Abstract
The purpose of this paper is to examine current health care literature (1980–2000) regarding the microbiology of the home environment, to summarize evidence of transmission within the home, and to assess effectiveness of cleaning practices and products. The home environment, particularly the kitchen and bathroom, serves as a reservoir of large numbers of microorganisms, particularly Enterobacteriacae,and infectious disease transmission has been demonstrated to occur in 6–60% of households in which one member is ill. Current food preparation and cleaning practices provide multiple opportunities for intra-household member spread. Routine cleaning is often sufficient, but in cases of household infection, may not adequately reduce environmental contamination. The effectiveness of disinfectants varies considerably and depends on how they are used as well as their intrinsic efficacy. The behavioral aspects of infection prevention in the home (e.g., foodhandling and cleaning practices) warrant increased public attention and education.
Article PDF
Similar content being viewed by others
REFERENCES
Tomes N. The Gospel of Germs: Men, Women and the Microbe in American Life. Cambridge: Harvard University Press, 1998.
Scott E, Bloomfield SF, Barlow CG. An investigation of microbial contamination in the home. J Hyg (London) 1982;89:279–293
Scott E, Bloomfield SF. The survival and transfer of microbial contamination via cloths, hands and utensils. J Appl Bacteriol 1990;68:271–278.
Speirs JP, Anderton A, Anderson JG. A study of the microbial content of the domestic kitchen. Intern J Environmen Health Research 1995;5:109–122
Enriquez C, Enriquez-Gordillo R, Kennedy D, Gerba C. Bacteriological Survey of Used Cellulose Sponges and Cotton Dishcloths from Domestic Kitchens. Dairy, Food Environmen Sanitation 1997; 17:20–24
Humphrey TJ, Martin KW, Slader J, Durham K. Campylobacter spp. in the kitchen: spread and persistence. J Appl Microbiol. 2001; 90Suppl:115S-120S.
Sattar SA, Tetro J, Springthorpe VS. Impact of changing societal trends on the spread of infections in American and Canadian homes. Am J Infect Contr 1999;27:S4-S21.
Scott E. Hygiene issues in the home. Am J Infect Contr 1999;27:S22-S25.
Sockett PN, Cowden JM, Baigue SL, Ross D, Adak GK, Evans H. Foodborne disease surveillance in England and Wales; 1989–1991. Commun Dis Rep Rev 1993:R159–173. London: Public Health Laboratory Service, pp 3–12.
Bloomfield SF, Stevens D. Hygiene in the domestic setting: the international situation. Ann Ig 2000;12:189–204.
de Wit JC, Broekhuizen G, Kampelmacher EH. Cross-contamination during the preparation of frozen chickens in the kitchen. J Hyg (Lond) 1979; 83:27–32
Bloomfield SF, Scott, E. A risk assessment approachto use of disinfectants in the community. Res Clin Forums 1997;19:37–47
Rutala W, Weber D, Barbee S, Gergen M, Sobsey M. Evaluation of antibiotic resistant bacteria in home kitchens (abstract). Infect Contr Hosp Epidemiol 2000; 21:132
Humphrey T. Can consumers prevent the spread of foodborne pathogens in domestic kitchens? “Hygiene and Health". Paris: Institute Pasteur, January 25–27, 2001 (no page numbers).
Cogan TA, Bloomfield SF, Humphrey TJ. The effectiveness of hygiene procedures for prevention of cross-contamination from chicken carcases in the domestic kitchen. Lett Appl Microbiol 1999; 29:354–358.
Barker J, Bloomfield SF. Survival of Salmonella in bathrooms and toilets in domestic homes following salmonellosis. J Appl Microbiol 2000;89:137–144
Scott E, Bloomfield SF. Investigations of the effectiveness of detergent washing, drying and chemical disinfection on contamination of cleaning cloths. J App l Bacteriol 1990; 68:279–283.
