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Journal of Biology, Agriculture and Healthcare
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.3, No.18, 2013

www.iiste.org

Bacterial Contamination of Computer Keyboards and Mice in a
University Setting
Wala’a Shawkat Ali* Khitam Ali Obaid Alkhezali Buthainah Mohammed Taha
Department of Biology , College of Science , Al-Mustansiriya University, P.O.box 14022 , Baghdad, Iraq.
*E. mail of the corresponding author: microrose.2788@yahoo.com
Abstract
In order to investigate the status of bacterial contamination of computer components , 50 samples (25 from
keyboards and 25 from mice ) were collected from the main internet center located in Al-Mustansiriya
University, Baghdad ,Iraq. Depending on the cultural, microscopic and biochemical examinations , A total of 59
isolates comprising 9 bacterial species were recovered from these samples ,the frequencies of occurrence of the
species were; Bacillus spp. (25.42%), Staphylococcus aureus(18.64%), Staphylococcus epidermidis(10.17%),
Pseudomonas aeruginosa (16.95%), Shigella spp. (15.25%), Klebsilla spp. (5.1% ), Salmonella spp. (3.39% ),
Proteus spp. (3.39% ), and Citrobacter spp. (1.7%). These results indicate that the computer keyboards and mice
might act as environmental vehicles for the transmission of potentially pathogenic bacteria in the university
settings and also indicate the need for increasing awareness among computer users on cleaning of such surfaces
or disinfection and adequate hand-washing hygiene.
Keywords: Bacterial contamination , computer keyboards, computer mice, university setting ,Iraq.
1. Introduction
People believe that microbes are only present in research labs or in hospitals and clinics and thus they have a
misleading feeling of security in other places. Lack of knowledge about where germs prowl could be the cause of
health problems. In fact 80% of infections are spread through hand contact with hands or other objects (AlGhamdi et al. 2011).
The presence of viable pathogenic bacteria on inanimate objects has been reported by earlier investigators.
Several studies of the human environment have demonstrated colonization and contamination of objects such as
door handles, faucets, phones, money, fabrics and plastics (Oluduro et al. 2011). Computers continue to have an
increased presence in almost every aspect of our occupational, recreational, and residential environments. In the
university environment, students have indicated that 100% have access to computers, 92.1% regularly use the
Internet, and 73.3% regularly use e-mail. To accommodate the extensive use of computer technology,
universities have developed multiple-user ‘‘computer laboratories'' on campus for general student access
(Anderson & Palombo 2009).
The increased availability of multiple-user computers in the organization setting means that these items or
equipment are handled by numerous users on a daily basis. Given that computers are not routinely disinfected,
the opportunity for the transmission of contaminating microorganisms is potentially great. Our understanding of
the ubiquity of microorganism in the environment is developing, but the risk or hazard of contamination posed
by the computer keyboards and mouse is not yet fully understood. No clear legislation or even widely recognized
guidelines have been formulated on the hazard caused by computer components (Kumar & Srivastava
2012).This is not in the best interest of campus students especially that computer keyboards and mice could
spread significant number of pathogens(Enemuor et al. 2012).
To our knowledge ,there are no work has been reported on bacterial contamination on computer equipment
(keyboard and mouse) used in university settings in Iraq, So the present study aimed to investigate the presence
of bacteria on computer keyboards and computer mice that are frequently used by students in the main internet
center of Al-Mustansiriya University, Baghdad.
2.Materials and Methods
A total of 50 samples were collected from keyboards (25 samples)and mice (25 samples)of multiple-user
computers used in the main internet center of Al-Mustansiriya University, Baghdad , Iraq.
A sterile normal saline moistened swabs were wiped firmly over the entire surface of the specific object. Each
swab was placed in 1 ml of brain heart infusion broth(Hi-Media / India) and incubated overnight at 37°C,
vortexed for one minute and serial ten-fold dilutions was made, 100 µl from the last dilution(10-6) was plated on
nutrient agar and incubated overnight at 37°C.Each colony was plated on blood agar, MacConkey agar ,eosin
methylene blue agar and mannitol salt agar(Hi-Media / India) then incubated aerobically at 37°C for 24 h. The
pure colonies of isolates were identified and characterized using standard microbiological techniques (Forbes et
al. 2007).

