by Dana Ryan, Certified Clinically Clean® Specialist

Soft surface sanitizing is one of the more commonly overlooked environmental cleaning issues in every industry, including healthcare.

Innovators are continually working to create solutions requiring less work for janitorial staff, while providing more protection against contamination and hospital-acquired infections. However, there has been relatively little done to establish standards or guidelines for soft surface sanitizing.

More Guidelines Needed

The importance of hard surface sanitization and disinfection are more clearly understood and there are established guidelines.

The Centers for Disease Control and Prevention (CDC) has published lengthy articles for hard surface infection prevention for healthcare and other industries. And yet recommendations by the CDC for soft surface sanitizing for carpet, rugs, curtains, etc. are limited to the following:

• Clean the surface using soap and wateror with cleaners appropriate for use on these surfaces.
• Launder items(if possible) according to the manufacturer’s instructions. Use the warmest appropriate water setting and dry items completely.

OR

• Disinfect with a household disinfectant on EPA List N: Disinfectants for Coronavirus (COVID-19)  approved for use on porous surfaces.
• Vacuum as usual.

It is clear that there is much work to do to inform the public on best practices for soft surface sanitizing.

Germs On Hospital Curtains

In a private survey published by the American Journal of Infection Control, hospital infection preventionists were asked how often their facility’s privacy curtains were cleaned. Most respondents (37%) answered “when visibly soiled.” Additional answers ranged from “once per month” to “once per year.” Yet it’s estimated by the Association for Professionals in Infection Control and Epidemiology that it takes only two days for a standard privacy curtain to become infected.

New resources, like the Society for Healthcare Epidemiology of America’s guidance on Healthcare Personnel Attire in Non-Operating-Room Settings are helping to inform healthcare personnel on contamination of soft surfaces (white coats). But much additional research and identification of patterns of pathogen transmission will be helpful to the industry.

All soft surfaces have the potential to be infected with germs: cotton, canvas, polyester, nylon, carpet, drapes and curtains, upholstered chairs, sofas, mattresses, pillows, etc. Pathogens on soft surfaces can survive for long periods of time and can be transferred to the hands or items worn by those who touch the contaminated surfaces.

Pathogen                                Lives On Soft Surface

Influenza Virus                        Several hours

MRSA                                      2 to 3 months

VRE                                          2 to 3 months

Pseudomonas aeruginosa      Several months

Candida albicans                     Up to 4 months

Reduce Risk Through Soft Surface Sanitization

Regularly performing soft surface sanitization can minimize the risk for transferring pathogens, but will not eliminate the potential for infection.

It is important to understand that there are differences between cleaning, sanitizing, and disinfecting. As we have reported previously in DisinfecTips.com, hard, nonporous surfaces can be disinfected when used according to the disinfectant’s label.

Cleaning refers to the physical removal of visible soil and organic filth by washing or wiping with a detergent. Cleaning should be performed prior to any sanitization or disinfection process.

Sanitizers reduce the level of bacteria on a surface to render the surface “safe,” but do not necessarily eliminate all bacteria. For more information the CDC publishes these guidelines.

There is a U.S. Environmental Protection Agency (EPA) claim specific for products approved for soft surface sanitizing.

• The product must achieve a 99.9% reduction efficacy on cotton and polyester soft surfaces using test organisms to include aureus, Enterobacter aerogenes or Klebsiella pneumoniae.
• Products with a soft surface sanitizing claim do not provide a claim for efficacy against viruses, fungi, mycobacteria, or bacterial spores.
• Sanitizing does not achieve the same kill level as a disinfection claim.

All EPA-registered disinfectants can sanitize, however, not all sanitizers are capable of disinfecting. Some multipurpose EPA-registered products can be used on both hard and soft surfaces.

To select a product for use on a soft surface, the product must be used according to the manufacturer’s “Directions For Use.” Relevant kill claims and approved uses will be included on the label including concentration and contact time. Contact time is the amount of time that the item or surface is to be kept “wet” with the disinfectant. In order for the cleaning product to work as claimed, it needs to stay wet on the surface long enough to kill the bacteria or virus. Once the surface dries, the disinfectant has no more germ-killing power. You may need to reapply the product if the surface dries before the recommended kill time.

by Autumn Ryan, Founder & CEO of Aseptic Health

This DisinfecTip is straight off the Environmental Protection Agency’s (EPA) website, hopefully paraphrased so that it’s easier for you to understand. The trail to being an N Listed disinfectant and receiving the Emerging Viral Pathogen claim is a lengthy process.

We’ve been on this path for months. First, we made the “N List”because we had kill claims for viruses that are more difficult to kill than the coronavirus that causes Covid 19. As of March 10, 2021, Aseptic Plus (the premiere hospital-grade disinfectant that has been Certified Clinically Clean® by Aseptic Health) has received the EPA’s Emerging Viral Pathogen claim.

