, it is important to keep in mind that viral re-contamination can occur almost immediately after disinfection if a person with contaminated hands touches it or if an infected person coughs or sneezes on it.

Many facilities have turned to day porter services specifically designed to wipe down commonly touched surfaces after occupant use to address this.

One significant drawback to this approach is the potential, and likely unnecessary, overuse of hazardous disinfectant products.

Realizing this, many facilities managers and house cleaning teams have reverted to increased cleaning frequencies with soap-based detergents and microfiber application tools to remove, and sometimes kill, many of the most common germs and bacteria routinely found on the facility fomites.

 

High-Touch Surfaces Commonly Implicated in Fomite Transmission

Certain surfaces and objects in facilities are more prone to contamination due to frequent contact by multiple people.

Identifying and prioritizing these high-touch points can significantly reduce the risk of pathogen spread. Examples include:

• Door handles and push plates
• Elevator buttons
• Light switches
• Restroom fixtures (faucets, toilet flush handles)
• Shared electronics (keyboards, touch screens, phones)
• Railings and handrails
• Breakroom appliances (microwaves, refrigerators, coffee machines)
• Shared equipment in fitness centers or healthcare facilities

Facilities that maintain updated inventories of these high-risk areas can implement targeted cleaning strategies to improve hygiene outcomes.

Emerging Technologies in Fomite Control

In addition to traditional cleaning and disinfection methods, emerging technologies are being deployed to reduce fomite contamination, such as:

• Antimicrobial Coatings: Surfaces treated with antimicrobial agents can continuously reduce microbial loads. These coatings are often used on high-touch surfaces in healthcare and transportation settings.
• UV-C Light Disinfection: Ultraviolet-C light has been shown to inactivate a wide range of pathogens on surfaces. Mobile UV-C devices are frequently used in hospitals to disinfect patient rooms and surgical areas.
• Self-Disinfecting Materials: New materials, such as copper and copper alloys, possess natural antimicrobial properties that can inhibit the survival of bacteria and viruses on contact surfaces.
• Touchless Technologies: Motion-activated doors, faucets, and dispensers can minimize the need for contact with potentially contaminated surfaces, further reducing the risk of transmission.

 

The Role of Fomite Transmission in Healthcare-Associated Infections (HAIs)

Fomite transmission is a significant concern in healthcare settings, where patients are often more susceptible to infections.

Healthcare-associated infections (HAIs) can be linked to contaminated surfaces, medical equipment, and healthcare workers' hands. Common HAIs associated with fomite transmission include:

• Methicillin-resistant Staphylococcus aureus (MRSA)
• Clostridioides difficile (C. diff)
• Vancomycin-resistant Enterococci (VRE)
• Norovirus

Rigorous environmental cleaning protocols and adherence to hand hygiene guidelines are critical in minimizing the risk of HAIs.

Fomite Transmission Beyond Healthcare: Schools, Gyms, and Workplaces

While healthcare settings are frequently studied, fomite transmission plays a role in other environments as well. For example:

• Schools: Shared learning tools, desks, and playground equipment can harbor bacteria and viruses, contributing to outbreaks of respiratory and gastrointestinal illnesses.
• Gyms: Exercise equipment, mats, and locker room facilities often become breeding grounds for skin infections such as athlete’s foot, ringworm, and MRSA.
• Workplaces: Shared office spaces, communal kitchens, and break rooms can be hotspots for pathogen spread, particularly during cold and flu season.

Implementing simple preventive measures, like regular surface cleaning, encouraging hand hygiene, and providing disinfectant wipes for shared equipment, can make a big difference.

 

Behavioral Interventions to Reduce Fomite Transmission

Behavior plays a critical role in fomite transmission. Educating and encouraging individuals to adopt better hygiene habits can drastically cut down on contamination. Effective behavioral interventions include:

• Hand Hygiene Training Programs
• Posters and Signage Promoting Clean Hands and Respiratory Etiquette
• Access to Hand Sanitizer Stations in High-Traffic Areas
• Regular Reminders or Nudges via Email or App Notifications

Behavioral science suggests that combining education with environmental cues (like strategically placed hand sanitizer) can improve compliance and reduce the risk of transmission.

 

How to Reduce Fomite Contamination in Facilities

1. Identify High-Touch Surfaces

• Focus on areas frequently touched: doorknobs, switches, keyboards, and shared equipment.

2. Establish Hand Hygiene Practices

• Encourage regular handwashing with signage and provide hand sanitizer stations.

3. Develop a Cleaning and Disinfection Plan

• Clean surfaces regularly using soap and water.
• Disinfect with EPA-approved products, ensuring proper dwell time.

4. Implement Day Porter Services

• Assign staff for continuous cleaning during operating hours.

5. Review and Adjust Protocols

• Audit cleaning processes and train staff regularly.

 

FAQ: Fomite Contamination in Facilities

What is fomite contamination?

Fomite contamination occurs when non-living objects or surfaces become carriers of pathogens, leading to disease transmission through contact.

How do fomites become contaminated?

Fomites are contaminated by:

• Unwashed hands touching surfaces.
• Toilet plumes aerosolizing pathogens.
• Coughing, sneezing, and air-blown hand dryers dispersing germs.

Which pathogens are commonly found on fomites?

Common pathogens include:

• E. coli
• Staphylococcus aureus
• Klebsiella
• Salmonella
• Pseudomonas aeruginosa

What are the health risks associated with fomite contamination?

Pathogens on fomites can cause infections and illnesses, contributing to outbreaks in facilities with high human traffic.

What strategies reduce fomite contamination?

Effective strategies include:

• Frequent handwashing campaigns.
• Increased surface cleaning schedules.
• Targeted disinfection of high-touch areas.
• Using appropriate disinfectants and adhering to dwell times.

Are there risks with overusing disinfectants?

Yes. Overuse can lead to unnecessary exposure to harsh chemicals. Facilities may opt for increased cleaning with soap-based detergents and microfiber cloths as safer alternatives.

What services can help control fomite contamination?

Day porter services and professional cleaning teams can provide regular surface disinfection and maintenance, reducing the risk of pathogen spread.

 

References

1. Boskey, E. (2011, April 6). Fomite Transmission and STD Risk. Verywell Health; Verywell Health. https://www.verywellhealth.com/what-is-fomite-transmission-3132826
2. Ayuba1, L., Suwange2, M., & Enefiok1, U. (2019). Bacterial Contamination of Door Handles/Knobs in Gombe State University, Nigeria. International Journal of Modern Science and Technology, 4(8), 204–211. https://nebula.wsimg.com/38d57f063c75754746e182b3075c17b0?AccessKeyId=7F4D485B7198C0BD2695&disposition=0&alloworigin=1
3. Zhao, J., Eisenberg, J. E., Spicknall, I. H., Li, S., & Koopman, J. S. (2012). Model Analysis of Fomite Mediated Influenza Transmission. PLoS ONE, 7(12), e51984. https://doi.org/10.1371/journal.pone.0051984

 

Conclusion

By all accounts, fomite contamination and its function as a vehicle for pathogenic bacteria and pathogen transmission are a major route of transmission for disease and infection.

The issue can be safely addressed through a combination of increased cleaning frequencies, handwashing campaigns, and targeted disinfection protocols completed by trained personnel.

Outsourcing your facility's cleaning requirements is a proven method for cost-effectively onboarding valuable services without the challenges faced by managing in-house teams.

If you would like more information regarding the effectiveness of high-performance infection prevention and control measures, or if you would like to schedule a free, no-obligation onsite assessment of your facility's custodial needs, contact us today for a free quote!

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