Gerba C, Watson S, Kennedy D. Cross contamination and survival of enteric pathogens in laundry. “Hygiene and Health".Paris: Institute Pasteur, January 25–27, 2001 (no page numbers).
Petrocci AM, Clarke P. Proposed test method for antimicrobial laundry additives. J AssocOffic ial Analy Chemists 1969; 52:836–842
Goldmann D. Transmission of viral respiratory infections in the home. Pediatr Infect Dis J 2000; 19:S97-S102
Hall CB, Douglas RG. Modes of transmission of respiratory syncytial virus. J Pediatr 1981;99: 100–103.
Gwaltney JM, Moskalski PB, Hendley JO. Hand-to-hand transmission of rhinovirus colds. Ann Intern Med 1978;88:463–467.
Sattar SA, Jacobsen H, Rahman H, Cusack TM, Rubino JR. Interruption of rotavirus spread through chemical disinfection. Infect Control Hosp Epidemiol 1994; 15:751–756.
Dennehy PH. Transmission of rotavirus and other enteric pathogens in the home. Pediatr Infect Dis J 2000; 19:S103-S105.
Fleet GH, Heiskanen, P., Reid, I., Buckle, K.A., Foodborne viral illness--status in Australia. J Food Microbiol 2000; 59:127–136
Barker J, Stevens D, Bloomfield SF. Spread and prevention of some common viral infections in community facilities and domestic homes. J Appl Microbiol 2001; 91:7–21
Bidawid S, Farber JM, Sattar SA. Contamination of foods by food handlers: experiments on hepatitis A virus transfer to food and its interruption. Appl Environ Microbiol 2000; 66:2759–2763
Collins JE. Impact of changing consumer lifestyles on the emergence/reemergence of foodborne pathogens. Emerg Infect Dis 1997; 3:471–479
Jay LS, Comar D, Govenlock LD. A video study of Australian domestic food-handling practices. J Food Prot 1999; 62:1285–1296.
Andersen J. Food safety mistakes caught on tape: Food and Drug Administration: Associated Press, 2000. Accessed 6/21/00 at web site: http: //ipn.intelihealth.com/ipn/ihtIPN
ASM. America's dirty little secret-Our hands. Vol. 2001: American Society for Microbiology. Clean hands campaign., 2000. Accessed 5/15/01 at web site: http://www.washup.org/ page03.htm
Jay LS, Comar D, Govenlock LD. A national Australian food safety telephone survey. J Food Prot 1999; 62:921–928.
Rusin P, Gerba C, Maxwell S. Studies show that some diseases could easily be transmitted from common articles in the home and community. Proceedings of The 100th General Meeting of the American Society for Microbiology. Los Angeles, CA: American Society for Microbiology, 2000. Accessed on 5/25/00 on website: http://www.asmusa.org/pcsrc/gm2000/10004.html
Rusin P, Maxwell S, Gerba C. Comparative transfer efficiency of bacteria and viruses from common fomites to hands and from the hand to the lip. Proceedings of the 100th General Meeting of the American Society for Microbiology. Los Angeles, CA: American Society for Microbiology, 2000. Accessed on 5/25/00 on website:http://www.asmusa.org/pcsrc/gm2000/10004.html (Session Q-84, p.83).
Rheinbaben F, Schunemann S, Gross T, Wolff H. Transmission of viruses via contact in ahousehold setting: experiments using bacteriophage straight phiX174 as a model virus. J Hosp Infect 2000; 46:61–66.
Bloomfield SF, Scott E. Cross-contamination and infection in the domestic environment and the role of chemical disinfectants. J Appl Microbiol 1997;83:1–9
Schutze GE, Sikes JD, Stefanova R, Cave MD. The home environment and salmonellosis in children. Pediatr 1999;103:E1.
Mead PS, Finelli L, Lambert-Fair MA, Champ D, Townes J, Hutwagner L, Barrett T, Spitalny K, Mintz E. Risk factors for sporadic infection with Escherichia coli O157:H7. Arch Intern Med 1997; 157:204–208.
