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HEALTHCARE CLEANING ‘‘


When selecting a wipe for the clinical setting, it cannot be assumed that all wipes will have this ‘gold standard’ EN16615 certification. Many wipes will instead have EN14476 certification without EN16615, which should raise the question of whether these wipes are really fit for purpose


Choosing the optimum disinfection product may mean that a number of different ones are required, depending on the surface to be cleaned. For example, 70% ethanol shows a significant activity on the human coronavirus,5


so a virucidal,


ethanol-based disinfector/cleaner such as mikrozid liquid could play a useful role in the cleaning and disinfection of hard surfaces, particularly as it is effective against enveloped viruses within one minute (EN14476). In contrast, an alcohol- free wipe may be needed to clean and disinfect surfaces sensitive to alcohol, such as leather, PVC, and acrylic glass. A low-alcohol disinfectant may be required where a material-friendly disinfectant is required, such as in patient treatment units and with sensitive equipment. Whatever type of disinfectant is required, it should still meet the requirements defined in EN14476 for virucidal efficacy.


A two-stage process


Having selected the most appropriate and efficacious disinfectant, it should be remembered that cleaning is a two-stage process. The first stage is to clean the surface, which prepares it for the disinfection stage. Cleaning physically


removes contamination, including some microorganisms and soiling if present. It is a vital step before disinfection, to allow the disinfectant to make contact with the virus, but does not necessarily destroy all viruses and microorganisms present, even if a surface looks clean. The second stage is to disinfect the surface. The aim here is to reduce the number of viruses and microorganisms present to a level that is unlikely to cause infection. The principle that only clean things can be efficiently disinfected holds true.5


Some, but not all, hospital


disinfectants also have cleaning properties which may include added surfactants, meaning that only one product is required for this two-stage process.


Properly trained staff


The latest guidance on cleaning and decontamination from Public Health England recommends that ‘Cleaning and decontamination should only be performed by staff trained in the use of the appropriate PPE; in some instances, this may need to be trained clinical staff rather than domestic staff, in which case, clinical staff may require additional training on standards and order of cleaning.’ This means that some staff may need to undergo additional training to ensure that environmental cleaning is carried out safely, both for the benefit of staff, but also for patients. With the number of COVID-19 cases still rising, and no specific drug therapies or vaccinations yet available to manage the disease, the prevention of further spread in healthcare facilities is essential. Selecting optimum disinfectants is critical, as they must be capable of inactivating the virus which causes COVID-19 within a relatively fast time. Not all cleaners/ disinfectants have the same antimicrobial properties. Those which conform to EN standards like EN14476 for virucidal activity will be the most effective when cleaning surfaces contaminated with coronaviruses. The selection of disinfectants has never been more important.


Besides the disinfectant content, consideration should also be given to the material of which the wipe is composed, as this is also key to achieving effective disinfection.


52 Health Estate Journal May 2020


References 1 Kraay ANM, Hayashi MAL, Hernandez- Ceron N et al. Fomite-mediated transmission as a sufficient pathway: a comparative analysis across three


viral pathogens. BMC Infect Dis 2018; 18 (1): 540.


2 Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect 2020; 104 (3): 246-51.


3 van Doremalen N, Bushmaker T, Morris DH et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382 (16): 1564-7.


4 Public Health England. Guidance: Novel coronavirus (2019-nCoV) infection prevention and control guidance. Updated 6 April 2020.


[https://www.gov.uk/government/ collections/wuhan-novel-coronavirus].


5 Geller C, Varbanov M, Duval RE. Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses 2012; 4 (11): 3044-68.


Dr Tim Sandle hej


Dr Sandle is a chartered biologist (Royal Society for Biology), and holds a first-class honours degree in Applied Biology and a Master’s degree in education; he obtained his doctorate from Keele University. He is an honorary tutor with the School of Pharmacy and Pharmaceutical Sciences, University of Manchester. He serves on several national and international committees relating to pharmaceutical microbiology and cleanroom contamination control, and has written over 500 book chapters, peer-reviewed papers, and technical articles relating to microbiology, healthcare, and pharmaceutical science. He has also delivered papers to over 100 conferences. Dr Sandle is the editor of the Pharmaceutical Microbiology Interest Group journal, and runs an on-line microbiology website and forum (www.pharmamicroresources.com).


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