Should you wear a hazmat suit when you operate an elevator

In their quest to culture every object on planet Earth, researchers have found that hospital elevator buttons are more contaminated with bacteria than restroom surfaces.

Of 120 randomly cultured elevator buttons, 73 (61%) grew bacteria. Washroom surfaces were cultured 96 times with 41 (43%) showing microbial growth.

As is customary with papers like this, the media sensationalized the findings with headlines like "Why you should never ever touch that hospital elevator button."

Most stories eventually mentioned the fact that the authors said the majority of bacteria found ”had low pathogenicity," but some, including Vox.com, mrsaidblog.com, newsok.com, and mynews13.com, did not. In fact, the MRSAID blog also confused the benign streptococcus found in this paper with the pathogen that causes strep throat.

Ive written several posts about the culturing of various inanimate objects and pointed out that disease transmission has not been documented for almost all surfaces on which bacteria are found. If you click on the "Infection" label to your right, you can read as many as you wish.

Like most papers in this genre, this one has some flaws. You can read the full text here.

It was published in an open-access journal called "Open Medicine." It is not among the top 40 internal medicine journals listed by impact factor. It has no discernible impact factor at all and is not listed PubMed.

The title of the paper "Elevator buttons as unrecognized sources of bacterial colonization in hospitals" overstates the case a bit.

This table shows the types of bacteria found on both the elevator buttons and surfaces in the restrooms.

You can see that pathogens were few. Multiple organisms were found in several instances accounting for some of the numerical discrepancies. I could not figure out how the percentages were calculated. In neither column did the percentages add up to 100%.

Samples of restrooms surfaces were taken "a few months" after the elevator buttons were cultured. The authors conceded that this may have confounded the results.

Washroom sample swabs were taken from the exterior and interior entry-door handles, the privacy latch, and the toilet flusher. They did not swab toilet seats, which previous studies have shown are the gold standard to which all inanimate surfaces should be compared.

It may surprise you to learn that most of the bacteria found on elevator buttons and restroom surfaces can also normally be found ON YOUR HANDS!

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Dr Topols bad day

Dr. Eric Topol is a cardiologist, author, editor-in-chief of Medscape, and genomics professor. In 2009, he was named one of the 12 Rock Stars of Science by none other than GQ magazine.

But even rock stars occasionally have a bad day. After blogging for almost 5 years, I sometimes have trouble thinking of things to write about. This apparently happened to Dr. Topol the other day. He published a Medscape article with an accompanying video about how doctors are being squeezed by many outside forces that require them to do things they dont want to do.

It was kind of a rambling discourse in which he suggested that doctors should offload the responsibility to do these "more mundane aspects of care" to the patients. He thinks this would make medicine more exciting "the way it used to be."

Dr. Topol offered this cartoon to illustrate the outside forces that are squeezing doctors.

Genomics is a focus of Dr. Topols research, but I dont think a lot of doctors are concerned that they lack knowledge about it.

His post created a lot of controversy prompting Medscape to take down all of the comments.

With great foresight, one physician, Dr. Kristin Held, preserved her comment with a screenshot which I have thoughtfully provided for you below.

What do you think she really wanted to say with the start of her second paragraph? Could it have been "How about growing a _ _ _ _ of _ _ _ _s?

Like Dr. Held, I have no idea which of the "mundane aspects of this new world" Dr. Topol had in mind to offload on the patients. Of the 16 forces squeezing doctors that he illustrated, I dont see many of them being taken over by patients. They already control patient satisfaction and whats written on Yelp. Maybe they can cover the lack of genomic knowledge too.

Its sad that an influential doctor like Topol is so lost in the woods. However, the bright side is that gave me something to write about.

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