Aseptic Plus kills SARS-CoV-2, the coronavirus that causes the Coronavirus Disease 2019 (COVID-19) in 5 minutes.

We received this kill claim in December, 2020 from an EPA accredited lab.

Why So Long?

You may wonder why it took so long for the EPA to stamp our claim.

Since the novel coronavirus appeared in 2019 many manufacturers of disinfecting products have been formulating and reformulating products to meet the emerging viral pathogen for large and small enveloped and non-enveloped viruses. (More about the different viruses to follow.)

The truth is, the EPA is inundated with manufacturer’s claims, and that’s not all the agency is responsible for. With floods, storms and the pandemic under their purview, they’ve been busy. It can take up to 90 days to receive approval, although they have tried to fast-track claims associated with Covid 19. Our claim was stamped right around the 90-day mark.

What Are Emerging Viral Pathogen Claims?

The National Institute of Allergy and Infectious Diseases defines “emerging infectious diseases/pathogens” as those “that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range.”

Many of these diseases are viruses, such as SARS-CoV-2.

Emerging pathogens are not all common or predictable. Few disinfectants on store shelves that are EPA-registered product labels specify use against this category of infectious agents. Why? Testing is expensive and manufacturer’s would rather pay for testing commonly known pathogens.

In 2016, the EPA provided a voluntary, two-stage process to enable use of certain EPA-registered disinfectant products against emerging viral pathogens not identified on the product label.

A manufacturer can even apply for an emerging viral pathogen claim before an outbreak occurs, based on previous EPA-approved claims for harder-to-kill viruses.

That is how Aseptic Plus achieved its listing on the EPA List N not long after the pandemic was declared. It was expected to kill SARS-CoV-2 (a large enveloped virus) because it kills pathogens that are even harder to kill such as HIV, Hep A, B and C and others. In addition, Aseptic Plus had the canine coronavirus and feline coronavirus kill claims on our product label prior to the outbreak.

In Review

Once the emerging pathogen is tested and killed—in this case SARS-CoV-2 is a relatively easy virus to kill—the EPA reviews the supporting information to determine acceptability.

Aseptic Plus was accepted for use against:

• An enveloped virus (easier to kill). These viruses are the least resistant to inactivation by disinfectants. Their structure includes a lipid envelope which is easily compromised by most disinfectants. Once the lipid envelope is damaged, the integrity of the virus is compromised, thereby neutralizing its infectivity.
• A large, non-enveloped virus (harder to kill than an enveloped virus) such as Norovirus (stomach flu). These viruses are less resistant to inactivation than small non-enveloped viruses. Although they have a resistant protein capsid, their larger size makes them more vulnerable to inactivation than a small non-enveloped virus. Our kill time for this group is 10 minutes.
• A small, non-enveloped virus (hardest to kill). An example of this virus is Adenovirus, a truly nasty virus that can cause pink eye, diarrhea, sore throat, cough and fever. Small, non-enveloped viruses can be highly resistant to inactivation by disinfectants. Despite the lack of a lipid envelope, these organisms have a very resistant protein capsid. Our kill time for this group is 10 minutes.

EPA Lists

All EPA-registered pesticides—a disinfectant is a pesticide—must have an EPA registration number. This number consists of a company number and a product number (e.g., 82972-1). Alternative brand names, such as Aseptic Plus, have the same EPA registration number as the primary product followed by additional numbers: 82972-1-91603. The primary product number is what appears on the list.

• When purchasing a product for use against a specific pathogen, check the EPA registration number versus the products included on the list.
• If you would like to review the product label information for any EPA registered product, please visit the EPA product label system.
• Inclusion on any list does not constitute an endorsement by EPA.

Aseptic Plus is included on the following EPA Lists:

List C: EPA’s Registered Antimicrobial Products Effective Against Human HIV-1 Virus

List D: EPA’s Registered Antimicrobial Products Effective Against Human HIV-1 and Hepatitis B Virus

List F: EPA’s Registered Antimicrobial Products Effective Against Hepatitis C

List G: EPA’s Registered Antimicrobial Products Effective Against Norovirus

List N: Disinfectants for Use Against SARS-CoV-2

by Andrea Velasquez, Certified Clinically Clean® Specialist

Look around your workspace. Have any idea where germs live? Keep reading to learn more about where germs come from and where they like to hang out.

What Is A Germ?

Germs are tiny, microscopic organisms that fall into one of four types. Germs are either Bacteria, Viruses, Fungi or Protozoa. Not all germs are bad. In fact, life wouldn’t exist without them.

Bacteria

These are tiny, one-celled creatures that get nutrients from their environments in order to live, such as the human body. Bacteria can reproduce outside of the body or within. Inside the body they can cause infections such as earache, tonsillitis, strep throat or pneumonia. But not all bacteria are bad. Some bacteria are good for our bodies and keep our intestines balanced. In addition, some bacteria are used to produce medicines and vaccines.

