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Paper Towels or Hot Air Dryers - Which is Better & Why?

  
  
  
  
  

We all know 80% of common infectious diseases are spread by our hands and effective hand washing remains our best defense - but what about hand drying? Are all methods created equal?    


A recent hygienic efficacy study of different hand drying methodsled by researches at Queensland University in Brisbane, Australia put this question to the test.  Hand drying after all is an essential part of the hand washing process, as the spread of bacteria is more likely to occur with wet skin than from dry skin. 

 

Scientists reviewed twelve independent studies comparing paper towels, cloth towels, and hot air dryers.  Hand drying effectiveness included, "the speed of drying, degree of dryness, effective removal of bacteria, and prevention of cross-contamination."


 

Before you read the results of this latest study, please cast your vote on which drying method is more effective. Please also use the comments section below to share your feedback and insight about other studies and best practice recommendations. 

 

The study revealed, "from a hygiene viewpoint, paper towels are superior to electronic air dryers" and "drying hands thoroughly with single-use, disposable paper towels is the preferred method of hand drying."  It concluded by recommending, "The provision of paper towels should be considered as a means of improving hand hygiene adherence." 

 

When it came to drying efficiency for example, the results indicated that, "residual water was more efficiently removed from the hands by cloth or paper towels." In fact, with just 10 seconds of drying with a single serve towel, the residual water on the hands was reduced to just 4% and dropped to just 1% with 15 seconds of drying.  Air dryers were much slower and required 45 seconds to reduce the residual water to 3%.  The bottom line, paper towels can generally achieve 90% or more dryness with normal use.

 

Paper Towels and Hand WashingThe effectiveness in the removal of bacteria was measured by assessing the, "changes in the number of bacteria on the hands before and after the use of paper towels, hot air dryer, or jet air dryer.  Finger pads were sampled by contact plates, and the palms were sampled by swabbing and inoculation of agar plates." 

 

They found that paper towels, "reduced the numbers of all types of bacteria on the hands" and hot air dryers were the least effective method of removing bacteria from washed hands.  Many studies have found that friction is the key component in hand drying as it helps to remove contamination.  Micobiological testing of the paper towels after use, demonstrates that many bacteria are transferred from the hands to the paper towels."

 

Even more terrifying for all of us is the fact that every time a toilet is flushed, "a fine aerosol mist can be sprayed into the air.  This mist may contain may types of fecal bacteria that can cause diseases. Air movement can encourage the dispersal and transmission of bacteria and increase the chance of cross-contamination.  Used air dryers in washrooms are often contaminated and can emit bacteria in their air flow.  So there is a potential risk of persons standing in front of air dryers acquiring the bacteria being  dispersed into the air current towards them.  The bacteria can then be inhaled or can be deposited on the person's body or clothes, thus making him/her a potential mobile source of infection."  No such spread was seen with either paper or cloth towels.

 

Heavy Duty Hand Cleaner

 

The review suggests that ultimately paper towels are the best option for settings where infection prevention is critical.  However you may have no choice, which is often the case in public or workplace washrooms in which only hot air dryers are provided.  The study did reveal that users have a strong preference for using paper towels and that "hand hygiene adherence would possibly decrease if paper towels are not available in washrooms." 

 

Also, air dryers that are used in many washrooms allow for only one user at a time and each person could take up to one minute to dry their hands.  This is not convenient and often leads to avoidance or incomplete drying.  In several studies, on average people spent just 22.5 seconds drying hands, and 41% wiped their hands unhygienically on clothes.

 

In instances where paper towels are not available remember to always follow recommended hand washing technique, take extra time to dry your hands with an air dryers and consider carrying a personal size bottle of alcohol hand sanitizer as an added level of defense.  

