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.

Friday, November 30, 2012

Disinfectant Chemistry Report Card #10 – IMPROVED H2O2 – Have we found the silver bullet?


In May, the Chemistry Blog focused on Hydrogen Peroxide.  Now, you might wonder, why then would we dedicate a second blog to Hydrogen Peroxide.  Aside from the fact that the Improved H2O2 formulations are patented, the primary reasoning is that these formulations truly stand out as unique and novel technologies that warrant further discussion.

Ever since the progression of the medical sciences various chemicals have been used as active ingredients for disinfection and sanitization, with the newer actives being more effective, safer, and easier to use. Currently, the most common disinfectants use quaternary ammonium compounds (QUATS), alcohols, or sodium hypochlorite (bleach) as their active ingredients. The use of above actives imposes various problems such as user hazards, efficacy limitations, and negative environmental effects. Improved Hydrogen Peroxide has successfully tackled all these issues.

Improved Hydrogen Peroxide formulations contain varying levels of Hydrogen Peroxide in combination with anionic and /or non-ionic surfactants (detergents), and other inerts such as chelating agents and wetting agents.  This combination of chemicals works in synergy to provide exceptional cleaning efficiency but most importantly, from an infection prevention perspective, boosts the antimicrobial speed and spectrum of efficacy of hydrogen peroxide.  Improved Hydrogen Peroxide leaves no residues on applied surfaces as it turns into water and oxygen upon drying, and imposes no use or environmental hazards as its use concentrations and decomposition products are very low and thus safe.  In fact, Improved Hydrogen Peroxide formulations have attained the lowest toxicity category as defined by the US EPA.  As Category IV classified compounds they are considered practically non-toxic and non-irritating.

Improved Hydrogen Peroxide products are commercially available through a number of companies in various concentrations ranging from 0.5% to 7% and varying applications.  Such companies have differing marketing terminology for their patented technologies such as “Accelerated Hydrogen Peroxide” or “Activated Hydrogen Peroxide”.  As per the advantages described above, Improved Hydrogen Peroxide is a well-rounded active ingredient that has no limitations in its use at ranges of product types. At concentrations of 0.5% to 1.4%, Improved Hydrogen Peroxide formulations can be used for cleaning and disinfection of environmental surfaces and non-critical devices.  Improved Hydrogen Peroxide formulations with peroxide concentrations higher than 2% can be used as high level disinfectants and chemosterilants; solutions that can be used to submerge semi-critical and critical medical devices. Utilization of Improved Hydrogen Peroxide in hand sanitizers is another new method for skin surface sanitizers. Its use provides superior antimicrobial efficacy without endangering the users by skin sensitization, toxic chemical residue leftover, or risks of oral consumption abuse. Similar to the dermal applications, the use of Improved Hydrogen Peroxide for animal hygiene is also another advantage to produce animal care products that are both safe and effective. Due to generally high compatibility and low corrosiveness of Improved Hydrogen Peroxide, its disinfectant solutions are also used to disinfect a variety of sensitive medical instruments and apparatuses. Improved Hydrogen Peroxide is not limited in its uses; more areas of development are considering its use while its acceptance among the end users is growing due to its advantages.

Depending on application Improved Hydrogen Peroxide formulations are utilized within a spectrum of various concentrations.  Taking this into account, here’s how we would score Improved Hydrogen Peroxide on the key decision making criteria:

• Speed of Disinfection – A to B

o Formulation dependent, surface disinfectants range from 30 second sanitizing to 10 minute disinfection, Sporicidal Surface Disinfectant in 10 minutes, High Level Disinfectants for Instrument disinfection 5 minute disinfection and Chemical Sterilants in 20 minutes.

• Spectrum of Kill – A

o Similar to above, spectrum of kill is formulation dependant

o Depending on the Improved Hydrogen Peroxide formulation they are capable of killing all microorganisms; bacteria, viruses, fungi, mycobacteria and spores.

