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IMPORTANT NOSOCOMIAL INFORMATION
A study and laboratory analysis of Grab Bars completed
in August 2004 concluded that:
“Stainless steel grab bars have porous microbe-hosting
surfaces which combined with unacceptably low hand-hygiene
compliance rates of care-givers, may result in a lethal
combination in healthcare facilities.”
Grab bars are generally installed in microbe-rich
bathroom/toilet environments and are by definition in
frequent contact with the hands of care-givers, patients,
and visitors. Studies by the Hand Hygiene Resource Center,
by researchers from Northwestern University, Temple
University and the Center for Disease Control and Prevention
indicate that hospital staff hand washing compliance
rates are unacceptably low and are a major cause of
nosocomial infections. The hand hygiene rates for patients
and patient visitors are likely to be substantially
less than staff, thereby making the patient toilet facility
an extremely rich microbial growth environment.
Therefore, the following factors combine to produce
virtually ideal sites in healthcare facilities for the
growth and propagation of life-threatening pathogens:
(a) low staff hand hygiene rates, (b) staff, patient
and visitor use of toilet facilities, (c) warm, humid
and dark toilet room environments, and (d) porous-surfaced,
corrosion-prone steel grab bars.
The frequency of observed discoloration, corrosion
and rust on steel grab bars in existing facilities caused
the investigators to undertake laboratory analysis to
compare the surface porosity and roughness of four grab
bar materials. The objective of the analysis was to
quantitatively determine which of the four grab bar
materials provides the least and most robust microbe
repository and propagation sites. The materials analyzed
were:
- Common satin-finish, 18 Gauge, Type 304 stainless
steel grab bar material.
- Rough peened-finish 18 Gauge, Type 304 stainless
steel grab bar material.
- Commercial sample of anodized aluminum.
- Polyamide 6 Nylon grab bar material.
New unused samples of the products were analyzed by
PM Laboratories utilizing 500x magnification and 440
Series Precision Devices Surfometer per ASME B 46.1
Standards to precisely measure porosity and depth of
roughness. The mathematic and photographic test results
are provided in the full test report.
Summary Conclusions
- Type 304 Steel Grab Bars are very porous and
are a robust nosocomial bacterial infection
host site.
- Shotpeened Type 304 Steel Grab Bars are the
most unsanitary bacterial host surfaces.
- Anodized Aluminum surfaces are significantly
less porous than Type 304 Steel, but significantly
more porous than Nylon.
- Nylon is a non-porous material that provides
the most sanitary anti-microbial material for
grab bars. It is also the most slip-resistant
due to lack of porosity.
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Infection Prevention personnel should implement special
sanitation procedures for steel grab bars in their facilities
and should systematically replace them with bars made
of less porous materials. Non-porous surfaced grab bars
should be specified for all new construction.
The full text of the report: “Steel Grab Bars:
Transmitters of Nosocomial Infections.” is publicly
available at: http://www.unsafegrabbars.org
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