 

 

 

Comments

Hands down, paper towels. They remove more bacteria and so not contaminate the environment. Hot air is just that, hot air. Proven time and time again that paper is the best solution.
Posted @ Wednesday, July 10, 2013 12:59 PM by Wayne
Well written article! I have spoken to a lot of people who put more emphasis on the "green" factor of hot air dryers, and after a little research, found that in addition to being more hygienic, paper towels are actually greener than hot air dryers, as well. See my article here: http://blog.rjschinner.com/2013/01/08/advising-your-customers-on-the-benefits-of-paper-towels-vs-hot-air-dryers/
Posted @ Wednesday, July 10, 2013 1:01 PM by Amy
It seems in making the decision of which to use, you are picking the lesser of two evils. Both have their benefits, but both have disadvantages as well. You have to look at your operation to see which disadvantage causes you more headaches.  
Paper towels offer the advantages of not needed electrical power where they are installed as well as employees have the opportunity to pull off the towels and dry their hands as they walk. Having that employee back to his work center a minute faster as we achieve faster run rates. However paper towel dispensers do run out so employees may go without drying their hands until the dispenser is refilled. Depending on the plant, this could lead to different hazards. The employee may have to operate electrical equipment with the undried hands creating a shock hazard. They may dry their hands on their uniform, which is not as clean as they think, and contaminate their hands. Then there is the ever present threat of foreign material contamination from the small pieces of paper that tear off at the dispenser.  
Hot air dryers eliminate the threat of foreign material contamination from the paper, but they might not be appropriate in all plants. Hot air dryers in a bakery could blow flour dust up from the floor every time someone dried their hands. The big negative with the air dryers is the time it takes to dry. We have all walked away from a dryer before we were dry because we were tired of waiting. You also have to consider that puddle of water you have created below the dryer. You have created a slip hazard and provided water for whatever bacteria are on the floor.  
As far as which to use in the restrooms, you have to look at your staff. Have you hired employees that do not understand the pipes and toilets cannot handle paper towels like toilet paper. Do you need to eliminate paper towels from the bathrooms to prevent clogged toilets?
Posted @ Wednesday, July 10, 2013 1:08 PM by Bobby Hartfield
Definitely paper towels. Sometimes you also need to blow your nose or wipe off the dirt off the shoes, and dryers are of course not suitable for that.
Posted @ Wednesday, July 10, 2013 1:35 PM by Zoffix Znet
Environmentally conservative people will prefer hot air any day. Why waste paper?
Posted @ Wednesday, July 10, 2013 6:07 PM by Sean M
Thanks for your comment Amy and enjoyed reading your article. There's an MIT study that is believed to be the first to assess the 'greenest way' of drying your hands. It concluded, " ..paper towels and warm air hand dryers have the highest environmental toll – generating 70% more carbon emissions," and cold-air systems were significantly less but with more hygienic risk of course. If you can look past the fact the study was commissioned by the cold air manufacturer, it does present some interesting paper towel findings. http://www.guardian.co.uk/environment/2011/nov/11/paper-towels-drying-hands-energy
Posted @ Wednesday, July 10, 2013 6:14 PM by Patrick Boshell
Thanks for the comment Wayne. Yes, many studies have found that friction is the key component in hand drying as it helps to remove contamination. Also, its suggested people have a strong preference for paper towels and that hand hygiene compliance may actually drop if paper towels were not available. A study on this would be very helpful.
