Monk, the phobia-challenged, television detective, may have it right. One should approach the world with caution and antiseptic wipes — especially if you work in an office.

"Office spaces are very dirty," said Michelle McCarthy, occupational health nurse in the Atlanta regional office of ADP, a worldwide human-resources and payroll-services company. "People cough and sneeze over everything, and they eat at their desks, and that gives bacteria something extra to feed on. Unless work surfaces are cleaned regularly, they become very dirty places."

SCOTT THIGPEN/Special (ENLARGE)

Photos by BARRY WILLIAMS/Special (ENLARGE)

Michelle McCarthy, occupational health nurse at ADP, examines security supervisor Art Kantanen. 'Prevention is key,' she said. 'Keeping workers healthy is worth its weight in gold. Not every company has an occupational health nurse or medical department, but everyone can use the Centers for Disease Control and Prevention materials to teach hand hygiene and proper cold and flu etiquette.'

(ENLARGE)

ADP employee Angie Pharr cleanses her hands at one of the company's sanitizing dispensers.

What you can't see can hurt you, it turns out. In 2001, Charles Gerba of the University of Arizona conducted a series of "Germs in the Workplace" studies to test work surfaces in a variety of offices. He found that, on average, desks may harbor 400 times more microbes than the average toilet seat. Phones averaged 25,127 microbes per square inch; keyboards, 3,295; and computer mice, 1,676. By comparison, the average toilet seat had 49 microbes per square inch.

While cleaning crews scrub bathrooms regularly, most office workers don't clean the items they touch most often.

The study found the top five germ-laden spots to be phones, desktops, water fountain handles, microwave door handles and keyboards.

"Desks are really bacteria cafeterias," Gerba wrote. "They're breakfast buffets, lunch tables and snack bars, as we spend more and more hours at the office. Germ levels on desks could be considered a business liability."

That liability increases during cold and flu season, because contagious workers touch, cough or sneeze on workplace surfaces — and some germs can live there for up to 72 hours. Think about the handle of the coffeepot in the break room, a call-center workstation, the businessperson with whom you shook hands or the doorknob to any office.

"If you have to travel for business, airports are the worst. Viruses from all over the world live there," said Dr. James Steinberg, professor of infectious diseases at Emory University School of Medicine and hospital epidemiologist at Emory Crawford Long Hospital, part of Emory Healthcare.

"Employee absenteeism and loss of productivity are big issues for business — and one more reason why education about infectious diseases and how to avoid spreading or getting them is so important," he said.

According to the National Center for Health Statistics, absences caused by colds represent 22 million days lost from work and more than 7.9 million doctor visits a year in the United States.

"People spend a lot of time at work, often in close quarters, and because they can be contagious two to three days before showing symptoms, the bugs spread quickly," McCarthy said. "If we have a worse-than-average cold and flu season, it will have a major impact on business, so we do everything we can to treat and educate our workers."

An ounce of prevention

ADP's medical department provides on-site health care, wellness programs and disease prevention to about 3,500 employees in metro Atlanta. The physician, nurse practitioner and nurses see employees with colds, flu, ear infections, bronchitis and other common illnesses as well as more serious conditions such as blood clots, high blood pressure and extreme allergic reactions to medications.

The health professionals offer prescriptions, remedies and advice for handling symptoms to sick patients and prevention education to everyone.

"Prevention is key," McCarthy said. "Keeping workers healthy is worth its weight in gold. Not every company has an occupational health nurse or medical department, but everyone can use the Centers for Disease Control and Prevention materials to teach hand hygiene and proper cold and flu etiquette."

Your mother was right, McCarthy noted: One of the best ways to stop the spread of germs is by cleaning your hands often. The CDC hand-hygiene guidelines recommend washing hands before preparing or eating food; after going to the bathroom; after blowing your nose, coughing or sneezing; and after changing diapers or handling garbage.

People should scrub with soap for 20 seconds (the time it takes to sing "Happy Birthday" twice). As an added precaution, use the paper towel to turn off the water and open the door when leaving the bathroom.

"Since soap and water aren't readily available everywhere in the workplace, we have placed about 55 alcohol-based hand-sanitizer dispensers throughout the building — at the entrance, at elevators, in stairwells, in break stations and other places," McCarthy said.

Alcohol-based hand rubs significantly reduce the number of microorganisms on the skin and are fast-acting. People who use the sanitizers frequently should apply a lotion afterward to prevent dryness and cracking, health care workers advise.

"We also encourage our workers to clean their work areas with antibacterial wipes at least once a week," McCarthy said.

The University of Arizona study found that disinfecting wipes can reduce the number of germs and bacteria on office surfaces by up to 99.9 percent. That reduces the risk of colds, flu and more serious infectious diseases.

"Viruses are transmitted hand-to-hand or through the respiratory droplets of sneezes and coughs. More people using the CDC's safe-cough and -sneeze techniques would make a difference in workplace illness," Steinberg said.

Most people sneeze or cough into their hands to stop germs from getting into the air, but then their hands spread the germs to everything they touch. The CDC has printed posters and provided public service announcements to try to change the way people sneeze and cough. The preferred method is to use a tissue that can be discarded or to sneeze or cough into your sleeve.

Flu fighters

Every year, ADP educates employees on the signs and symptoms of flu and how to take care of themselves if they catch it.

"When people are contagious, we suggest they stay home or limit contact, such as rescheduling a meeting or having a phone conference instead," McCarthy said.

ADP offers free flu shots in the late fall. "We gave about 800 this year and would like to give more," she said.

Emory Healthcare created a high-visibility campaign for employee flu shots last year, wanting to reduce the risks among patients and staff.

"In general, people don't get flu shots for a variety of reasons," Steinberg said. "They don't like needles, they're skeptical about the effectiveness of the vaccine and there's a common myth that people can get the flu from the shot. That's not true. There's no live virus in the vaccine."

It takes about two weeks for the antibodies to develop in the body, so if someone is exposed soon after getting the shot, he or she can get the flu, but it can lessen the severity. It's also possible to catch a different strain of the flu. Even people who don't normally get the flu potentially could give the virus to someone else.

Many people don't think of the flu as serious, but it is a serious disease of the nose, throat and lungs and can lead to pneumonia and other complications, according to the CDC. People who have chronic health conditions or who have compromised immune systems from illness or chemotherapy treatments are at greater risk. About 36,000 people (particularly the elderly) die each year from the flu.

"By making the vaccine easily accessible and with encouragement from the top levels of leadership, we were able to increase the number of immunized employees from 43 [percent] to 67 percent and won an award from the American Nurses Association," Steinberg said. "The national average is about 40 percent. We're proud but not satisfied and want to see even higher numbers."

Data show that, in a healthy population, the flu vaccine reduces employee absences and the loss of productivity from sick people not performing at their usual levels.

"The savings far outweigh the cost of the shot," Steinberg said.

For more information about the flu and free materials for businesses, see www.cdc.gov/flu.

With the costs of health care rising, more companies are turning to prevention and wellness programs led by company safety officers or occupational health nurses.

"It's so important to keep workers healthy," McCarthy said. "Even simple things can make a big difference."