Cleaning to prevent cross-contamination and the spread of infectious disease has always been a high priority for cleaning personnel in office environments. But in light of the current H1N1 influenza outbreak across the United States, jan/san distributors must make sure that their commercial clients are up to par on infection control products and procedures.

By the end of October, flu activity was increasing at a rate much higher than past flu seasons and health officials report that as many as 40 percent of Americans could contract H1N1 in the next 20 months with mortality in the hundreds of thousands if vaccines are not successful. Hospitals and schools are taking extra precautions, and commercial facilities are also stepping up their flu and infection control practices.

Disinfecting

Studies have shown that influenza viruses survive on surfaces for up to eight hours, giving them ample time to spread around an office. The Centers for Disease Control (CDC) recommends cleaning using U.S. Environmental Protection Agency-registered disinfectant cleaners with efficacy against Type A Influenza viruses such as H1N1.

These disinfectants should always be used on hard, non-porous surfaces that receive frequent hand contact, says Jonathan Cohen, vice president and director of sales for I. Janvey & Sons Inc., Hempstead, N.Y. In office spaces, these surfaces include fax and copy machines, desks, phones, computer keyboards and mice, light switches, door knobs, push plates, handles, railings and elevator buttons. In areas such as the break room common touch points to be disinfected are water fountains and water coolers, coffee pots, refrigerator handles, microwave handles and keypads and sink fixtures — to name just a few.

Custodians who want disinfectant cleaners to be effective must ensure that they are paying attention to two variables: dilution and dwell time.

Diluting concentrated chemical to the appropriate efficacy is important to ensure accurate kill claims. Chemical dispensing systems that automatically and properly dilute chemical, take away any guesswork. Many dispensing systems utilize a color-coded system to make it easier for cleaning staff, especially those who speak English as a second language. Shelf time is another consideration: After 30 days premixed or bottled disinfectants lose efficacy, which can result in reduced infection control and wasted labor dollars. Note the date when it was mixed on the bottle or in the janitor's closet — and replace it on the due date.

Dwell time is another very important procedural issue when using disinfectants. Just spraying and wiping doesn't give the chemical the time it needs to kill 99 percent of bacteria, says Jeannie Murphy, president of Murphy Sanitary Supply LLC, Tulsa, Okla. To do its job correctly, Murphy explains, disinfectant cleaners must sit on a surface for a specific amount of time according to the product's instructions — typically 10 minutes for proper disinfection. Not adhering to the needed time will waste product and labor dollars.

Speaking of labor dollars, disinfection products that perform multiple functions such as also serving as a cleaner and odor eliminator, add value by reducing products purchased and reducing labor, says Murphy.

Custodians can also use color-coded tools to prevent tracking germs from areas like the restroom to other areas such as the break room in commercial facilities. By using certain colors for certain areas in a facility, it can help janitors avoid accidentally using the same mop or cloth in a restroom and in office areas. Distributors highly recommend color coding as it's a way to simplify the cleaning procedures and it's easy for cleaners to recognize what product to use and where.

Microfiber technology is also helpful in preventing cross-contamination, says Eric Cadell, vice president of operations for Dutch Hollow Janitorial Supply, Belleville, Ill. These products provide better agitation and with chemicals, can help with the efficacy of kill claims for disinfectants. Microfiber cloths and mops also contain about 95 percent of bacteria found on a surface in the cloth, while traditional products may spread the bacteria around. Plus, microfiber cloths and pads are easier to swap out from room to room, so they are less likely to be used in multiple settings.

"Microfiber picks up more bacteria, dust and grime and can be laundered more often than cloth, so in the long run they're also doing a better job cleaning," says Cadell.

When cleaning, distributors also suggest cleaning personnel be instructed to wear protective equipment, including gloves and masks, to protect themselves when handling disinfectants.

Employees can also aid in infection control by being given spray-and-wipe or aerosol sanitizers to use in high-traffic, high-touch areas between full cleaning and disinfecting by maintenance staff. Distributors say premoistened disinfectant wipes are very well suited for offices as employees can use them throughout the day on telephones, keyboards, chairs and other commonly touched surfaces.

Encouraging Hand Washing

Infectious germs are primarily transmitted by the hands, so in addition to disinfecting, the CDC recommends hand washing. Proper hand washing entails first wetting and then scrubbing hands, wrists, cuticles and under fingernails for 15 to 20 seconds with soap and then rinsing and drying hands completely.

The CDC also recommends that if a person can't get to a restroom to wash hands, that alcohol-based hand sanitizer be used. These can be wall mounted or mounted on a stand and placed in common areas such as reception areas and elevator banks. As with proper hand washing, it's recommended to cover all surfaces of the wrists, hands, fingers and nails with product, but instead of rinsing, allowing it to air dry. Many offices are also providing employees with personal-use hand sanitizer to use throughout the day as needed and to bring with them on business trips.

Hands-free restroom fixtures encourage hand washing and reduce cross-contamination by eliminating traditional high-touch surface risks including flush handles, faucets, soap and towel dispensers and air dryers.

Distributors can also help their clients encourage hand washing by giving them posters they create themselves or get from manufacturers. These posters remind employees to wash their hands after using the restroom and relay personal hygiene habits such as not touching their eyes, nose or mouth.

All it takes is one person carrying a virus to make an entire office sick. Making sure infection control procedures are in place will help decrease absenteeism during the flu season, but building occupants have to make their own commitment to personal hygiene as well.

"Preventing infection is not only about what the custodian does," says Murphy. "It's all about personal habits like washing hands and staying home when sick."

Lauren Summerstone is a freelance writer based in Madison, Wis.

Selling Supplies

With a H1N1 pandemic among us, distributors should be prepared to offer clients a pandemic kit — a list of products and procedures aimed at keeping building occupants healthy.

Eric Cadell, vice president of operations for Dutch Hollow Janitorial Supply, Belleville, Ill., says his company has been receiving a dozen calls a day asking for such a package since word first started spreading about the population being exposed to H1N1. Because of the demand, Dutch Hollow created a promotion called "PIG": Preinfluenza suggestions. This list includes disinfectant, facial tissue, instant hand sanitizer, gloves for cleaning and facemasks for people currently infected.

"Those are the five things the CDC recommends," says Cadell. "It gives the package credibility. They're already buying hand soap and hand towels, but these are the Ôwhat am I still needing?' items. Customers want to know they're going to be taken care of, especially in a pandemic situation."

Jeannie Murphy, president of Murphy Sanitary Supply, LLC, Tulsa, Okla., has been asked by her customers for a similar solution, so her company created a list of specific products that she now e-mails to clients that includes spray disinfectants, premoistened disinfectant wipes, hand care products and sanitizing foggers in case remediation is called for.

But helping clients with their infection control needs has not gone as smoothly as distributors would like. With consumers washing their hands more, there is high demand for soap and hand sanitizer products — so much that manufacturers cannot keep pace — causing backorders.

"No one expected H1N1 to take off like it did and that entire offices would be washing their hands four times a day," says Cadell.

To avoid disgruntled customers, distributors are best suited to let their customers know up-front that hand sanitizer and soap products are at a high-demand. Communicating to customers ahead of time is better than letting them order the product and being disappointed later because it's backordered.