AIM: To analyze the level of knowledge, attitude and practice of health care workers regarding mobile phone hygiene in Riyadh Elm University. METHODS: A total of 153 respondents completed the questionnaire. A 26 variable questionnaire was employed to assess knowledge, attitude and practice regarding mobile phone hygiene amongst health care workers after obtaining consent and institutional permission. RESULTS: A response rate of 92.8% resulted in 153 questionnaires to be assessed. The study results showed that 62.5% of the respondents used mobile phones regularly, for professional or personal use and 82.4% of them considered mobile phones as a source of nosocomial infection. 90.2% of them opined that they would clean their mobile phones regularly following the COVID 19 (Coronavirus) infection. CONCLUSION: Easily available disinfectant materials must be employed in health care settings to disinfect mobile phone. Educational interventional programs must be advocated to ensure proper phone hygiene.

1. Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among Healthcare Workers from Riyadh Elm University in Riyadh City
IJPHER
Knowledge, Attitudes, and Practice towards Mobile Phone
Hygiene among Healthcare Workers from Riyadh Elm
University in Riyadh City
*1Sultan Ahmed Al Mani, 2Navin Anand Ingle
1Postgraduate Resident, Dental Public Health, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi
Arabia
2Program Director, Dental Public Health, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
AIM: To analyze the level of knowledge, attitude and practice of health care workers regarding mobile
phone hygiene in Riyadh Elm University. METHODS: A total of 153 respondents completed the
questionnaire. A 26 variable questionnaire was employed to assess knowledge, attitude and practice
regarding mobile phone hygiene amongst health care workers after obtaining consent and institutional
permission. RESULTS: A response rate of 92.8% resulted in 153 questionnaires to be assessed. The
study results showed that 62.5% of the respondents used mobile phones regularly, for professional or
personal use and 82.4% of them considered mobile phones as a source of nosocomial infection. 90.2%
of them opined that they would clean their mobile phones regularly following the COVID 19 (Coronavirus)
infection. CONCLUSION: Easily available disinfectant materials must be employed in health care settings
to disinfect mobile phone. Educational interventional programs must be advocated to ensure proper
phone hygiene.
Keywords: Attitude, health care workers, knowledge, mobile hygiene, nosocomial infection
INTRODUCTION
Information technology has evolved in recent times, with
the advent of telecommunications which is a branch of IT.
Access to an individual has shifted from a stable device to
an ambulatory unit. This unit is compact, easily storable
apart from helping communicate people. Such unit is
termed as “Mobile phones” of “Cellular phones” (Nasim et
al 2015).
Mobile technology enhances communication speed and
facilitates efficiency of the health care delivery by
increasing the contact speed. Mobiles are indispensable to
humans in their social and professional lives.
Unfortunately, as they are not cleaned regularly, even after
patient examination harbouring pathogenic entities and
poses a potential threat of nosocomial infections in the
hospitals (Jayalakshmi et al 2008).
Health care personnel are dependent on mobile
networking communication as their profession requires
speedy access, particularly in emergencies. In this
context, the dental professional is considered to be an
operative field requiring maximum infection control during
routine procedures (Singh et al 2010). Health care
institutions face the problem of nosocomial infections
resulting from multidrug- resistant gram-positive
microbiota like Staphylococcus aureus and enterococcal
species. The infection source could be endogenous
(presence of bacterial flora in procedural site) or
exogenous (equipment, aerosol, hands of dentist and his
team) (WHO, 2002).
Evidences described in the literature have supported the
colonization of several objects like pagers, personal digital
assistant, hand and mobile phones by pathogenic
microbes (Braddy (2005), Karabay (2007), Ulger et al
(2009), acting as vectors for transmission of pathogens
*Corresponding Author: Sultan Ahmed Al Mani,
Postgraduate Resident, Dental Public Health, College of
Dentistry, Riyadh Elm University, Riyadh, Kingdom of
Saudi Arabia.
Email: sultan.a.almani@student.riyadh.edu.sa
Co-Author Email: naviningle4@gmail.com
Research Article
Vol. 6(2), pp. 152-156, July, 2020. © www.premierpublishers.org. ISSN: 1406-089X
International Journal of Public Health and Epidemiology Research

2. Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among Healthcare Workers from Riyadh Elm University in Riyadh City
Al Mani and Ingle 153
from the health care professionals to the patients. It is of
major concern, that the dental clinic has higher aerosol
volume and spatter during dental procedures, surfaces act
a potential infectious reservoir (Murray ,1957).So it is
imperative for the dentists to understand their susceptibility
to infections due to mobile phone usage and they remain
aware regarding the same to ensure appropriate infection
control implementation.
