Faraday Partner in science and technology to the UK, William F. (Bill) Hadley, CEO of Bio-Pro Research, has lectured globally on bio-technology applications in environmental health and facility maintenance. Here he explains some of the misconceptions regarding surface cleaning and the products used.
Attaining and maintaining a truly hygienic condition in facilities has become a major focus as it has been determined that environmental surfaces in public environments can pose a formidable foe in the battle against communicable diseases.
This is particularly the case when people are 'living' in close quarters such as in healthcare, elder care, child care, and correctional facilities. When inhabitants have compromised immune systems as is common in healthcare and elder care settings, the threat of infection is further exacerbated. Studies have shown that approximately one in 10 patients in hospitals contract a hospital borne infection such as c.difficile Colitis, MRSA, or VRSA.
Environmental surfaces play a large role in the spread of these infections as they are often the common link between people. Surfaces that have been soiled - especially with organic matter, can serve as breeding grounds for unwanted microorganisms. Some contaminants are difficult to remove once they have dried and, in the case of urine, have formed a nearly insoluble crystalline structure that binds proteins as well as other organic soils to the surfaces.
A failed argument is often made that maintenance departments rely on sanitisers or disinfectants to control infectious disease opportunities. This argument is not well founded when one considers that even if used properly, sanitisers and disinfectants are not cleaners and do not remove soils. Their sole function is to disrupt cell structure and kill microbes. They are only effective in their claims if all application factors are correct.
The human factor is the largest challenge in relying heavily on disinfection do to the fact that disinfectants are very seldom applied correctly. Most disinfectants rely on three factors to achieve their kill claims; coverage, strength, and dwell time. Coverage assumes that the entire surface to be disinfected is thoroughly wetted with the disinfectant for cellular contact.
Picture left shows that what looks clean, isn't, under Black Light inspection
Most disinfectants are spray applied and achieving full coverage is seldom attained. The strength of the disinfectant can wane with age. A bleach solution, for example, loses strength rapidly when diluted and exposed to air. The only way to tell the true strength of bleach and quaternary compounds is with test strips, which are seldom, if ever seen used in a dynamic sanitation environment.
The third factor is dwell time. Most disinfectants require a minimum of five and many of them require 10 minutes at recommended application strength to perform their desired function. Observing most housekeepers will reveal a 'spray and wipe' mentality that violates all three precepts. The reliance on so called combination 'cleaner/disinfectants' that claim to do both functions usually ends up short changing both the cleaning and disinfection results.
Furthering the cause of not relying heavily on disinfection is the fact that surface soils can provide the perfect breeding ground for infectious germs. Even if it is assumed that the disinfection process was executed properly, disinfection has no residual effect and the organic soils that were left behind can be easily re-infected with microbes. Once re-infected and provided with a rich growth media of organic soils, the microbes enter an exponential growth phase and can grow from one microbe to a very healthy, highly infectious colony in short order.
The proper approach for facilities to take in their quest for hygiene is to start by first properly cleaning the surface. It is estimated that as much as 80% of microbes are removed from the surface in the cleaning process (much better even than that attained by the 50% kill-rate sanitising standard).
EVS departments would be well served to concentrate on the tools, training, and methods utilised in the proper cleaning of surfaces, then sanitising them. If the sanitiser is not used exactly to protocols, there is still a dramatic reduction in communicable organisms and the growth media is removed to help prevent growth of infectious colonies.
EVS staff training in the use of the proper tools and methods for cleaning will not only contribute to a drop in facility-borne infectious disease incidents, but it will also save money.
For example, uric acid in urine deposits contributes to the oxidation of assets, shortening their lives. In facilities with vinyl mattress and upholstery materials, the common use of bleach as a cleaning/disinfecting agent drastically shortens the life of the vinyl by causing 'plasticiser migration', making the vinyl brittle and causing cracking failures. In correctional facilities, for example, mattress life is often reduced from the budgeted (and guaranteed) three years to six months at a huge additional cost to the facility for replacement and disposal, with the warranty voided.
Tools that make cleaning easy and effective are simple. Microfibre is a revolutionary breakthrough material that has made possible a quantum leap in cleaning effectiveness. There are new highly effective bio-enzymatic cleaners that have made the once difficult task of removing dried urine and other organics into an easy process. Verification and inspection tools are now available that are effective and inexpensive. EVS cleaning staff can now use cutting edge technology to find the soils that were previously 'unseen' and EVS directors and managers can now 'inspect what they expect'.
At the end of the day, everyone wins: the guests and patients can reduce facility-borne illnesses that cause pain and suffering; the facility saves money by prolonging asset life and reducing the exposure to civil suits; the environment wins by reducing solid waste caused by premature asset replacement and overuse of toxic chemicals; and EVS staff wins by being properly trained in the use of non-toxic cleaning products, dramatically reducing their exposure to potentially harmful chemicals.
Bill Hadley is the CEO of Bio-Pro Research, a USA-based research and development company that concentrates on technologies, products, and methodologies for facilities maintenance.
He has focused on hygiene and maintenance issues, authoring the first national FOG (fats, oils, and grease wastewater treatment) course in 1992, the NEHA (National Environmental Health Association) certified facility pretreatment course in 1996, and the official EPA course on FOG pretreatment in 2000. He also serves on the Tennessee State FOG pretreatment Committee of TDEC (Tennessee Department of Environment and Conservation) and other public boards and commissions.
Bio-Pro Research was honored as a finalist for the Gulf Coast Technology Innovation Award, an award recognizing outstanding Florida technology companies.
Attaining and maintaining a truly hygienic condition in facilities has become a major focus as it has been determined that environmental surfaces in public environments can pose a formidable foe in the battle against communicable diseases.