11
Journal of Biology, Agriculture and Healthcare
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
093X
Vol.3, No.18, 2013

www.iiste.org

3.Results and discussion
Numerous studies have indicated that computer keyboards and mice can become contaminated wit pathogenic
with
bacteria. In health care settings, it is perhaps not unexpected that such microorganisms would contaminate these
common work surfaces(Anderson & Palombo 2009). The present study showed that the bacterial contamination
also occurs on computer equipment located in a large university environment.
quipment
Depending on microscopic, cultural examinations and biochemical tests, 32 isolates of Gram positive bacteria
isolates
were identified ; 15 of Bacillus spp., 11of Staphylococcus aureus and 6 of Staphylococcus epidermidis and 27
isolates of Gram negative bacteria were identified ; 10 of Pseudomonas aeruginosa , 9 of Shigella spp., 3 of
Klebsilla spp., 2 isolates for both Salmonella spp.and Proteus spp. and one isolate for Citrobacter spp. (table 1).
Table 1. Numbers of bacterial isolates from computer keyboards and mice

Bacterial isolates
Bacillus spp.
Staphylococcus aureus
Staphylococcus epidermidis
Pseudomonas aeruginosa
Shigella spp.
Klebsilla spp.
Salmonella spp.
Proteus spp.
Citrobacter spp.
Total No. of bacterial isolates

No. of bacterial
isolates from
keyboards
9
3
6
8
2
3
1
1
33

No. of bacterial
isolates from mice

Total No. of
bacterial isolates

6
8
2
7
2
1
26

15
11
6
10
9
3
2
2
1
59

The isolation percentage of Gram positive bacteria was 5
54.24% while the isolation percentage of Gram negative
bacteria was 45.76% (figure 1). However, both Gram +ve and Gram -ve bacteria have been shown to have
ve
similar transfer rates from laminate surfaces to fingertips (Scott & Bloomfield 2008).
Gram postive bacteria
54.24%
%

Gram negative bacteria
45.76%

Figure 1. Isolation percentages of Gram positive and Gram negative bacteria from computer keyboards and mice.
As shown in figure 2, frequencies of occurrence of the species were; Bacillus spp. (25.42%), S. aureus(18.64%),
S. epidermidis(10.17%), P. aeruginosa (16.95%), Shigella spp. (15.25%), Klebsilla spp. (5.1% ), Salmonella spp.
(3.39% ), Proteus spp. (3.39% ), and Citrobacter spp. (1.7%).

12
Journal of Biology, Agriculture and Healthcare
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
093X
Vol.3, No.18, 2013

www.iiste.org

30

Isolation percentage (%)

