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For many years I (and many of my infection control colleagues) have been saying that using spray bottles for environmental cleaning is not a good thing, due to potential OH&S risks (eg aerosolisation and inhalation of chemicals) and the difficulties of keeping spray bottles and nozzles clean, among other concerns.
Have again been asked to justify this position, and again I am having difficulty finding actual evidence to support this best practice recommendation (see http://remotehealthatlas.nt.gov.au/0719_spray_bottle_communique.pdf for someone brave enough to put this in writing). Does anyone have any convincing studies or well-referenced guidelines to support this recommendation?
Would also be interested in other views: is this considered best practice by the infection control community in Australia?
Thanks for any discussion on this.Cheers
MichaelMichael Wishart
Public Health Nurse,Communicable Disease Control
Logan West Moreton PHU
Ph 34131200 Fax 34131221
To contact Nursing team:
LWM_PHN@health.qld.gov.au********************************************************************************
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Hi Michael,
NSW Infection Control Policy 2007_036 section 5.2 states ‘Care should be
taken not to aerosolise cleaning agents.’ however this is unreferenced
however, it has largely been linked to OH&S risks outlined on MSDS
information supplied by manufacturers.Regards,
SueSue Greig
Senior Project Officer
Australian Commission on Safety and Quality in Health Care
GPO Box 5480 Sydney NSW 2001 | Level 7, 1 Oxford Street, Darlinghurst NSW
2010
( direct (02) 9126 3565 | ( switchboard (02) 9126 3600 | 6 (02) 9126 3613
|
Email sue.greig@safetyandquality.gov.au | http://www.safetyandquality.gov.auMichael Wishart
Sent by: AICA Infexion Connexion
15/05/2012 02:56 PM
Please respond to
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Spray bottles and environmental cleaning [SEC=No Protective Marking]For many years I (and many of my infection control colleagues) have been
saying that using spray bottles for environmental cleaning is not a good
thing, due to potential OH&S risks (eg aerosolisation and inhalation of
chemicals) and the difficulties of keeping spray bottles and nozzles
clean, among other concerns.Have again been asked to justify this position, and again I am having
difficulty finding actual evidence to support this best practice
recommendation (see
http://remotehealthatlas.nt.gov.au/0719_spray_bottle_communique.pdf for
someone brave enough to put this in writing). Does anyone have any
convincing studies or well-referenced guidelines to support this
recommendation?Would also be interested in other views: is this considered best practice
by the infection control community in Australia?Thanks for any discussion on this.
Cheers
MichaelMichael Wishart
Public Health Nurse,Communicable Disease Control
Logan West Moreton PHU
Ph 34131200 Fax 34131221To contact Nursing team:
LWM_PHN@health.qld.gov.au********************************************************************************
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Dear Michael,
Another issue around using Spray bottles ( aerosols) is the field of
spray of the chemical, which visually is not able to be assessed,
possess risk of contamination of sterile stock.( To show effect for
a demo but some food colouring in water and spray it spreads much
further than anticipated)It is particularly not recommended in Sterile stock areas, Operating
rooms etc, But this principle applies anywhere sterile stock is stored
( therefore just about all areas in hospitals) this is referenced in
AS4187.
As far as cleaning units, they should be treated as buckets etc and
emptied and washer at the end of use ( if you continue using them)
could go through bowl washers. I will look up reference and send it
when I have a minute
Kind RegardsLesley Alway
Director
Strategic Health Resources. (Infection Control Consultant)
107 Mountain View Rd
Briar Hill.
Victoria.3088
Lesley@ihc.com.au
0394340344
0408324727—–Original Message—–
Of Michael WishartFor many years I (and many of my infection control colleagues) have been
saying that using spray bottles for environmental cleaning is not a good
thing, due to potential OH&S risks (eg aerosolisation and inhalation of
chemicals) and the difficulties of keeping spray bottles and nozzles
clean, among other concerns.Have again been asked to justify this position, and again I am having
difficulty finding actual evidence to support this best practice
recommendation (see
http://remotehealthatlas.nt.gov.au/0719_spray_bottle_communique.pdf for
someone brave enough to put this in writing). Does anyone have any
convincing studies or well-referenced guidelines to support this
recommendation?Would also be interested in other views: is this considered best practice
by the infection control community in Australia?Thanks for any discussion on this.
