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ORIGINAL ARTICLE
Year : 2015  |  Volume : 13  |  Issue : 3  |  Page : 337-341

Assessment of microbial contamination and oral health risks associated with handling of Indian currency notes circulating in Bengaluru city: A cross-sectional survey


Department of Public Health Dentistry, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India

Date of Web Publication14-Sep-2015

Correspondence Address:
Suvarna V Biradar
Department of Public Health Dentistry, Vydehi Institute of Dental Sciences and Research Centre EPIP # 82, Room No. 9, Whitefield, Bengaluru, Karnataka - 560 066
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.165312

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  Abstract 

Introduction: Accumulated data obtained over the last 20 years on the microbial status and survival of pathogens on currency notes indicate that this could represent a potential cause of sporadic cases of food borne illness. Objectives: To identify the micro-organisms present on the Indian currency notes and the oral health risks due to microbial contamination of Indian currency notes circulating in Bengaluru city. Materials and Methods: A cross-sectional survey was conducted and the Indian currency notes of various denominations (Rs. 10, Rs. 20, Rs. 50, Rs. 100, Rs. 500, and Rs. 1000) were collected from fruit vendors, hawkers, vegetable vendors, bus conductors, railway ticket counters, hotel counters, and butchers. Sample size was determined to be 70 Indian currency notes. Convenience sampling technique was used. Microbiological analysis of the collected currency notes was done. Results: The contamination rate of collected currency notes from the butchers and hawkers were 80% and 60% respectively. Staphylococcus aureus was present on 15 currency notes (21.42%) and was found to be higher in Rs. 10 than in other currency denominations. Streptococcus pyogenes was present on four currency notes (5.714%) of Rs. 10. Conclusion: The Indian currency notes circulating in Bengaluru city were contaminated with pathogenic bacteria. The oral health risks due to microbial contamination of Indian currency notes are acute pharyngitis, peritonsillar or retropharyngeal abscess, mastoiditis, sinusitis, otitis media, mild cellulitis, angular cheilitis, some endodontic infections, osteomyelitis of the jaw, parotitis, and oral mucositis.

Keywords: Indian currency notes, microbial contamination, Staphylococcus spp


How to cite this article:
Narayan D P, Reddy MT, Sujatha B K, Biradar SV. Assessment of microbial contamination and oral health risks associated with handling of Indian currency notes circulating in Bengaluru city: A cross-sectional survey. J Indian Assoc Public Health Dent 2015;13:337-41

How to cite this URL:
Narayan D P, Reddy MT, Sujatha B K, Biradar SV. Assessment of microbial contamination and oral health risks associated with handling of Indian currency notes circulating in Bengaluru city: A cross-sectional survey. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2019 Dec 12];13:337-41. Available from: http://www.jiaphd.org/text.asp?2015/13/3/337/165312


  Introduction Top


Currency whether in the form of coins or paper notes is perhaps the most widely used article everyday by the people throughout the world, and each currency is exchanged many times during the time it circulates. Since people from all walks of life handle them, they are bound to get contaminated either from the environment or from the persons handling them. [1] They represent a universal medium since they are used by everyone and form the source of transmission of bacteria in the environment and among humans. The possibility that the currency notes might act as an environmental vehicles for the transmission of potential pathogenic micro-organisms was suggested in 1970's. [2]

They can be contaminated with pathogenic bacteria, which is of a much public health concern as it can be a source of serious pathogens. Paper currency, therefore, presents a particular risk to public health, since they go in circulation and contaminate the hands of others transmitting pathogenic organisms and it can provide a vehicle for easy transmission of pathogens between handlers. [3],[4] Available literature reveals mere information about the influence of contaminated currency notes on oral health. Hence, the present study has been conducted.

Aim of the study

To assess microbial contamination and oral health risks associated with handling of Indian currency notes circulating in Bengaluru city.

Objectives of this study

  • To identify the micro-organisms present on the Indian currency notes circulating in Bengaluru city
  • To determine the oral health risks caused due to isolated micro-organisms based on the available literature.

  Materials and methods Top


A cross-sectional survey was conducted from July 2013 to August 2013 in Bengaluru city. The study proposal was approved by the Institutional Review Board. The sample size was calculated scientifically by using the appropriate formula. Moreover, the sample size was 70 Indian currency notes. A pilot study was conducted to know the feasibility.

Sample size determination

The sample size was calculated by using the following



where Z = 1.96; P = Prevalence rate 0.64 (based on the previous studies)

q = (1 − p) =1 − 0.64; d = 20% of p

The sample size was 70.

