The Janitors' Closet

How To Clean and Disinfect Schools To Help Slow the Spread of Flu

Good article on flu.gov, "How To Clean and Disinfect Schools To Help Slow the Spread of Flu".

The article focuses on schools, clearly the habitat of an at-risk part of the population.  Schools are also a good test subject, and they closely monitor "sick days", which many businesses do not.  But what goes for schools, in terms of keeping ones folks healthy, also goes for commercial firms.

The article begins with the following useful distinctions:

" Know the difference between cleaning, disinfecting, and sanitizing:

"Cleaning removes germs, dirt, and impurities from surfaces or objects. Cleaning works by using soap (or detergent) and water to physically remove germs from surfaces. This process does not necessarily kill germs, but by removing them, it lowers their numbers and the risk of spreading infection.

"Disinfecting kills germs on surfaces or objects. Disinfecting works by using chemicals to kill germs on surfaces or objects. This process does not necessarily clean dirty surfaces or remove germs, but by killing germs on a surface after cleaning, it can further lower the risk of spreading infection.

"Sanitizing lowers the number of germs on surfaces or objects to a safe level, as judged by public health standards or requirements. This process works by either cleaning or disinfecting surfaces or objects to lower the risk of spreading infection."

Saw a handbill from one of my competitors advocating combating flu via "cleaning" touch-points, etc.  Almost no mention of sanitizing of disinfecting.  So even the "professionals" often do not have a clue.

The article continues with cleaning and disinfecting (note the latter word) touch points, systematizing ones routine, properly using the proper chemicals, safety, and so on.  Stuff we've been doing for years, but a good synopsis of proper procedures.

 

The science of disinfectants

Here's a good article on the basic types of disinfectants, their properties, and their effectiveness in various applications.

Quats, for instance, are quite effective at disinfecting, but not at cleaning, particularly since the addition of a surfactant (needed to spread the solution) diminishes the effect of the disinfectant.  So we use a hospital grade quat product in restrooms and lunchrooms, as part of a two part process - clean first, and then disinfect.  We can apply the quat disinfectant liberally, on restroom fixtures, without worry about damage, and give it the 10 minutes dwell time required.  And we don't have to rinse it off - both a time saver and a help in not re-infecting the surface.

For touch-points around the office, we use a hydrogen peroxide based product - it's both a good cleaner, and a good sanitizer (not quite a disinfectant, but we don't need quite the level of pathogen kill on a door jamb that we do on a urinal).  And, it gives us effective sanitation with a dwell time of 30 to 60 seconds, achievable on touch-points.  So we can wipe with a saturated microfiber cloth (microfiber cleans quite well on its own), clean the surface, remove both dirt and most germs, and leave the surface moist enough to achieve sanitation - without spraying the chemical on the surface, and into the air, and having it run down the wall.

Pretty good all around system.  And a good article.

Quantifying germ removal

Good article in Cleaning & Maintenance Management, Feb. 2012, on the above.

The magazine's editor, Aaron Baunee, gives a useful overview on ATP measurement ("measures an energy molecule found in all living - or once living - organisms"), ultraviolet light inspections (UV, or black-light, causes bodily fluids to fluoresce - just like OJ's footprints), and airborne particle counters (to measure fine airborne dust, including germs).  Was a bit startled to find myself quoted on the latter; I'd forgotten I'd given them a quick interview.

We have ATP measurement available for critical surfaces - think preschool and grade-school desktops.  We also use UV lights extensively.  We recently started having all of our crews use them to inspect their own work; we had been using them just at the supervisory and customer service level.  Our crews bought into the program easily; it's given us a major improvement in restroom detail work in particular.  We do a number of small "draw centers" - medical offices that draw blood and take urine tests.  You'd be surprised where-all a bit of urine over-spray can hide.

Each quantifying method has its drawbacks.  ATP measurement cannot tell if the offending organism is dead or alive, only if it's been removed, so you can get a positive reading on a surface that's been disinfected by killing the germs.  UV light fluoresces substances other than bodily fluids (some restroom caulk, for instance), so one needs to look a bit further to see it you've really got a problem.  And indoor air quality measuring counts the number of particles per unit of air, but does not tell you how many of those particle are germs, or spores, or of what variety.

But, used in conjunction, and with a bit of common sense, one can identify, and remedy, cleaning and sanitation issues.

Hospital battles infections with robots

Interesting article in CNN Money, "Hospital battles infections with robots".  Nice video attached, too.

