Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.

Our expertise is utilized by Infection Preventionists, Public Health Experts, First Responders, Dentists, Physicians, Nurses, Veterinarians, Aestheticians, Environmental Services professionals and janitorial product distributors to develop more sustainable cleaning and disinfection practices in North America.

Our commitment to providing chemical disinfectant education is more than business, it is a passion.

Wednesday, July 27, 2011

See no evil....

This week for a change of pace I have included a video – I’ve watched it a zillion times and always chuckle and hope you will too. But before you click the play button and start dancing to the catchy tune let me ask you a question. Have you ever stood back after cleaning your bathroom or kitchen and commended yourself on a job well done? I’m sure we’ve all thought “WOW! Look how shiny everything looks! Did I ever out do myself this week!” In that same instance did the thought ever cross your mind..... “I wonder what I have left behind?”


Shiny Bubbles Video


Traditionally cleaning chemicals are designed to break down grease and grime and help lift it off the surface so it can be picked up by a sponge, cloth or mop. The cleaning process generally introduces a cleaner or cleaner disinfectant that can be comprised of a number of different chemical agents including large quantities of water. These now clean but wet surfaces are left to dry, where only the water component of your cleaning solution evaporates leaving residual chemicals to dry on the surface. Just like the shiny little bubbles from the video.


Many of the common cleaning and disinfecting products used at home, in daycares or schools and healthcare facilities are known to leave behind chemical residues. Now – not all residues are equal. If you don’t rinse your dishes after washing them by hand, you may taste the soap residue, but it’s not going to kill you. Other chemicals such as phenols are known to leave a residue that can cause skin irritation, have been identified as known carcinogens and are not to be used around children. Quaternary ammonium compounds (Quats) are also known to leave residues on surfaces and while Quats are not considered toxic, the residues they leave behind can harbour dirt and bugs that were not removed from the cleaning process and build up overtime. It is this bioburden that in some cases has been associated with continued facility outbreaks – especially of C. difficile where the C. diff spore can survive on surfaces for months on end.


Another concern that comes with residues being left on surfaces is the potential for development of chemical resistance. These residues are at the sub-lethal dose meaning they are below the effective concentration needed to achieve disinfection and while most studies supporting the development of chemical resistance have been conducted in laboratory settings there are a few documented occurrences from the field (we’ll delve into the development of chemical resistance in a later blog).


As Lee and I have been highlighting, perhaps ad nauseam over the past seven weeks choosing a cleaner, a disinfectant or disinfectant cleaner cannot be based on one criteria alone, but is a decision made after research and review of all the criteria that are of importance to you, your family or the facility for which you are choosing the product for. When it comes to chemical residues, the bottom line is the fewer residuals left behind on the surface the better.



Bugging Off!


Nicole

Wednesday, July 20, 2011

What’s In Your Bottle??

At the beginning of nearly every speaking opportunity I have, I choose to review some key trends and the corresponding implications surrounding the use of disinfectants and their role in infection prevention and control. I believe that by addressing these few points it sets the stage for a hopefully informative, educational session.

One of the big picture trends that I am sure you will all recognize is that infection prevention and control is moving mainstream. It isn’t isolated to healthcare any longer, but has become a part of our daily lives like it has never been in our past. This trend directly drives another important trend: the consumption of disinfectants is increasing dramatically. This should come as no surprise. It’s an almost mathematical equation. If our awareness for infection and prevention and control increases, so too will the usage of the tools to prevent infections. Disinfectants are a key tool in the fight against microbes. Unfortunately, a critical implication of this increased disinfectant usage is the potential negative impact it could have on our environment. So this begs the question, how can we lessen or eliminate this negative impact on the environment without compromising our infection prevention and control practices?