Posted @ Wednesday, July 10, 2013 6:16 PM by Patrick Boshell
Some 'real world' practical insight is always helpful Bobby - thank you. And yes, both have advantages and disadvantages. The study is helpful as it views from a 'hygienic standpoint' and considers criteria such as "the speed of drying, degree of dryness, effective removal of bacteria, and prevention of cross-contamination" and suggests paper towels are the best option for settings where infection prevention/hand hygiene adherence is critical.
Posted @ Wednesday, July 10, 2013 6:24 PM by Patrick Boshell
I'd like to be the person that comes up with the 'golden bullet' solution of efficient, hygienic drying that is kind to the environment and cost effective. I'm often asked my opinion and for me it's paper all day. I was briefly seduced by the Airblade but it's not very hygienic.
Posted @ Thursday, July 11, 2013 2:58 AM by John Joyce
Hot air dryers are only effective if they dry the hands completely. Paper towels allows the hands to be dryer but are not always sanitary. After a look at both methods in lab testing it shows that there is very little difference in the amount of bacteria removed. Washing process is what makes the difference and even then the dispenser or bar of soap can actually transfer bacteria that was not there prior to washing. I participated in these experiments in a biology class and was amazed how little was removed by normal washing and drying. The most effective was with a soap pack and sterile towel which are only used once come to the person prepackaged and then disposed of.
Posted @ Thursday, July 11, 2013 12:11 PM by Jeanette
Interesting, thank you! I have heard much of it before...but it ties it all nicely together.
Posted @ Thursday, July 11, 2013 12:12 PM by JS
Paper towels in rest rooms have potentially several other problems such as scattered towel litter from users not using waste containers and also instances of people going into restrooms that have not restocked towels thus leaving visitor with either using toilet paper or clothing to dry hands-or even worst, not washing their hands!
Posted @ Thursday, July 11, 2013 12:16 PM by Pat
I am a strong supporter of the paper towel drying method. Somehow, I never get my hands well dried with the Hot Air Dryer. I am glad to see that I am doing the right thing.
Posted @ Thursday, July 11, 2013 1:56 PM by Wieslawa
Thanks for the comments Jeanette and Wieslawa. Absolutely agree that it starts with an effective hand hygiene protocol/education, especially in critical infection prevention environments such as healthcare or food processing/service. We did an article on effective hand hygiene at the following link http://info.debgroup.com/blog/bid/267193/Better-Hand-Washing-as-First-Line-of-Defense-Against-the-Flu 
Also, the topic of bacteria on a bar of soap has come up before and was addressed in one of our Q&A articles. You can read more here http://info.debgroup.com/blog/bid/290636/Got-a-Hand-Hygiene-Question-Ask-the-Experts 
Posted @ Thursday, July 11, 2013 2:11 PM by Patrick Boshell
Thanks for the comment JS. This seems to be a 'hot topic' with different views from both a hygienic and green standpoint. Effective hand hygiene remains the most important aspect regardless. We did another article on this topic which you can view here. http://info.debgroup.com/blog/bid/267193/Better-Hand-Washing-as-First-Line-of-Defense-Against-the-Flu
Posted @ Thursday, July 11, 2013 2:40 PM by Patrick Boshell
I would note that one comparison of an air blade dryer (motion sensor activated in my experience) vs a hot air dryer demonstrated that the air blade dryer was more effective than the hot air dryer when using a 10 second drying time. From personal observation, that's as long as many people allow for a hot dryer to work before they walk away from it and open the restroom door with damp hands.  
 