"At any given time, 1 in 20 hospital patients is battling an infection that they got on site, according to the Centers for Disease Control. Hospitals now pay greater attention to hand hygiene -- Purell dispensers have become ubiquitous -- but their main infection control methods haven't changed much for decades. Most rooms are still disinfected by housekeepers armed with chemical cleaners."

The "robot" showcased is a portable ultraviolet pulse generator, for use in patient rooms, bathrooms, and so on.  UV light kills pathogens.  After the anthrax scare a few years back, for instance, the Post Office explored treating mail with UV lights to kill such things as, well, anthrax.  Might have worked except for the long exposure time each side of every letter would have required (mail delivery is slow enough as it is).  UV lights are also what air conditioning firms use in AC ductwork to kill airborne germs as they blow by.

In janitorial, we mostly use chemicals to kill germs - a hydrogen peroxide product for touch-point sanitation, and a quat disinfectant for restrooms and lunchrooms.  We also use microfiber technology to remove most germs - dead or alive - from surfaces.  Where damp cleaning is not practical - think computer keyboards - we have available an inexpensive UV light that, when passed slowly over an item, kills the pathogens.

Which brings up the cost of the UV robot - about $80,000.00.  Reasonable for a hospital - think what a single hospital acquired infection costs to treat - but a bit less affordable for a janitorial firm.  Looking ahead, though, given that most technological innovations drop rapidly in price as they propegate, something similar could well be in our future.

Workplace bacteria

With cold and flu season beginning, it seems time to consider a prime pathogen breeding ground - your desk, phone and keyboard.

In a CNN Health Report, Dr. Charles Gerba, a microbiologist down the road from us at the University of
Arizona, "counted bacteria on workplace surfaces for a study sponsored by The Clorox Co., makers of Clorox bleach.  Office toilet seats had 49 germs per square inch, he found. But desktops had almost 21,000 germs per square inch. Phones were worse -- more than 25,000 germs per square inch.  Desks, phones, computer keyboards and mice are key germ transfer points because people touch them so often..."

Easy enough to sanitize desktops and phone handsets, but hard to properly disinfect computer keyboards using a chemical disinfectant - you need to up-plug the keyboard, use compressed air to removed lodged particles, and use a Q-tip to swab disinfectant onto tops and sides of the keys.  Time consuming and sloppy.  I know of no local janitorial firm including such service in their standard package.

A good alternative is an ultra-violet light sanitizer.  It won't help the visual impact of a dirty keyboard but, with a 10 second or so application, it can pretty effectively sanitize the keys.  That's why we're making it available as part of our "cleaning for health" package.

The smell of disinfectant in the morning

Every once and a while, I run across a client who who's firmly convinced that the restrooms could not have been thoroughly cleaned because she cannot smell the disinfectant.

Usually a quick explanation that most commercial disinfectants have little or no odor;  that fragrances, if present, have usually been added to convince the consumer of the strength of the chemical; that adding a fragrence (whether of a "medicine" or a floral "hide the foul odors" type) is not good for the occasional sensitive individual - backs her off.  Or I let her smell our quat-based, hospital grade disinfectant.  Which has no odor I can detect.

Should none of that avail, we give in and squirt a bit of a strong smelling chemical behind the toilet, every night. 

Generally, though, if one can smell the "disinfectant" in the morning, it's a good bet that something other than a modern disinfectant is being used.  Health becomes an issue.

Incidentally, we don't have our bookkeeper enter the "strong smelling, behind the toilet" chemical in the column for "janitorial chemicals".  We use the "child psychology" one.

Musty odor from the wet carpet

Eye opening article in Cleanfax on the source of musty odors in recently flooded carpet.

We do a fair number of small emergency flood clean-up jobs (from plumbing problems, roof leaks, etc.) for our janitorial clients.  We can generally respond faster than a carpet cleaning firm, price more reasonably, and come in after-hours without the client having to be present.  (We generally include with our full service janitorial contracts the various periodic services - burnishing and refinishing, windows, carpet cleaning - that other janitorial services either charge extra for on do not do at all.  Thus we keep floor technicians on staff, properly trained and equipped, for tasks like extracting.)

For wet carpet, we generally extract, then bonnet to get residual moisture out, set up fans if needed, and apply a quat based disinfectant.  We've always assumed (as most folks seem to) that what we're preventing is mold growth, as evidenced by that musty odor a day or two later.  Turns out that mold takes ten days or more to become apparent (unless today's flood has re-activated existing but dormant mold).  What generally grows fast enough to be apparent in a day or two is bacteria - already present in the carpet (and most everywhere else), mostly harmless, but capable of producing the odor.