Sampling design

Convenience sampling technique was used for the survey.

Source of sample

The currency notes of various denominations were collected from fruit vendors, hawkers, vegetable vendors, bus conductors, railway ticket counters, hotel counters, and butchers in Bengaluru city.

Sample collection

A total of 70 Indian currency notes of denominations (Rs. 10, Rs. 20, Rs. 50, Rs. 100, Rs. 500, and Rs. 1000) were collected from the source of sample in Bengaluru city.

The lower denomination currency (Rs. 10, Rs. 20, Rs. 50, and Rs. 100) were collected from the fruit vendors, hawkers, vegetable vendors, butchers and from bus conductors and the higher denomination currency (Rs. 500 and Rs. 1000) were collected from the hotel counters and the railway ticket counters. A total of ten currency notes of each denomination were collected from each source.

The envelopes were sterilized with ethylene oxide and were transported in a sterile cover. Persons handling the currency notes were asked to deposit them in the sterile envelopes. They were compensated with other currency note of the same denomination. The collected currency notes in sterile envelopes were taken to the Department of Microbiology at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru for the microbiological analysis in a sterile cover.

Microbiological analysis

The collected currency notes were picked from the envelopes with sterile forceps and immersed in 40 ml of nutrient broth in glass test tubes and were then incubated at 37°C for 24 h in an aerobic environment. For the bacterial isolation - a loop full of the incubated nutrient broth was then inoculated onto MacConkey's Agar plates and incubated for 24 h at 37°C in an aerobic environment. Colonies on the MacConkey agar were identified using standardized microbiological techniques.

Morphological and biochemical characterization of the bacterial isolates

The bacterial isolates were characterized on the basis of their morphology, staining, and biochemical tests. Gram's staining was carried out to ascertain the morphology and Gram's reaction - behavior of the bacterial isolates. After Gram's staining, the micro-organisms were identified through a microscope. The biochemical tests carried out were - the Indole test, Mannitol test, Catalase test, Citrate test, Urease test and the coagulase test for the confirmation of micro-organisms identified.

Statistical analysis

Descriptive statistical analysis has been used in this study.


  Results Top


The contamination rate of currency notes collected from the butchers and hawkers were 80% and 60% respectively. Rs. 20, which were collected from fruit vendors, the number of contaminated currency notes with bacterial isolation were four with the contamination rate 40%. Rs. 50 which were collected from vegetable vendors, the number of contaminated currency notes with bacterial isolation were five with the contamination rate 50%. Rs. 100 which were collected from bus conductors, the number of contaminated currency notes with bacterial isolation were five with the contamination rate 50%. Rs. 500 which were collected from hotel counters, the number of contaminated currency notes with bacterial isolation were four with the contamination rate of 40%. Rs. 1000, which were collected from the railway ticket counters, the number of contaminated currency notes with bacterial isolation were four with the contamination rate of 40% [Table 1]. The overall contamination rate of the collected currency notes was 51.42%.
Table 1: Contamination rate of the currency notes in the study sample


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The number of contaminated currency notes with the bacterial isolation of denomination Rs. 10 was eight from butchers. Out of eight currency notes, five had shown the presence of Gram-positive cocci and three had shown the presence of Gram-negative Bacilli by Gram's staining. The number of contaminated currency notes with the bacterial isolation of denomination Rs. 10 was 6 collected from hawkers. Out of 6 currency notes, four had shown the presence of Gram-positive cocci, and two had shown the presence of Gram-negative Bacilli. Similarly, the currency notes of denomination Rs. 20 collected from fruit vendors, the number of contaminated currency notes with bacterial isolation were four. Out of four currency notes, one had shown the presence of Gram-positive cocci and three had shown the presence of Gram-negative Bacilli. The number of contaminated currency notes with the bacterial isolation of denomination Rs. 50 was five. Out of five currency notes, two had shown the presence of Gram-positive cocci and three had shown the presence of Gram-negative Bacilli. The number of contaminated currency notes with the bacterial isolation of denomination Rs. 100 was five. Out of five currency notes, two had shown the presence of Gram-positive cocci and three had shown the presence of Gram-negative cocci. The number of contaminated currency notes with the bacterial isolation of denomination Rs. 500 was four. Of the four currency notes, one had shown the presence of Gram-positive cocci and three had shown the presence of Gram-negative Bacilli. The number of contaminated currency notes with the bacterial isolation of denomination Rs. 1000 was four. Of the four currency notes, two had shown the presence of Gram-positive cocci and two had shown the presence of Gram-negative Bacilli [Table 2].
Table 2: The Gram's character and the microscopic morphology of the contaminated currency notes with bacterial isolation


