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Higher concentration dilution of sodium hypochlorite

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  • #75664
    Richard Bartolo
    Participant

    Author:
    Richard Bartolo

    Email:
    richard.bartolo@wh.org.au

    Organisation:
    Western Health

    State:
    VIC

    Hi Everyone,
    We are looking at higher concentration dilution of sodium hypochlorite (10% bleach solution) (1:10 solution = 1 part bleach for every 9 parts water) for terminal cleaning. This concentration is 5 times the currently used dose 5000 ppm vs 1000ppm. The higher concentrations of chlorine are deemed respiratory sensitizers which have the potential to trigger reactions in some staff. Has anyone had issues?

    Kind Regards,

    Richard

    Richard Bartolo
    Manager Infection Prevention

    Western Health
    Gordon Street, Footscray VIC 3011
    Ph. 03 8345 6113
    Mob. 0438 560 441
    Email. richard.bartolo@wh.org.au
    Web. http://www.westernhealth.org.au

    This was sent from my iPhone.
    Kind Regards,

    Richard Bartolo
    Manager Infection Prevention

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #75665
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Email:
    Michael.Wishart@svha.org.au

    Organisation:

    State:
    NSW

    Hi Richard

    Well, where should I start? This, admittedly, if from quite a few years ago, but anything above 1000ppm available chlorine was problematic for my staff at the time. We initially tried 10000ppm available chlorine, and saw severe cases of skin problems, and some respiratory sensitisation. And the surfaces showed a very rapid decline… even stainless steel benches showed rapid wear! So we moved down to 5000pmm and saw less respiratory sensitisation, still had multiple cases of skin problems, and still had surface wear. This was over a period of several years, mind you. So, after that, I abandoned sodium hypochlorite unless I had absolutely no alternative, and then only at level 1000ppm or less.

    There are other disinfectants now available, although bleach remains easy to obtain and cheap, making it desirable from a cost perspective. But I would strongly argue that wide use of bleach is a definite hazard to staff that is very hard to control.

    My opinion, at any rate.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    —–Original Message—–
    From: ACIPC Infexion Connexion On Behalf Of Bartolo, Richard
    Sent: Wednesday, 31 July 2019 3:58 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] Higher concentration dilution of sodium hypochlorite

    Hi Everyone,
    We are looking at higher concentration dilution of sodium hypochlorite (10% bleach solution) (1:10 solution = 1 part bleach for every 9 parts water) for terminal cleaning. This concentration is 5 times the currently used dose 5000 ppm vs 1000ppm. The higher concentrations of chlorine are deemed respiratory sensitizers which have the potential to trigger reactions in some staff. Has anyone had issues?

    Kind Regards,

    Richard

    Richard Bartolo
    Manager Infection Prevention

    Western Health
    Gordon Street, Footscray VIC 3011
    Ph. 03 8345 6113
    Mob. 0438 560 441
    Email. richard.bartolo@wh.org.au
    Web. https://clicktime.symantec.com/3T9CBetsUTQQ1UEyZRZusdP7Vc?u=www.westernhealth.org.au

    This was sent from my iPhone.
    Kind Regards,

    Richard Bartolo
    Manager Infection Prevention

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at https://clicktime.symantec.com/3Dwg8t4eyUjTyhBVEtBSnwC7Vc?u=http%3A%2F%2Faicalist.org.au%2Farchives – registration and login required.

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    #75667
    Richard Bartolo
    Participant

    Author:
    Richard Bartolo

    Email:
    richard.bartolo@wh.org.au

    Organisation:
    Western Health

    State:
    VIC

    Good morning John,

    Thanks you for your reply, the 2019 Australian Guidelines for the Prevention and Control of Infection in Healthcare recommends the higher concentration dilution of sodium hypochlorite (10% bleach solution) (1:10 solution = 1 part bleach for every 9 parts water) for the cleaning and disinfection of clostridium difficile, fungal spores and during norovirus outbreaks. Important to note difficulty in getting rid of c diff spores even when we use recommended concentrations of hypochlorite.

    We have introduced sporicidal wipes recently, but it’s too early to note any effects. I will however try to explore any new technology as far as chemicals is concerned.

