What’s New in the Patient Safety World

May  2011

The Best Laid Plans…Electronic Water Faucet Paradox



What a great idea for infection control – water faucets that let you wash your hands without touching any handles or other surfaces! Or is it? Turns out what sounds like a great idea may be backfiring. A new study from the infection control service at Johns Hopkins (Johns Hopkins Medicine 2011) has shown that electronic faucets may be harboring bacteria, including pathogens potentially very dangerous in hospitals. The researchers at Hopkins demonstrated 50% of electronic water faucets grew Legionella species, compared to 15% of manual faucets. The study, presented by Sydnor ERM, et al. as an abstract at the SHEA 2011 Scientific Meeting, was actually conducted to see if flushing the faucets with chlorine helped reduce bacterial counts. Of special concern was that such flushing with chlorine did not appear to be as successful in reducing bacteria in the electronic faucets as in manual faucets. They felt that the complex valve structure of the electronic faucets predisposed to growth of Legionella.


Not everyone is jumping on the bandwagon, though. A joint statement (ASHE/APIC 2011) issued by the American Society for Healthcare Engineering (ASHE) and the Association for Professionals in Infection Control and Epidemiology (APIC) cautioned that the data have only been presented in abstract form and may conflict with other evidence in the literature. The joint statement highlights some of the previous studies and provides comments as to why the findings may not be of serious significance but also notes potential reasons why the new faucets might be more prone to bacterial growth (such as the complexity and materials making them more prone to biofilms). Both the joint statement and comments from the Hopkins group note that the electronic faucets have been very successful at reducing total amounts of water used, the other main reason for their installation. ASHE and APIC undoubtedly will be looking at the issue as they start work on a planned update of their “Guidelines for Design and Construction of Health Care Facilities”.


But the folks at Hopkins were so concerned that they have removed 20 electronic faucets in patient care areas and cancelled planned installation of about 1000 such faucets in a new clinical building.


You can bet other investigators will be trying to replicate these findings elsewhere, given the potentially serious infection control implications. There will be lots of people watching to see how this issue plays out. We’re not changing our faucets yet – but this could be well another item added to our ever-increasing list of unintended consequences.






Johns Hopkins Medicine. Latest Hands-Free Electronic Water Faucets Found to be Hindrance, Not Help, in Hospital Infection Control. Newswise 3/28/2011




ASHE/APIC. Joint ASHE & APIC Statement on Recently Presented Research on Electronic Faucets. April 7, 2011














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