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Commode chairs: High risk surfaces

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The spread of the infectious risk in healthcare settings can be transmitted in different ways: air,
droplets, direct or indirect contact. Indirect contact contamination occurs mainly when a person
touches a surface contaminated with a pathogenic microorganism and puts their hands to their
faces or mouth to eat. Hence the importance of always washing your hands well. We can find in
the healthcare environment various equipment which can be at the origin of a propagation of the
infectious risk by indirect contamination when they are badly disinfected. This is the case, among
other things, for the commode chair. This is equipment that seems to be harmless on a care unit
but which potentially represents a significant risk of contamination due to its usefulness. It can be
contaminated with pathogenic bacteria and viruses that we find in the stool, examples; Clostridium
difficile spores, gastroenteritis virus (Norovirus), etc. There may even be in the stool the presence of
SARS – CoV-2 which is at the origin of the Covid-19 pandemic. However, it should be noted that we
do not currently know whether the presence of this virus in the stool is a risk to human health. We
must therefore apply precautionary principles.

Risks may increase with chair type

The risk of spreading pathogenic germs is mainly associated with the following factors:
improper cleaning / disinfection, transportation of the seal with the stool and emptying of the pail
that contains stools. First, it is therefore important to be able to properly clean and disinfect a commode chair. Unfortunately, we still find commode chairs in healthcare settings that come with surfaces that are difficult to clean and disinfect. As an example, we still find commodes with mesh or
fabric backrests, the presence of leatherette, many perforations, rough arm rests, etc. Some chairs
easily corrode in the presence of disinfectants. It should be noted that in addition to representing
an increased risk of contamination, these commodes with these types of surfaces generally take
longer to be effectively cleaned and disinfected.
In addition to the risk of contamination linked to surfaces, transporting and emptying the pail also
represents a risk of contamination for both staff and users. When transporting the pail there is a
risk of dropping it and spilling its contaminated contents. Emptying the pails is increases risk of
splashing, as well as creating a contaminated aerosol when flushing the toilet.
Because of these findings, reducing the risk of the spread of nosocomial infections through
commode chairs therefore requires:

  • The rigorous application of adequate cleaning and disinfection procedures.
  • The use of a corrosion resistant commode that limits surfaces that are difficult to
    decontaminate.
  • The use of hygienic bags which reduce the risk of accidents during transport and contamination
    of the patient environment.