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As fears of a flu epidemic that could cause severe illness or death gripped much of the United States the past two winters, George Boue grappled with more fear than just his own. As vice president of human resources for a Fort Lauderdale commercial real estate firm, Boue had to devise a plan to reassure and protect not only the company's employees but also the tenants of the 45 office buildings and shopping centers it managed.

Hand washing and hygiene became one of the key tactics embraced by the Stiles Corp. safety committee, Boue said. The company put up posters in common areas and employees received e-mails containing U.S. National Institutes of Health guidelines on how to properly wash their hands.

But, as tension mounted, Stiles Corp. went further. It placed pump bottles of alcohol-based hand sanitizer in all its conference rooms. Dispensers also were placed in key spots near elevators and in lobbies.

The educational messages and the ready access to hand sanitizer played a key role in preventing the spread of influenza through the company, Boue said. Only one other strategy — urging people to stay home when they were sick — proved potentially more effective.

The above example found in a Bloomberg Business Week article published in December shows just how effective hand washing can be. Yet, American Society of Microbiology studies have found that only 75 percent of females and 58 percent of males wash their hands, and that more than half of them fail to use soap.

A study by the Joint Commission Center for Transforming Healthcare found among the top reasons for not washing were ineffective placement of paper towel and soap dispensers and the perceived difficulty of their operation.

Here's where an organization's custodial program can make a real difference. Proper selection and placement of a facility's soap, towel and hand sanitizing dispensers can greatly increase hand washing among occupants and thereby boost the health of the entire operation.

The good news is that custodial operations became more diligent and pickier about paper towels and soap in recent years, according to Ronnie Kent, president of Conyers, Ga.-based Associated Paper Inc.

"Since the H1N1 scare, schools in particular have doubled or tripled the paper and soap they were going through because everyone is emphatic about getting kids to wash their hands," he says. "We have seen a lot more facilities looking at new [soap and towel dispensing] systems that make it easier for people to use them."

Picking Paper

Commercial towel dispensers are offered in a wide variety of styles; their function doesn't change, but the style does, as does the choice of paper. Generally, the choice of paper comes down to paper sheets or paper rolls. Paper sheets come in either C-fold or multifold, and most dispensers are designed to use either. Paper rolls are a growing trend in high-traffic facilities and those that are diligent with inventory control.

One area that has grown is paper towel with a percentage of recycled content. As companies go green, they generally look to green their paper products as well, says Kent. For those facilities, there are plenty of affordable options.

"The first time we had the big recycling craze (in the 1970s), paper towel [with recycled content] was more expensive and the quality wasn't as good, but the quality is just as good now and there is no price differential," he says. "There are a lot more people this go around who are much more open to recycled paper products than they were 20 years ago because the quality is so much better."

While most paper towel choices remain somewhat static: brown vs. white and economy-grade vs. high-end products, Kent says facilities have far more choices than in the past, particularly among higher-end options.

"There are less paper towel manufacturers but there are more high-end, high-quality products," he says.

Manufacturers are also producing larger multi-fold and C-fold towels that hang out of the dispenser, one at a time, eliminating the need for the next person to reach their hands into the dispenser to retrieve a towel. The larger size also reduces towel use because people are less likely to reach for two or three or four sheets.

"In the past, the C-folds used to be considerably narrower and what would happen is when the dispenser was nearly empty, a user would pull on the towel and three towels would come out," Kent says. "The wider towels won't come out of the dispenser like that."

The plethora of choices helps out as many facilities look to save money in a troubled economy, states T.J. Elliott, sales manager of Inland Supply in Reno, Nev.

"We're seeing a big push for cost savings, and we are trying to find a compromise between a fair price and a decent quality."

But price isn't the only consideration when deciding what towel to buy. As custodial departments explore their options, Kent recommends they consider the following:

  • How many occupants are there?
  • How much traffic does the building get? "A high traffic facility can be accommodated with a high-capacity towel that won't need to be changed out as often," says Elliott.
  • How much paper towel is currently being used?

"If high usage is a big deal, the custodial manager might want to consider a dispensing system that will help control some of the volume of what they go through in order to cut costs without sacrificing quality," Kent says.

Custodial operations also need to consider the quality of towel they need. A single tenant building where only company employees use the restrooms might opt for a lesser grade of towel. But a public building or Class A office building will likely require a towel that sets them apart from other facilities.

"It says, ‘We charge more rent because we are worth it,'" Kent emphasizes. "Whereas a factory might choose a low-cost, brown paper towel as opposed to plush, white paper towel, because they are not worried about aesthetics, they are only worried about getting the hands dry."

Selecting Soap

When it comes to soap, foam soaps are where it's at, says Kent.

"The great thing about foam soaps is they are very cost effective to use," says Kent. "They don't damage or dry the skin and they wash off quicker."

And for the custodial operation, foam soaps are generally less expansive to use.

"You can get up to 3,000 to 4,000 hand washes per foam refill," says Elliott. "That is a substantial improvement over liquid soap."

Kent adds that foam soaps offer the best of both worlds.

"People see foam soap as an upgrade in quality but you're actually using less of it because you're aerating the soap and making it last longer," he says.

However, while newer dispensers exist that can use either liquid or foam, most manufacturers require an investment in new dispensers when switching from liquid to foam soaps.

Hand soap also offers plenty of choices; so housekeeping operations need to take a close look at the environment. For example, a high-end restaurant or Class A office building might require a scented foam soap.

"But a factory might require a more aggressive soap as opposed to one that's scented or contains lotion," Kent says. "The soap a factory uses would need to be aggressive on grease and oil."

Determining Dispensers

Commercial towel and soap dispensers come in a vast variety of styles. In fact, the dizzying array of choices for towel dispensers has contributed to a reduction in air hand dryers.

"We are seeing less air dryers than ever before," Kent says. "I think a lot of it has to do with the improved quality of paper dispensing systems."

But whatever the system, it had better be hands-free, he adds.

"People don't have to worry about the germs and don't want to touch that dispenser," he explains. "Nobody liked having the levers and the cranks on these systems, except for the people who were truly trying to save money. Today people don't want to touch anything when they go into a restroom."

These systems can be either automatic wave-type dispensers that automatically dispense the towels or mechanical systems using perforated towels where the user simply pulls on the towel and it breaks at the perforation. One company even offers a hybrid model that does both. Users can either pull on the exposed towel to retrieve it or wave their hands at the unit to dispense toweling automatically. Soap dispensers also come in wave-type and mechanical versions.

The newer automatic systems, while they pack an initial investment cost, do not require any more maintenance than their mechanical counterparts. Custodial operations need only change the batteries periodically, when the system begins to run more slowly than normal.

"Your additional cost is in batteries, but that cost is minimal," says Elliott. In fact, Kent points out the batteries can last up to two years in many cases.

Once these product decisions have been made, the route to better hand washing is more direct. Place the dispensers where they are readily accessible to those who need to use them. Teach the entire staff proper hand washing techniques. And hang signage that reminds staffers to wash their hands.

A proper hand-washing program incorporates all of these things, contributing to a healthier workplace for all.

Ronnie Garrett is a freelance writer based in Fort Atkinson, Wis.