25.42
25
20

18.64
64

16.95

15.25

15
10.17
10
5.1
5

3.39

3.39
3

1.7

0

Figure 2. Percentages of bacterial isolates from computer keyboards and mice
mice.
Overall Bacillus spp. was the predominant i
isolate followed by S.aureus .The isolation of Bacillus spp. confirms
the ubiquitous nature of this bacteria giving it greater colonization ability as well as the ability of its spores to
resist environmental changes, withstand dry heat and certain chemical disinfectants for moderates periods
(Tagoe & Kumi-Ansah 2011). S. aureus is a major component of the normal flora of the skin and nostrils, which
probably explains its high prevalence as a contaminant, as it can easily be discharged by several human activ
activities,
including sneezing, talking and contact with moist skin. It has also been associated with numerous infectious
disease conditions and nosocomial infections. It follows that since users constantly touch interfaces and often
sneeze, there is every chance of introducing S. aureus on to the interface in use. Also, airborne organisms can be
ce
transported from users or passers-by(Oluduro et al. 2011). On the other hand, S.epidemidis which was only
by(Oluduro
isolated from keyboards samples is a normal habitat of the skin but can occasionally assume an opportunistic
skin
pathogenic role in causing human infection such as endocarditis (Anastasiades et al. 2009)
. 2009).
Of particular interest was the isolation of P. aeruginosa and bacteria belonging to of the Enterobactericeae
family, including Shigella spp., Klebsilla spp., Salmonella spp., Proteus spp. and Citrobacter spp. .Most enteric
bacteria, such as E. coli, Klebsiella, Citrobacter and Proteus, are ubiquitous and that these organisms can be
shed from the body, clothing, beddings, nostrils and carried in the dust particles to other surfaces(
beddings,
surfaces(Itah & Ben
2004), hence their presence on the computer keyboards and mice. However, In places where there are a lot of
),
people moving in and out, such as offices and internet cafés, there is likely to be a good number of people sick,
likely
and through them comes new bacteria that will eventually settle on the keyboard through air or from physical
contact (Tagoe & Kumi-Ansah 2011).
Ansah
In conclusion, the isolation of the bacteria from computer keyboards and mouse is a clear indication that the
sterilization/aseptic procedures/methods adopted by the operators if at all, is not effective in significantly
reducing the level of the organism on these surfaces to an acceptable level (Kumar & Srivastava 2012).As well
as, the level of knowledge among the computer users in computer centers about the possibility of
microorganisms on the keyboard and mouse is very poor. Microbes are everywhere, including the air around us,
it is therefore greatly recommended that hand washing hygiene should be adopted before and after using the
hand-washing
computers to reduce the microbial transmission. Computer keyboards and mice should also be cleaned with
alcohol or other disinfectants on a regular basis (Enemuor et al. 2012).
Acknowledgment
We would like to thank the staff members of the main internet center in Al Mustansiriya University to allow
Al-Mustansiriya
sampling of the computers.
References
Ashshi,
Jiman-Fatani, A. A. (2011),
Al-Ghamdi, A. K., Abdelmalek, S. M. A., Ashshi A. M., Faidah, H., Shukri, H. & Jiman
“Bacterial contamination of computer keyboards and mice, elevator buttons and shopping carts Afr. J.
carts”,

13
Journal of Biology, Agriculture and Healthcare
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.3, No.18, 2013

www.iiste.org

Microbiol. Res. 5(23), 3998-4003.
Anastasiades, P., Pratt, T.L., Rousseau, L.H., Steinberg, W.H. & Joubert, G.( 2009), “ Staphylococcus aureus
on computer mice and keyboards in intensive care units of the universitas academic hospital, Bloemfontein and
ICU staff’s knowledge of its hazards and cleaning practices”, South Afr. J. Epidemiol. Infect. 24 (20), 22-26.
Anderson, G. & Palombo, E.A.(2009), “Microbial contamination of computer keyboards in a university setting”.
Am. J. Infect. Control 37, 507-509.
Enemuor, S.C. , Apeh, T.A. & Oguntibeju, O.O.(2012), “ Microorganisms associated with computer keyboards
and mice in a university environment”, Afr. J. Microbiol. Res. 6(20), 4424-4426.
Forbes, B.A. , Sahm, D.F. & Weissfeld, A.S.(2007), “ Bailey and Scott’s Diagnostic Microbiology.12th ed. ”,
Mosby Elsevier, China.
Itah, A.Y. & Ben, A.E.(2004), “ Incidence of enteric bacteria and Staphylococcus aureus in day care centers in
Akwa-Ibom State, Nigeria”, Southeast Asian J. Trop. Med. Public Health. 35(1),202-209.
Kumar, A. & Srivastava, M.(2012), “Computer components in college and its surroundings encompass the
pathogenic bacteria”, J. Appl. Sci. Environ. Sanitation 7 (1), 43-47.
Oluduro, A. O., Ubani, E. K. & Ofoezie, I. E.(2011), “ Bacterial assessment of electronic hardware user
interfaces in Ile-Ife, Nigeria”, J. Basic Appl. Pharmaceutical Sci. 32(3),323-334.
Scott, E. & Bloomfield, S.F. (2008), “The survival and transfer of microbial contamination via cloths, hands and
utensils”, J. Appl. Microbiol. 68,271-278.
Tagoe, D.N.A. & Kumi-Ansah, F.(2011), “Computer keyboard and mice : Potential sources of disease
transmission and infections”, Internet J. Public Health.1(2).