Larson E, Duarte CG. Home hygiene practices and infectious disease symptoms among household members. PublicHealth Nurs 2001;18:116–127.
Oosterom J, den Uyl CH, Banffer JR, Huisman J. Epidemiological investigations on Campylobacter jejuni in households with a primary infection. J Hyg (Lond) 1984; 93:325–332.
Parry SM, Salmon RL. Sporadic STEC O157 infection: secondary household transmission in Wales. Emerg Infect Dis 1998; 4:657–661.
Shopsin B, Mathema B, Martinez B, Campo M, Alcabes P, Kreiswirth B. Familial carriage and transmission of S. aureus colonizing children and their guardians. In: Third Annual Symposium of Molecular Epidemiology. 1999. New York: New York Academy of Medicine (no page numbers)
Jones M. Application of HACCP to identify hygiene risks in the home. Intern Biodeter Biodegrad 1998;41:191–199.
Haas C, Rose J, Gerba C. Quantitative microbial risk assessment New York: John Wiley & Sons, Inc, 1999.
Rosenberg S. Consumer and market use of antibacterials at home. Pediatr Infect Dis J 2000;19: S114-S116.
Rutala WA, Barbee SL, Aguiar NC, Sobsey MD, Weber DJ. Antimicrobial activity of home disinfectants and natural products against potential human pathogens. Infect Control Hosp Epidemiol 2000;21:33–38.
Parnes C. Efficacy of sodium hypochlorite bleach and “alternative” products in preventing transfer of bacteria to and from inanimate surfaces. Environ Health 1997;Jan/Feb 14–20.
Sattar SA, Jacobsen H, Springthorpe VS, Cusack TM, Rubino JR. Chemical disinfection to interrupt transfer of rhinovirus type 14 from environmental surfaces to hands. Appl Environ Microbiol 1993;59:1579–1585.
Ward RL, Bernstein DI, Knowlton DR, Sherwood JR, Young EC, Cusack TM, Rubino JR, Schiff GM. Prevention of surface-to-human transmission of rotaviruses by treatment with disinfectant spray. J Clin Microbiol 1991; 29:1991–1996.
Rusin P, Orosz-Coughlin P, Gerba C. Reduction of faecal coliform, coliform and heterotrophic plate count bacteria in the household kitchen and bathroom by disinfection with hypochlorite cleaners. J Appl Microbiol 1998; 85:819–828.
Josephson KL, Rubino JR, Pepper IL. Characterization and quantification of bacterial pathogens and indicator organisms in household kitchens with and without the use of a disinfectant cleaner. J Appl Microbiol 1997; 83:737–750.
Scott E, Bloomfield SF, Barlow CG. Evaluation of disinfectants in the domestic environment under ‘in use’ conditions. J Hyg (Lond) 1984; 92:193–203.
Kusumaningrum H, Beumer R. Effect of Antibacterial dshwashing liquid on food-borne pathogens. In: Preventing Infectious Intestinal Disease in the Domestic Setting: A Shared Responsibility. A joint conference by the International Scientific Forum on Home Hygiene and the Public Health Laboratory Service. Central Public HealthLaboratory, London:, 2000. Accessed 5/15/01 at web site: http://www.ifh-homehygiene.org/infect/inf00.htm
Kusumaningrum H, Beumer R. Growthand survival of pathogens and competitive microorganisms on domestic sponges. In: Preventing Infectious Intestinal Disease in the Domestic Setting: A Shared Responsibility. A joint conference by the International Scientific Forum on Home Hygiene and the Public HealthLaboratory Service. Central Public HealthLaboratory, London:, 2000. Accessed 5/15/01 at web site:http://www.ifh-homehygiene.org/infect/inf00.htm
Zhao P, Zhao T, Doyle MP, Rubino JR, Meng J. Development of a model for evaluation of microbial cross-contamination in the kitchen. J Food Prot 1998; 61:960–963.
