Study Pinpoints HAI Risks in Hospital Restrooms

September 17, 2025

Many of the pathogens linked to healthcare-associated infections (HAIs) are present on environmental surfaces, reinforcing the importance of environmental decontamination in healthcare settings. Hospital restrooms, in particular, require vigilant cleaning.

HAI transmission methods include toilet flushing, which generates microbe-carrying particles into the air, which then settle on nearby surfaces or follow air currents. Through flushing, restroom users may come into contact with aerosolized organisms or pathogens. A study published by the Journal of Hospital Infection measured HAI risk potential through aerosolized particles by different types and surfaces of hospital restrooms.

The experiment tested for harmful, bacterial pathogens in the restrooms of three different hospitals across touch sites, floors, and ceilings. The data provided evidence to inform restroom design, designation, and decontamination practices and also revealed potential HAI risks from healthcare toilets.

Surprisingly, hand-touch sites tested the cleanest, followed consecutively by ceilings and floors. Moreover, researchers found a difference in cleanliness between female, male, and unisex restroom toilets—with the most pathogens found in unisex restroom toilets, followed by male restroom toilets. Similar pathogens found on floors and ceilings suggested aerosolization during flushing.

Finally, the study reported higher levels of bioburden in patient restrooms, as opposed to staff and worker restrooms. Results indicated that cleaning frequencies should be increased in areas that tested for higher bioburden, such as in unisex and patient restrooms.

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