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Staphylococcus aureus was identified when Indole test was negative, and Mannitol test, and Catalase tests were positive. Streptococcus pyogenes was identified when Indole test and the Catalase tests were negative, and Mannitol test was positive. Escherichia coli was identified when Indole test, Mannitol test, Catalase tests were positive and Citrate test negative. Klebsiella pneumoniae was identified when Indole test was negative, and the Mannitol test, Urease test, and the Catalase tests were positive. Citrobacter was identified when Indole test and Urease tests were negative, and Mannitol test, Catalase test, and Citrate tests were positive. Enterobacter was identified when Indole test and Mannitol tests were negative, and Urease test, Citrate test, and the Catalase tests were positive. Proteus bacilli were identified when Indole test and Citrate test were negative and Urease and Catalase tests positive. Pseudomonas aeruginosa was identified when Indole test was negative and Catalase test positive [Table 3].
Table 3: The biochemical characterization of the contaminated currency notes with bacterial isolation


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Eight different species of micro-organisms were isolated. E. coli was present on nine currency notes (12.85%) and was found to be higher in denominations Rs. 10. Rs. 100 and Rs. 1000. S. aureus was present on 15 currency notes (21.42%) and was found to be higher in Rs. 10 than in other currency denominations. S. pyogenes was present on four currency notes (5.714%) of Rs. 10, P. aeruginosa was present on five currency notes (7.14%) and was found to be higher in Rs. 500, Enterobacter, Citrobacter and Proteus bacillus were present on one currency note of denominations Rs. 10, Rs. 100 and Rs. 50 (1.42%) and K. pneumoniae was present on two currency notes (2.85%) of Rs. 20 [Table 4].
Table 4: The number of currency denominations with bacterial isolation


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  Discussion Top


In India, the poor currency handling culture is widespread, and there is an indiscriminate abuse of currency notes. A great majority of the population does not carry money in wallets and squeezing of currency notes is a common occurrence. [5]

In this study, the Indian currency notes of various denominations were collected from the butchers, hawkers, fruit vendors, vegetable vendors, bus conductors, hotel counters, and from the railway ticket counters. The micro-organisms isolated were the S. aureus, S. pyogenes, E. coli, K. pneumoniae, Proteus bacillus, P. aeruginosa, Citrobacter and Enterobacter. The currency notes of lower denominations were (Rs. 10 and Rs. 20) the most contaminated than the currency notes of a higher denomination (Rs. 500 and Rs. 1000). The isolation of Gram-positive and Gram-negative bacteria from the currency notes confirmed that currency notes might play an important role as a vector in the transmission of pathogenic bacteria in the community.

In a similar study conducted by Basavarajappa et al. the predominant bacteria isolated were coagulase negative Staphylococci, K. pneumoniae, E. coli, S. aureus, Pseudomonas species and Bacillus species. [1]

In most of the studies micro-organisms isolated were E. coli, K. pneumoniae, P. aeruginosa and S. aureus. [2],[3],[4],[6],[7],[8] These micro-organisms were also isolated in this study. Hence, the results of this study are in accordance with various studies conducted.

Lamichhane et al. in their study isolated bacteria from Nepal currency notes. [5] Results of this study revealed that the currency notes were contaminated with coagulase negative S. aureus, alpha-hemolytic Streptococcus, Enterobacter species and Bacillus species and most prevalent contamination was found in Rs. 10 and least prevalent among Rs. 500 and Rs. 1000. The results of present study also reveals the presence of similar micro-organisms and the currency notes of lower denominations (Rs. 10 and Rs. 20) were the most contaminated than the currency notes of higher denomination (Rs. 500 and Rs. 1000). [5]

S. aureus and S. pyogenes are the predominant micro-organisms which are responsible for the oral health risks and were retrieved from the Indian currency notes of various denominations in this study. S. aureus and S. pyogenes were isolated in various previous studies conducted. [8],[5],[9],[10]

S. pyogenes is the most common bacterial cause of acute pharyngitis, accounting for approximately 15-30% of cases in children and 5-10% of cases in adults. Further complications caused by S. pyogenes includes peritonsillar or retropharyngeal abscess, mastoiditis, sinusitis, and otitis media.[11] Less complicated manifestation caused by S. pyogenes is mild cellulitis. [12]

Some infections caused at least in part by S. aureus include angular cheilitis, some endodontic infections, osteomylelitis of the jaw, parotitis and the most recently recognized, a form of oral mucositis in elderly, highly dependent patients with parenteral nutrition. [13],[14]

The limitation of this study is that the coins were not included, and their microbial contamination was not determined.