Ideally, we will select a disinfectant product that carries both suitable germicidal performance for our particular application AND an environmental profile that is preferable and sustainable. Historically speaking this has been quite difficult to achieve because chemical formulators often have to play a balancing act when developing disinfectants. On one side – speed and spectrum of disinfection; on the other – safety and environmental profile. If the goal was to develop a product that carried broad spectrum performance in a rapid contact time, the safety and environmental profile was nearly always sacrificed as a result. The opposite was also true. If a safe, environmentally preferable product was favoured, the scales would shift and disinfectant performance was often compromised and thus poor as a result. Fortunately, new, novel disinfectant chemistries are coming to market that address this flaw in many legacy disinfectants. These unique disinfectants can strike the needed balance between germicidal performance and safety (personal and environmental) profiles without compromising on either.

Before I go, I am compelled to provide a couple of last suggestions. First and foremost, don’t simply rely upon fancy marketing materials or pretty green labels advertising the product as GREEN. Wherever possible, search for industry recognized Eco-Labels such as EcoLogo to ensure that the claims being made pertaining to the environmental profile of the product have been reviewed and validated against standardized criteria. This will ensure that you’re not being “Greenwashed” as they call it. Lastly, double check the disinfectant claims on your “Green” disinfectant to ensure you’re not giving up too much in the way of disinfectant performance to secure an environmentally preferable disinfectant.

How important is an environmentally preferable disinfectant to you or your organization? Are you willing to compromise on disinfectant performance (slower contact time, narrower spectrum of kill) to achieve this environmental responsibility?

Hasta la vista!


Lee – The Germinator

Thursday, July 14, 2011

We Break from Our Regularly Scheduled Programming for this News Flash!

For any of our readers living in Canada, many of you have no doubt been blindsided by the barrage of news stories emanating from the Ontario healthcare facilities that are currently in the clutches of Clostridium difficile outbreaks. For this reason, we are breaking from our scheduled topic of discussion to address this infection prevention and control issue that’s dominating the news.


In the writing of this blog I’m going to skip the basics in the assumption that many of our readers are already familiar with this information. However, if you’re not, please feel free to review the information found in the following links:


Clostridium difficile Fact Sheet


Testing, Surveillance & Management of Clostridium difficile in All Health Care Settings


Let’s jump directly into the discussion that is of direct interest to The Clean Freaks. How do we go about cleaning and disinfecting the environment to adequately remove C. diff spore contamination?


Clearly the most important or unique aspect of cleaning and disinfecting an environment that is potentially contaminated with C. diff is the fact that Clostridium difficile is most commonly found in its very resistant spore form when deposited in the environment. Essentially, this spore acts like a coat of armour on the bacteria protecting it from various environmental hazards including many cleaning and disinfecting chemicals. This has major implications on the practices and particularly the disinfectant products that need to be utilized to render the surfaces safe. Unlike vegetative bacteria or viruses, typical hospital grade disinfectants are simply not effective for the disinfection of C. diff spores. For this reason, specialized agents must be employed to penetrate the spore and kill the bacteria.


So when should we implement these specialized spore killers? How aggressive should we be with their use?


Some would argue that we should take a pro-active or preventative approach with C. diff as we do with many other pathogens. That is, implement a disinfectant for daily use throughout a healthcare facility that effectively kills C. diff, thus potentially preventing the deadly and costly outbreaks before they even begin. While I understand this way of thinking and would certainly agree that this is what we should work towards, I do not believe we are at a point where this approach is feasible. This is namely because the current commercially available sporicidal agents are simply too aggressive for day-to-day usage throughout an entire facility. By this, I mean they typically require heightened safety precautions and their prolonged use will likely result in the premature degradation of some surfaces and sensitive equipment. Certainly, neither of these side-effects would be considered desirable. Therefore, I suggest an alternative option. One that consists of a more targeted, or task oriented stepwise approach. Instead of recklessly bathing a facility with highly concentrated disinfectant solutions on a daily basis regardless of outbreak status, I propose addressing only those areas where C. diff is most likely to be present or is suspected to be present with these sporicidal agents. For example, scientific studies have shown that the bathrooms of C. diff isolation rooms are the most highly contaminated areas. Therefore, the usage of a sporicidal agent in that confined space makes sense as a first level intervention. Or perhaps if a facility is battling endemic C. diff, we contemplate cleaning and disinfecting all bathrooms throughout the facility in this manner in an effort to reduce the potential bio-burden that may be present. Lastly, should the unfortunate situation arise where a cluster or outbreak of C. diff occurs do we contemplate aggressively blitzing the affected unit/ward or entire facility with the sporicidal agent. In following this approach, the intent is to minimize the potential for negative consequences that could result from the misuse of sporicidal agents and instead get the greatest return on our investment from their usage.