No confirmatory evidence was obtained regarding the
maintenance of mobile hygiene till date. No studies were
conducted regarding the knowledge and awareness about
mobile hygiene in health care workers from the Riyadh
province, which mandated the need for the study.
MATERIALS AND METHODS
A cross-sectional study was conducted among health care
workers of Riyadh Elm University, Riyadh province to
assess knowledge, attitude and practice towards mobile
phone hygiene, from April 2020 to May 2020. The study
protocol was approved by the Institutional Ethical
clearance of Riyadh Elm University
(FPGRP/2020/467/167/161).
The study sample comprised a total of 153 health care
workers of different sects including staff, postgraduates,
undergraduates and interns.
A pre – designed, self-administered 26 variable
questionnaires was used to assess the knowledge of
health care workers. The variables elaborated
demographic characteristics, knowledge regarding mobile
hygiene, attitude towards cleaning procedure and mobile
phone related virus transmission variables. Each question
was framed as multiple- choice questions, with the request
to the participants to fill in relevant choice as per them. The
only completed questionnaire was retained.
The questionnaire was pilot- tested on a group of 20 HCWs
before the start of the study in order to ensure for the
content clarity and relevance. No modifications were made
in the questionnaire after evaluating. The respondents in
the pilot study were not included in the final analysis. The
questionnaire was distributed using Google forms online
survey forum. Confidentiality of all participants was
ensured and they were voluntary, with access through an
email invitation link. The survey was open for a month and
a remainder for filling the survey forms was sent midway.
The data collected were transferred to spreadsheets and
analyzed using SPSS 20.0 version. Frequencies and
percentages for each variable were calculated.
Comparison analysis between respondents based on their
gender was done by employing the Chi-square test, setting
a level of significance at 5%.
RESULTS
The questionnaire was sent out to 165 health care workers
of Riyadh Elm University, out of which 153 were included
making a response of 92.8%. The general characteristic
of the health care personnel is presented in Table 1.
57.5% of the health care workers were males while 42.5%
were females. (Figure 1). 43.1% of the participants were
between 20 – 24 years, 17.0 % between 25-29 and 39.9%
above the age of 30 years. (Figure 2)
Figure 1: Distribution of study population based on age
Figure 2: Distribution of study population based on
gender
A comparative analysis between gender on knowledge,
attitude and practices was conducted for the variables
assessed. (Table 2). A good 62.5% (83) of the health care
workers reported using a mobile phone at work regularly,
which was significant at p =0.007. Fortunately, a majority
of the respondents (86.4%) agreed mobile phones to be a
source of nosocomial infection. However, it was
disheartening to find that, only 18.3% and 23.5% of them
cleaned their mobile phones daily before and after entering
43.1 %
17.0 %
39.9 %
57.5 %
42.5 %

3. Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among Healthcare Workers from Riyadh Elm University in Riyadh City
Int. J. Public Health Epidemiol. Res. 154
the dental clinic respectively. While 10.5% of them never
cleaned their mobile phones, 66.7% were willing to clean
it daily if there was ready to use disinfectant. Regarding
viral transmission, 90.2% of the study respondents
increased their frequency of cleaning post-COVID-19
pandemic, though only 56.2% of them considered mobile
phones as a source of viral transmission.
DISCUSSION
With advancements in technology, mobile phones have
become an indispensable part of human lives. Mobile
phones are a communication device for making and
receiving calls over a radio link with a wide ambulatory
area. Evidence supports mobiles are a serious source of
infection as they are in frequent contact with hands,
especially to the drug- resistant microbes (Kilic, 2009).
Research supports 40% of mobile phones in the hospital
setting to harbour pathogenic bacteria (Tagoe, 2011),
hence posing a serious health hazard.
The present study reported 62.5% bringing mobiles to
work, which is lesser than that compared to the study of
Leong XYA et al (2020), reporting 90% of HCW
respondents fetching mobile phones daily.
81.7% of the respondents agreed on mobile phones as a
source of nosocomial infection. The study of Singh et al
(2010) showed that mobile phone usage by faculty and
trainees who are in direct contact with patient not only had
higher bacterial contamination, but also enhanced
nosocomial pathogens such as Staphylococcus aureus,
Acinetobacter, Pseudomonas and Staphylococcus citrus.
