Germ warfare: Experts debate the pluses and minuses of disinfectant use
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“I am concerned about the haphazard use and application of disinfectants in our built environments,” says Roger McFadden, vice president of technical services, Coastwide Laboratories, Portland, Ore. “The use of sanitizers and disinfectants should not replace effective cleaning products and practices unless there is a real need for infection control.”
Disinfectants and one-step cleaner-disinfectants are typically more expensive than general-purpose cleaners. They must be used according to label directions to be effective. And they require accurate dilution and a specific dwell time in order to kill germs. Finally, disinfectants and one-step cleaner-disinfectants are considered pesticides by the U.S. Environmental Protection Agency, requiring special procedures for handling, use and disposal.
“Use of disinfectants requires pre-cleaning of a surface prior to disinfecting, which can increase the time needed for cleaning,” McFadden says. “Overuse of one-step cleaner-disinfectants can create sticky floor conditions.”
To make sure disinfecting products are only used where they are needed, McFadden suggests housekeeping managers draw themselves a general floor plan of their facilities, identifying likely cross-contamination points he calls “hot spots,” or areas and surfaces people frequently touch.
“In the floor plan, [a manager] might identify toilet and urinal flush handles, or a door that is frequently opened and closed,” he says. “This will help teach professional cleaning staff to think about where bacteria harbor and breed.”
Special care should be taken when cleaning restroom surfaces and high-touch areas. Bed rails, doorknobs, light switches and handles should be cleaned and disinfected more often than surfaces with minimal hand contact.
When gross contamination of blood or body fluids are present, a special disinfectant or one-step cleaner-disinfectant effective against tuberculosis or HIV-1 and hepatitis B should be used to comply with the U.S. Occupational Safety and Health Administration Bloodborne Pathogens Standard.
Cleaning vs. disinfecting
“Disinfecting and cleaning are two separate things, but they’re very connected,” McFadden says. “An effective infection-control process will include both.”
Cleaning is the removal of unwanted soil or contaminants.
Disinfecting is the elimination of most pathogenic organisms from surfaces. Disinfecting provides a higher level of germ killing than cleaning or sanitizing. Disinfectants should not be used as a substitute for routine cleaning activities.
Disinfectants require the removal of soils from surfaces before they can be effective. Disinfectant-cleaners are available, however. Product labels should say that the product “cleans and disinfects.”
“Cleaning is extremely important in an effective infection-control process,” says McFadden. “Cleaning removes soil, which is the food source for bacteria and pathogenic microorganisms. If bacteria don’t have a food source, they cannot live.”
In some cases, he says, disinfectants get all the credit for controlling germs when routine cleaning is just as important.
“For example, someone brings a virus to a cruise ship, it is transferred to a surface and people touch it and get sick,” he says. “Frequent and proper cleaning of contaminated surfaces will reduce the opportunity of these germs to harm us. Yet, the cruise lines will often wait until an outbreak occurs and then respond with extreme disinfecting measures instead of implementing effective infection-control cleaning and controlled disinfecting practices to help prevent the spread of disease.”
“‘More disinfecting’ is the wrong message to send at a time when we’re trying to understand the growth of asthma in developed nations, like the U.S.,” says McFadden. “We’re filling our indoor environments with chemicals.”
Is it clean?
Once a surface is wiped with a cleaner or disinfectant, is it clean?
“There is no way to measure the effectiveness of products, or whether or not [a surface] is clean or disinfected,” says Steve Spencer, facilities management services, State Farm Insurance, Bloomington, Ill. “I wonder if we depend too much on chemicals to do the cleaning when we might not need them.”
Spencer sometimes uses an ATP tester to check surfaces for bacteria. The tool is used in the food industry to detect adenosine triphosphate (ATP), an essential molecule for all living cells.
“ATP is in all living things, so it’s in all bacteria,” Spencer says. “If we’re looking for clean, maybe that’s the way to go.”
If the cleaning industry had a way to measure the cleanliness of surfaces after using various cleaning methods and products, he says, housekeepers would know whether or not certain cleaners and disinfectants are necessary.
“Are some of these products overkill?” says Spencer. “Do we need to use a stick of dynamite when all we need is a cap?”
|Choosing a disinfectant
When specifying disinfectants, managers should consider the specific and reasonable threat that individual germs pose to their facilities and building occupants. Disinfectants should not be substituted for cleaning products unless it is determined that their use is necessary.
Selecting a disinfectant that kills more germs is not necessarily the best choice. Disinfectants that kill more germs can be more toxic to humans and/or the environment. It is unnecessary to expose the environment to the potential toxic effects of the active ingredients in disinfectants when cleaning products with lower toxicity can be used.
— Roger McFadden,