Types of Disinfectants Used in Healthcare Facilities

In order for a product to be labeled a disinfectant, it needs to be approved by and registered with the U.S. Environmental Protection Agency (EPA).
The EPA has recently published a list of hospital-grade disinfectants that have been tested or are pending testing, says Hicks. The Antimicrobial Testing Program list includes those whose efficacy has been confirmed, as well as products that are under EPA deliberation.

The EPA breaks disinfectants into the following categories: bleach, phenols, quats, accelerated hydrogen peroxide, botanicals and silver dihydrogen citrate.

Disinfectant wipes can also be a good solution, especially for areas that need to be cleaned quickly, or by non-environmental services personnel.
A number of facilities are incorporating accelerated hydrogen peroxides into cleaning programs, which not only work very effectively as a disinfectant and tuberculocidal, but are also gentle on surfaces and on people. The drawback is most of them are ready-to-use (RTU) only, adding a significant price increase per use of the product.

“For large areas, like floors, the RTU accelerated hydrogen peroxides don’t make sense. But if you’re cleaning up blood or urine or other bodily fluids, you want to use a tuberculocidal hydrogen peroxide product for specific things like that,” says Beatrix Babcock of HGI Consulting in Denver.
Most sophisticated cleaning operations use a dilution control system for disinfection, Thomas says — and the price difference between concentrated chemicals and RTU chemicals is tremendous.

“Using a concentrate might cost you 20 cents a quart in diluted form whereas an RTU disinfectant might cost $5 a quart — but in a healthcare environment where accreditation is at stake and compliance is required, the cost may be justified,” Thomas says. “Most of these products with quicker dwell times are ready-to-use, so you’re weighing cost against time, and when time is money, it can make sense to use the product that allows you to work more efficiently.”

The benefits of hydrogen peroxide technology are four-fold, says Attman: disinfecting a wider range of microorganisms, faster, safer, and greener.
“When you use it on a surface, you’re really going to get the necessary penetration in that one minute kill claim — versus the alcohol-based quat products that have a two-minute dwell time which also may require a cleaning of the surface,” Attman says.

Clostridium difficile (C. diff) is the most difficult infection to kill and currently a huge priority and problem in healthcare facilities. The only disinfectants that work against this threat are accelerated hydrogen peroxide and bleach-based products.

Faster Dwell Times Here To Stay

Any time a manufacturer releases a new disinfectant, the goal will be to get as short a dwell time as possible, Thomas says. But 30 seconds may be the limit as to how fast disinfectants achieve efficacy.

“Typically, dry time for any liquid product that is sprayed on a surface is two to three minutes, so I would think that would be the goal for most products that currently have longer dwell times,” he says.

Some facilities will continue to use products with a 10-minute dwell time, however; those types of disinfectants are tried and true, and aren’t going away.

“There will still be a place for the 10-minute dwell time. If a public or private office building has a presentable restroom and the janitorial services are using a disinfectant with a 10-minute dwell time, nobody’s going to question that. Building managers aren’t going to want to pay more for a different, more expensive product,” Thomas says.