Clean & Healthy: It’s What You Don’t Know

According to the building maintenance goals taught at the University of Colorado/Denver, one of the primary goals of an effective facility manager is “to ensure the buildings and building systems provide a clean and positive environment [for building] occupants.”

Ensuring a facility is clean and healthy can be one of a facility manager’s most challenging tasks. Although many aspects of the work create cleaning challenges, one in particular is that floors, walls, or other surfaces may look clean, but upon further investigation, may not be clean and healthy at all.

We have learned this over the years in a variety of different ways. For instance, a surface thought to be clean would be swabbed and the sample collected would be wiped over the agar in a Petri dish. Allowing three or four days to go by, the contents of the Petri dish would then be analyzed. Analysis invariably uncovered scores of germs and bacteria living on those “clean” surfaces. So, what facility managers and cleaning professionals have learned is that what looks clean has little to do with is clean.

Another obstacle in their endeavor to provide a clean and healthy facility for building occupants is the fact that germs and bacteria may be present on unexpected surfaces. This was recently pointed out in a study published in the Journal of Hospital Infection in July 2018.

In this study, researchers tested the restroom walls, floors, and counters surrounding or near electric hand dryers and paper towel dispensers in three different hospitals in Europe. Altogether, 120 samples were taken over 12 weeks. Some hospitals had units called JADs installed. These are jet air electric hand dryers that dry hands using cool air at high volumes. The other hospitals installed warm air dryers that dried hands using warm air at low volume. Traditional paper towel dispensers were also installed in some hospitals on walls near sinks and faucets.

The samples were then analyzed in a laboratory. Here is what the laboratory reported:

• Surfaces were most frequently covered with pathogens around the JADs. Plus, pathogens were found in vast areas surrounding the dryers.
• Around the warm air dryers pathogens were found, but in lesser amounts and more limited areas.
• Where paper towel dispensers were installed, pathogens were still found, but in even smaller numbers and areas closer to the dispenser.

The most common types of pathogens found on the surfaces included:

• Methicillin-susceptible Staphylococcus aureus (MSSA) is a bacterium that causes skin infections and can even cause pneumonia; however, it is not resistant to antibiotics and usually can be treated.
• Enterococci, another bacterium that is typically not life-threatening except when it is found in hospital settings or among people with pre-existing health conditions.
• Extended-spectrum b-lactamase (BSBL) are enzymes that are resistant to many antibiotics; ESBL is found mainly in hospitals and long-term care facilities, and for those infected, it can be fatal.

The Takeaways
There are several things facility managers should know about this study, and the first one is this: the electric hand dryers are not the culprit. Similar studies have been conducted in the past, and very often they conclude that electric hand dryers are unsanitary. However, the real problem is the fact that many people still do not adequately wash their hands. Pathogens left on the hands after washing become airborne when the electric hand dryers are used.

The second major takeaway is the importance of knowing not only where pathogens are located, but the scope of the region they may cover. When looking for pathogens today, cleaning professionals often turn to ATP (adenosine triphosphate) monitoring systems. With these systems, a small area is swabbed, possibly no more prominent than the switch on a light panel. Swabs are then placed in the monitor for evaluation. Within 20 seconds, the system indicates if living cells, which could potentially be harmful pathogens, are present.*

“However, facility managers and cleaning professionals place too much faith in ATP,” says Brad Evans, CEO of OptiSolve, a surface imaging company. “We need to know far more than if possible, pathogens are on the tip of a light switch or not. What about the surrounding surfaces?”

This is why Evans suggests a key takeaway of this study is the need to see a pathogen “image map.”  Image maps are created using new imaging technologies. They help point out “how large an area on a surface pathogens may exist and in what concentrations.”  Typically, using one of these image map technologies, darker or “redder” areas denote more significant concentrations of the pathogen.

Using This Information
So, what should facility managers and cleaning professionals do with this information if, for instance, an image map indicates pathogens may be present?

The first thing is that we must realize that walls, counters, even floors are considered “touchable” surfaces. It is estimated that we may have as many as 50 direct and indirect contacts with floors every day. Because building users can touch these potentially contaminated surfaces and then spread pathogens to other surfaces and other people, proper and effective cleaning is our only answer. To accomplish this, both managers and cleaning professionals should do the following:

• Clean all surfaces where pathogens are present with an all-purpose cleaning solution. Use microfiber cleaning cloths and change the cleaning cloths after each use.
• Once the surfaces are clean, use a disinfectant to clean the same areas. We clean first to remove soil and then clean again to kill pathogens. A two-step process. Once again, use microfiber cleaning cloths only once.
• The disinfectant should be a “broad-range” disinfectant. This means it is designed to clean a variety of different pathogens.
• Dilute the disinfectant per manufacturer’s instructions, always remembering that too much is wasteful and can leave a chemical residue on surfaces, resulting in rapid re-soiling.

Finally, Evans suggests testing surfaces regularly using imaging technologies. “The goal here is to establish a type of benchmark. We want to see how quickly surfaces build up with pathogens. That way, we can determine how often these areas must be cleaned and disinfected.”

Robert Kravitz is a frequent writer for the professional cleaning, building, and food service industries.

*Neither ATP systems nor imaging technologies indicate what specific pathogens may be present.