A particular study reported Acinetobacter species to be
present n 30% of all ICU related nosocomial infections.2
This finding was further supported by an Israelian study
identifying multidrug-resistant Acinetobacter baumannii on
the hands, cell phones of HCWs, and patients admitted to
the ICU (Borer, 2005). Due to this finding, the use of mobile
phones in inpatient care was stopped on their premises.
Apart from this fungal growth and gram negative-bacteria
were also seen.
80% of the health care participants of the study of Leong
XYA et al reported that they would clean their mobiles if
there was a ready to use disinfectant in changing rooms,
which was almost in similar grounds to our study with 66.7
% of the participants agreeing to do so.
Hazard of cross infection due to contaminated or in
adequately sterilised surface and setting is stressed
increasingly in the health care set up. Though the interplay
of suspended bacteria in air on surfaces is not well
researched, it is still of belief that microbes eventually will
harbour on to the surfaces present in the ecology (Osorio
et al 1995).
After deposition on surfaces, infectious agents can easily
survive for extended periods, unless they are eliminated
by disinfection or sterilization procedures. It is of interest to
mention here that volume of aerosols and spatter
produced during dental treatment is of great concern as it
contaminates surfaces in the dental operatory becoming
potential reservoirs for infection. The cellular telephones
which are used in close proximity to such surfaces have
an increased risk of being cross-contaminated with such
organisms. The constant handling along with the amount
of heat generated by mobile phones results in a prime
breeding site for microbes which are normal commensals
on skin surfaces. This could be because microbes multiply
in optimum temperature and mobile phones provide the
perfect breeding ground as they are easily carried in
pockets, handbags or briefcases.
Studies have recommended the use of gloves, frequent
hand washing, and disinfectant alcohol wipes, restricted
usage of mobile phone in high risk areas and appropriate
health worker education to be given in order to decrease
colonization of microbes on the mobile phones. The same
can also be employed for patients treated and their
attendants in hospital settings (Brady et al 2009, Beer et al
2006).
Usage of gloves does not eliminate the need for hand-
washing as the gloves themselves may become
contaminated as a result of punctures or the hands may
become contaminated after the gloves are removed
(Shalaby et al 2020). Hand-washing is stamped to be the
most significant intervention to prevent bacterial and viral
transmission from hands of health care workers. Hence,
attention must be given to compliance with hand-washing
guidelines. Though continuing education is a useful
intervention to enhance compliance, it is difficult to sustain
a behavioural change without continual reinforcement.
CONCLUSION
Health care workers demonstrate a moderate lack of
awareness regarding mobile hygiene in the present study.
Phone hygiene is generally overlooked due to factors like
the absence of a readily available disinfectant in hospital
settings and decreased awareness regarding the use of
disinfection. The Advocation of educational interventional
programs is recommended to increase phone hygiene
compliance.
REFERENCES
Beer D, Vandermeer B, Brosnikoff C, Shokoples S, Rennie
R, Forgie S. Bacterial contamination of health care
workers’ pagers and the efficacy of various disinfecting
agents. (2006). Pediatr Infect Dis J. 25: 1074-5.
Borer A, Gilad J, Smolyakov R. Cell phones and
Acinetobacter transmission. (2005). Emerg Infect
Dis.11:1160-1.
Braddy CM, Blair JE. Colonization of personal digital as-
sistants used in a health care setting.( 2005). Am J
Infect Control.33:230–2.

4. Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among Healthcare Workers from Riyadh Elm University in Riyadh City
Al Mani and Ingle 155
Brady RRW, Verran J, Damani NN, Gibb AP. Review of
the mobile communication devices reservoirs of
nosocomial pathogens. (2009). J Hosp Infect.71: 295-
300.
Ducel G, Fabry J, Nicolle L,(2002). eds. Prevention of
hospital-acquired infections: a practical guide, 2nd ed.
Geneva: World Health Organization. 1-64
Jayalakshmi J, Appalaraju B, Usha S. Cell phones as
reservoirs of nosocomial pathogens. (2008). J Assoc
Physicians India.56:388–9.
Karabay O, Kocoglu E, Tahtaci M. The role of mobile
phones in the spread of bacteria associated with
nosocomial infections. (2007). J Infect Dev Ctries.1:72–
3.