• Cleaning Effectiveness – A

o Excellent cleaning capabilities as the formulations include a blend of non-ionic and anionic surfactants which are known to provide superior cleaning in conjunction with H2O2 which also aids in cleaning

• Safety Profile – A to B

o At their in-use concentrations, surface disinfectants are non-toxic and non-irritating for users. 

o Instrument disinfectants are non-toxic and do not require special ventilation systems

• Environmental Profile – A

o H2O2 degrades into water and oxygen. 

o Some Improved Hydrogen Peroxide surface formulations have been developed to achieve Eco-certifications such as EcoLogo and EPA’s Design for the Environment (DfE).


**For more in-depth scientific information about Improved Hydrogen Peroxide and other disinfectant chemistries, stay tuned to www.infectionpreventionresource.com.

Bugging Off!
 
Nicole

 

Thursday, November 22, 2012

Hand Washing and Drying to Reduce Microbial Contamination


Everybody’s hands are frequently contaminated with enteric microorganisms, and food workers are no exception. These workers may be even more exposed because of their work with raw food ingredients and their frequent contact with fellow workers and the public.

Unlike hand contamination with staphylococci from the nasopharynx, the enteric bacteria that contaminate the hands of food workers more often are associated with raw foods of animal origin rather than poor personal hygiene after visiting the toilet.

Hand hygiene compliance at the retail food service level is known to be inadequate. Hand hygiene practices of food workers are dependent on the type of work involved and the type and nature of the soil on their hands. Compliance begins with a commitment by management to designate safety as the number 1 concern in the establishment and to introduce regular training programs for safe production of food, as well as when and how to wash hands effectively.

Many people, workers included, feel that their hygiene routines are sufficient because no adverse consequences have been experienced over many years of performing the same procedures. Gross hygiene errors may be in place for a long time in foodservice operations and not be identified until associated illnesses are reported. For instance, two United Kingdom catering facilities (in Scotland and Wales) were thoroughly investigated in public inquiries following large outbreaks with illnesses and deaths. Workers with management acceptance had contaminated cooked meat products.

Washing

Hand washing times of 15 to 30 seconds have been recommended by different agencies around the world. For many years sanitarians have specified that the hands of food service workers should be washed and rinsed in hot water to reduce the risk of cross-contamination and disease transmission. However, the use of water at these temperatures has not been supported by research. Hand washing with water at high temperatures may contribute to skin damage when frequent hand washing is required, and insistence on hot water usage may be a deterrent to hand washing compliance.

To reduce the potential for bacterial transfer, food workers may need to wash their hands for longer than 15 seconds or may need to wash more often. Thorough rinsing is important because this action also removes potential skin irritants and contact sensitizers originating in food, soaps, metals, and facility disinfectants that could lead to dermatitis. Triclosan, triclocarban-trichlorocarbamide, and parachlorometaxylenol-chloroxylenol are commonly used antibacterial hand cleaning agents, however Gillespy and Thorpe found that germicidal soaps were not remarkably more effective than ordinary soap for reducing the numbers of bacteria transferable from the skin to handled objects. Infectious disease outbreaks have also been linked to workers with long or artificial fingernails. Without the regular use of a nail brush, they are very difficult to clean even with appropriate soaps, hand rubs, or gels.

Drying

Hand drying has two effects: removal of moisture through absorption and removal of microorganisms through friction. The friction generated during hand drying is even more important than that generated during washing because the soaping stage has loosened the microorganisms from the skin. The drying stage physically removes microorganisms in a film of water from the skin by wiping and depositing them on a towel. Thus, hand hygiene efficiency is a combination of washing efficiency (soap, water, rubbing, and rinsing) and hand drying.