Recommendations

  • Currency notes must be handled with caution
  • Personal hygiene to reduce the risk of infection is recommended especially for those who handle food and money simultaneously
  • There should be public awareness of the fact that the currency notes could be a source of infection and for this an efficient health awareness campaign program should be fully implemented
  • Studies have to be conducted using coins to assess their microbial contamination since they are also exchanged frequently.



  Conclusion Top


From this study, it can be concluded that the Indian currency notes circulating in Bengaluru city are contaminated with pathogenic bacteria like S. aureus, S. pyogenes, E. coli, K. pneumoniae, Citrobacter, Enterobacter, Proteus bacillus and P. aeruginosa. And this contamination of the Indian currency notes may play a significant role in the transmission of infectious diseases among the public.

Acknowledgment

The authors would like to acknowledge the Head of the Department, Department of Microbiology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru for giving the permission to carry out this study. Further, the authors are thankful to all staff members and technicians for their timely support.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Basavarajappa KG, Rao PN, Suresh K. Study of bacterial, fungal, and parasitic contaminaiton of currency notes in circulation. Indian J Pathol Microbiol 2005;48:278-9.  Back to cited text no. 1
    
2.
Pradeep NV, Anupama, Muralasiddaiah BS, Chetana M, Gayatri P, Madhuri SN, et al. Microbial contamination of Indian currency notes in circulation. J Res Biol 2012;2:377-82.  Back to cited text no. 2
    
3.
Sawalha H, Mowais MA. Bacterial contamination of paper bank notes in circulation: A case study in Jenin district, Palestine. J Sci 2012;1:36-9.  Back to cited text no. 3
    
4.
Bhat N, Bhat S, Asawa K, Agarwal A. An assessment of oral health risk associated with handling of currency notes. Int J Dent Clin 2010;2:266-71.  Back to cited text no. 4
    
5.
Lamichhane J, Adhikary S, Gautam P, Maharjan R, Dhakal B. et al. Risk of handling paper currency in circulation chances of potential bacterial transmittance. Nepal J S Technol 2009;10:161-6.  Back to cited text no. 5
    
6.
Ahmed, Parveen S, Nasreen T, Feroza B. Evaluation of the microbial contamination of Bangladesh paper currency notes (Taka) in circulation. Adv Biol Res 2010;4:266-7.  Back to cited text no. 6
    
7.
Neel R. Bacteriological examination of paper currency notes in Tanga in Tangania. Int J Pharm Sci Rev Res 2012;16:9-12.  Back to cited text no. 7
    
8.
Igumbor EO, Obi CL, Bessong PO, Potgieter N, Mkasi TC. Microbiological analysis of banknotes circulating in the Venda region of Limpopo province, South Africa. S Afr J Sci 2007;103:365-6.  Back to cited text no. 8
    
9.
Neel R. Isolation of pathogenic micro-organisms from contaminated paper currency notes in circulation from different market places in Korogwe and Mombo towns in Tanzania. J Microbiol Biotechnol Res 2012;2:470-4.  Back to cited text no. 9
    
10.
Borah D, Parida P, Kumar T. Paper currencies, a potential carrier of pathogenic micro-organisms. Int J Appl Biol Pharm Technol 2012;3:23-5.  Back to cited text no. 10
    
11.
Bisno AL. Acute pharyngitis. N Engl J Med 2001;344:205-11.  Back to cited text no. 11
    
12.
Johansson L, Thulin P, Low DE, Norrby-Teglund A. Getting under the skin: The immunopathogenesis of Streptococcus pyogenes deep tissue infections. Clin Infect Dis 2010;51:58-65.  Back to cited text no. 12
    
13.
Smith AJ, Jackson MS, Bagg J. The ecology of Staphylococcus species in the oral cavity. J Med Microbiol 2001;50:940-6.  Back to cited text no. 13
    
14.
Smith AJ, Robertson D, Tang MK, Jackson MS, MacKenzie D, Bagg J. Staphylococcus aureus in the oral cavity: A three-year retrospective analysis of clinical laboratory data. Br Dent J 2003;195:701-3.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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