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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 PreventionWestern 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.auThis was sent from my iPhone.
Kind Regards,Richard Bartolo
Manager Infection PreventionMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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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
MichaelMichael 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 hypochloriteHi 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 PreventionWestern 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.auThis was sent from my iPhone.
Kind Regards,Richard Bartolo
Manager Infection PreventionMESSAGES 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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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
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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 hypochloriteHi 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
—–Original Message—–
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Michael Wishart
Sent: Wednesday, 31 July 2019 4:15 PM
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
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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______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
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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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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 Department03 9496 6625
Level 7, Harold Stokes Building
145 Studley Road, Heidelberg
PO Box 5555, Victoria, 3084—–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
MichaelMichael 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 PreventionWestern 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.auThis was sent from my iPhone.
Kind Regards,Richard Bartolo
Manager Infection PreventionMESSAGES 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?uhttp%3A%2F%2Faicalist.org.au%2Farchives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
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______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.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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