Cleaners, disinfectants, and sterilants are commonly used in healthcare facilities. However, these products are costly and can be toxic. Therefore, learning more about them and ways to reduce their use while still maintaining the appropriate level of clean can help you lessen your employees’ exposure to chemicals, save your facility money, and minimize environmental impacts. To help your facility, MnTAP has developed guidelines for cleaning and disinfection in healthcare facilities: Hospital and Clinic Cleaning Guidelines and Disinfection Best Management Practices.
Disinfectants are technically pesticides, and as such, they are inherently toxic. Limiting their use in your facility can not only save money, but can also limit your employees’ and patients' exposure to toxic chemicals. The Centers for Disease Control and Prevention (CDC) set guidelines [PDF 948KB] for cleaning and disinfecting surfaces in healthcare facilities. These guidelines recommend disinfecting only surfaces in patient care areas that are “high touch” and/or come in contact with broken skin. Non- or low-touch surfaces and those in non-patient care areas such as administration, waiting areas, and purchasing only need cleaning and do not generally require disinfecting. Also, floors do not routinely require disinfecting unless a body fluid spill has occurred.
Using alternative disinfectants may be an option for your facility. For example, hydrogen peroxide is an effective disinfectant that readily breaks down to oxygen and water. It is environmentally preferable to quaternary ammonium compounds (quats), which contain chlorine. Hydrogen peroxide is effective against hospital pathogens including tuberculosis, hepatitis, and HIV. Currently, two U.S. Environmental Protection Agency (EPA)-registered hydrogen peroxide hospital grade disinfectants are available: Carpe Diem and Oxivir.
Through a MnTAP intern project, Olmsted Medical Center in Rochester, Minnesota, was able to eliminate its use of five different disinfectants and switch to hydrogen peroxide for disinfecting surfaces. This switch saved $20,000 annually, reduced over 1,500 waste containers, and did not result in increased occurrances of hospital-acquired infections.
Detergents and Cleaning Compounds
Detergents and cleaning compounds include chemicals that enhance water’s ability to remove dirt and clean surfaces. However, when these chemicals are washed down the drain and sent to the wastewater treatment plant, may not be adequately broken down before being further discharged to lakes, rivers, and streams and potentially cause environmental harm.
Water alone can be an effective cleaner and sanitizer. At least two products are available using hot water/steam and ionized water technology. More information regarding the cleaning power of water can be found on the Active Ion Web site. Steam used for cleaning is also gaining favor in healthcare facilities. More information can be found in the article, Steam vapor for cleaning has New Jersey hospital seeing green.
The environmental impact of cleaning compounds can be minimized by using a greener product. Green Seal is a national certification agency for environmentally preferable products, including institutional cleaners. Two Minnesota companies, Restore the Earth and MultiClean, manufacture Green Seal certified cleaners.
Additional Cleaning Agents and Resources
The following cleaning agents may be found in your facility. MnTAP has provided in-depth regulatory and waste reduction information about each item through the Non-Hospital Healthcare Project.
- Aerosol Products
- Air Fresheners
- Antibacterial Soaps
- Antimicrobial Wipes
- Cold Sterilants
- Hand Sanitizers
- Ultrasonic Cleaners
The following resources may help you answer your cleaning and disinfecting questions.
- MnTAP Fact Sheet: Hospitals and Clinic Cleaning Guidelines (2009). This reference list can help you reduce the number of cleaners and disinfectants being used, reduce cleaning times, minimize patient and staff exposures to toxic chemicals, and reduce procurement costs.
- MnTAP Intern Summary: Improving Cleaning Processes at Olmsted Medical Center (2007). This project focused on reducing the number and toxicity of housekeeping chemicals used and improving the efficiency of procedures.
- EPA Tool: Green Cleaning Pollution Prevention Calculator. This tool can help environmental, health, and safety managers estimate the benefits of adopting green cleaning practices.
- Project Summary: Janitorial Products Pollution Prevention Project. The Western Regional Pollution Prevention Network has put together fact sheets and resources to assist with safer and environmentally preferable janitorial products and practices.
- CDC Guidelines: Levels of Disinfection. These guidelines were developed for levels of disinfection according to type of equipment and level of disinfection needed.
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