14
This academic article was published by The International Institute for Science,
Technology and Education (IISTE). The IISTE is a pioneer in the Open Access
Publishing service based in the U.S. and Europe. The aim of the institute is
Accelerating Global Knowledge Sharing.
More information about the publisher can be found in the IISTE’s homepage:
http://www.iiste.org
CALL FOR JOURNAL PAPERS
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collaborating with academic institutions around the world. There’s no deadline for
submission. Prospective authors of IISTE journals can find the submission
instruction on the following page: http://www.iiste.org/journals/
The IISTE
editorial team promises to the review and publish all the qualified submissions in a
fast manner. All the journals articles are available online to the readers all over the
world without financial, legal, or technical barriers other than those inseparable from
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Bacterial Contamination of Computer Keyboards and Mice

  • 1. Journal of Biology, Agriculture and Healthcare ISSN 2224-3208 (Paper) ISSN 2225-093X (Online) Vol.3, No.18, 2013 www.iiste.org Bacterial Contamination of Computer Keyboards and Mice in a University Setting Wala’a Shawkat Ali* Khitam Ali Obaid Alkhezali Buthainah Mohammed Taha Department of Biology , College of Science , Al-Mustansiriya University, P.O.box 14022 , Baghdad, Iraq. *E. mail of the corresponding author: microrose.2788@yahoo.com Abstract In order to investigate the status of bacterial contamination of computer components , 50 samples (25 from keyboards and 25 from mice ) were collected from the main internet center located in Al-Mustansiriya University, Baghdad ,Iraq. Depending on the cultural, microscopic and biochemical examinations , A total of 59 isolates comprising 9 bacterial species were recovered from these samples ,the frequencies of occurrence of the species were; Bacillus spp. (25.42%), Staphylococcus aureus(18.64%), Staphylococcus epidermidis(10.17%), Pseudomonas aeruginosa (16.95%), Shigella spp. (15.25%), Klebsilla spp. (5.1% ), Salmonella spp. (3.39% ), Proteus spp. (3.39% ), and Citrobacter spp. (1.7%). These results indicate that the computer keyboards and mice might act as environmental vehicles for the transmission of potentially pathogenic bacteria in the university settings and also indicate the need for increasing awareness among computer users on cleaning of such surfaces or disinfection and adequate hand-washing hygiene. Keywords: Bacterial contamination , computer keyboards, computer mice, university setting ,Iraq. 1. Introduction People believe that microbes are only present in research labs or in hospitals and clinics and thus they have a misleading feeling of security in other places. Lack of knowledge about where germs prowl could be the cause of health problems. In fact 80% of infections are spread through hand contact with hands or other objects (AlGhamdi et al. 2011). The presence of viable pathogenic bacteria on inanimate objects has been reported by earlier investigators. Several studies of the human environment have demonstrated colonization and contamination of objects such as door handles, faucets, phones, money, fabrics and plastics (Oluduro et al. 2011). Computers continue to have an increased presence in almost every aspect of our occupational, recreational, and residential environments. In the university environment, students have indicated that 100% have access to computers, 92.1% regularly use the Internet, and 73.3% regularly use e-mail. To accommodate the extensive use of computer technology, universities have developed multiple-user ‘‘computer laboratories'' on campus for general student access (Anderson & Palombo 2009). The increased availability of multiple-user computers in the organization setting means that these items or equipment are handled by numerous users on a daily basis. Given that computers are not routinely disinfected, the opportunity for the transmission of contaminating microorganisms is potentially great. Our understanding of the ubiquity of microorganism in the environment is developing, but the risk or hazard of contamination posed by the computer keyboards and mouse is not yet fully understood. No clear legislation or even widely recognized guidelines have been formulated on the hazard caused by computer components (Kumar & Srivastava 2012).This is not in the best interest of campus students especially that computer keyboards and mice could spread significant number of pathogens(Enemuor et al. 2012). To our knowledge ,there are no work has been reported on bacterial contamination on computer equipment (keyboard and mouse) used in university settings in Iraq, So the present study aimed to investigate the presence of bacteria on computer keyboards and computer mice that are frequently used by students in the main internet center of Al-Mustansiriya University, Baghdad. 