title: The effect of rings on microbial load of health care workers' hands.
abstract: BACKGROUND
  The hands of health care workers (HCWs) serve as a major route for transmission of nosocomial infection. Although handwashing is known to reduce cross-transmission of infection, the influence of rings on the efficacy of handwashing and the carriage of bacteria on the hands has not been well established.
  
  
  METHODS
  In this study, 50 HCWs with rings were paired by unit with 50 HCWs without rings. Cultures were obtained by use of a timed-friction rinse before and after a timed handwashing. Standard laboratory procedures were followed for identification of the bacteria.
  
  
  RESULTS
  When colony counts before handwashing are taken into consideration, a significant difference is seen after handwashing between the two groups (R2 = 0.56). The regression model showed that the slope was significantly steeper (p < 0.0014) for the group with rings. This effect is more apparent when the colony count on hands is greater than 1000 colony forming units before handwashing.
  
  
  CONCLUSIONS
  A standardized, timed handwashing procedure was effective in decreasing the bioload of HCWs' hands. The effect of rings on the bioload was significant in this study.
authors.affiliation: Infection Control Department, Akron General Medical Center, OH 44307, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Salisbury
authors.forename: P
authors.initials: P
authors.lastname: Hutfilz
authors.forename: L M
authors.initials: LM
authors.lastname: Treen
authors.forename: G E
authors.initials: GE
authors.lastname: Bollin
authors.forename: S
authors.initials: S
authors.lastname: Gautam
mesh_terms: D016022:Case-Control Studies; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000382:microbiology*; D005385:Fingers / Q000382:microbiology; D006225:Hand / Q000382:microbiology*; D006235:Hand Disinfection / Q000379:methods*; D006282:Health Personnel; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient; D012044:Regression Analysis