Even in times of division, almost everyone agrees on the importance of proper hand hygiene. According to the Centers for Disease Control and Prevention (CDC), hand hygiene is the single most important practice in the reduction of the transmission of infection in healthcare settings. For other settings — like schools or offices — the COVID-19 pandemic helped drive the handwashing lesson home for building occupants. It’s now common knowledge: wash hands for at least 20 seconds (or two rounds of the “Happy Birthday” song) and be sure to use soap.  

Though often overlooked, the type of dispenser providing the soap matters. It can make the difference between clean, safe hands, and hands that carry even more dirt and bacteria after washing than before.  

Commonly, there are two kinds of soap dispensers: bulk dispensers where liquid soap is poured in from a bigger bottle, and cartridge dispensers where pre-sealed units of soap are changed out. Both choices have inherent advantages and disadvantages, but when it comes to hygiene and safety, there is a clear standout. By understanding the pros and cons of each option, building service contractors (BSCs) can make sound recommendations to facility clients and ensure their frontline staff are adequately trained to address both.  

Beware of Bulk 

Bulk soap dispenser technology has been around for a long time. Bolted to the restroom wall right next to the sink, bulk dispensers get a lot of things right. Buying product to fill these dispensers is much cheaper when compared to sealed cartridges. Users can also switch to a different soap brand easily, so swapping out soap scents or colors is a breeze.  

“Plastic cartridges are proprietary, and proprietary soap systems are designed by manufacturers to accept only their products,” explains Darrel Hicks, a cleaning consultant based in St. Louis. “I've been through conversions from one soap brand to a different one and I wouldn't wish it on anybody.” 

But the biggest advantage of bulk soap dispensers is their minimal impact on the environment. Unlike sealed cartridges, there is nothing to throw away after refilling bulk dispensers. This feature matters to many companies.  

“Reducing plastic waste and increasing sustainability is a big focus for many healthcare organizations,” says Shari Solomon, president, CleanHealth Environmental LLC, Silver Spring, Maryland.   

According to industry consultants, the advantages of bulk soap dispensers, however, end there. For example, bacteria can, and does, grow in bulk soap dispensers.  

“One project funded by  a soap manufacturer evaluated bulk soap in public restroom dispensers. It found that up to 25 percent,” explains Amanda Anderson, industrial hygiene manager, CleanHealth Environmental LLC.  refillable bulk-soap dispensers were contaminated with bacteria,” explains Amanda Anderson, industrial hygiene manager, CleanHealth Environmental LLC.   

Dr. Charles Gerba, microbiologist at the University of Arizona, led several of these studies. His team found that bacteria — including fecal bacteria from these contaminated dispensers — will stay on skin even after using the soap.  

“You get more fecal bacteria on your hands than if you stuck your hands in the toilet,” says Dr. Gerba. 

Once on the hands, germs easily transfer to other surfaces. Anderson quotes from a 2011 American Society of Microbiology study titled “Bacterial Hand Contamination and Transfer after Use of Contaminated Bulk-Soap-Refillable Dispensers”, which quantitatively demonstrated in community settings that washing hands with contaminated liquid soap increases the number of bacteria on hands: 

“Furthermore, the results directly demonstrate that bacteria from contaminated hands can be transferred to secondary surfaces. They therefore conclude that washing with contaminated soap not only defeats the purpose of handwashing but may contribute to the transmission of potentially harmful bacteria.” 

Bacteria can enter the bulk dispenser from a variety of sources.  

“Just opening the dispenser can introduce germs into the system, leading to contaminated contents,” says Hicks. “A researcher visited two sites where soap was contaminated during the mixing process prior to filling the dispenser. Out of curiosity, I opened the lid and saw mold around the edges; that’s the first sign that something’s wrong. Then I saw things floating in the soap and the residue building up at the bottom.” 

It gets worse. Hicks continues, “Vandals have been known to sabotage soap in unsecured, bulk dispensers. Even if the soap wasn't contaminated by a dispenser that hasn't been cleaned since it was installed 25 years ago, vandals can pour bodily fluids into the dispenser. One doesn't know what they are washing their hands with.”  

Bulk soap dispensers also allow cleaners to top off or dilute products with water. While these practices reduce waste, they also introduce risk. Soaps have different formulations and preservatives, so topping off one brand with another may negate the preservatives in both formulas. And diluting liquid soap with tap water affects the quality and introduces impurities.  

Risky as they are, bulk soap dispensers can still be used.  

“Don’t just assume all bulk soap dispensers are contaminated,” says Solomon, with caution. “But they do require additional maintenance activities and practices.”  

David Trinks of Trinks Consulting Group in Franklin, Massachusetts, agrees and ads that one of the biggest disadvantages of using bulk dispensers is the maintenance required to assure these products are functioning properly and providing a healthy option for building occupants.  

“These systems are labor-intensive, especially if you follow the manufacturer’s recommended cleaning schedule,” says Trinks. “That also includes regular sanitizing, refilling the soap, replacing batteries should it be motion activated, cleaning the nozzle, and unclogging the dispensing ‘pathway’ if necessary.” 

According to experts, it takes about 15-20 minutes to remove the dispenser from the wall, empty the old product, and clean out each dispenser. And the CDC recommends it during every refill.  

It’s unlikely that any time-pressed janitor is taking these precautions. Ironically, it might not even help much if they did. Because of its constantly moist environment, stubborn biofilm may form inside the dispenser.  

“Biofilms are the bigger problem, as once they form it’s difficult to remove,” says Trinks.  

Even soaking the dispenser in bleach doesn’t help much. Anderson points to a study of soap dispenser remediation, where the devices were soaked for 10 minutes in 5000 mg of sodium hypochlorite (bleach) to determine the efficacy of cleaning and disinfectant procedures against established biofilms: “The testing showed that contamination of the bulk soap returned to pre-test levels within seven to 14 days,” the study notes. 

That’s why if biofilm is discovered, “it’s advised to discard and replace the unit,” according to Trinks.  

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