The Unseen Can Get You!

For those of you who guessed "disinfecting" as the answer to our latest poll, you are right! Quaternary ammonium compounds, phenolics, alcohol and bleach all fall under the category of disinfectants. They have varying uses and perform different functions. Would you like to learn more? Read the following information which previously appeared in the April, 2008 issue of As The Toilet Turns, a monthly custodial/maintenance newsletter, and learn more in-depth information about cleaners.

The unseen can get you! How true that is, especially when we are talking about microscopic germs, bacteria and other disease-causing organisms. But what do you really know about these and how can you effectively remove them? Let’s see.
Microbes as defined in the dictionary are either animals or plants of microscopic size. When we use this word microbe we are referring to bacteria, fungi, viruses, spores and mold. Microbes must travel to a host to survive. Harmful microbes are called Pathogens. They can reproduce by Binary Fission (rapid splitting and duplicating of a cell.) Under favorable conditions, cells can divide every 30 to 120 minutes. One microbe can grow to one million overnight! Your job is to cancel their traveling arrangement by cleaning, disinfecting and using personal protective equipment and procedures.
These microbes or germs usually cause some type of disease by hiding under the soil where the disinfectant can’t reach them. We need to remove the soil in order to reach the germs. Cleaning in itself removes most germs as it removes the soil. Remember to always pay special attention to the modes of transmission, the personal protective equipment of the custodians and staff and then always discuss procedures among the custodial staff that will stop the chain of infection.
Microbes have their own unique way of getting around. Microbiologists call this “chain of infection.” The chain of infection has six segments or links. The first link is the Pathogen. Pathogens are harmful microbes and we use our disinfectant cleaners to attack them.
People with existing illnesses are more likely to be at risk. Pathogens consist of bacteria, viruses and fungi.
The second link is the “reservoir.” Pathogens need an environment to grow in or on; the human body, soiled linen, mops, dirty gloves, et cetera. The reservoir must also provide special needs like food, light, air, and moisture.
The third link is the “exit portal.” These would be areas where pathogens leave the environment they are in through such means as body wastes, sneezing, coughing and open wounds. Pathogens are also able to travel through careless housekeeping habits such as dirty mop water, dirty or soiled shoes, and so on. Changing mop water daily is a must because of this.
The fourth Link is the “mode of transmission.” How does the microbe get to its next home? There are six ways we can view this link. Direct contact, (touching an infected person), indirect contact, (touching a contaminated object), droplet transmission, (coughs or sneezes), vehicle transmission, (by foods or IV’s), airborne transmission, (by suspension in air) and vector transmission (by insect stings or rodent bites).
Our fifth link is “portal entry.” This is how the pathogen enters its new home. It could be through the mouth, nose, eyes, or breaks in the skin.
Our last link is “susceptible host.” Humans become more susceptible when the body defenses break down and allow pathogens to enter and react. It is important to get enough sleep, keep up your defenses, maintain a healthy diet, and keep pathogens out of your body. This is done most effectively by washing your hands before eating, smoking, or touching area’s of your face or eyes.
Anywhere along this chain of six links, we have the power to break their effects by cleaning, disinfecting and isolation.
Let’s start a strategy to battle these germs and viruses before they cause us problems. Our first important principle to remember is “You can’t kill it if you don’t clean it”.
Our five-part battle plan consists of the following information and facts:
1. Viruses, bacteria, and all microbes hide inside the soil found on all surfaces.
2. Body fluids and waste can offer a protective barrier for germs to hide in.
3. Disinfectants are only good if the surface is clean and they can touch the germs.
4. Some, but not all disinfectants, are also cleaners and can help remove these soils.
5. Heavier build-ups do require a detergent cleaner with agitation by brush or mop to get down to the dirt so as to reach the pathogens.
Noting those steps, let’s take a look at disinfectants. All disinfectants need time to work. The protective barrier provided by food, human fluids or soil can increase the time required for the disinfectant to reach the viruses and germs. With that in mind, we can appreciate why disinfectants are necessary. Three steps are involved for the disinfectants to work properly.
The first step: When we use our disinfectants and apply them to any surface, the dirt and germs are unaffected in the first few minutes of contact.
The second step: When we leave the disinfectant on the surface and use agitation, we break down the dirt barrier.
The third step: Finally, the germs are attacked by the disinfectant as the agitation occurs on the floor or surface being cleaned and the germs or viruses surroundings are revealed.
When it comes to cleaning, there are different levels to be considered. These would be environmental, sanitizing, disinfecting and sterilizing. Let’s look at each of these individually.