Gangar V, Meyers E, Roering A, Johnson H, Curiale M, Michaels B. The dynamics of surface cleaning and sanitization. In: Preventing Infectious Intestinal Disease in the Domestic Setting: A Shared responsibility. A joint conference by the International Scientific Forum on Home Hygiene and the Public HealthLaboratory Service. Central Public HealthLaboratory, London:, 2000. Accessed 5/15/01 at web site: http://www.ifh-homehygiene.org/infect/inf00.htm
Jaska JM, Fredell DL. Impact of detergent systems on bacterial survival on laundered fabrics. Appl Environ Microbiol 1980; 39:743–748.
Smith J, Neil K, Davidson C, Davidson R. Effect of water temperature on bacterial killing in laundry. Infect Contr 1987;8:204–209.
Christian R, Manchester J, Mellor M. Bacteriological quality of fabrics washed at lower-than-standard temperatures in a hospitallaundry facility. J Appl Environ Microbiol 1983;45:591–597.
Legnani P, Leoni E. Factors affecting the bacteriological contamination of commercial washing machines. Zentralblatt fur Hyg Umweltmedizin 1997; 200:319–333.
Davis S, Ainsworth P. The disinfectant action of low-temperature laundering. J Consum Stud Home Econ 1989;13:61–66.
Belkin N. Aseptics and aesthetics of chlorine bleach: Can its use in laundering be safely abandoned? Am J Infect Contr 1998:149–151.
Scott E, Bloomfield SF. A bacteriological investigation of the effectiveness of cleaning and disinfection procedures for toilet hygiene. J Appl Bacteriol 1985;59:291–297.
Larson E. A causal link between handwashing and risk of infection? Examination of the evidence. Infect Control Hosp Epidemiol 1988; 9:28–36.
Bryan JL, Cohran J, Larson EL. Hand washing: a ritual revisited. Crit Care Nurs Clin NA 1995; 7: 617–625.
Kimel LS. Handwashing education can decrease illness absenteeism. J School Nurs 1996; 12:14–16, 18.
Keswick BH, Berge, C.A., Bartolo, R.G., Watson, D.D. 1997. Antimicrobial soaps: their role in personal hygiene IN Aly R, Beutner KR, Maibach H. Cutaneous infection and therapy. New York: Marcel Dekker, Inc, 49–82.
Editors. ASM inagurates nationwide public education effort. ASM News. 1996; 62:547–548.
Larson EL. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Contr 1995; 23:251–269.
Ali Y, Dolan, M.J., Fendler, E.J., Larson, E.L. Alcohols. In: Block SS (ed). Disinfection, Sterilization and Preservation, 5 ed. 2001. Philadelphia: Lippincott, Williams and Wilkins, 229–254.
Larson EL, Aiello AE, Bastyr J, Lyle C, Stahl J, Cronquist A, Lai L, Della-Latta P. Assessment of two hand hygiene regimens for intensive care unit personnel. Criti Care Med 2001;29:944–951.
Korting HC, Kober M, Mueller M, Braun-Falco O. Influence of repeated washings with soap and synthetic detergents on pH and resident flora of the skin of forehead and forearm. Results of a cross-over trial in health probationers. Acta Dermato-Venereol (Stockh) 1987; 67:41–47.
Hoffler U, Gloor M, Peters G, Ko HL, Brautigan A, Thurn A, Pulverer G. Qualitative and quantitative investigations on the resident bacterial skin flora in healthy persons and in the non-affected skin of patients withseborrh eic eczema. Arch Dermatol Res 1980; 268:297–312.
Grunewald AM, Gloor M, Gehring W, Kleesz P. Efficacy of barrier creams. In Elsner P, Maibach HI (eds). Irritant dermatitis. New clinical and experimental aspects. Curr Probl Dermatol. vol. 23. 1995. Basel: Karger, 187–197.
