Contact patterns during cleaning of vomitus: A simulation study

•Cleaning of simulated vomitus was relatively quick.•Cleaners infrequently touched their own bodies while cleaning.•Cleaners touched the cleaning cart more often than other surfaces, on average.•Each participant used different cleaning practices, but used similar cleaning practices each time he or she cleaned.•Few cleaners followed the recommended protocol for cleaning bodily fluids.•Following the recommended protocol for cleaning bodily fluids was associated with fewer surface contacts and improved cleaning quality. Environmental service workers cleaning bodily fluids may transfer pathogens through the environment and to themselves through contacts. Participants with experience in cleaning of hospital environments were asked to clean simulated vomitus using normal practices in a simulated patient room while being videorecorded. Contacts with environmental surfaces and self were later observed. In 21 experimental trials with 7 participants, environmental surfaces were contacted 26.8 times per trial, at a frequency of 266 contacts per hour, on average. Self-contact occurred in 9 of 21 trials, and involved 1-18 contacts, mostly to the upper body. The recommended protocol of cleaning bodily fluids was followed by a minority of participants (2 of 7), and was associated with fewer surface contacts, improved cleaning quality, and different tool use. Participants used different cleaning practices, but each employed similar practices each time they performed an experimental trial. Training in the use of the recommended protocol may standardize cleaning practices and reduce the number of surface contacts.