Viruses 

These organisms depend on living cells to grow and reproduce. Most viruses can’t survive very long if they’re not inside a living thing like a plant, animal, or person. Viruses can cause diseases such as chickenpox, measles and the flu.

Fungi 

These are multi-celled, plant-like organisms. Unlike other plants though, fungi cannot make their own food. Instead, fungi get their nutrition from plants, people, and animals. They love damp, warm places, and many fungi are not dangerous in healthy people. An example of something caused by fungi is athlete’s foot.

Protozoa 

These are also one-celled organisms. They love moisture and often spread diseases through water. Some protozoa cause intestinal infections that lead to diarrhea, nausea, and stomach pain.

Where Germs Live In The Workplace

Although germs exist naturally, bacteria, viruses, fungi, and other microbes can cause serious problems when they are allowed to replicate. For this and other reasons, it is safest to have a regular workplace cleaning regime.

Some facilities, such as dialysis clinics or urgent care facilities, have an even greater need to prevent contamination. But even if your workplace is outside of the healthcare space, it can still be made safer by controlling germ populations.

Here are 10 places where germs live.

1 – Inside the Body

Did you know that according to research from the University of Colorado at Boulder,

at any given time we carry 3,200 bacteria from 150 different species on our hands? Though this may seem like a lot it’s a small fraction of the number of bacteria living inside you. The number of bacteria that inhabit your gastrointestinal system is greater than the number of cells that make up your entire body.

Fortunately, the bacteria in our GI tract shouldn’t come into contact with others in normal circumstances. Still, people have bacteria on the skin and nasal secretions that could potentially harm someone, especially a person with a compromised immune system.

As a result of the pandemic, we’re now very familiar with how to keep from getting sick from person to person contact. Fist or elbow bumps instead of shaking hands. Frequent hand washing. Don’t touch your face with your hands. In the workplace, if you haven’t already, post a sign in the restrooms that reads: Wash Your Hands! Use soap and water while singing Happy Birthday through twice (20 seconds).

2 – Faucets and Drinking Fountains

Another obvious place where germs live—because we use our hands to turn them on—are faucets and drinking fountain knobs. The presence of water itself favors bacteria. High-touch items such as these need to be disinfected correctly. Read the disinfectant’s label to know how long the faucet or knob must stay wet before it kills germs properly. You may need to keep the surface wet with disinfectant for a full 10 minutes.

3 – Telephones

Telephones are clearly a possible source of infection. People touch them with their hands holding them close to their face for prolonged periods of time. Routinely disinfecting phones is an effective way to reduce the risk of infection. Again, check the label of the disinfectant to know how long the telephone must stay wet to be properly disinfected.

4 – Keyboards and Computers

The keyboards most people use every day are the perfect breeding ground for bacteria from hands. Keep your keyboard, mouse and mousepad clean and disinfected. Avoid touching your face while using your keyboard. After using your keyboard, wash your hands for 20 seconds with soap and water.

5 – Ventilation Systems

The ventilation and cooling systems are frequently guilty of harboring and dispersing germs through the air. They can cause infections that are difficult to treat, such as pneumonia. If your workplace is experiencing viral or bacterial outbreaks often, you may want to have a professional inspect your ventilation system for mold or a heavy build-up of dust.

6 – Curtains

In a private survey published by the American Journal of Infection Control, hospital infection preventionists were asked how often their facility’s privacy curtains were cleaned. Most respondents (37%) answered “when visibly soiled.” Additional answers ranged from “once per month” to “once per year.” Yet it’s estimated by the Association for Professionals in Infection Control and Epidemiology that it takes only two days for a standard privacy curtain to become infected.

All soft surfaces have the potential to be infected with germs: cotton, canvas, polyester, nylon, carpet, drapes and curtains, upholstered chairs, sofas, mattresses, pillows, etc. Pathogens on soft surfaces can survive for long periods of time and can be transferred to the hands or items worn by those who touch the contaminated surfaces.

Pathogen                                           Lives On Soft Surface

Influenza Virus                                 Several hours

MRSA                                                2 to 3 months

VRE                                                    2 to 3 months

Pseudomonas aeruginosa             Several months

Candida albicans                             Up to 4 months

7 – Furniture

Like curtains, furniture is rarely cleaned in the workplace. And like on curtains, germs can survive on chairs for a long time. Try and disinfect the arms of your office chair daily. Or if an armless chair, disinfect the bottom of the seat where you’re likely to grab with your hands.

8 – Floor

Germs are tracked in on the soles of shoes making the floor one of the germiest places in your workplace. That is why most food production facilities require employees to enter through a shoe bath.

9 – Elevators

Elevators are an often overlooked hiding spot for germs. They are a small, confined space shared by everybody. Also, they require the users to push buttons to operate.

10 – Kitchen Appliances

Most workplaces have a kitchen area or lounge where employees can share meals and potentially share germs. In eating areas, the most common place where germs live are on the buttons and handles of the microwave and refrigerator. Also don’t forget to clean and disinfect shared salt and pepper shakers.

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