Lucky for me, it just so happens that some of the leading infection prevention and control experts also agree with this approach (See earlier link to PIDAC C. diff Management Guideline). So how do you clean and disinfect your facility when C. diff may be an issue?


Hasta la vista!


Lee- The Germinator

Wednesday, July 6, 2011

VOCs – the smells and signs of summer

What words pop into your head when you think of summer? Ranked in no particular order, I think of: flowers, fresh fruits and vegetables, sun tan lotion, smog, boating, bug repellent and beer. Aside from their association with summer, they are also all linked with emitting Volatile Organic Compounds (VOCs), well except for smog which is a result of air pollution due to VOCs.

Organic compounds are chemicals that contain carbon and are found in all living things. Volatile organic compounds, often referred to as VOCs, are a large and diverse group of man-made and naturally occurring chemical compounds, both solid and liquid that easily emit vapours or gases. Oddly enough, the majority of VOCs arise from plants (tomato plants emit some of the highest concentrations of VOCs). Man-made or anthropogenic emissions contribute about 10% of the biological level, but include the compounds that are regulated, especially for indoors where concentrations can be highest (up to 10 times higher than the level found outdoors).

Organic chemicals are widely used as ingredients in commercial and consumer products. Paints, varnishes, and wax all contain organic solvents, as do pesticides, building materials, furnishings (thanks to our fire regulations and the much needed stain resistant chemicals we add to protect said furniture!). Fuels are also made up of organic chemicals and we all know there are more cars on the road and boats in the water during the summer. Of course many cleaning, disinfecting, cosmetic, hobby products (who doesn’t love the smell of fruit flavoured markers and modeling glue) and last but not least air fresheners of all forms – scented candles, plug-ins, sprays and yes even those awesome reed diffusers! All of these products can release volatile organic compounds while you are using them, and, to some degree, even when they are stored.

The health effects of VOCs can range from being highly toxic to having no known health effects depending on to the compound. The health effects will also depend on nature of the volatile organic compound, the level of exposure, and length of exposure. Long-term exposure to VOCs can cause damage to the liver, kidneys and central nervous system while short-term exposure to can cause eye and respiratory tract irritation, headaches, dizziness, visual disorders, fatigue, loss of coordination, allergic skin reactions, nausea, and memory impairment.

So where does this lead us? Why to prevention and avoidance, of course. We can prevent air pollution through the avoidance of the use of VOC laden products. As consumers we can make choices about the products we use at home. Avoid the use of products containing solvents, alcohols and fragrances (more on fragrances in a future blog). Those ambitious enough can bike or walk to work. The less ambitious could investigate car pooling. As decision makers for cleaning and disinfectants used in healthcare and educational facilities while avoidance of all VOC-containing products is unavoidable we can certainly try to limit the use of products that unnecessarily contain VOCs. Alcohol-based hand sanitizers most definitely emit VOCs; however, the importance of clean hands in stopping the transmission of hospital acquired infections is far too important to cease their use. We can reduce the emissions of VOCs by wisely choosing the cleaning and disinfection chemicals which are VOC free. These are the chemicals that are used daily in every area of the facility in far larger quantities and on far more surfaces – the impact from switching to VOC-free products will markedly improve the quality of the air we breathe.

Who knows…maybe the memory impairment and the daily fatigue I was contributing to old age and chasing after a 2 year old is in fact a result of breathing in volatile organic compounds - I am fastidious in my infection control practices and do so love the smell of my Lemon Grass reed diffuser………

Lee is back next week to blog about the importance of chemical sustainability and chemical resistance development.

Bugging Off!
Nicole