by Darrel Hicks — Originally published in the April 2016 issue of ISSA
While there remains no sure-fire “silver bullet” when it comes to cleaning and disinfecting, there have been many advances over the past 20 years that are showing great promise in the fight to create healthy environments. Below are a few of them:
Engineered Water
Originally, there was what was called activated water, which referred to “nonaugmented tap water—in which no salt or other minerals were added—that was altered by passing an electrical current through the tap water,” says Allen Rathey, president of the Healthy House Institute. “The main problem was consistency-of-solution created by the inability to control the tap water, which varies in its mineral content. Tap water with adequate mineral content can be properly electrolyzed, but tap water without sufficient dissolved minerals cannot.
Today’s more recent technologies employ what has been termed “engineered-water,” based on either activated ozone-infused or electrolyzed water systems.
Perhaps over-simplified, but ewateradvantage.com defines the two as “Aqueous ozone is the name given to water that has been infused with ozone gas and requires only air, water, and electricity to produce a highly effective cleaner-deodorizer-sanitizer in a single product; electrolyzed water uses salt, water, and electricity to produce two products, one an alkaline cleaner excellent for degreasing and the second an acidic chlorine-based sanitizer.”
While these two types of engineered water rely on different technologies, they are similar enough that for our purposes we can discuss them together.
The first benefit of the use of these water technologies is that they release little to no chemicals or gases into the atmosphere other than those produced on site by the addition of salt or ozone. This means no fumes, no mixing of more toxic chemicals, and little if any negative impact on indoor air quality, all of which make it probably the most effective green cleaning strategy known to date.
These environmental and health benefits are not the only advantage to water-based systems, however. Among the other benefits worth noting are:
- Labor savings. Chemical residue left on a surface can attract soil to the surface, increasing the cleaning needs of a facility.
- Increased safety. A large percentage of the injuries that happen when cleaning are a direct result of accidents and exposure to chemicals.
- Product cost savings. There are no cleaning chemicals to buy.
- Enhanced sustainability. Chemicals must be packaged and delivered. When no chemicals are used, there are none to package or deliver.
A few of these systems produce sanitizers and low-level disinfectants. In my opinion, the leading engineered water system produces a form of super-oxidized water that is odorless, pH neutral and is 80 to 100 times more effective than bleach. Its active ingredient of hypochlorous acid (produced when chlorine dissolves in water) is highly effective against all healthcare associated infection (HAI) pathogens, such as Methicillin-Resistant Staphylococcus Aureus (MRSA), Vancomycin-Resistant Enterococci (VRE), Norovirus, and bloodborne, killing them in as short as 60 seconds (three minutes for bacteria and fungi; 1 minute for viruses). It has an HMIS rating of 0-0-0.
A ready-to-use form of the hypochlorous acid will be available soon for a three-minute kill claim for Clostridium (C.) difficile. It will also have a safe HMIS rating. All the in-use products are stable for over a year.
Antibacterial & Antiviral Surfaces
MRSA is a type of staph bacteria that is resistant to several antibiotics. In the general community, MRSA can cause skin and other infections and even death. A recent USA TODAY investigation showed MRSA bacteria, once confined to hospitals, are emerging in communities to strike an increasing number of children as well as schools, prisons, and, even, locker rooms.
Scientific evidence provides strong support indicating that contaminated hospital surfaces play a role in the transmission of pathogens (bacteria capable of causing disease and/or death) to humans, including MRSA. The ability of an antimicrobial agent, engineered at Emory University, to reduce bacterial bioburden on hospital surfaces was examined. The application of an antimicrobial coating saw a significant reduction of Staphylococcus Aureus (Staph infection) microorganisms—but not total bacteria count—on hospital surfaces across a nine-month study. A targeted study of other organisms is needed, but this antimicrobial coating shows promise in applications outside of hospitals, too.
The first antibacterial and antiviral material is in development and should be available in the coming months. The material can be made in thicknesses from a plastic film to plastic cases for cell phones. The antiviral properties inherent in the unique manufactured materials would be able to kill bacteria (like MRSA) and viruses such as Norovirus, common cold, influenza, and others.
Thus far I’ve only discussed antibacterial and antiviral coatings for hard surfaces. But a U.S. company has developed similar technology in textiles. This isn’t an antibacterial fabric where silver or copper provide the killing action, but rather, a quaternary ammonium compound (quat) on the outside surface of the garment, not against the skin.
This textile technology is currently being used to make scrubs and white coats (like the ones worn by doctors) so that MRSA bacteria are killed when they come into contact with the surface. The scrubs also repel dangerous exposures to body fluids (blood, urine, vomit) so the employee’s skin never comes into contact with potential bloodborne pathogens. The manufacturer states that its uniform bridges the gap between regular cloth uniforms and personal protective equipment (PPE). As such, the company sent several hundred sets of these scrubs to the medical staffs battling the Ebola crisis in Western Africa in 2014 to help minimize dangerous exposure to body fluids.
Chemical Disinfectants
An article in the May 2015 issue of the American Journal of Infection Control was titled, “Cleaning and Disinfecting Environmental Surfaces in Health Care; Toward an Integrated Framework for Infection and Occupational Illness Prevention.” That’s a long title for a very important look at the role that some legacy disinfectants play in asthma-related employee exposures. Although the study looked at chemical respiratory hazards in cleaning and disinfecting, the application is to every segment of the business of providing safe, clean, and disinfected surfaces in all public places of business. According to the article:
“Although the demand for more effective cleaning and disinfecting is growing, there is also increasing evidence that exposures to cleaning can cause acute and chronic health effects, particularly respiratory illness…Potentially harmful occupational exposures from cleaning and disinfecting are a function of multiple factors, including (1) the chemical characteristics of the cleaning or disinfecting product, (2) the physical characteristics (aerosols vs. liquids), (3) the methods of product application (spraying vs. wiping), (4) the characteristics of the built environment (ventilation, room size).”
And it’s not just the ill effects on the cleaning staff. This problem reaches to building occupants who are affected by chemical exposures. Currently there are few systematic evaluations of green cleaning and disinfecting products, new technologies, and application methods for effective infection prevention or for occupational health and safety.
The call to action is this: To support the safe use of cleaning and disinfecting products, safety data sheets (SDS) and labeling of these products must be accurate. Future risk assessments of chemical ingredients and mixtures should incorporate asthma, other respiratory effects, and dermatologic conditions as health endpoints so SDS are relevant to these health concerns.
In closing, be aware that no single mode of preventing infections is effective by itself.
New communication strategies are needed to reach administrators, allied health professionals, office managers, purchasing managers, cleaning professionals, and other stakeholders with this information. And a multimodal approach is necessary to win the “germ war” and this relies on all industry categories working together: Manufacturers must continue to spend money on research and development to create new, safer products; distributors must help their customers realize the benefits of using safer products, and facility service providers—both in house and contractors—must use and train their staffs to use all cleaning products correctly, safely.
Remember, fully engaged cleaning professionals, given the right education, training, best in class tools, and proper amount of time to do their tasks, can prevent more infections than a room full of doctors can cure.
Darrel Hicks, BA, MREH, A.C.T., is director of the Green Cleaning Institute’s environmental services program and author of Infection Control for Dummies. He can be reached at dhicks@gcicertified.com.