August 01, 2023 4 min read


Initial results are in and they will shock you!

Being such high-touch environments, hygiene practice in therapy settings, such as physiotherapy, osteopathy, massage and myotherapy, bowen and beauty therapy, etc., is crucial to a therapist’s duty of care, even more so these days with a heightened awareness among consumers.

A significant amount of government funding is consistently allocated to research into infection risk and prevention in hospital environments, however, the same cannot be said for therapy environments. And the areas of risk highlighted in hospitals, and the subsequent solutions developed and processes implemented to improve their hygiene practice, are not always transferrable.

Such is the lack of research into hygiene and hygiene practice in therapy industries, a systematic review, performed by an independent microbiologist working at Macquarie University in Sydney, found only one article* where data gathered from a test environment could potentially be considered relevant for therapy settings.

The article investigated the bacterial contamination of chiropractic treatment table surfaces, as well as the attitudes and practices of therapists towards table disinfection. Of the 14 tables tested:

  • all 14 tables contained microbes
  • 5 of the 14 tables showed the presence of Staphylococcus aureus
  • the Staphylococcus aureus found on 3 of those 5 tables was methicillin resistant.

It was concluded that the “…deficiency in table/paper design may be deemed the most substantial risk factor for horizontal transmission of infectious disease.”

And although 81% of therapists surveyed agreed on the importance of disinfecting their tables, 38% of those surveyed reported no routine disinfecting protocol, with 27% disinfecting only on a weekly or as-needed basis.

It was this lack of research that prompted Purifas’ founder and practicing physiotherapist to commission his own preliminary research into the infection risks associated with therapy beds, with a focus on the transmission of both bacteria and saliva.

The research would also compare the clinical effectiveness of using antibacterial wipes (which typically claim to kill 99.9% of germs) in removing bacteria, with the clinical effectiveness of using Purifas’ single-use barriers, namely the Purifas FaceShield and the Purifas BodyShield.

The test environment was such that:

  • Participants were each given two 10-minute massages while lying face down on a therapy bed.
  • For the first massage, the therapy bed was covered with the BodyShield and the face hole was protected by the FaceShield.
  • For the second massage, both the therapy bed and its face hole were left exposed.
  • For each massage the subject’s arms were positioned over the edges of the bed to ensure the armpits were exposed to the therapy bed (which for some is a very natural position).
  • Before the start of each massage, the therapy bed was wiped down using an antibacterial wipe, and swabs were taken of the internal aspect of the face hole, the anticipated armpit resting place, as well as the resting place of the forehead and chin, to acquire surface samples for bacteria testing. The internal aspect of the face hole was also swabbed to test for the presence of saliva.
  • During each massage, the subject was asked to cough twice, as well as count out loud to 60, in order to simulate a conversation.
  • A second set of swabs of the same aforementioned areas was taken immediately after each massage.

The results were shocking!

A colony-forming unit (CFU) is a unit that estimates the number of bacteria, fungi, viruses, etc., in a sample that are able to multiply. This is important when analysing bacteria in experiments where a quantitative analysis/comparison of bacterial growth is required.

A statistical analysis of all data collected revealed the following:

  • During one 10-minute massage and without use of the FaceShield, an astonishing 55,643 CFUs were present on the internal aspect of the face hole.

    This is the minimum numbers of CFUs the next client would be exposed to if the therapist was not compliant with hygiene practice. (It is worth noting that the number of CFUs would increase as the number of clients who used the same bed increased.)

    The number of CFUs present when the FaceShield is used is reduced to less than 1,815; a reduction in the number of bacteria by an average of 84%.
  • When using the BodyShield, bacteria transferred from the left and right armpits is reduced significantly. Combining the data from both armpits (and in turn strengthening the accuracy of information), bacteria is reduced by an astounding 94%.
  • As the swabs were taken before and after the use of antibacterial wipes – once for the control and once following a 10-minute massage – the research was also able to establish the clinical effectiveness of the wipes: there was no evidence to show that the antibacterial wipes used were more effective than using the FaceShield and/or the BodyShield.

    In fact, Staphylococcus aureus was found in varying amounts following all subjects tested (with wiping in between) – indicating the bacteria’s resilience to antibacterial wipes. The presence of saliva was also found in the face hole after every single subject – despite cleaning between subjects.
  • Comparatively, when the FaceShield was used, the saliva that was present was equivalent to baseline figures (after cleaning) on all seven subjects, indicating no additional saliva was transmitted with the use of the FaceShield.
It is strongly implied, therefore, that the results from this preliminary research can translate into a healthier experience and lower risk of infection for clients when using our FaceShield and BodyShield.

Utilising these single-use barriers also helps to overcome any staff compliance issues associated with wiping down equipment and provides a visually hygienic practice for your clients – a great value add for your business.


* Puhl, Aaron A. et al. (2011) ‘An investigation of bacterial contamination on treatment table surfaces of chiropractors in private practice and attitudes and practices concerning table disinfection’, American Journal of Infection Control, 39(1), pp. 56–63. doi:10.1016/j.ajic.2010.11.001.

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