Table 3.
Strengths and weaknesses of included hand drying articles
| Citation | Strengths | Weaknesses |
|---|---|---|
| Matthews and Newsom (1987) | Statistical analysis | Experimental conditions lacked real‐world variable effects |
| Blackmore (1989) | Statistical analysis; large sample size (n > 110) | Unrealistic wash and drying conditions; used just HPCs; Low concentrations |
| Ngeow et al. (1989) | Realistic seed concentrations | No statistical comparisons; low limit of detection values; no aerosol sampling. |
| Ansari et al. (1991) | Tested virus and bacteria; statistical analysis; single volunteer for all methods | Unrealistic handwashing conditions; small sample size |
| Hanna et al. (1996) | Optimized laboratory recovery methods | No statistical analysis; unrealistic conditions; large seed concentrations |
| Patrick et al. (1997) | Small sample size (n = 7) but large number of replicates (n ≥ 36) | Towels autoclaved prior to use; no statistical analysis |
| Gustafson et al. (2000) | Advanced statistical analysis; large sample size (n = 99); Randomized study design; high seed concentrations but implemented a realistic handwashing scenario | No evaluation of real‐world microbial contaminants |
| Taylor et al. (2000) | Statistical analysis used with a 5% confidence level for significance | Dry times not consistent; volunteers instructed to dry hands until they felt dry |
| Montville et al. (2002) | Model simulations (n = 1000) validated with experimental data (n = 30) | Data compiled from highly diverse studies with data quality uncertainties |
| Harrison et al. (2003) | Performed statistical analysis; large number of replicates | Did not compare dryers and towels |
| Yamamoto et al. (2005) | Statistical analysis | Starting counts sometimes low‐ less than 10; data varied across different hand locations; inconsistent results; complicated indigenous flora parameter‐ no evidence of threat |
| Snelling et al. (2011) | Statistical analysis; used real‐world scenario to contaminate hands (handling raw meat followed by handwashing) | Data highly variable; comparisons not always significant; failed to test for pathogens |
| Gendron et al. (2012) | Considered background PT contamination impacts | No statistical comparisons; no risk evaluations |
| Margas et al. (2013) | Statistical analysis; controlled environmental conditions; Large number of volunteers (n = 100) | Data highly variable among participants |
| Best et al. (2014) | Statistical analysis; multiple tracers used | High inoculum; paint not representative of real‐world conditions |
| Best and Redway (2015) | Utilized both chemical and microbial tracers | No statistical analysis; high microbial burden may exaggerate transmission potentials; difficult to control reproducibility of volunteer behaviours; assumed handwashing is suboptimal; Risk not evaluated |
| Jensen et al. (2015) | Statistical analysis; pathogen surrogate tracers | Lack comparison to WD or JD method; Large data variability; Information lacking on data distributions; Exaggerated bacterial concentrations |
| Kimmitt and Redway (2016) | Statistical analysis; used virus surrogates | High seed concentrations; Lack comparison of WD vs PT |
| Wilcox et al. (2017) | Statistical analysis; targeted HPC and faecal indicator bacteria | Small pilot study (26 sampling days, single site, 2 washrooms, up to 5 swabs per locale); Information lacking on data distributions |
| Best et al. (2018) | Statistical analysis; large sample size (n = 120 sampling sessions); Multi‐site, multi‐scenario analysis; targeted faecal indicators and pathogenic bacteria | Highly variable site conditions; Low concentration differentials; Upper detection limit of 300 CFU; Information lacking on data distributions |
| Huesca‐Espitia et al. (2018) | Statistical analysis; multiple test organisms; VARIOUS air filtration methods | Low concentrations; data details not shown |
| Pitt et al. (2018) | Statistical analysis; utilized realistic handwashing and drying scenario; identified sampled organisms | Detailed data not provided; inconsistent drying times; methodology difficult to replicate and may not provide accurate counts |
| Mutters and Warnes (2019) | Statistical analysis; large number of volunteers (n = 80); bacterial tracer and resident flora; controlled and consistent environmental conditions; incorporated handwashing and evaluated drying and no drying variables | No environment sampling; drying methods may not be realistic |