Technology Essential To Eliminate High-Resistance Infections

Building occupants are often willing participants in the ongoing fight against colds and flu. However, infection control experts encourage facility cleaning managers to monitor their employees' use of disinfectants and discourage them from bringing in outside cleaning supplies.

"We want people to clean, but we want them to use the same products that the cleaning staff uses," says Wilcox. "When they take cleaning or disinfecting into their own hands, they can do more harm than good by introducing toxic chemicals into their facilities, decreasing indoor air quality, and working against what their custodial staff is doing."

Instead, Wilcox recommends building occupants use all-purpose wipes and focus on cleaning rather than killing.

"We see up to 95 percent removal of soil and possible pathogens with cleaning — and you'll keep yourself healthier," she says.

Similarly, the housekeeping staff should sanitize high-touch surfaces multiple times a day using a product that kills to a public health level of 99.9 percent or 3-log reduction. Depending on the time of year, staff may need to vary the chemical's concentration. Should an outbreak occur, a disinfectant with a 99.999 percent concentration or 5-log reduction and up to a 10-minute dwell time may be needed, depending on the type of microorganism being addressed.

However, very few facilities adhere to a 10-minute dwell time, which is why more facilities are adopting new technologies that allow them to vary the disinfectant's concentration and dwell times to meet new end user requirements.

"Manual cleaning is not enough," says Wilcox. "Facilities need to start looking at using technology because infectious diseases are becoming more resistant. The right technology and chemical classes of sanitizers and disinfectants, such as electrostatics and hypochlorous acid, will save time and provide the ability to sanitize and disinfect daily."

At the University of Wisconsin, the housekeeping staff uses aqueous ozone technology to clean and sanitize all areas of the residence halls once a day. During cold and flu season, the technology is used on elevator buttons and doorknobs of resident rooms several times a day.

One of the reasons the department switched to aqueous ozone is the shorter dwell time compared to traditional disinfectants. Prior to implementing the change, the department used multiple disinfectants with a 10-minute dwell time that often required rewetting the surface.

"For daily cleaning, we allow [the aqueous ozone] to sit on the surface for 30 to 60 seconds," says Krause. "But if we become aware of illness in a building, we ask the custodians to increase the dwell time to two minutes before wiping everything down."

The university is also in the process of transitioning from cotton to microfiber cloths — considered by many custodial departments to be the gold standard in removing soil, dirt and pathogens.

"There's been some resistance to microfiber from staff, but we're addressing that with education and a better program that uses color coding," says Krause, who hopes to complete the transition by spring 2020.

The Outlook On Outbreaks

No doubt, proper cleaning technologies and procedures are essential to prevent cross-contamination and control infectious outbreaks — not just during cold and flu season but all year long.

"Facilities should be using standard operating procedures for year-round public health, but over 90 percent of them don't," says Wilcox. "They have an in-house disinfectant, and they use it when things get dicey. They're cleaning, but they aren't sanitizing and disinfecting every day."

Management should also be in constant communication with building occupants so that they can respond quickly in the event of an outbreak.

"When symptoms are seen and communicated to the facility supervisors and managers, then the protocol can be kicked up to handle infectious symptoms and keep them from spreading," says Wilcox.

For facilities that invest in technology and year-round cleaning/disinfecting protocols, the benefits are tangible. For example, since the University of Wisconsin implemented aqueous ozone technology five years ago, reports of infections and illnesses have dropped significantly.

"I've been here 20 years and I've seen entire floors of buildings taken down by the flu," says Krause. "We haven't had anything like that in the last five years. So I think our cleaning practices and people's hand hygiene have improved a lot."

Kassandra Kania is a freelance writer based in Charlotte, North Carolina.