For a 30-35 second drying time the air blade was more effective, but not to a statistically significant degree.  
 
See: Comparative evaluation of the hygienic efficacy of an ultra-rapid hand dryer vs conventional warm air hand dryers, J.Appl. Microbiol., 110(1): 19-26, January 2011.  
 
There are apparently some stadium and venue washrooms (high volume at peak usage) where as you walk out of the washroom there is a line of airblades on both side of the exit corridor. Keeps the line of people moving as they walk out of the washroom - less congestion and arguably more sanitary to boot. Of course these must have separate entrance and exit corridors and no door at the end of the exit corridor.
Posted @ Friday, July 12, 2013 2:18 PM by Richard
Air drying are traps for microorganisms. Blowing dirty air to dry hands is not a good idea. Single use paper towels are more effective at drying hands, and they do not spread micro-organisms!
Posted @ Saturday, July 13, 2013 8:22 AM by Albert Lee
This report makes me sick. Facts are entirely missed. How many people even read the actual report. 
It evaluates old studies to come up with a recent published study. The paper towel quality used for drying was found to have a huge difference. The studies looked at we're mostly paid for or commissioned by paper towel companies. And finally ....... The report that this article was written about was in cooperation with an employee from one of the largest paper towel companies, Kimberley Clark . So was this professor just used? Hand dryers with hepa filters and that dry hands in under 15 secs are adequate as the surfaces we touch all day long are worse and hand dryers save the environment .
Posted @ Saturday, July 13, 2013 4:18 PM by Jeremy Kronk
The answer is not only one, regardless all comments that were made:  
*paper towels WET WITH AN bactericide, fungicidal and yeast- moulds chemical agents; AFTER a proper hand washing; where remove all rest in hands and eventually the arm. 
*Hot air dryer, to ensure that don´t remain moisture which can give the necessary moisture to make as viable some spores which can resist all the previous and adequate treatment.
Posted @ Saturday, July 13, 2013 4:56 PM by Ariel de la Fuente Rumbo
Paper Towels is the Better method- Hot air dryer can blow microorganisms & contaminate your hands.
Posted @ Tuesday, July 16, 2013 7:53 AM by Apolinario
Assessment of the environmental microbiological cross-contamination following hand drying with paper hand towels or an air blade dryer 
http://onlinelibrary.wiley.com/doi/10.1111/jam.12248/abstract  
E. Margas, E. Maguire, C. R. Berland, F. Welander, J. T. Holah  
Journal of Applied Microbiology  
This study compares the potential for cross-contamination of the surrounding environment resulting from two different hand drying methods: paper towels and the use of an air blade dryer. 
One hundred volunteers for each method washed their hands and dried them using one of the two methods. Bacterial contamination of the surrounding environment was measured using settle plates placed on the floor in a grid pattern, air sampling and surface swabs. Both drying methods produced ballistic droplets in the immediate vicinity of the hand drying process. The air blade dryer produced a larger number of droplets which were dispersed over a larger area. Settle plates showed increased microbial contamination in the grid squares which were affected by ballistic droplets. Using the settle plates counts, it was estimated that approximately 1.7x105 cfu more microorganisms were left on the laboratory floor (total area approximately 17.15 m2) after 100 volunteers used an air blade dryer compared to when paper towels were used. 
The two drying methods led to different patterns of ballistic droplets and levels of microbial contamination under heavy use conditions. Whilst the increase in microbial levels in the environment is not significant if only non-pathogenic microorganisms are spread, it may increase the risk of pathogen contamination of the environment when pathogens are occasionally present on people's hands. The study suggests that the risk of cross-contamination from the washroom users to the environment and subsequent users should be considered when choosing a hand drying method. The data could potentially give guidance following the selection of drying methods on implementing measures to minimize the risk of cross-contamination.
Posted @ Tuesday, July 16, 2013 7:55 AM by Kaarin
I have found that the high powered hand dryers, like the Dysons, are more effective at drying hands quickly and eliminating mess in a restroom. Paper towels often end up getting wasted (I know, I have watched my children take three times the amount they need to dry their little hands), or end up all over the floor; and the hot air dryers take a long time to actually dry your hands. In my experience as a consumer, the high powered air dryers that blow the water off your skin are the most effective and quickest way to dry your hands- no muss, no fuss, less waste! 
As far as energy consumption is concerned, I am not able to give a knowledgeable answer. My best guess would be: with the advances in technology most well made modern products are Energy Star certified and use increasingly lower amounts of energy to operate. That is just my guess though, I have no information to back that up.
Posted @ Tuesday, July 16, 2013 7:55 AM by Ariel H
From an Ecological and Operational aspect hand dryers are the best option. The current generation of high velocity hand dryers actually dry hands and do so very quickly. They have a lower carbon footprint in every aspect from distribution through waste removal. While they do use more energy than automatic towel dispensers they are very energy efficient. 
 
From a cost stand point most hand dryers pay for themselves within 6 months even if there is a need to run an electric supply line to the location. It is important to understand that the paper towel industry is a “razorblade” scenario. They will supply you with the dispenser as long as you buy their towels. This continual supply demand is infinite, hand dryers are a one time buy. 
 
From an operators aspect they solve the harsh reality of how to maintain a customer friendly bathroom environment during high volume meal segments. Restaurants rely on employees to cross function and “check” and maintain the bathrooms every hour, we’ve all seen the check off sheets with their initials. Bathrooms see their heaviest use during meal segments which also corresponds to the busiest times of the day in the front and back of the house when there is a lack of personnel to attend to bathroom duties. 
 
Nearly every customer uses the bathroom and an untidy and littered facility will influence their perception of the cleanliness of the rest of the restaurant, their dining experience and the restaurants reputation. 
 
Hand dryers should also be considered for kitchen areas to reduce the amount of cross contamination that occurs. Paper towels are exposed to a lot of airborne grease which can me transferred when drying hands.
Posted @ Tuesday, July 16, 2013 7:56 AM by Alan R
Unfortunately, many people don't have the patience to wait for air drying to complete and end up wiping the remaining water off on their clothing. For me, this gives paper towels the edge.
Posted @ Tuesday, July 16, 2013 7:56 AM by Michael
Thanks everyone for your feedback and insight. To Jeremy's point, yes most of these studies are funded by the manufacturers and need to be reviewed accordingly. The full study referenced in this article is available at the following link if you would like to review more http://www.mayoclinicproceedings.org/article/S0025-6196(12)00393-X/fulltext
Posted @ Tuesday, July 16, 2013 8:27 AM by Patrick Boshell
It was with great interest that I read the article and comments. I studied the challenge to quantifying differences in drying methods for many years and witnessed many a toilet clog due to paper towels. But by far the biggest gag factor is the atomization of toilet droplets every time a toilet is flushed. Every study trying to make comparisons has its weakness but this is science and nothing is ever 100%.  
 
