Study: Hospital Elevator Buttons Carry More Bacteria Than Toilet Surfaces

You might want to think twice about skipping the hand sanitizer dispensers on your next visit to the hospital, especially after stepping out of an elevator.

A recent study conducted by researchers at the University of Toronto and published in Open Medicine on July 8 found that bacteria commonly colonize on elevator buttons, although most pathogens were not clinically relevant. The study concluded that the risk of pathogen transmission might be reduced by simple countermeasures.

A total of 120 elevator buttons and 96 toilet surfaces were swabbed over separate intervals at three large, urban teaching hospitals located in Toronto, Ontario. Researchers took samples from the ground floor button, a randomly selected upper level floor button, and the two exterior “up” and “down” buttons while swabs were taken from the exterior and interior handles of public washrooms, the privacy latch on the door and the toilet flusher.

The prevalence of bacteria colonization on elevator buttons was 61 percent with no significant differences in relation to the location of the buttons, day of the week, or panel position within the elevator, according to the study. Toilet surfaces, on the other hand, had a prevalence of 43 percent.  

Coagulase-negative staphylococci (a form of skin bacteria) were the most common organisms cultured, whereas Enterococcus  and Pseudomonas species were infrequent.

Absence of pathogenic organisms on elevator buttons reflects prevailing cleaning services combined with widespread hand hygiene. However, the prevalence of colonization reveals that patients still remain at risk of cross-contamination because of the frequent use of elevator buttons, according to the study.

Researchers noted that the study was conducted during flu season which may have influenced the bacteria count due to increased use of hand sanitizer. Conversely, it may have increased hospital traffic and generalized exposures.

Authors of the study recommend alcohol-based hand sanitizers combined with their strategic placement both inside and outside elevators as a possible effective method for removing surface bacteria. Additional countermeasures could include enlarging elevator buttons to allow for elbow activation, installing touchless proximity sensors, and increasing public education about hand hygiene targeted towards individuals using elevators.