Jewellery and Artificial Fingernails: Infection Risk or Urban Legend?

Jewellery and artificial nail use by healthcare workers has been linked to the development of healthcare-acquired infections, although evidence remains weak. As a result, restrictions on their use are not uniform and are often presented as suggestions rather than strict rules. Currently, there is no scientific evidence that has clearly demonstrated a patient infection caused by a microorganism acquired from a healthcare worker associated with jewellery or artificial nails.

The Institute for Healthcare Improvement’s 5 Million Lives campaign in the United States targeted the potential spread of pathogens from healthcare workers (HCWs) to patients. Jewellery, including rings, watches, and piercings, as well as artificial and polished nails, have been postulated to contribute to the spread of infection.

According to the current policies on jewellery and artificial nails the WHO restricts very strictly the wearing of any jewellery and artificial nails except for wedding rings that may be acceptable. They acknowledge that the role of jewellery in pathogen transmission has not been proven and note that further studies are needed. In regard to artificial nails and fingernail length, their recommendations are more direct, prohibiting all artificial nails or extenders in direct patient care and recommending that nails be kept short (~0.5 cm long).