The Janitors' Closet

Cleaning for Health - not just medical facilities

America still has higher hospital acquired infection rates than much of the world; generally, our rates are twice that of Europe, I see from various publications.

Part of the reason is still insufficient hand-washing between patients (a bit of a no brainer).  Another significant factor is antiquated janitorial procedures.  Europeans were 15 years or so in advance of us in adopting microfiber damp mops, for instance.  We still mostly use cotton string mops, and traditional buckets and wringers.

Picture your janitor mopping down a corridor of patient rooms.  Even if you can get him to change his mop water after each room (close to impossible, and inefficient as heck), he's still using the same mop head on each room, thereby moving the pathogens from room A to room B, and from both to room C, and so on.  Give him, instead, a bucket designed to hold a couple of dozen microfiber mops.  When starting each room, he pulls a fresh mop out of the bucket.  He does not re-immerse it; when finished with the room, or sooner if the mop runs out of solution, he puts the used mop head in a bag for laundering, and pulls out a fresh mop.  Always a fresh mop, always clean mop solution.  No cross-contamination.

I could go on.  Vacuuming rather than dust-mopping (to pick up more pathogens and general dirt).  Using a HEPA filter on the vacuum.  Microfiber wipes rather than cotton rags.  Filtered burnishers.   Hospital grade disinfectant.  Nothing costly, or needing more research, or difficult to implement.  And hospital acquired infections plummet.  Not exactly rocket science.

Matter of fact, it's all easy enough that we use those procedures in all our client accounts, not just the health care ones.  Kind of original, trying to keep ordinary office space healthful for its occupants.

Indoor Air Quality: Clearing The Air

"Clearing the Air" by Ronnie Garrett appeared a while back in Cleanlink; it pretty much describes our program of cleaning for health.

Areas focussed on are, first, entry matting: "Stopping contaminants at the source requires a solid understanding of what the sources of contamination are. For example, consider the contaminants walked in on a person's shoes. These particles include dust generated by industrial facilities, pesticides and more, which is present in soil and on city streets and sidewalks."

Secondly, vacuuming: "CRI (the Carpet and Rug Institute) simplifies vacuum selection through its Seal of Approval Program. This program rates vacuums on soil removal, dust containment and safety to carpet surfaces.  'The Seal of Approval is the only quantifiable testing program for vacuums in the world,' says Bethany Richmond, CRI communications manager. 'We test vacuum cleaners to see if they work, are low emitting and don't destroy the carpet.'  When targeting IAQ concerns, Braun recommends cleaning operations choose vacuums with CRI Seal of Approval Gold certification. This certification ensures a vacuum removes and holds particles as small as 35 micrograms."

Third, vacuuming hard surface floors:   "Other countries have been vacuuming their hard-surface floors since the 1980s," says Ian Grieg, CEO of Daniels Associates (Ian's been our go-to consultant for some 25 years).  "We still don't vacuum hard-surface floors and that's one of the largest causes of poor IAQ because dust mops just throw particles into the air."

Further, microfiber:  "Cleaning operations need microfiber wipes for all dusting, damp wiping and damp mopping," says Grieg.

Finally, chemical selection and use:  "Sanitizers and disinfectants also contribute to healthier environments so they do have their place in cleaning, but their harmful affects can be mitigated by how they are used. For example, an aerosol disinfectant adds chemical to the air, but a squeeze bottle solution, where cleaners squeeze a stream directly onto a cloth, can alleviate this problem. Apply these products with a microfiber cloth or mop and IAQ improves again because custodians use less chemistry to clean.  "Microfiber allows the use of less corrosive chemistries because it physically removes contaminants," says Grieg.

Add HEPA filters to the vacuum, and it's our program in a nutshell.

 

Microfiber cleaning

Damp-mopping with microfiber flat mops is the prime focus of an article in a recent Cleanink publication.

"More than 90 percent of the mopping in the United States uses a traditional string mop with a single compartment bucket. According to a study conducted by the American Institute for Cleaning Sciences, in a traditional mopping system, the water and mop head soil rapidly after the first few dips into the mop bucket. Potential contaminants and soil are redistributed to the floor and/or grout lines after the first 1,000 square feet of mopping. 

"This cleaning process may also damage building interiors, specifically the vertical baseboard grout lines causing a “ring around the building.” This occurs when the string mop, saturated with dirty mop water, is maneuvered close to the floor edges. The higher string mop profile of two to three inches drags along the baseboard causing soiling. Over time, this unintended consequence of mopping lowers appearance-based cleaning scores. Eventually it will cost the building service contractor time and money in grout restoration."

I use the "ring around the building" test when doing an initial walk-through on a sales call; I point the ring out to the client, and explain that it's the result of outdated string mop technology.  Then I ask to see the janitor closet, to confirm the string mop diagnosis.  It's an easy way to look competent.