Kilic I.H. , M.Ozaslan, I.D.Karagoz, V.Davatoglu.,
(2009), The microbial colonisation of mobile phones
used by health care staffs, Pakistan journals of
biological science. 78: 882-884.
Murray JP, Slack GL. Some sources of bacterial contami-
nation in everyday dental practice. (1957). Br Dent
J.134:172–4.
Nasim V S, Ahmed Al-Hakami, Mohammed Nadeem
Ahmed Bijle, Sulthan Ahmed Al-Manea, Mohammed
Dahman Al‑ Shehri, Saleh Mohammed Al-Malki.
Evaluation of Cellular phones for potential risk of
nocsocomial infection amongst dental operators and
auxiliary staff. (2015).Journal of International Oral
Health;7(4):51-53.
Osorio R, Toledano M, Liebana J, Rosales JI, Lozano JA.
Environmental microbial contamination: pilot study in a
dental surgery. (1995). Int Dent J. 45: 352-7.
Shalaby, M. N., Mostafa, M., Sakoury, A., Rabei, M. A.,
Alzayani, A. K., & Ahmed, M. S. (n.d.). Covid-19
Pandemic Era. (2020). AEGAEUM JOURNAL.. 8(6).
Singh S, Acharya S, Bhat M, Rao SK, Pentapati KC.
Mobile phone hygiene: Potential risks posed by use in
the clinics of an Indian dental school. (2010). J Dent
Educ.74(10):1153-8.
Tagoe D.N. , Gyande Vik, Ansah Evo., (2011),
Bacterial contaminant of mobile phones, Central
microbiology journal. 65: 121-125.
Ulger F, Esen S, Dilek A, Yanik K, Gunaydin M, Leble-
bicioglu H. Are we aware how contaminated our mobile
phones with nosocomial pathogens? (2009). Ann Clin
MicrobiolAntimicrob.8:7.
X.Y.A. Leong, Shin Yuet Chong, Si En Angel Koh, Bee
Chin Yeo, Kwee Yuen Tan, Moi Lin Lang. Health care
workers beliefs, attitudes and compliance with mobile
phone hygiene in a main operating theatre complex.
(2020). Infection Prevention in Practice.2:1-5.
Table 1: Comparative analysis of variables of mobile phone hygiene based on gender
Questions Options Males
N (%)
Females
N (%)
Total
N (%)
Chi square statistic
and p value
Do you have a mobile phone that you
use at work regularly
Yes
No
83(61.5)
5 (27.8)
52(38.5)
13(72.2)
135(88.2)
18 (11.8)
7.383 and 0.007*
Mobile phones are a source of
nosocomial infection
Agree
Disagree
76(86.4)
12(13.6)
49 (75.4)
16 (24.6)
125(81.7)
28 (18.3)
3.014 and 0.064
Do you clean your mobile phone
before entering dental clinic
Never
When my phone is
obviously dirty
Occasionally
Daily
20(22.7)
26(29.5)
28(31.8)
14(15.9)
23(35.4)
17(26.2)
11(16.9)
14(21.5)
43(28.1)
43(28.1)
39(25.5)
28(18.3)
6.186 and and 0.103
Do you clean your mobile phone
after entering dental clinic
Never
When my phone is
obviously dirty
Occasionally
Daily
16 (18.2)
28(31.8)
25(28.4)
19(21.6)
15(23.1)
10(15.4)
23(35.4)
17(26.2)
31(20.3)
38(24.8)
483(1.4)
36(23.5)
5.418 and 0.014*
Do you use disinfectant materials for
cleaning your mobile
Never
Sometimes
Always
22(25.0)
48(54.5)
18(20.5)
16(24.6)
31(47.7)
18(27.7)
38(24.8)
79(51.6)
36(23.5)
1.175 and 0.556
If used, what are the disinfectant
materials used
Wet wipes
Tissue paper
Cotton with alcohol
Brush and spray
31(35.2)
21(23.9)
28(31.8)
8(9.1)
12(18.5)
13(20.0)
36(55.4)
4(6.2)
43(28.1)
34(22.2)
64(41.8)
12(7.8)
9.386 and 0.025*
Cleaning frequency of mobile phone Daily
Once a week
Monthly
Less than once per
month
Never
29 (33.0)
23(26.1)
22(25.0)
6(6.8)
8(9.1)
11 (16.9)
14(21.5)
23(35.4)
9(13.8)
8(12.3)
40(26.1)
37(24.2)
45(29.4)
15(9.8)