Drying hands is primal and seems to be hard wired ever since our species started walking upright. With this milestone our hands developed a rich set of nerve endings and even having evolved out of the swamp we more or less became so evolved that we not only left that slime behind but we prefer dry hands. As pointed out in one comment the method of hand drying offered including none at all will influence the greatest driver reducing infection rates, HH compliance. When hands are wet and no drying method is available (or even with hot air dryers (not really hot) people wipe their hands on their clothes. This is not quite as bad as no washing at all but it comes in as third worst negative endpoint. Sucking bacteria and worst viruses out of toilet plumes and layering them onto wet hands like fly paper to flies is probably second worst because frequency it is not always a sure thing.  
 
And yes the champion worst situation for humans and having been so for probably several million years is failing to wash hands when contaminated. Our next closest primate will wipe hands on leaves and grass with mixed hygienic efficiency. I could go on but must get back to my germ busting work and have bigger fish to fry.  
 
I like the monkeys appreciate the organic aspect of paper towel drying and no one has really given much thought to how much carbon capture occurs as a tree grows. It seems that every cellulose chain that makes up individual paper fibers in a paper towel came from CO2 being bound up through photosynthesis with oxygen as a not so harmful by product. Trees are felled and replanted to make up a sustainable carbon capture and oxygen releasing process that does not end with wiping our hands. It is hard to quantify how much of the oxygen we breath comes from the forests just used to grow trees for paper but it probably is considerable. I do not want virgin forests cut down for paper to dry our hands and use in our toilets but there is a sustainable level that should be possible to satisfy all of our needs without sacrificing hygiene.  
 
This is much like the issue faced by soap companies where water is the premium commodity necessary for hand hygiene to work effectively and efficiently. The smart companies developed environmentally sustainable solutions to this and to them and green paper companies I take a drink and fresh breath of air every time I get a chance.
Posted @ Thursday, July 18, 2013 11:52 AM by Barry Michaels
Fast efficient air dryers cause droplets of contamination in half washed hands to be airborne. How close is your machine to food prep and production? In a roadside café recently I was disturbed by the noise and the draught of these super fast machines. Research needed me thinks..
Posted @ Sunday, July 21, 2013 6:27 PM by Mike Flynn
In our experiance Hot Air Dryers tend not to be used and so people wash and dont dry, wash and dry by rubbing on soiled clothing, or dont wash.  
Paper towels do creat an issue of rubbish/litter but all organisations will have litter bins and the management of these needs to be coordinated into the usual GMP/PRP/ Training management protocols.
Posted @ Wednesday, July 24, 2013 8:29 AM by Rob
I agree with Rob, staff tend to avoid Hot Air Dryers. Training helps but needs to be enforced. I work for cake manufacturing plant (+/- 120 staff) and we are currently using paper towels but it's a huge expense. Trying to switch over to Hot Air Dryers just because I feel sorry for the trees.  
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Posted @ Wednesday, July 24, 2013 8:30 AM by Anel
Love this article!
Posted @ Monday, September 09, 2013 12:41 PM by Parm Johal
Thanks for feedback Parm!
Posted @ Thursday, September 12, 2013 11:44 AM by Patrick Boshell
I do support the choice of paper towel over air dryers for many reasons: 
- Paper are single use and can be used to close the robinet without touching 
- With a good quality of paper it dry quickly 
-Air dryers do cause turbulence of air around and can bring back germs on hands 
Air dryers can cause harm to hands especially to sensitive dry skin 
Recommend the choice of good quality paper towel that absorbs well the water and do not tear quickly during drying
Posted @ Monday, September 23, 2013 4:54 AM by Soraya Terzaki
Hello, 
The above post is about the blow drier.It will be very useful. 
Blow Motion dryers
Posted @ Tuesday, October 29, 2013 10:44 PM by Blow Motion dryers
The age old paper towel vs hand dryer argument has been ended by this hand dryer/sterilisation unit
Posted @ Friday, December 13, 2013 4:55 PM by Helen Cameron
good info
Posted @ Monday, January 13, 2014 5:28 PM by liz
HH
Posted @ Monday, January 13, 2014 5:30 PM by liz
hh info
Posted @ Monday, January 13, 2014 5:32 PM by elizabeth.gulyas@viha.ca
People need to stop posting, the argument is now well and truly over. Yes hand towels were more hygienic than old hand dryers, maybe even than the likes of the Dyson Airblade according to the Wetminster report anyway, but the introduction of a bipolar ionisation or cold plasma generator has ended this argument, a hand dryer using warm air is actively destroying bacteria and viruses on the hands!
Posted @ Tuesday, January 14, 2014 3:02 AM by Andrew Cameron
Hi There! 
 
