Should you take your shoes off -- or leave them on -- in your house? Breaking down the research

65% of Local 4 Insiders we polled remove shoes inside

You may not have directly debated this topic but I’m sure in your life you’ve become aware of it. Some people wear shoes in their house others don’t.

You may not have directly debated this topic but I’m sure in your life you’ve become aware of it. Some people wear shoes in their house others don’t.

It’s probably crossed your mind when you’ve visited with a friend or when kids come over to play with your kids. Often the decision about shoe-wearing in the house is cultural, and in the United States, we have a very wide range of shoe-wearing practices.

Some people see shoes as bringing dirt into a home, other people are not bothered one way or another, and still, others look at it in terms of contaminants and germs even if they can’t see any dirt.

In an informal survey we did among our viewers, 64% always take their shoes off in the house, 21% sometimes do, and 15% leave them on. Their behavior towards guests is slightly different, 48% say they do not ask their guests to remove their shoes, 27% sometimes ask, and 26% always ask guests to remove their shoes. At the end of the day, one real question is whether there are any health reasons that shoes on or off in the house might be better.

I will confess that I do not wear shoes in my house. In my case, there are two distinct reasons. First off, working in an emergency department I’m not excited about the potential of tracking patients’ bodily fluids into my home. More relevant though, I have never worn shoes in the house, it’s just the way I was raised.

It’s different for Jennifer Krause and her family, she says “sometimes we take them off, sometimes we leave them on, it just depends.” For her it’s a matter of convenience, sometimes she just prefers leaving her shoes on. Jennifer is a nurse and has a different view of the germ situation, she says “it doesn’t bother me, with the amount of germs that I see at work, I feel like shoes in the house is small potatoes.”

So, is there a right answer to whether shoes on or off in the house is healthier? Medically speaking, there isn’t exactly a clear right answer. There have been studies testing the bottoms of shoes and they have found many different types of bacteria.

The most commonly identified bacteria on the bottom of shoes are E. coli. The source is generally human or animal feces, and depending on the type of E. coli, and the circumstances in which a person might become infected, it can cause human illness.

What many people correctly point out though is that E. coli is commonly found in people’s homes regardless of shoe-wearing. And the fact is, E. coli on the bottoms of shoes has not been linked directly to human illness in any published research.

Studies have also found other microbes, allergens, and environmental contaminants including pesticides or lead on the bottoms of shoes. There are people that have concerns bringing any of those things into a home could pose a health risk.

While that concern seems logical, there is no clear research linking the presence of any of those things on the bottoms of people’s shoes to illness in humans. Personally, I think if you have allergies or small children that play on the floor, decreasing the amount of pollen and chemicals in your home or on your floor is very sensible, but that is just my opinion.

Regarding the cleanliness of shoes, some people have pointed out that in hospital operating rooms we wear shoe covers, the question is whether they make a difference. I think again, most people would agree that tracking dirt from the outside into an operating room is not a good idea. This has been studied in different settings and the results are mixed, some studies show that protective footwear does reduce bacterial contamination on operating room floors. However, there have also been studies showing that the use of shoe covers does not prevent surgical site infections. In fact, one study even suggested the act of putting shoe covers on and taking them off was might contaminate a person’s hand and therefore possibly increase the risk of infection. I’m not suggesting we do away with the practice of covering our shoes in an operating room but the point is the data is not bulletproof.

Going back to shoes in a person’s house, there is a counterargument suggesting that shoes in the house might be beneficial. There is evidence that having an overly clean environment might contribute to allergies and susceptibility to infections. This happens when our immune systems are not being trained and challenged as they’re meant to be naturally. This is known as the hygiene hypothesis.

Henry Ford Health Dr. Christine Cole Johnson was an early researcher and a proponent of the hygiene hypothesis. She suggests regular exposure to dirt and germs is healthy and natural.

“A lot of these bacteria protect you against the bad bacteria. You want a nice ecology of bacteria that’s very diverse on your body and in your home in order to protect ourselves against the bad actors.” said Dr. Johnson.

Regarding the need to take our shoes off in our homes, Dr. Johnson added, “there is no biological rationale for that. For one thing, there’s so much bacteria on us and in our homes already, it doesn’t make a difference.”

Dr. Johnson also notes that people with pets have a very diverse microbiome in their home and believes it is beneficial.

There’s also a practical side to wearing shoes in the house, especially if you have ever stepped on a stray Lego brick or stubbed your toe.

Dr. Nicole Brouyette, a podiatrist at Henry Ford Health says, “there are plenty of reasons why people should wear shoes indoors.”

She recommends wearing a rigid shoe to protect the bottom of the foot and allow the arch to be supported. Older people can benefit from the added stability and traction that a shoe provides to prevent falls. Dr. Brouyette also notes that for older people the added support can help with arthritis.

Jennifer Krauss, whose family wears shoes indoors, also has family members with a special need to wear shoes, “my husband is diabetic and my mother-in-law is diabetic so it is important for them to have shoes on so they do not injure their feet.”

Dr. Brouyette echoes that and says that diabetics who have peripheral neuropathy have difficulty feeling the bottom of their feet and need protection so they do not develop injuries that can lead to infections. Incidentally, Dr. Brouyette suggests people who want to wear shoes indoors have a separate pair of indoor shoes if they don’t want to wear outdoor shoes inside.

The bottom line is that regardless of which side your family falls on this issue, there are reasonable arguments on both sides. In the end, it really comes down to personal choice.

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About the Author:

Dr. McGeorge can be seen on Local 4 News helping Metro Detroiters with health concerns when he isn't helping save lives in the emergency room at Henry Ford Hospital.