    Sodium hypochlorite

    Despite the emergence of new disinfection products and technologies, sodium hypochlorite remains a commonly used and accessible chlorine-based disinfectant with broad spectrum antimicrobial properties. The evidence suggests that when the dilution factor is sufficient for sporicidal activity ( 5000ppm free chlorine), sodium hypochlorite is effective against C. difficile. There is also evidence to suggest that sodium hypochlorite disinfection is effective for managing norovirus outbreaks[126]

    Kind Regards,

    Richard

    Richard Bartolo

    Manager Infection Prevention

    Western Health

    Gordon Street, Footscray VIC 3011

    Ph. 03 8345 6113

    Mob. 0438 560 441

    Email. richard.bartolo@wh.org.au

    Web. http://www.westernhealth.org.au

    Notice:

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    —–Original Message—–
    From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of GREENOUGH, John
    Sent: Wednesday, 31 July 2019 4:54 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Higher concentration dilution of sodium hypochlorite

    Hi Richard,

    I am interested as to why you need to use a concentration of greater than 1000 ppm for terminal cleaning/disinfection.

    At Austin Health we have been using a cleaning disinfection solution with 1000 ppm sodium hypochlorite for over ten years as a standardised cleaning agent for all environmental cleaning in all clinical areas. We have not encountered substantial OH&S issues as long as staff use appropriate PPE and are trained in safe chemical handling. We couple this standardised cleaning system with monthly VRE environmental surveillance. Our surveillance usually does not yield VRE detections , but when we identify VRE on an item such as a commode chair we inform the clinical area to re-clean all the commode chair. We have found the standard application of 1000 ppm is effective.

    Kind regards,

    John Greenough

    Manager – Infection Control Department

    03 9496 6625

    Level 7, Harold Stokes Building

    145 Studley Road, Heidelberg

    PO Box 5555, Victoria, 3084

    http://www.austin.org.au

    —–Original Message—–

    From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Michael Wishart

    Sent: Wednesday, 31 July 2019 4:15 PM

    To: ACIPCLIST@ACIPC.ORG.AU

    Subject: Re: [ACIPC_Infexion_Connexion] Higher concentration dilution of sodium hypochlorite

    Hi Richard

    Well, where should I start? This, admittedly, if from quite a few years ago, but anything above 1000ppm available chlorine was problematic for my staff at the time. We initially tried 10000ppm available chlorine, and saw severe cases of skin problems, and some respiratory sensitisation. And the surfaces showed a very rapid decline… even stainless steel benches showed rapid wear! So we moved down to 5000pmm and saw less respiratory sensitisation, still had multiple cases of skin problems, and still had surface wear. This was over a period of several years, mind you. So, after that, I abandoned sodium hypochlorite unless I had absolutely no alternative, and then only at level 1000ppm or less.

    There are other disinfectants now available, although bleach remains easy to obtain and cheap, making it desirable from a cost perspective. But I would strongly argue that wide use of bleach is a definite hazard to staff that is very hard to control.

    My opinion, at any rate.

    Cheers

    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032 T +61 7 3326 3068 | F +61 7 3607 2226 E michael.wishart@svha.org.au | W https://clicktime.symantec.com/39g5xiNNWMD9XxxzMLsFgPw7Vc?u=https%3A%2F%2Fwww.svphn.org.au

    —–Original Message—–

    From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Bartolo, Richard

    Sent: Wednesday, 31 July 2019 3:58 PM

    To: ACIPCLIST@ACIPC.ORG.AU

    Subject: [ACIPC_Infexion_Connexion] Higher concentration dilution of sodium hypochlorite

    Hi Everyone,

    We are looking at higher concentration dilution of sodium hypochlorite (10% bleach solution) (1:10 solution = 1 part bleach for every 9 parts water) for terminal cleaning. This concentration is 5 times the currently used dose 5000 ppm vs 1000ppm. The higher concentrations of chlorine are deemed respiratory sensitizers which have the potential to trigger reactions in some staff. Has anyone had issues?

    Kind Regards,

    Richard

    Richard Bartolo

    Manager Infection Prevention

    Western Health

    Gordon Street, Footscray VIC 3011

    Ph. 03 8345 6113

    Mob. 0438 560 441

    Email. richard.bartolo@wh.org.au

    Web. https://clicktime.symantec.com/3T9CBetsUTQQ1UEyZRZusdP7Vc?u=www.westernhealth.org.au

    This was sent from my iPhone.