A few thoughts on microfiber:

Both field experience and numerous studies indicate that microfiber ("flat") damp mops use less solution, need less chemical in that solution, and leave a cleaner floor than traditional string mops.

Because microfiber mops lay down less solution than string mops, less solution is used.  Given better scrubbing action and better absorption of the microfiber, we also found that we could "ratchet down" the chemical used in the solution, substituting a neutral cleaner for an alkaline one, or even plain water for a neutral cleaner.  So less chemical used, less water, and fewer trips to the slop sink.  The microfiber also picks up more of the solution it laid down, so the floor dries faster (quite an important safety consideration in a 24 hour a day facility, with folks walking around) and leaves less watermarking.

Further, the microfiber picks up small particles, and even bacteria, much better than cotton string mops, so the floor is left cleaner.  Better appearance, fewer particles left to become airborne and impact indoor air quality, and less dust left tonight to be dealt with tomorrow night.

Worker productivity is improved: the microfiber mops cover a wider area, and hence move faster; get under furniture and along edges more efficiently; are lighter, reducing worker fatigue; and don't slop solution up onto baseboards and furniture legs.

Floors look better: less streaking and water marking, and less soil left behind.  Not much to not like.

Microfiber damp mops contribute credits to LEED certification

Caught a quick presentation by Dan Welton of Contracting Profits in the magazine's "CleanLink Minute" on Microfiber mops and the U. S. Green Building Council's LEED for Existing Buildings Operations and Maintenance program.

Dan mentions sustainability requirements, and that microfiber mops use less water and chemical than string mops.  Doubtless because of the one minute format, he omits other advantages, some "environmental", some not: fewer workplace injuries (a lighter mop and less frequent mop bucket dumping); floors drying faster (because less solution is left on the floor) leading to fewer slip/fall injuries among both workforce and the public; less particle mass left on the floor, to be kicked up by foot traffic or airflow to contribute to poorer indoor air quality; less pathogen cross-contamination room to room or area to area; greater employee productivity; cleaner looking floors.

Not much to not like.  Used 'em for years.

The science of disinfectants

Here's a good article on the basic types of disinfectants, their properties, and their effectiveness in various applications.

Quats, for instance, are quite effective at disinfecting, but not at cleaning, particularly since the addition of a surfactant (needed to spread the solution) diminishes the effect of the disinfectant.  So we use a hospital grade quat product in restrooms and lunchrooms, as part of a two part process - clean first, and then disinfect.  We can apply the quat disinfectant liberally, on restroom fixtures, without worry about damage, and give it the 10 minutes dwell time required.  And we don't have to rinse it off - both a time saver and a help in not re-infecting the surface.

For touch-points around the office, we use a hydrogen peroxide based product - it's both a good cleaner, and a good sanitizer (not quite a disinfectant, but we don't need quite the level of pathogen kill on a door jamb that we do on a urinal).  And, it gives us effective sanitation with a dwell time of 30 to 60 seconds, achievable on touch-points.  So we can wipe with a saturated microfiber cloth (microfiber cleans quite well on its own), clean the surface, remove both dirt and most germs, and leave the surface moist enough to achieve sanitation - without spraying the chemical on the surface, and into the air, and having it run down the wall.

Pretty good all around system.  And a good article.

Hospital battles infections with robots

Interesting article in CNN Money, "Hospital battles infections with robots".  Nice video attached, too.

"At any given time, 1 in 20 hospital patients is battling an infection that they got on site, according to the Centers for Disease Control. Hospitals now pay greater attention to hand hygiene -- Purell dispensers have become ubiquitous -- but their main infection control methods haven't changed much for decades. Most rooms are still disinfected by housekeepers armed with chemical cleaners."

The "robot" showcased is a portable ultraviolet pulse generator, for use in patient rooms, bathrooms, and so on.  UV light kills pathogens.  After the anthrax scare a few years back, for instance, the Post Office explored treating mail with UV lights to kill such things as, well, anthrax.  Might have worked except for the long exposure time each side of every letter would have required (mail delivery is slow enough as it is).  UV lights are also what air conditioning firms use in AC ductwork to kill airborne germs as they blow by.

In janitorial, we mostly use chemicals to kill germs - a hydrogen peroxide product for touch-point sanitation, and a quat disinfectant for restrooms and lunchrooms.  We also use microfiber technology to remove most germs - dead or alive - from surfaces.  Where damp cleaning is not practical - think computer keyboards - we have available an inexpensive UV light that, when passed slowly over an item, kills the pathogens.

Which brings up the cost of the UV robot - about $80,000.00.  Reasonable for a hospital - think what a single hospital acquired infection costs to treat - but a bit less affordable for a janitorial firm.  Looking ahead, though, given that most technological innovations drop rapidly in price as they propegate, something similar could well be in our future.

Are schools making kids sick?

