Misconceptions Of Cleaners And Disinfectants

This Manufacturer Roundtable took the compilation of questions Facility Cleaning Decisions received from in-house custodial professionals and posed them directly to cleaning industry manufacturers. Here are their responses:

Contributors:
Jason Welch
Microbiologist
Spartan Chemical Co. Inc.
Maumee, Ohio

Sara Snow
Senior Scientist
Clorox Professional Products Company
Oakland, Calif.

Q: Are there any misconceptions about cleaners and disinfectants?

Welch — Disinfecting is more important than cleaning – Ultimately, infection control comes down to efficient cleaning practices and not simply applying a disinfectant. The physical removal of a "germ" is much more important than the chemical destruction of it. A good example of this is: You are at a picnic...you drop part of a sandwich on the ground...before you know it you are being invaded by ants. Now, if you want to take the "disinfectant" approach you can simply spray insect spray on the ants. The ants will die, but you will find that more ants will return from another angle.
Now if you do the right thing by picking up the sandwich and placing it in the trash, or "cleaning” it from the area, you will have eliminated the food source and thus ultimately stopping and preventing the problem.
•    Hospital Grade disinfectants require a TB claim – A “Hospital Grade” Disinfectant only requires 2 organisms to be tested: Pseudomonas aeruginosa and Staphylococcus aureus. 
In fact, tuberculocidal disinfectants are not used to control the spread of TB; the TB claim is only used as an indicator of strength.  TB is transmitted only by the airborne route, meaning that the only way this disease is spread is by infected people coughing and sneezing tiny infected droplets into the air and others breathing those droplets into their lungs.  Therefore, surface cleaners and disinfectants will have no impact on the spread of this pathogen. 
•    Bleach is the ultimate disinfectant.  In order for bleach to function properly as a disinfectant or sanitizer the surface MUST be precleaned prior to the application of bleach.  (NO if, ands, or buts about it.) Disinfecting and sanitizing with bleach is a two-step process. 
Bleach's shelf life is unstable.  Depending on the age and storage conditions, the actual amount of active chlorine will vary. Sodium hypochlorite a.k.a. bleach will break down into salt and water. Never store bleach in warm areas.  Because of this the following are true:
o    A fresh solution of bleach must be made prior to disinfection or sanitation.  (Water ions or hardness and soil contaminants from a dirty container can adversely affect available chlorine ppms)
o    Only an E.P.A. registered bleach product can be used for disinfection or sanitation.
•    Microorganisms are becoming resistant to disinfectants or disinfectants are promoting antibiotic resistance in microorganisms - The mode of action for a disinfectant is different than the mode of action of an antibiotic. For example – if antibiotics are like poison to a bacteria, then disinfectants would be like a shotgun. The same thing that protects you from poison would not protect you from a shotgun.   
This same scenario applies to antibiotic resistant bacteria (think MRSA or CRE).  Antibiotic resistant bacteria have developed a resistance to a type of antibiotic; the ability of a bacteria to be resistant to an antibiotic has no direct indication of the efficacy of a disinfectant for that same bacteria.

Snow — There are many misconceptions associated with cleaners and disinfectants in healthcare settings, some include:
•    Kill time is the same as wet time. This is untrue—the time it takes a product to eliminate microorganisms is not necessarily the same as the time it is able to keep a surface wet.
•    Fast “overall” kill times are best. While fast kill times are important, what the product kills is more important. Some manufacturers may leave off tough-to-kill organisms in order to achieve a fast overall kill time. For example, if it takes a certain product 5 minutes to kill Norovirus, but the manufacturer wants to keep the overall product kill time to 3 minutes, they may leave Norovirus off the label all together.
•    All products will react the same on surfaces. Different ingredients and different formulas will react differently with different surfaces. And just because two products may have the same active ingredient doesn’t mean they will necessarily have the same interactions with surfaces.  For example, some products contain special corrosion inhibitors in their formulas to provide enhanced surface compatibility.
•    Residue is bad. Usually residue left behind on a surface by a product is due to dissolved ingredients in the formula that dry on the surface as solids. These are often important ingredients, such as detergents for more powerful cleaning, corrosion inhibitors for protecting surfaces, or stabilizing agents to maintain product shelf life. To protect surfaces, avoid residue buildup by periodically removing it with a clean, damp cloth.
•    The more chemical, the better. Cleaning and disinfecting products are formulated for use in specific amounts and concentrations. When mixing or diluting products, it is important to closely follow the manufacturer’s instructions to avoid potentially hazardous situations.
•    Bleach contains chlorine gas. This is untrue. Sodium hypochlorite is the active ingredient in bleach disinfectants.
•    Bleach odor is harmful. Multiple studies have shown that when exposed to bleach, little or no concern about the odor of bleach was expressed by patients, families or staff. EPA-registered bleach disinfectants are formulated well below the levels recognized to cause potential respiratory irritation or overt health effects. Bleach is not a recognized asthmagen by any regulatory agency.
•    Bleach is bad for the Environment. Sodium hypochlorite breaks down rapidly into salt and water in the environment and has no negative impact on the environment. According to the EPA, “currently registered uses of the hypochlorites will not result in unreasonable adverse effects to the environment.”