16(10.5)
7.626 and 0.010*

5. Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among Healthcare Workers from Riyadh Elm University in Riyadh City
Int. J. Public Health Epidemiol. Res. 156
I will clean my mobile phone more often if
there is a ready accessible disinfection
method in the dental clinic
Yes
No
I already clean my mobile
phone daily
64(72.7)
15(17.0)
9(10.2)
38(58.5)
10(16.3)
17(26.2)
102(66.7)
25(16.3)
26(17.0)
6.785 and
0.034*
I am not cleaning my mobile phone daily
because
Hand phones are not a
source of nosocomial
infection
I don’t think about it
I don’t know what to use
Cleaning is not effective in
reducing bacterial
contamination
Takes too much time
38(43.2)
26(29.5)
7(8.0)
10(11.4)
7(8.0)
31(47.7)
16(24.6)
8(12.3)
5(7.7)
5(7.7)
69(45.1)
42(27.5)
15(9.8)
15(9.8)
12(7.8)
1.740 and
.784
Do you think lack of available resources to
clean your mobile phone are the causes of
not cleaning your mobile phone
Yes
No
69(78.4)
19(21.6)
45(69.2)
20(30.8)
114(74.5)
39(25.5)
1.658 and
0.136
Do you think using disinfectant wipes will
damage your mobile phone
Yes
No
Not sure
40 (45.5)
22(25.0)
26(29.5)
20(30.8)
22(33.8)
23(35.4)
60(39.2)
44(28.8)
49(32.0)
3.471 and
0.017*
Do you think having visual reminders on the
phone will help improve mobile phone
hygiene
Yes
No
May be
54(61.4)
19(21.6)
1517.0)
36(55.4)
14(21.5)
15(23.1)
90(58.8)
33(21.6)
30(19.6)
0.921 and
0.631
Do you wash your hands before and after
using your mobile
Yes
No
46(52.3)
42(47.7)
35(53.8)
30(46.2)
81(52.9)
72(47.1)
0.037 and
0.489
Do you make phone calls while attending to
patients
Yes
No
45(51.1)
43(48.9)
30(46.2)
35(53.8)
75(49.0)
78(51.0)
3.71 and
0.328
The main purpose of using mobile phone
during procedure in clinic
Check time
Answer the call
Social media
To show X ray to colleague
or superior
34(38.6)
17(19.3)
27(30.7)
10(11.4)
19(29.2)
13(20.0)
25(38.5)
8(12.3)
53(34.6)
30(19.6)
52(34.0)
18(11.8)
1.658 and
0.064
Do you exchange phone with friends and
colleagues
Yes
No
54(61.4)
34(38.6)
30(46.2)
35(53.8)
84(54.9)
69(45.1)
3.493 and
0.044*
Do you use headsets while using your mobile
phone
Yes
No
44(50.0)
44(50.0)
35(53.8)
30(46.2)
79(51.6)
74(48.4)
2.21 and
.380
Do you have cover for your mobile phone Yes
No
73(83.0)
15(17.0)
53(81.5)
12(18.5)
126(82.4)
27(17. 6)
.520 and
.492
Function of mobile phone use Personal use only
Clinical use only
Combined personal and
clinical use
11(12.5)
14(15.9)
63(71.6)
14(21.5)
8(12.3)
43(66.2)
25(16.3)
22(14.4)
106(69.3)
2.366 and
0.306
Mobile phone is one of the reasons to spread
virus
Yes
No
Not sure
52(59.1)
12(13.6)
24(27.3)
34(52.3)
12(18.5)
19(29.2)
86(56.2)
24(15.7)
43(28.1)
9.12 and
0.634
Do you increase in cleaning mobile phone
after COVID 19 appears
Yes
No
81(92.0)
7(8.0)
57(87.7)
8(12.3)
138(90.2)
15(9.8)
8.01 and
0.020*
Total 88(100) 65(100 153(100)
Accepted 8 July 2020
Citation: Al Mani SA, Ingle NA (2020). Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among
Healthcare Workers from Riyadh Elm University in Riyadh City. International Journal of Public Health and Epidemiology
Research, 6(2): 152-156.
Copyright: © 2020 Al Mani and Ingle. This is an open-access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original
author and source are cited.