Caught an article in CNN Health on the links between students' health and indoor air quality: the debilitating presence of mold, airborne dust and other pollutants in schools.

According to author David S. Martin, "Figures are hard to come by, but studies have estimated that a third or more of U.S. schools have mold, dust and other indoor air problems serious enough to provoke respiratory issues like asthma in students and teachers.  A national survey of school nurses found that 40% knew children and staff adversely affected by indoor pollutants."

Mold is not quite the concern here in Arizona's dry Sonoran desert as it might be in moister locals, but we do perform a visual inspection for it when doing a Greenguard Environmental Institute based facility inspection for a client.

Dust (see above about a dry Sonoran desert), however, is a biggie.

Using HEPA filtration on our vacuums, vacuuming rather than dust mopping tile floors, using microfiber damp mops rather than string mops, and microfiber wipes rather than feather or lambs wool dusters, we've the systems in place to remove, rather than redistribute, dust, and to keep it out of the air.  We also measure indoor air quality - airborne dust particles in the size range of most allergens - and share results with our clients.  In a tightly sealed facility, cleaned multiple nights per week, we generally see a substantial reduction in airborne dust.  It's called "cleaning for health".  Clients appreciate the benefit.

If a school kid is home sick from a pathogen or allergen he inhaled at school, he cannot learn.  If a client is home sick from a particle he inhaled at work, he cannot sign our check...

Home Environment affects asthematic kids - in single parent homes.

Caught an article in USA Today (courtesy of the Indoor Air Quality Association's Digest) that "Home Environment affects asthmatic kids".

The article explores a study (not yet published or peer reviewed) claiming that "Children with asthma who live in single-parent homes are 50 percent more likely to return to the hospital for treatment within a year than those who live in two-parent homes".  Kids from low income families, as well as those from homes with "time constraints" , are also likely to face problems.  "Parents play an important role in controlling their child's asthma and it takes time, energy and resources to follow their physician's treatment plan, including reducing triggers and consistently giving medicines," Dr. Terri Moncrief said in a College of Allergy, Asthma and Immunology news release.

While my firm combats asthma and allergy triggers in cleaning commercial facilities, clearly what folks breath at home is also an issue.  Cleaning ones home similarly to how we clean offices (HEPA filtered vacuums, microfiber mops and wipes, careful chemical selection, etc.) would doubtless benefit ones family, but many other factors are also in play.  Lower family income, and "time constraints" - that is, less parental time available to insure that the kid takes his medication or uses his inhaler - are clearly associated with single parent families, as are a variety of societal problems.  Statistically, the best indicator of a child's success in later life is the presence - or absence - of two parents.  Even the disparity of home mortgages granted to different races goes away if one corrects for single versus two adult households.

Society has become more accepting of divorce, and single-parenting; consequently, we've instituted no-fault divorce.  Many more families are single parent.  We see many programs, and suggestions of programs, to deal with the consequences.

Wonder if we might be treating the symptoms rather than the disease?

A nice new wetmop on the market

Got a call several months ago from a Todd Williams of CT Development, asking us to field test a new wet-mop he'd just designed.  As he offered several free mops for the test, I figured I had nothing to lose.

He calls his mop the "Maximizer".  Here's my response to him, after a few weeks in the field with several of my crews, including both janitorial and floor techs.

"We appreciated the opportunity to “field test” your new Maximizer wet-mop.  Compared to a conventional mop, it lays much flatter on the floor, thus giving much wider coverage for its weight.  Our crews, particular our women and lighter men, appreciate the ease of use.  It also rinses well, fits better into a standard wringer, and as a consequence seems to streak the floor less than a conventional mop.  Finally, it seems to hold up well under heavy use and high soil loads.  We’ll continue to use, and appreciate, the Maximizer."

(I should note that, for both quality and health reasons, we use flat microfiber mops for "damp-mopping"; a wet-mop, like the ones we tested, is used to lay more solution on the floor, let the solution dwell for a bit, and then pick it up; damp-mopping involves a dryer mop and just one pass over the floor.  Wet mopping is used for heavy soil build-up, damp-mopping for lighter work on a cleaner floor.  The Maximizer thus fills a niche for us.)

One interesting side light:  our initial response to Todd mentioned that the mop was producing a bit of lint.  A couple of weeks later, a few more mops arrived in my mail.  Todd had tweaked the manufacturing process; the new mops worked fine, with no lint.  An impressively quick fix.  And a neat product.

Health and Indoor Air Quality

I had a nice article on the health benefits of proper vacuuming procedure in the on-line edition of  
Contracting Profits.

I stressed HEPA filtration, microfiber wipes instead of feather dusters, vacuuming rather dust-mopping hard floors, microfiber damp mops - and their collective effect on indoor air quality, and the keeping allergens and other harmful particles out of the air we breath.

But heck - read the article.