    Kind Regards,

    Richard Bartolo

    Manager Infection Prevention

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at https://clicktime.symantec.com/3Dwg8t4eyUjTyhBVEtBSnwC7Vc?u=http%3A%2F%2Faicalist.org.au%2Farchives – registration and login required.

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    ______________________________________________________________________

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    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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    ——————————————————————————

    WARNING: This message originated from outside the Northern/Melbourne/Western Health e-mail network. The sender cannot be validated. Caution is advised. Contact IT Services for more information.

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #75672
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Email:
    infexion@ozemail.com.au

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi John,

    Are you saying you have had no clusters or outbreaks of VRE since the implementation 1000 ppm sodium hypochlorite for all environmental cleaning in all clinical areas ten years ago?

    Also does the cleaning schedule include the use of 1000 ppm sodium hypochlorite on non-critical medical devices?

    Regards

    Glenys

    Glenys Harrington
    Consultant
    Infection Control Consultancy (ICC)
    P.O. Box 6385
    Melbourne
    Australia, 3004
    M: +61 404816434
    E: infexion@ozemail.com.au

    —–Original Message—–

    Hi Richard,
    I am interested as to why you need to use a concentration of greater than 1000 ppm for terminal cleaning/disinfection.

    At Austin Health we have been using a cleaning disinfection solution with 1000 ppm sodium hypochlorite for over ten years as a standardised cleaning agent for all environmental cleaning in all clinical areas. We have not encountered substantial OH&S issues as long as staff use appropriate PPE and are trained in safe chemical handling. We couple this standardised cleaning system with monthly VRE environmental surveillance. Our surveillance usually does not yield VRE detections , but when we identify VRE on an item such as a commode chair we inform the clinical area to re-clean all the commode chair. We have found the standard application of 1000 ppm is effective.

    Kind regards,

    John Greenough
    Manager – Infection Control Department

    03 9496 6625

    Level 7, Harold Stokes Building
    145 Studley Road, Heidelberg
    PO Box 5555, Victoria, 3084

    http://www.austin.org.au

    —–Original Message—–

    Hi Richard

    Well, where should I start? This, admittedly, if from quite a few years ago, but anything above 1000ppm available chlorine was problematic for my staff at the time. We initially tried 10000ppm available chlorine, and saw severe cases of skin problems, and some respiratory sensitisation. And the surfaces showed a very rapid decline… even stainless steel benches showed rapid wear! So we moved down to 5000pmm and saw less respiratory sensitisation, still had multiple cases of skin problems, and still had surface wear. This was over a period of several years, mind you. So, after that, I abandoned sodium hypochlorite unless I had absolutely no alternative, and then only at level 1000ppm or less.

    There are other disinfectants now available, although bleach remains easy to obtain and cheap, making it desirable from a cost perspective. But I would strongly argue that wide use of bleach is a definite hazard to staff that is very hard to control.

    My opinion, at any rate.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032 T +61 7 3326 3068 | F +61 7 3607 2226 E michael.wishart@svha.org.au | W https://clicktime.symantec.com/39g5xiNNWMD9XxxzMLsFgPw7Vc?uhttps%3A%2F%2Fwww.svphn.org.au

    —–Original Message—–

    Hi Everyone,
    We are looking at higher concentration dilution of sodium hypochlorite (10% bleach solution) (1:10 solution 1 part bleach for every 9 parts water) for terminal cleaning. This concentration is 5 times the currently used dose 5000 ppm vs 1000ppm. The higher concentrations of chlorine are deemed respiratory sensitizers which have the potential to trigger reactions in some staff. Has anyone had issues?

    Kind Regards,

    Richard

    Richard Bartolo
    Manager Infection Prevention

    Western Health
    Gordon Street, Footscray VIC 3011
    Ph. 03 8345 6113
    Mob. 0438 560 441
    Email. richard.bartolo@wh.org.au
    Web. https://clicktime.symantec.com/3T9CBetsUTQQ1UEyZRZusdP7Vc?uwww.westernhealth.org.au

    This was sent from my iPhone.
    Kind Regards,

    Richard Bartolo
    Manager Infection Prevention

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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    ______________________________________________________________________
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