Despite the wide use of sanitizers and disinfectants, it's becoming clear that conventional cleaning methods are not achieving the standards or results that are essential for our health and well-being. Outbreaks of MRSA, VRE, C difficile, Norovirus and a host of other health hazards are becoming commonplace. What is it about currently used cleaning processes that are not combating these risks? As health care and education costs escalate, are cleaning standards being lowered in the name of economy? Is this a recent phenomenon? Or, has cleaning practice stagnated and failed to react to today's needs?
What is it about currently used cleaning processes that are not combating these risks? Probably that processes haven't really changed much until recently. As far back as 1970, a study by the University of Ottawa, Canada, published in Applied Microbiology, the journal of the American Society for Microbiology, in 1971, clearly identified floor mopping practices as being responsible for significant contamination of floor surfaces at the Ottawa General Hospital. The study found:
'A preliminary survey in our hospital, involving 134 cultures of floors before and after mopping, and of mops and cleaning materials before and after use, showed that the ‘cleaning' procedures were in fact spreading gross contamination throughout the hospital.'
In addition a British study of pharmaceutical cleaning, states: 'Mops can be a serious potential source of contamination. Maurer showed that even when mops were soaked in phenolic disinfectant overnight contaminants could still be harvested…'
Are cleaning standards being lowered in the name of economy? This is likely; however the challenge is for the industry to develop effective cost-efficient cleaning methods to meet the economic challenges facing education and healthcare providers.
Is this awareness a recent phenomenon? Evidently not, considering that the Ottawa study was done almost forty years ago, and anecdotal evidence suggests the problem has existed for many more years.
While wet mopping continues to be the standard method of floor cleaning today, there are signs that the industry is rising to the challenge with changes in tools, products and processes. The realization that mops are a source of contamination has caused at least one manufacturer of cleaning equipment to develop new ways of cleaning - providing removal of contaminants rather than dispersal. As the Ottawa study concluded, 'it is our view that the daily painting of hospital floors with thick suspensions of such organisms must be regarded as an unsatisfactory practice.' Simply put, contaminants should be removed rather than spread around.
One process now in use meets that requirement; the spray and vacuum system. Spraying the contaminated surfaces provides agitation to break down soils and hold them in solution which is then vacuumed up and disposed of through the sewer system. There are many benefits to this method; the cleaning solution is only used once rather than being progressively soiled as in a mop and bucket process. The equipment used for this process must be specially designed; simply using a pressure washer and wet vacuum won't work. If the water flow and pressure aren't designed for this type of work, the operator will be exposed to an aerosol cloud of contamination which will also deposit contaminated solution on surfaces in the room.
These issues have been addressed in a program of Integrated Cleaning and Measurement (ICM) developed by industry consultants in collaboration with the cleaning science community.
The system involves a spray and vac system and scientific testing to confirm that contaminants such as urine and other bio-contaminants and substances have been removed from the surfaces being cleaned. Testing to confirm cleaning is essential if there is to be any confidence in the cleaning process.
Based on the studies quoted in this article it is clear that the mop and bucket process fails to meet an acceptable standard.
In a recent article discussing the merits of spray and vacuum cleaning, Dr. Paul S. Darby said: 'The traditional cleaning method essentially turns a restroom floor into a very large culture plate, supplying ample water and nutrition to disease-causing organisms that can rapidly proliferate.' Dr. Darby operates an active consulting practice in medicinal chemistry and biotechnology. He is board-certified in Occupational and Environmental Medicine and is in full-time practice, specializing in acute industrial trauma, chemically-related illness, and maritime medicine.
1 - Applied Microbiology, Apr. 1971, p. 693-697
2 - The Pharmaceutical Journal Vol 264 No 7088 p446-448 March 18, 2000. A survey of disinfectant use in hospital pharmacy aseptic preparation areas. Original Papers By S. M. Murtough, BSc, Sarah J. Hiom, PhD, MRPharmS, Maria Palmer, PhD, MRPharmS, and A. D. Russell, DSc, FRPharmS, Maurer IM. Hospital hygiene (3rd ed). London: Edward Arnold, 1985.