Cheers
MichaelMichael Wishart
Public Health Nurse,Communicable Disease Control
Logan West Moreton PHU
Ph 34131200 Fax 34131221To contact Nursing team:
LWM_PHN@health.qld.gov.au**************************************************************************
******
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Hi Michael,
From the Blue Book, Victorian IC Guidelines;Appendix 6: Cleaning and waste disposal procedures
* cleaning methods should avoid generation of aerosols
* sprays should not be used as they can become contaminated and are difficult to clean. Sprays are not effective as they do not touch all parts of the surface to be cleanedRegards
KathyKathy Taylor CICP
Infection Control Manager
The Wesley Hospital
PO Box 499,
Toowong, Qld 4066
07 3232 7558
katherine.taylor@uchealth.com.au—–Original Message—–
For many years I (and many of my infection control colleagues) have been saying that using spray bottles for environmental cleaning is not a good thing, due to potential OH&S risks (eg aerosolisation and inhalation of chemicals) and the difficulties of keeping spray bottles and nozzles clean, among other concerns.
Have again been asked to justify this position, and again I am having difficulty finding actual evidence to support this best practice recommendation (see http://remotehealthatlas.nt.gov.au/0719_spray_bottle_communique.pdf for someone brave enough to put this in writing). Does anyone have any convincing studies or well-referenced guidelines to support this recommendation?
Would also be interested in other views: is this considered best practice by the infection control community in Australia?
Thanks for any discussion on this.Cheers
MichaelMichael Wishart
Public Health Nurse,Communicable Disease Control Logan West Moreton PHU Ph 34131200 Fax 34131221
To contact Nursing team:
LWM_PHN@health.qld.gov.au********************************************************************************
This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s), or if it is transmitted/received in error.
Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters.
If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.
If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.
Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person’s computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email.
Unless stated otherwise, this email represents only the views of the sender and not the views of the Queensland Government.
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Michael,
Information below may be of interest/use:
1. J.W. Medcraft, et al. Potential hazard from spray cleaning of floors in
hospital wards. Journal of Hospital Infection, Volume 9, Issue 2, March
1987, Pages 151-157Abstract
The potential hazard from using contaminated spray cleaning fluid to clean
hospital floors was investigated. Eight of 10 sprays in daily hospital use
failed the ‘in-use’ test of Kelsey & Maures. Contamination was due to
Gram-negative bacilli, mainly Pseudomonas spp. An experiment showed that
freshly diluted cleaning fluid in a new spray container became contaminated
in 6 days, although the route of contamination of the fluid is not clear.
Air samples and samples from bedding collected during spray cleaning with
contaminated fluid showed the presence of Pseudomonas spp. Use of freshly
diluted cleaning fluid and daily cleaning of spray containers is
recommended.2. Remote Health Branch, Northern Territory Government – Best Practice
Communique 07 -19Extract below:
“The primary concerns over the use of spray bottles include:
1. Infection: reported findings of heavy growths of pathogens in spray
bottles, which are of clinical significance in the hospital setting; the
inability to totally clean and dry the trigger mechanism (therefore it
remains damp and promotes bacterial growth); the dispersal of those
pathogens by the spray mechanism;2. OH&S: the potential for the chemical to cause injury as a respiratory
irritant for staff and visitors.3. Anecdotally most refillable bottles would appear to be poorly labelled
and dated (making it unclear what the product is and when it was mixed)Best Practice Group discussions revealed a clear recognition of the
usefulness of spray bottles in Health Centres. However, given the risks for
the systems becoming a reservoir for infection, and the strong
recommendation from DHCS Infection Control representatives, there was
unanimous agreement to follow RDH’s lead, and remove spray bottles from RHB
Health Centre use”.The document includes this reference but I have not been able to locate it –
perhaps someone in QLD can assist? – Reference – Abstract – ‘Trigger Happy:
Hidden dangers of spray bottles’ from the Queensland Infection Control
Association conference (2001).3. B.M. Andersen. Et al. Floor cleaning: effect on bacteria and organic
materials in hospital rooms Original Research Article. Journal of Hospital
Infection, Volume 71, Issue 1, January 2009, Pages 57-65Summary
Routine surface cleaning is recommended to control the spread of pathogens
in hospital environments. In Norway, ordinary cleaning of patient rooms is
traditionally performed with soap and water. In this study, four
floor-mopping methods – dry, spray, moist and wet mopping – were compared by
two systems using adenosine triphosphate (ATP) bioluminescence (Hygiena and
Biotrace). These systems assess residual organic soil on surfaces. The
floor-mopping methods were also assessed by microbiological samples from the
floor and air, before and after cleaning. All methods reduced organic
material on the floors but wet and moist mopping seemed to be the most
effective (P < 0.001, P < 0.011, respectively, ATP Hygiena). The two ATP
methods were easy to use, although each had their own reading scales.