Although cloth towels are popular because of their rapid drying, they become contaminated through multiple usages, and once pathogens are deposited on towels, they can survive long enough to contaminate the hands of other users. Cellulose fiber is the main material in institutional paper towels, which are usually made of rougher paper than used for domestic paper towels. The coarser the grain of paper used, the more efficient the friction effect will be for organism removal, although harsh, non-absorbent paper towels could discourage their use compared to softer paper. Also, hand-operated paper towel dispensers have their limitations.

In a survey of 12 food processing or food service facilities, researchers found coliforms, E. coli, and S. aureus on paper towel dispenser equipment. Air driers that are used in many communal washrooms allow one user at a time, and that take up to 1 minute to dry the hands, have not been convenient and lead to avoidance or incomplete drying. In several studies, on average people spent 22.5 seconds drying hands, and 41% wiped their hands unhygienically on clothes. Newer fast air flow driers are becoming more widespread, but have yet to be completely evaluated for their sanitary qualities.

Because of the uncertain or limited effectiveness of hand hygiene, multiple hurdles to reduce pathogen contamination and reduce their spread are better than one or two hurdles. When coupled with glove use and proper handwashing, these steps should minimize the opportunities for pathogens to reach the food being prepared.

This blog was originally posted on the DEB Hand Hygiene Blog.
 
 
Prof. Todd is an Adjunct Professor with the Food Science and Human Nutrition Department at Michigan State University.  As a scientist with over 45 years in food safety, in particular relating to foodborne outbreaks, Prof. Todd has written many publications and spoken at national and international meetings. He is currently working on Listeria transfer coefficient and modeling projects, hygiene in child care centers, avoidance of norovirus in elder care facilities, and rapid recall and traceability research in multidisciplinary projects with colleagues at MSU and other universities.
 

 

Friday, November 16, 2012

Tag YOU’RE It!!!

As winter approaches, more and more people start to feel like they’re coming down with “something.” You can always tell when cold and flu season has arrived at our offices because when our team gets together for a meeting, it’s like watching children playing a game of musical chairs.  Everyone is vying to find a seat farthest away from the “sick” person and best of all it’s the “older” colleagues that seem to freak out the most....I suppose that could be due to their declining immune systems.  Today there were three of us “sickies” and without intending we did a darn good job of spreading out and making it virtually impossible for our colleagues to find a spot where they weren’t in some way going to come in contact with us.

In some latest polling information it has been reported that nearly 80 percent of office workers come to work even when they know they are sick. For those that stay home, more than two-thirds return to work when they are still contagious, putting coworkers' health and business productivity at risk. In a typical year, approximately 70 million missed workdays can be attributed to having the flu which can be translated to an estimated $10 billion in lost office productivity.

So how do you know if you have the flu or the common cold?  Both have similar symptoms, so it can be hard to tell the difference. In general, the flu is worse than the common cold. Symptoms such as fever, body aches, tiredness, and cough are more common and intense with the flu. People with colds are more likely to have a runny or stuffy nose.

Unless you have young children where you basically just have to come to terms that if they’re sick, you’re going to be sick, the tricks to avoid catching the flu or cold are pretty simple.

1. Wash your hands!  Wash after you shake hands, after you go to the “facilities” and by gosh WASH BEFORE YOU EAT!
2. Clean and disinfect your workspace! (when was the last time YOU actually wiped down your desk, phone, keyboard or mouse with a disinfectant wipe?)
3. Stay Away!  Coughs and sneezes spread diseases!  Keep your distance from people displaying symptoms – respiratory droplets from coughs and sneezes can spread for up to 6 feet!
4. Get your Flu Shot! (and no, the flu shot will not give you the flu...)

Let’s do a case study:  

One of my colleagues and I were at a conference this week from Sunday to Tuesday. As luck would have it, this also happens to correspond to the first 3 days my cold came on. With the cold viruses, the first 3 days tend to be when you are most infectious and colds generally have an incubation period of 2 – 5 days. To my defense, I covered my mouth when I sneezed or coughed, sat at the end of the rows to try and keep my distance from others and washed my hands or used hand sanitizer CONSTANTLY! Melissa who I was travelling with has started showing signs of a cold (she sat beside me on the plane, at the conference – definitely not 6 feet away from my respiratory droplets regardless of how well I tried to contain them). She’s coming to work. She’s definitely infectious.