Lachapelle JM. Efficacy of protective creams and/or gels. In Elsner P, Lachapelle JM, Wahlberg JE, Maibach HI (eds). Prevention of contact dermatitis. Curr Probl Dermatol. vol. 25. 1996. Basel: Karger, 182–192.
Gillespie WA, Simpson, K., Tozer, R.C. Staphylococcal infection in a maternal hospital: epidemiology and control. Lancet 1958;2:1075–1078.
McBride ME, Montes LF, Knox JM. The persistence and penetration of antiseptic activity. Surg Gynecol Obstetr 1968; 127:270–274.
Larson E. Skin hygiene and infection prevention: more of the same or different approaches? Clin Infect Dis 1999; 29:1287–1294.
Larson E. Hygiene of the skin: when is clean too clean? Emerg Infect Dis 2001; 7:225–230.
Rutala WA, Cole EC, Thomann CA, Weber DJ. Stability and bactericidal activity of chlorine solutions. Infect Contr Hosp Epidemiol 1998; 19:323–227.
Bloomfield SF, Arthur M., Looney E., Begun K., Patel H. Compatitive testing of disinfectant and antiseptic products using proposed European suspension testing methods. Lett Appl. Microbiol 1991; 13:233–237.
Berman D, Rice EW, Hoff JC. Inactivation of particle-associated coliforms by chlorine and monochloramine. Appl Environmen Microbiol 1988; 54:507–512.
Skaliy P, Thompson TA, Gorman GW, Morris GK, McEachern HV, Mackel DC. Laboratory studies of disinfectants against Legionella pneumophila. Appl Environmen Microbiol 1980; 40:697–700.
Sattar SA, Springthorpe VS, Karim Y, Loro P. Chemical disinfection of non-porous inanimate surfaces experimentally contaminated with four human pathogenic viruses. Epidemiol Infect 1989; 102:493–505.
Churn CC, Bates RC, Boardman GD. Mechanism of chlorine inactivation of DNA-containing parvovirus H-1. Appl Environ Microbiol 1983; 46:1394–1402.
Sellers RF. The inactivation of foot-and mouth disease virus by chemicals and disinfectants. Veterin Rec 1968;83:504–506.
Childs JE, Kaufmann AF, Peters CJ, Ehrenberg RL. Hantavirus infection--southwestern United States: interim recommendations for risk reduction. Centers for Disease Control and Prevention. MMWR--Morbidity & Mortality Weekly Report 1993; 42:1–13.
Lloyd-Evans N, Springthorpe VS, Sattar SA. Chemical disinfection of human rotavirus-contaminated inanimate surfaces. J Hyg 1986; 97:163–173.
Rutala WA, Weber DJ. Uses of inorganic hypochlorite (bleach) in health-care facility. ClinMicrobiol Rev 1997; 10:597–610.
Weber DJ, Barbee SL, Sobsey MD, Rutala WA. The effect of blood on the antiviral activity ofsodium hypochlorite, a phenolic, and a quaternary ammonium compound. Infect Contr Hosp Epidemiol 1999; 20:821–827.
Yang CY. Comparative studies on the detoxification of aflatoxins by sodium hypochlorite and commercial bleaches. Appl Microbiol 1972; 24:885–890.
Best M, Springthorpe VS, Sattar SA. Feasibility of a combined carrier test for disinfectants: studies witha mixture of five types of microorganisms. Am J Infect Contr 1994; 22:152–162.
Whitmore TN, Denny S. The effect of disinfectants on a geosmin-producing strain of Streptomyces griseus. J Appl Bacteriol 1992; 72:160–165.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kagan, L.J., Aiello, A.E. & Larson, E. The Role of the Home Environment in the Transmission of Infectious Diseases. Journal of Community Health 27, 247–267 (2002). https://doi.org/10.1023/A:1016378226861
Issue Date:
DOI: https://doi.org/10.1023/A:1016378226861