Cleaning reduced organic material to 5-36% of the level present before
cleaning, depending upon mopping method. All four mopping methods reduced
bacteria on the floor from about 60-100 to 30-60 colony-forming units
(cfu)/20 cm2 floor. Wet, moist and dry mopping seemed to be more effective
in reducing bacteria on the floor, than the spray mopping (P = 0.007, P 0.002 and P = 0.011, respectively). The burden of bacteria in air increased
for all methods just after mopping. The overall best cleaning methods seemed
to be moist and wet mopping.Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426—–Original Message—–
Michael WishartFor many years I (and many of my infection control colleagues) have been
saying that using spray bottles for environmental cleaning is not a good
thing, due to potential OH&S risks (eg aerosolisation and inhalation of
chemicals) and the difficulties of keeping spray bottles and nozzles clean,
among other concerns.Have again been asked to justify this position, and again I am having
difficulty finding actual evidence to support this best practice
recommendation (see
http://remotehealthatlas.nt.gov.au/0719_spray_bottle_communique.pdf for
someone brave enough to put this in writing). Does anyone have any
convincing studies or well-referenced guidelines to support this
recommendation?Would also be interested in other views: is this considered best practice by
the infection control community in Australia?Thanks for any discussion on this.
Cheers
MichaelMichael Wishart
Public Health Nurse,Communicable Disease Control Logan West Moreton PHU Ph
34131200 Fax 34131221To contact Nursing team:
LWM_PHN@health.qld.gov.au****************************************************************************
****
This email, including any attachments sent with it, is confidential and for
the sole use of the intended recipient(s). This confidentiality is not
waived or lost, if you receive it and you are not the intended recipient(s),
or if it is transmitted/received in error.
Any unauthorised use, alteration, disclosure, distribution or review of this
email is strictly prohibited. The information contained in this email,
including any attachment sent with it, may be subject to a statutory duty of
confidentiality if it relates to health service matters.
If you are not the intended recipient(s), or if you have received this email
in error, you are asked to immediately notify the sender by telephone
collect on Australia +61 1800 198 175 or by return email. You should also
delete this email, and any copies, from your computer system network and
destroy any hard copies produced.
If not an intended recipient of this email, you must not copy, distribute or
take any action(s) that relies on it; any form of disclosure, modification,
distribution and/or publication of this email is also prohibited.
Although Queensland Health takes all reasonable steps to ensure this email
does not contain malicious software, Queensland Health does not accept
responsibility for the consequences if any person's computer inadvertently
suffers any disruption to services, loss of information, harm or is infected
with a virus, other malicious computer programme or code that may occur as a
consequence of receiving this email.
Unless stated otherwise, this email represents only the views of the sender
and not the views of the Queensland Government.
****************************************************************************
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Michael, I found this, from CDC – “Guidelines for Environmental Infection Control in Health-Care Facilities, 2003.
Page 90
“Application of contaminated cleaning solutions, particularly from small quantity
aerosol spray bottles or with equipment that might generate aerosols during operation, should
be avoided, especially in high-risk patient areas.992, 993 Making sufficient fresh cleaning solution for
daily cleaning, discarding any remaining solution, and drying out the container will help to minimize the
degree of bacterial contamination. Containers that dispense liquid as opposed to spray-nozzle
dispensers (e.g., quart-sized dishwashing liquid bottles) can be used to apply detergent/disinfectants to
surfaces and then to cleaning cloths with minimal aerosol generation”
Regards,
Helen.Helen Scott
Infection Control Co-ordinator
Nepean Private Hospital
Penrith, NSW.
0247 327333
Helen.Scott@healthscope.com.auPlease consider the environment before printing this message
>>> On 15/05/2012 at 2:56 pm, in message , Michael Wishart wrote:
For many years I (and many of my infection control colleagues) have been saying that using spray bottles for environmental cleaning is not a good thing, due to potential OH&S risks (eg aerosolisation and inhalation of chemicals) and the difficulties of keeping spray bottles and nozzles clean, among other concerns.Have again been asked to justify this position, and again I am having difficulty finding actual evidence to support this best practice recommendation (see http://remotehealthatlas.nt.gov.au/0719_spray_bottle_communique.pdf for someone brave enough to put this in writing). Does anyone have any convincing studies or well-referenced guidelines to support this recommendation?
Would also be interested in other views: is this considered best practice by the infection control community in Australia?
Thanks for any discussion on this.
Cheers
MichaelMichael Wishart
Public Health Nurse,Communicable Disease Control
Logan West Moreton PHU
Ph 34131200 Fax 34131221To contact Nursing team:
LWM_PHN@health.qld.gov.au********************************************************************************
This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s), or if it is transmitted/received in error.
Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters.
If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.
If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.
Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person’s computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email.
Unless stated otherwise, this email represents only the views of the sender and not the views of the Queensland Government.
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