INFECTION CONTROL
Up-to-date standards key whenchoosingdisinfectants
Dr Tim Sandle, a Chartered Biologist with a first-class honours degree in Applied Biology, and a Masters degree in education, who is an honorary tutor with the School of Pharmacy and Pharmaceutical Sciences at the University of Manchester, discusses why the most up-to-date standards, known as European Norms (EN), should always be considered when selecting cleaning and disinfection products for use in hospitals and other healthcare facilities.
Effective disinfection of surfaces, instruments, and hands, is critical to minimise infection risks (bacterial, fungal and viral) in hospitals, especially during the current global pandemic. This requires the selection of the most appropriate disinfectants, their correct application, and an assessment of their capability to inactivate or kill microorganisms. There is a wide choice of disinfectant formulations available, and it is essential to ensure that the most appropriate disinfectants are selected and used correctly. This article examines European Norms (EN) in relation to disinfectants, considers the importance of updates to these standards, and offers some practical advice on ensuring that accurate comparisons between different disinfectants can be readily made. The main function of a disinfectant lies in its ability to kill or inactivate microorganisms. Therefore, a key step in the selection process is ensuring that the disinfectant has the required level of biocidal activity. Disinfection manufacturers provide efficacy data relating to the two key criteria of contact time and required concentration. This data should be based on product testing which is both rigorous and repeatable. In Europe, this means being tested to the European Norms (EN), which remain the ‘gold standard’ tests when selecting disinfectants for use in the UK.
A unique reference code
According to the EU, ‘a Standard’ (French: norme; German: Norm) is a document that provides rules, guidelines, or characteristics for activities or their results, for common and repeated use. Each European Standard is identified by a unique reference code, which contains the letters ‘EN’. These standards have a number, and are ‘version controlled’ by the stated year. European standards for testing disinfectants are based on test methods orientated towards the practical use of the disinfectant. Agreed standards ensure that manufacturers are able to validate claims of bactericidal (including tuberculocidal)
58 Health Estate Journal July 2020
A key step in the selection process is ensuring that the disinfectant has the required level of biocidal activity.
and virucidal efficacy. Theoretically, these standards should allow the direct comparison of disinfectants from different manufacturers, as they should have been tested using the same standard under the same test conditions.
Not mandatory
Standards are regularly reviewed and updated, but it is not mandatory for a disinfectant manufacturer to test to the latest standards. For example, the standard, EN 13624:2003, specifies the minimum requirements for fungicidal or yeasticidal activity of chemical disinfectants in the healthcare setting. The 2003 version was superseded by EN13624:2013, which specifies more rigorous efficacy testing. In practice this means that a disinfectant tested to the 2013 EN would need to be used at an increased concentration, and/or for a longer contact time, than if it were tested to the 2003 standard. If comparing two disinfectants, where one was tested to EN13624:2003, and the other to EN13624:2013, an accurate comparison could not be made in terms of the
concentration or contact times required. Equally, a disinfectant that has only been tested against the 2003 standard is not necessarily as effective for use within the hospital environment.
There is no mandatory requirement for an updated standard to be adopted by a manufacturer within a set period of time (or to be reassessed at all). As standards become increasingly rigorous to protect both patients and staff, there appears to be little incentive for disinfectant manufacturers to test to newer, tougher standards, which could necessitate increased disinfectant concentration times and longer contact times to ensure improved microbial efficacy. There are some manufacturers who will always adopt and test to the latest norms, to ensure that the highest infection prevention standards are maintained, but this may require a little research to ensure that disinfectant claims are truly comparable.
A variety of properties
Disinfectants have a variety of properties, which include spectrum of activity, mode of action, and efficacy. Equally, the active
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