Assuming by Monday, several more team members are showing symptoms of a cold, am I to blame? I didn’t come to work while sick – I was away!  It’s Melissa’s fault right?

 

Bugging Off!

Nicole

 
PS – sorry to anyone who attended #SocialintelATL if you’re coming down with a cold.....  

 

Friday, November 9, 2012

Disinfectant Wipes should not be used…..Say WHAT?!

While writing does not always come easy, one of the things I like most about writing the Talk Clean To Me Blog is that I can state my opinion in black and white with the hopes that some may agree and welcome the dialogue that occurs with those of you who think I’m completely off my rocker.
 
In the world of cleaning and disinfection, the science or proof some people rely on cannot keep up with the myriad of new products or processes that enter the market place.  Does this mean that one should not consider changing products or processes until such time as there is statistically significant information published about these new products or processes?  Most definitely not!

Let’s consider the pre-moistened disinfectant wipe.  Are they new to the market?  NO.  Have they been used successfully at many facilities across the globe?  YES.  To ensure a successful infection prevention program, do we need to consider how to use them correctly to ensure the desired outcome?  MOST DEFINITELY!


“Disinfectant wipes should be used by the primary care giver for point of care cleaning and disinfecting of patient equipment. They should not be used as a routine cleaning disinfectant tool.”

Admittedly, for the sake of keeping the blog to a reasonable length, I have not included the entire section, however, should you take the time to read the guideline, you will find that it is vague and without any references to support its justification.  While I agree wholeheartedly that all disinfectants must be used appropriately, the danger in making such a statement is that there is no strong scientific evidence to conclusively limit the use of pre-moistened wipes at this time.   Perhaps instead, there should have been a more detailed discussion about the appropriate use of pre-moistened disinfecting wipes to ensure that they are used in such a fashion as to ensure contact time in accordance to the label is met.   Many of the leading pre-moistened wipes available on the market are Quat-alcohol based products with anywhere from 2 to 5 minute contact times.  As proven by science, such products will not remain on the surface for the contact time listed on the label as a result of the rapid evaporation rate of alcohol.  In fact a study published by Omidbakhsh in 2010 in the Journal of AOAC International investigated the discrepancy between drying time and contact time with respect to product efficacy.  Additionally, there have been publications investigating the effects of wipes in contaminating surfaces providing compelling evidence that we want to use 1 wipe for each surface especially if using a weak or slow-acting disinfectant in the wipe where the true chances of achieving disinfection are limited at best.

That said, proper disinfection with such wipes can be achieved with the physical action of wiping provided the disinfectant itself has a good and rapid broad-spectrum microbicidal activity. Therefore, there has to be a change in our thinking with regards to contact time for wipes as opposed to longer contact times needed when just spraying or pouring a liquid on surfaces. Perhaps the conclusion should be that in choosing a pre-moistened disinfectant wipe, one must consider more than just the cost per wipe. There needs to be a more fulsome investigation as to the number of wipes needed to achieve the contact time as listed on the label.  We need to review how the wipes will be utilized to ensure that good physical friction will be applied to help in removal of the pathogens from the surface, as well as frequent changing of such wipes to avoid redistributing the removed pathogens.  Lastly, one cannot discount the size of the wipe.  Certainly, the traditional wipes used in clinical areas for disinfecting patient care items such as BP Cuffs or Stethoscopes would not be recommended for use by Environmental Services due to their smaller size, however, most companies specializing in pre-moistened wipes provide larger options (10x10 inches or 12x12 inches) which are more than adequate for cleaning larger surfaces sizes. 