Thanks for great read. It's always so interesting to see the different perspectives of hand dryers vs. paper towels!  
 
Have you ever experienced or researched the Dyson Airblade? Created and manufactured to kill 99.9% of all bacteria! 
 
Take a look HERE: http://www.handdryersupply.com/dyson-airblade-db-ab14-grey-hand-dryer/ 
 
Thanks! 
Cameron @ HandDryerSupply.com
Posted @ Tuesday, February 11, 2014 1:17 PM by Cameron
That is called the best guidance. I am glad to read this info.
Posted @ Wednesday, April 02, 2014 7:12 AM by Hooded Towels
This is a very good batch of comments on both sides of the issue. Public health authorities will almost always side with paper towels for several reasons including; 1) speed of drying, 2) effective removal of hand contamination and deposition into waste basket not environment 3) degree of dryness in short period 10 seconds or less and 4) prevention of cross-contamination when a "hands free" unit is utilized. 
 
On the other side are business owners who have seen too many toilets clogged and fecal material spread all over the facility. This is a very real negative of paper towels and somewhere there is a point where frequency and severity of these clog-ups reduce the hygienic advantages of paper towels. Perhaps it is geography dependent or culture dependent but there are going to be places where abuse of towel use causes management to take the step of introducing warm air dryers. The Air Blade's speed and filtration take away some of the other advantages afforded by paper and this it might be far from a slam dunk in favor of paper.  
 
The environmental aspect, I feel should go to paper as we tie-up carbon dioxide to make paper fiber but this too needs to be reviewed in light of new technology. With regards to cross-contamination potential, the Margas et al. 2011 paper is helpful (see above comments). If you see dust build-up at the air outlet do a culture for yourself (swab and selective media agar plate) and you will see the problem with that particular unit but the technology is changing and ultimately it is a balancing of risks that needs to be considered.  
 
n a restroom there is often no choice between a dusty warm air dryer an toilet paper or a quick hand shake. Taking paper napkins in with you can help but I will often make the choice to shake hands off well and not to touch anything for a minute or two, rather than use a warm air dryer I know is heavily contaminated. In a sense this is a cool air dryer approach and the one shown in the video clip linked to this site. 
 
Another issue to consider is when recycled paper is used to make paper towels. This provides part of the green story but these products can sometimes have high microbial counts and depending on the paper source and process can lead to hidden issues. When was the last time you tested the microbial quality of the paper towels you were purchasing. Evidence based logic should prevail and new technology can be disruptive to long held beliefs. 
 
The wide spread introduction of instant hand sanitizers (2001-2002) has been disruptive (regarding the argument as to which is best paper or air) and the rapid self drying in some respects takes away from paper towels as less hand washing takes place. Clearly Dyson read the science and cast his hat in the ring with a credible alternative and we could see further development in this area.  
 
This brings me to the value of the Deb Infection Control blog as a forum for the "good, bad and ugly" in terms of hand hygiene. Hand hygiene is often considered a no-brainer but this and all the other discussion around hand hygiene shows that it is far from that. Hand hygiene is maybe not as complex as brain surgery but then there is a body of work on hand hygiene that makes successful surgery possible.
Posted @ Wednesday, April 02, 2014 10:41 AM by Barry Michaels
I agree with the majority of the points in this article and it’s great without any doubt. Really a wonderful post! I like it very much. Here I find everything in details. I hope I will see this type of post again in your blog. 
Thanks……. 
Posted @ Friday, June 27, 2014 4:03 PM by 24 hour Toronto coin Laundromat
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