2.Materials and Methods A total of 50 samples were collected from keyboards (25 samples)and mice (25 samples)of multiple-user computers used in the main internet center of Al-Mustansiriya University, Baghdad , Iraq. A sterile normal saline moistened swabs were wiped firmly over the entire surface of the specific object. Each swab was placed in 1 ml of brain heart infusion broth(Hi-Media / India) and incubated overnight at 37°C, vortexed for one minute and serial ten-fold dilutions was made, 100 µl from the last dilution(10-6) was plated on nutrient agar and incubated overnight at 37°C.Each colony was plated on blood agar, MacConkey agar ,eosin methylene blue agar and mannitol salt agar(Hi-Media / India) then incubated aerobically at 37°C for 24 h. The pure colonies of isolates were identified and characterized using standard microbiological techniques (Forbes et al. 2007). 11
  • 2. Journal of Biology, Agriculture and Healthcare ISSN 2224-3208 (Paper) ISSN 2225-093X (Online) 093X Vol.3, No.18, 2013 www.iiste.org 3.Results and discussion Numerous studies have indicated that computer keyboards and mice can become contaminated wit pathogenic with bacteria. In health care settings, it is perhaps not unexpected that such microorganisms would contaminate these common work surfaces(Anderson & Palombo 2009). The present study showed that the bacterial contamination also occurs on computer equipment located in a large university environment. quipment Depending on microscopic, cultural examinations and biochemical tests, 32 isolates of Gram positive bacteria isolates were identified ; 15 of Bacillus spp., 11of Staphylococcus aureus and 6 of Staphylococcus epidermidis and 27 isolates of Gram negative bacteria were identified ; 10 of Pseudomonas aeruginosa , 9 of Shigella spp., 3 of Klebsilla spp., 2 isolates for both Salmonella spp.and Proteus spp. and one isolate for Citrobacter spp. (table 1). Table 1. Numbers of bacterial isolates from computer keyboards and mice Bacterial isolates Bacillus spp. Staphylococcus aureus Staphylococcus epidermidis Pseudomonas aeruginosa Shigella spp. Klebsilla spp. Salmonella spp. Proteus spp. Citrobacter spp. Total No. of bacterial isolates No. of bacterial isolates from keyboards 9 3 6 8 2 3 1 1 33 No. of bacterial isolates from mice Total No. of bacterial isolates 6 8 2 7 2 1 26 15 11 6 10 9 3 2 2 1 59 The isolation percentage of Gram positive bacteria was 5 54.24% while the isolation percentage of Gram negative bacteria was 45.76% (figure 1). However, both Gram +ve and Gram -ve bacteria have been shown to have ve similar transfer rates from laminate surfaces to fingertips (Scott & Bloomfield 2008). Gram postive bacteria 54.24% % Gram negative bacteria 45.76% Figure 1. Isolation percentages of Gram positive and Gram negative bacteria from computer keyboards and mice. As shown in figure 2, frequencies of occurrence of the species were; Bacillus spp. (25.42%), S. aureus(18.64%), S. epidermidis(10.17%), P. aeruginosa (16.95%), Shigella spp. (15.25%), Klebsilla spp. (5.1% ), Salmonella spp. (3.39% ), Proteus spp. (3.39% ), and Citrobacter spp. (1.7%). 12
  • 3. Journal of Biology, Agriculture and Healthcare ISSN 2224-3208 (Paper) ISSN 2225-093X (Online) 093X Vol.3, No.18, 2013 www.iiste.org 30 Isolation percentage (%) 25.42 25 20 18.64 64 16.95 15.25 15 10.17 10 5.1 5 3.39 3.39 3 1.7 0 Figure 2. Percentages of bacterial isolates from computer keyboards and mice mice. Overall Bacillus spp. was the predominant i isolate followed by S.aureus .The isolation of Bacillus spp. confirms the ubiquitous nature of this bacteria giving it greater colonization ability as well as the ability of its spores to resist environmental changes, withstand dry heat and certain chemical disinfectants for moderates periods (Tagoe & Kumi-Ansah 2011). S. aureus is a major component of the normal flora of the skin and nostrils, which probably explains its high prevalence as a contaminant, as it can easily be discharged by several human activ activities, including sneezing, talking and contact with moist skin. It has also been associated with numerous infectious disease conditions and nosocomial infections. It follows that since users constantly touch interfaces and often sneeze, there is every chance of introducing S. aureus on to the interface in use. Also, airborne organisms can be ce transported from users or passers-by(Oluduro et al. 2011). On the other hand, S.epidemidis which was only by(Oluduro isolated from keyboards samples is a normal habitat of the skin but can occasionally assume an opportunistic skin pathogenic role in causing human infection such as endocarditis (Anastasiades et al. 2009) . 