Perhaps the use of pre-moistened disinfectant wipes is no different than the use of antibiotics?  When prescribing antibiotics you need the right drug at the right concentration for the right length of time.  For pre-moistened wipes you need the right claims, the right contact time and the right size to do the job.

So….am I off my rocker?

 

Bugging Off!

Nicole

Friday, November 2, 2012

Disinfectant #9: Peracetic acid: Weak acid, Strong Disinfectant?

Peracetic acid (PAA) was first registered as a disinfectant in 1985 by the EPA. PAA is produced by combining acetic acid (vinegar) and hydrogen peroxide.  The result is a peroxide version of acetic acid (vinegar) that has a very distinctive and a pungent vinegary smell.  It is a weak acid compared to acetic acid but can be highly corrosive if not used at the appropriate dilutions. Peracetic acid is a versatile chemical that can be used in a variety of applications with its main use as a disinfectant product in food and beverage processing/producing plants due to the fact that it leaves no harmful residues and decomposes into harmless by-products.

As a cleaner, peracetic performs poorly as it lacks detergency properties.  As alluded to in previous blogs, you may wonder whether increasing the concentration of this acid would benefit its cleaning. The answer in short is: No. A higher concentration would not increase its cleaning abilities and in fact would lead to an increase in corrosiveness.
 
As a germicide, peracetic acid shows fairly strong efficacy against a broad spectrum of pathogens. Like many disinfectants, the temperature, pH and concentration all play a significant role in determining the antimicrobial properties. It is bactericidal at 10ppm, fungicidal at 30 ppm and virucidal at 400 ppm in a 5 minute contact time. Furthermore, it is sporicidal at concentrations of 3000 ppm. It is more effective at slightly higher temperatures and its germicidal activity increases at higher pH ranges. Combinations of PAA and hydrogen peroxide further boost the efficacy profile, as this blend can prevent the formation of biofilms on hard surfaces. The method by which PAA attacks pathogens is through the reaction with the cellular walls. This leads to breakdown of cell membranes and cellular death due to cell content leakage. An issue regarding PAA usage is its stability. In the presence of water, it breaks down quickly. This would have a direct affect on the viability of the product over time.

Peracetic acid’s safety profile can also be closely correlated to its concentration. The higher the concentration, the worse the safety profile is. For example, an in use solution of PAA of 5% has relatively low oral toxicity at this dilution. However, respiratory issues, including occupational asthma development associated with PAA have been reported. Further, it can strongly sensitize respiratory organs and cause mucus membrane inflammation. Furthermore it is important to be weary of skin and eye exposure as it can cause irritation. Overall, peracetic acid proper care needs to be taken in its use.

The environmental profile of peracetic acid once again depends on the concentrations encountered. At high concentrations, it can be toxic. However, in use concentrations do not pose major threats to the environment. Furthermore, PAA is a readily decomposable substance and breaks down to products that are not considered harmful to the environment.

This is how we would rate peracetic acid disinfectants based on the key decision making criteria:

• Speed of Disinfection – B to C

o At a 5 minute contact time for killing bacteria and viruses, peracetic acid is fairly rapid in killing. However it carries a 30 minute sporicidal contact time, which is unrealistic unless used for soaking applications.

• Spectrum of Kill – A to C

o Certain temperatures, pH, and concentrations affect the efficacy of peracetic acid.

o At 3000 ppm, peracetic acid can kill all microbial life whereas at 10 ppm, it only kills bacteria.

• Cleaning Effectiveness – C to D

o Peracetic acid has poor cleaning capabilities.

• Safety Profile – B to C

o Peracetic acid has a safe oral toxicity, however, it is sensitizing to the respiratory tract and irritating to skin and the eyes.

• Environmental Profile – A to B

o Peracetic acid readily decomposes and its primary and secondary products are all deemed non-harmful to the environment.

• Cost Effectiveness – B

o Peracetic acid is readily available from various manufacturers and can be found in both concentrated and ready-to-use formats.




Bugging Off!

Nicole