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That electric hand dryer study was bogus Heres why

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Just about everyone I follow on Twitter commented and/or linked to an article about a study claiming that electric hand dryers spew bacteria all over people using restrooms.

The paper, which appeared online in The Journal of Hospital Infection, said that airborne germ counts near jet air dryers were 27 times higher than counts near paper towel dispensers, and counts near warm air dryers were 4.5 times higher. The authors also coated subjects hands with black paint and measured spatter patterns on surrounding walls and persons dressed in disposable coveralls. And a photo from the study shows the dispersal pattern from a warm air dryer.

So case closed—paper towels are better, right?

Im not so sure. Instead of reading an article about the paper or just the abstract, I obtained a copy of the whole paper. I also found some comments about it from a spokesperson for a hand dryer manufacturer.

What are the flaws in the study?


From the papers Methods section: "For each test, gloved hands [not bare hands] were first coated by immersion in a suspension of lactobacilli (107 cfu/mL) that were cultured from a proprietary yoghurt." FYI, 107 cfu/mL is a lot of bacteria—certainly more than most of us would get on our hands during an average trip to the restroom. Its the equivalent of putting your hands in liquid feces, except that lactobacilli are benign bugs.

After dipping the gloved hands in bacteria, they werent washed. Stick gloved hands in bacteria, dont wash them, and then stick them in an electric dryer. No doubt there will be dispersal of bacteria around the room.

Also from the Methods section: "For [another] test, gloved hands were coated in a solution of black water-based paint." Water-based paint on gloves is not the same as water on bare hands. Have you ever seen water all over the walls next to a warm air dryer? I havent.

The study was funded by the European Tissue Symposium (ETS). Although this sounds like some kind of scientific conference, it is actually a trade organization of companies that make paper towels. The senior author of the study, Dr. M.H. Wilcox, "has received honoraria from ETS for microbiological advice and travel expenses to attend an ETS meeting." He also co-authored a consensus statement sponsored by the ETS which happened to find that paper towels are the most hygienic way to try hands.

I have always preferred paper towels. I feel that my hands can be completely dried in far less time than when I use the electric dryers. The drying process helps to reduce bacterial counts on the hands. Some studies have shown that when using electric dryers, many people do not completely dry their hands because it takes too long. See the table below.


A 2012 review of hand drying methods from the Mayo Clinic Proceedings concluded that paper towels were better than electric dryers from a hygiene standpoint, and that paper towels should be used in hospitals. [Note: One of the authors of that study had been a consultant to a paper towel manufacturer.] Thats why you dont see electric hand dryers in patient care areas of hospitals.

I also hate the noise generated by electric dryers and the faster they are, the noisier they are. You can see the decibel levels of several devices in the table above.

The paper towels vs. electric hand dryers debate has been going on for years not only about hygiene, but also about which method is better ecologically.

Although I dont believe a word of the much-tweeted European Tissue Symposium study, I still prefer paper towels.




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Reaction to post on academia and social media

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"Should social media accomplishments be recognized by academia?" a post of mine from October 4th, generated some lively discussion on Twitter.

Here are a few of the more interesting responses:

@ashishkjha Important question from @Skepticscalpel Should academia value impact on social media? Yes. And its coming. Slowly.

@MartinSGaynor Science comes 1st, 2nd, 3rd.. MT @ashishkjha Important Q: @Skepticscalpel Shld academia value impact on social media?

@ashishkjha agree how to measure impact a key question. Eye balls cant be enough. But too important a question to ignore.

?@DoctorTennyson Yes-I think social media has a role for #publichealth, #education, and fosters collaboration. More than obscure journals

@NirajGusani still you add value to your dept -how do/should they measure it?

?@gorskon Heck, at @ScienceBasedMed, we get 1M page views a month, but I get no credit.

@gorskon I agree though. For the most part, social media harms, not helps, academic career.

@gorskon Cranks complaining to my chair & cancer center director dont help.

@gorskon If I ever want to change jobs, Google searches will likely harm, not help, prospects

@Nadia_EMPharmD We actually asked this very question in a study we published this past year:

?@JBMatthews Academic tracks have been modernized in many places including ours; beyond # of publcns.

@JBMatthews As a journal editor and department chair, I believe its starting to "count"

?@nataliestavas We should study what has more meaningful impact, # of twitter followers or an article in the @NEJM

Most agreed that social media activity should count for something, but quantifying that something may be difficult. A certain number of followers or page views would not necessarily signify value.

Via email, Dr. Jeffrey B. Matthews, Dallas B. Phemister Professor and Chairman of the Department of Surgery at the University of Chicago, said his school of medicine created a new track for faculty that does not require traditional scholarship for academic promotion. It is non-tenure (tenure still requires traditional discovery and traditional measures of impact and importance), but there is otherwise no distinction of title.

To advance to professor requires evidence that the faculty member is outstanding. The chair and faculty committee must define what "outstanding" means, whether it is distinction in clinical practice like a high-volume, high-complexity specialty or a national draw of patients, in educational leadership such as a program director with leadership roles at APDS, ABS, RRC, or "other."

He added, "I would have ZERO trouble convincing our promotions committee that a high visibility blog with high traffic views that had evidence of thought leadership in the public domain would qualify as high impact and outstanding. And that is at the University of Chicago."

What do you think of the University of Chicagos progressive stance?

Have any other schools taken such steps?
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