2009). Of particular interest was the isolation of P. aeruginosa and bacteria belonging to of the Enterobactericeae family, including Shigella spp., Klebsilla spp., Salmonella spp., Proteus spp. and Citrobacter spp. .Most enteric bacteria, such as E. coli, Klebsiella, Citrobacter and Proteus, are ubiquitous and that these organisms can be shed from the body, clothing, beddings, nostrils and carried in the dust particles to other surfaces( beddings, surfaces(Itah & Ben 2004), hence their presence on the computer keyboards and mice. However, In places where there are a lot of ), people moving in and out, such as offices and internet cafés, there is likely to be a good number of people sick, likely and through them comes new bacteria that will eventually settle on the keyboard through air or from physical contact (Tagoe & Kumi-Ansah 2011). Ansah In conclusion, the isolation of the bacteria from computer keyboards and mouse is a clear indication that the sterilization/aseptic procedures/methods adopted by the operators if at all, is not effective in significantly reducing the level of the organism on these surfaces to an acceptable level (Kumar & Srivastava 2012).As well as, the level of knowledge among the computer users in computer centers about the possibility of microorganisms on the keyboard and mouse is very poor. Microbes are everywhere, including the air around us, it is therefore greatly recommended that hand washing hygiene should be adopted before and after using the hand-washing computers to reduce the microbial transmission. Computer keyboards and mice should also be cleaned with alcohol or other disinfectants on a regular basis (Enemuor et al. 2012). Acknowledgment We would like to thank the staff members of the main internet center in Al Mustansiriya University to allow Al-Mustansiriya sampling of the computers. References Ashshi, Jiman-Fatani, A. A. (2011), Al-Ghamdi, A. K., Abdelmalek, S. M. A., Ashshi A. M., Faidah, H., Shukri, H. & Jiman “Bacterial contamination of computer keyboards and mice, elevator buttons and shopping carts Afr. J. carts”, 13
  • 4. Journal of Biology, Agriculture and Healthcare ISSN 2224-3208 (Paper) ISSN 2225-093X (Online) Vol.3, No.18, 2013 www.iiste.org Microbiol. Res. 5(23), 3998-4003. Anastasiades, P., Pratt, T.L., Rousseau, L.H., Steinberg, W.H. & Joubert, G.( 2009), “ Staphylococcus aureus on computer mice and keyboards in intensive care units of the universitas academic hospital, Bloemfontein and ICU staff’s knowledge of its hazards and cleaning practices”, South Afr. J. Epidemiol. Infect. 24 (20), 22-26. Anderson, G. & Palombo, E.A.(2009), “Microbial contamination of computer keyboards in a university setting”. Am. J. Infect. Control 37, 507-509. Enemuor, S.C. , Apeh, T.A. & Oguntibeju, O.O.(2012), “ Microorganisms associated with computer keyboards and mice in a university environment”, Afr. J. Microbiol. Res. 6(20), 4424-4426. Forbes, B.A. , Sahm, D.F. & Weissfeld, A.S.(2007), “ Bailey and Scott’s Diagnostic Microbiology.12th ed. ”, Mosby Elsevier, China. Itah, A.Y. & Ben, A.E.(2004), “ Incidence of enteric bacteria and Staphylococcus aureus in day care centers in Akwa-Ibom State, Nigeria”, Southeast Asian J. Trop. Med. Public Health. 35(1),202-209. Kumar, A. & Srivastava, M.(2012), “Computer components in college and its surroundings encompass the pathogenic bacteria”, J. Appl. Sci. Environ. Sanitation 7 (1), 43-47. Oluduro, A. O., Ubani, E. K. & Ofoezie, I. E.(2011), “ Bacterial assessment of electronic hardware user interfaces in Ile-Ife, Nigeria”, J. Basic Appl. Pharmaceutical Sci. 32(3),323-334. Scott, E. & Bloomfield, S.F. (2008), “The survival and transfer of microbial contamination via cloths, hands and utensils”, J. Appl. Microbiol. 68,271-278. Tagoe, D.N.A. & Kumi-Ansah, F.(2011), “Computer keyboard and mice : Potential sources of disease transmission and infections”, Internet J. Public Health.1(2). 14
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