Across every sector where infection control matters, including hospitals, aged care, food processing and building services, rigorous protocols govern the cleaning of surfaces, equipment and hands. Yet one device that workers touch hundreds of times a day, carry between rooms and rest on every available surface has largely escaped scrutiny: the mobile phone.
Scott McFadzen, CEO of Coach8, has seen the consequences of phone contamination play out in the field. “I know a restorer in the US who was close to death and was in hospital for a long period due to him being contaminated from his use of his phone, McFadzen says. “He got careless in a large CAT event, and it was directly related to his phone use.” It is a stark illustration of a risk that extends well beyond hospital wards.
Groundbreaking research from Bond University, published in the peer-reviewed journal MicrobiologyOpen, has confirmed what many infection control specialists have long suspected – finding that healthcare workers’ mobile phones harbour some of the world’s most dangerous antibiotic-resistant bacteria.
The study, the largest of its kind, analysed DNA samples taken from 95 mobile phones belonging to healthcare workers in Australian and United Arab Emirates hospitals. Using metagenomics, a technique that maps all genetic material present on a surface, researchers identified bacterial species responsible for a substantial share of the 13.7 million deaths attributed to bacterial infections globally in 2019 alone.
On average, each device carried more than three species from among the 10 bacteria linked to the highest worldwide mortality rates, including Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli, all designated priority pathogens by the World Health Organization. The researchers coined the term ‘phonome’ to describe this microbial ecosystem living on phone surfaces.
Litmas lab director Claire Bird says the findings deserve careful attention across the sector. “The study found an average of at least three of the top 10 bacterial infectious agents, measured by their mortality rate, on mobile phones. Multiple antibiotic resistance and virulence factors were also identified, increasing the risk of serious harm and reducing the likely success of medical treatments.”
Why phones are uniquely difficult to control
What distinguishes mobile phones from other frequently touched surfaces is how thoroughly they are woven into clinical workflow. Bird points to the sheer breadth of functions phones now serve. “The need for access to mobile phones by clinicians continues to increase as the technologies relied upon for communication, accessing health records, recording voice for AI assistants and scanning patient wristbands proliferate. Phones act as receivers for critical messages from patient monitors, nurse call systems and for rapid response. For these reasons, the mobile phone is seen as a device that forms part of a toolbox for those treating patients.”
This deep integration into clinical practice means that simply banning phone use in patient areas is neither realistic nor desirable. The challenge is managing phones with the same rigour applied to other clinical tools, a standard that currently falls well short of what the evidence demands.
A zone-based approach to risk
Developing a workable protocol requires acknowledging that risk varies considerably across a facility. Bird argues that any effective framework must begin with a clear-eyed assessment of where the greatest dangers lie. “The first job here would be to define the risks based on zones within different parts of the facility, with intensive care units, neonatal care, operating theatres and isolation rooms being the highest risk. Moderate risk areas such as general wards, aged care bedrooms and nurses’ stations may require a different process.”
On disinfection methods, Bird urges caution. “It is wise not to use bleach, hand sanitiser or other agents unless they are suitable and recommended for this use. UV-C devices are also deployed; however, care is needed as there are some pathogens that may be resistant to such treatment.” She also flags shared devices as a particular pressure point. “Devices are sometimes shared, with very high touch of the item taking place and cross-contamination risks becoming elevated. Documentation of who used devices, when and for what purpose would seem an important part of managing risks, as well as making contact tracing simpler in the event of an outbreak.”
What a serious protocol actually looks like
Bird outlines the kind of structured, shift-based cleaning guidance she believes facilities should be working towards. “Instructions may include: at the start of each shift before entering clinical areas; after use in a patient or resident care zone; after leaving an isolation room or outbreak area if phone use was unavoidable; before entering high-risk units; and at the end of the shift before leaving the facility.”
She is equally clear about the role of physical infrastructure in building good habits. “Providing phone-cleaning stations may be a valuable way to remind staff of the importance of thinking of their phones as an extension of their hands. Locating them close to hand-washing stations may help to reinforce this message.”
McFadzen has long taught a similar approach in his own field. “I have always taught our students that the user could put their phone into a sandwich clip lock bag and then keep it in there until the project is completed. The bags over the phones allow all photos to be taken through it and protect the phone.”
The cleaning industry’s evolving role
The question of who bears responsibility for phone hygiene sits at an important intersection for the cleaning sector. Bird sees a meaningful role for cleaning professionals, while drawing a clear boundary around personal accountability. “It should be the person using the device who takes responsibility for leaving it fit-for-purpose if sharing it or for preventing [the movement of] invisible microorganisms between patients and surfaces. A regime and understanding is needed about the sources, pathways and mechanisms for spreading infectious diseases if we are to see phones not fall down the gap of being between personal devices and medical equipment.”
She adds that cleaners should serve as system enablers rather than the last line of defence. “Cleaning is one cornerstone of infection prevention, where phones are involved in passing an infection from patient to patient, but this needs doing by way of a proper management plan, not cleaners following workers around to keep wiping their mobile devices. Rather, I think cleaners will act as the trainers, service providers for shared devices, supply of products and compliance auditing as part of infection control management plans.”
McFadzen sees the same tension playing out in restoration work. “These restoration projects create issues for the users as they are highly contaminated with fluids. The restorer is using their hands to move items and clean, but is also then asked by the insurance companies, third party groups and clients to take photos of jobs as they progress or when finished. This creates an issue.”
A gap the industry must help close
The evidence from the Bond University study, combined with the practical framework Bird outlines, points to a clear and pressing gap in how facilities approach infection control. Mobile phones are clinical tools in all but name, yet they remain outside the protocols that govern every other surface a healthcare worker touches. Closing that gap will require coordinated effort across clinical governance, facilities management and the cleaning sector, with each understanding its distinct but complementary role.