Both bacterial and mold require water to thrive, hence their growth after a flood.  Our disinfectant will kill both.  So, in using the disinfectant over the years, and assuming we've been combating mold, we've been doing the right thing for the wrong reason.

Better, I suppose, than the converse.

The bottom line - clean for health.

Most commercial janitorial firms clean for appearance.  They sell to clients, train and equip their crews, and inspect their jobs based upon "sparkling restrooms, dust free furniture, debris free floors" and so on.

Consider, though, whether the health of the building occupants might be at least as important as the appearance of the building.  One can pick up a lot of diseases from airborne allergens, germ laden touchpoints, and not quite disinfected restroom fixtures.  Sick building occupants equates to more sick days and lower productivity while at work.

The client's bottom line demands a healthy staff, and thus "cleaning for health".

An unexpected bonus is that cleaning for health improves building appearance as well.  You cannot disinfect restrooms or touchpoints without first "cleaning" the surfaces - get rid of the dirt so the germs have no place to hide.  Vacuuming (both carpet and tile) with a HEPA filter on your vac, and microfiber dust wiping rather than feather dusting, will remove visible dust and debris while removing allergens and bacteria.  So a healthy building tends to be a clean appearing building as well.

Unfortunately, the converse does not hold.  You can clean and polish restrooms and touchpoints without disinfecting; you can remove visible dust and debris without removing the small particles and germs that impact health.  So you can have a clean appearing, but un-healthy, building.

Particularly in a tight economy, the bottom line demands "cleaning for health".

Restroom odors

I received a call a couple of days ago (not from a client) asking advice on locating a stubborn restroom odor.  Here's a bit from our operations manual, giving a simple checklist, and some tips on inspecting restrooms:

Odor Problems:

   • Check timing & circumstances (i.e. does client notice odor first thing in morning after the door has been closed with fan off all night?)

   • Check floor and any other drains (pour clear water down at least weekly; use an enzyme if oder persists)

    • Check for urine spills with black-light, especially in grouting, near the base of the toilet, inside the bottom of and inside the edges of urinals, and under any floor-mats

    • Check to make sure exhaust fans are working properly and left on

    • Check to see if odor is coming from under a baseboard

How To Inspect Your Work:

Tools: black light; small hand mirror

Chemicals: None

Procedure: After you’ve finished cleaning the restroom, put yourself in the position of those who use it during the daytime hours.  For instance, sit on each toilet for a moment to gain the clients’ point of view (especially in executive areas), looking at those areas that you tend NOT to look at when cleaning.

Occasionally use a small mirror to check under the rim of the toilet for alkali buildup.  Use a black light to check for bodily fluids such as urine on walls, floors, and fixtures.

         Pretty straight forward, but I passed the above along; hope it helped.

 

Sometimes it takes a while...

Months ago, I quoted a mid-sized pediatric clinic.  The pediatrician I spoke with allowed that her partners preferred contracting with an individual, as opposed to a "business", in order to save money.

She was concerned that the VCT (90% of the facility) looks a bit dull, even though her "service" is stripping every couple of months (at extra charge) - probably because he doesn't own a burnisher.  I'll
bet if she added the stripping charges to her monthly fee, she'd find out that she's been paying more than a legitimate service would charge her to clean AND periodically burnish.

She was also concerned about the building's heavy dust load, but thinks it's unavoidable, because Arizona "is a dusty place".  Which it is. 

A quick look in the janitor closet revealed a dust-mop (filthy, as always) rather than a hard-floor vacuum, a string mop rather than microfiber, and a feather duster (kind of ratty) rather than microfiber wipes.  What with Arizona being a dusty place and all, you'd think it would be a good idea to work a bit on removing the dust from the building, instead of just recirculating it.

You'd also think that a place treating little kids would have some concern for the health of the kids.  But perhaps working to keep the airborne allergens and pathogens circulating in the building keeps the kids coughing, and business returning... 

Finally, you'd think that a firm subjected to various regulatory agencies would want to have the chemical bottles properly labeled, and an MSDS book on hand (both fineable OSHA violations), and maybe even a decent touch-point sanitizer available.  But not in this janitor closet.

It's been about eight months; finally got a call to begin service.  They've been putting up with quite inferior service for all that time, and their patients have been living with a less than satisfactory indoor environment.  I'm interested to see the janitor closet when I drop by to pick up the keys, and to compare Indoor Air Quality readings after a few weeks proper cleaning.