ENVIRONMENTAL
This is the basic level of cleaning. It removes soils and liquid soils with detergent and scrubbing action. It is for non-critical areas. It removes many microbes, but does not control any specific ones.

SANITIZING
Chemicals that kill some microbes, but are safe enough for contact with food utensils and food preparation areas are called sanitizers. Under test conditions, sanitizers can remove 99.999% of microbes, but do not kill endospores.

DISINFECTING
Chemicals that can destroy 100% of the microbes, but do not kill endospores are known as disinfectants. Disinfectants are used in patient rooms, surgical and clinical areas, restrooms and public areas. Disinfectants are tested for their effectiveness against specific microbes, and their effect is listed on each product.

STERILIZATION
The highest level of clean-using heat or long contact with the strongest chemicals available is known as sterilization. Sterilization is used on utensils and surfaces that contact tissue, open skin or other areas where blood may be present. This is an area of cleaning that is not usually for the housekeeping staff. Sterilization destroys all organic materials including endospores.
Let’s focus on one of the most commonly used cleaning tools, disinfectants. Disinfectants are tools that are used to fight off microbe contamination and that need to be used correctly. Each disinfectant is matched with a specific application. They fall into four different categories each with its’ own advantage and disadvantage. They are (1) quaternary ammonium compounds, (2) phenolics, (3) alcohols and (4) bleach. Let’s discuss each of them separately.

QUATERNARY AMMOUNIUM COMPOUNDS

Commonly called quats. An example would be Coastwide’s Virex 256. These quats or organic ammonium are mixed with water or alcohols. They are used for general disinfecting of floors, walls, counter tops and the like. They are effective against a wide range of germs. They have a low toxicity to humans and some are effective against such diseases as Tb.

PHENOLICS

Phenolics are used in critical areas where blood is present. They are effective against a wide range or spectrum of germs. Phenolics leave a residue on cleaned surfaces. They will irritate the skin and like quats, are effective against Tb.

ALCOHOL

Alcohol can be used as a quick cleaner for hard surfaces and hands. It can be used for blood-borne pathogen clean-ups and has a very broad spectrum of effectiveness. It can control Tb. It is not recommended for general cleaning because it evaporates quickly and can be expensive and flammable.

BLEACH

Bleach can be used in cafeteria settings for general sanitizing and cleaning. It cleans by reaction or oxidizing everything it touches. It is corrosive to metal and has a disagreeable odor.
When using disinfectants, proper dilution is crucial. They are typically mixed at the rate of 1/2 to 1 ounce per gallon of water. Too little disinfectant can impair the effectiveness of the product and does not give you a higher kill rate. Too much disinfectant will not make the solution more active but will leave a residue on the surface.
Clean and disinfect on a regular basis. Surfaces are constantly being re-contaminated so continual cleaning is required.
An important part of any health care maintenance program is the protection of you, the general custodian. Both the chemicals that you’re using and the pathogens that you’re cleaning demand that you take extra care of yourself.
Remember to:
· Always wear gloves and eye protection when filling and pouring disinfectants and when emptying soiled solutions.
· Keep the outside of your spray bottles clean and properly labeled. Rinse with disinfectant cleaner at the end of the day and allow to air dry.
· Wear additional Personal Protective equipment when disinfecting high risk areas.
· Wash your hands frequently!
Standard precautions should be the work place practices when handling waste products.
· Good hygiene
· Hand washing
· Use protective barriers such as gloves, gowns or aprons and mouth mask protectors
· Eye shield or goggles
· Proper handling and disposal of sharp products and soiled waste products
By using the correct cleaner, all can protect themselves from harmful germs and sicknesses which originate in the world of the unseen.

(This article is based on a previous series of articles appearing in 2003. They were written by Paul McTiernan of Coastwide Labs, Inc.)