and Green Cleaning:
Guiding Principles for Healthy Public Buildings
and disinfection (the removal or killing of disease-causing
germs) are critically important to maintain healthy
conditions in homes, schools, healthcare facilities
and other indoor areas. At the same time, the U.S.
Environmental Protection Agency and others have noted
that some cleaning products can present health and
environmental concerns. This has led a number of state
and local governments to enact programs designed to
reduce potential health and environmental impacts
from cleaning products used in public buildings.
of these "environmentally preferable" or "green" cleaning
initiatives include guidelines for the selection and
use of disinfectants. Because disinfectants play an
essential role in preventing the spread of disease-causing
germs, particularly in schools, daycare centers and
healthcare facilities, it is critically important
that green cleaning efforts promote effective and
safe uses of these products.
Water Quality & Health Council offers the following
guiding principles for addressing disinfectants under
green cleaning programs. These principles are intended
to help governments and other organizations design
programs to guide the responsible selection and use
of chemical products, while reinforcing public health
protection against microbial threats.
Preventing the spread of illnesses in schools, daycare
centers and healthcare facilities is a public health
policies and guidance related to green cleaning should
highlight the critical importance of controlling the
spread of disease-causing germs in schools, daycare
centers and healthcare facilities and other public
buildings. These facilities serve the populations
at highest risk for infections, including children
under five, the elderly, pregnant women and patients
with compromised immune systems.
surfaces can be the source of a wide variety of bacteria
and viruses - posing significant health risks to students,
patients, workers and others.
and flu viruses can survive on surfaces for up to
three days. According to U.S. Centers for Disease
Control and Prevention (CDC), nearly 22 million
school days are lost annually due to the common
surfaces are a source of norovirus infections. Norovirus
outbreaks, which may cause severe gastroenteritis
(diarrhea), have increased dramatically in recent
years, shutting down schools and business.
equipment in schools can harbor viruses, including
herpes gladiatorum, which can produce lesions on
the face, head and neck.
to the latest figures from CDC, healthcare-associated
infections (HAIs) account for at least 2 million
infections, 90,000 deaths and $4.5 billion in excess
health care costs annually. Contaminated surfaces
contribute to the spread of HAIs, acquired by patients
and residents within healthcare settings.
bacteria are a particular concern in bathrooms and
diaper changing stations. According to CDC, children,
especially toddlers aged 2 to 4, are the most likely
to get shigellosis, and many cases are related to
the spread of illness in child-care settings.
of infection are increasing due to emerging antibiotic
resistant microbes (e.g., Methicillin-resistant
Staphylococcus aureus (MRSA)) and the growth
of sensitive populations such as dialysis patients
and residents of long term care facilities.
of household and workplace surfaces may be critical
to control the spread of viruses in the event of
a pandemic influenza outbreak.
Appropriate disinfection techniques should be urged
for high-touch surfaces where germs can easily be
cleaning guidelines should highlight areas within
public buildings where the use of disinfectants is
appropriate to help prevent the spread of disease-causing
germs from person to surfaces to person.
is critically important for areas where people are
likely to come into contact with contaminated surfaces,
including bathroom fixtures, doorknobs, handrails,
athletic equipment, desk tops, computer key boards
and other high-touch surfaces. After cleaning, disinfection
provides an additional safeguard against the transmission
of illnesses. While disinfectants are not typically
required for many general purpose cleaning tasks (e.g.,
walls and floors), they may be appropriate in facilities
such as daycare centers, where contact with these
surfaces is more frequent and poses a greater risk
of contamination. Surfaces should be cleaned thoroughly,
whether or not disinfectants are used.
Illness prevention requires a continuous and proactive
disinfection protocols should be followed in response
to specific contamination incidents (e.g., spilled
blood or vomiting). Disinfection should also be considered
as part of routine cleaning and maintenance programs
to help control pathogens that may be commonly present
in indoor environments. Green cleaning program guidelines
should recommend cleaning and disinfection schedules
for high touch surfaces.
Promoting safe chemical practices helps protect workers,
students, patients and other building occupants.
key to reducing potential risks for workers and building
occupants is to ensure that disinfectants are stored,
handled and used safely. Cleaning programs can include
guidelines, employee training, safety information,
and other materials to effectively teach safe chemical
practices. Notable precautions to consider include:
follow product instructions;
improper mixing of disinfectants and other products;
products away from food, and in areas not accessible
to children; · Empty and thoroughly rinse out buckets
after each use;
gloves and other appropriate protective clothing
according to product instructions;
products in their original containers and never
remove product labels.
Disinfectants must be proven effective for their intended
maintain critical public health protection, all products
used to kill germs should be registered with EPA,
and have demonstrated efficacy that achieves health
protection goals for their intended use.
requires registration for any product sold or distributed
in the United States that claims to kill germs. The
registration process includes rigorous efficacy tests
to verify the manufacturer's claims. The manufacturer
must also submit the product label and extensive data
on chemistry and toxicology.
Criteria for "environmentally preferred" products
should be based on evidence of reduced health and
criteria developed for "environmentally preferable"
products should be based on scientific evidence of
reduced health and environmental risks, considering
both the characteristics of the specific product ingredients
and the potential for exposure.
the overall environmental performance of products
and services is complex. Each product has multiple
attributes related to its ingredients, packaging,
manufacturing processes and uses. Cleaning and disinfection
guidelines and product criteria should be periodically
reviewed as knowledge, products, and circumstances
Disinfectants should be considered separately from
other cleaning products.
In "green" cleaning programs, disinfectants should
be considered as a separate category from other products.
There are currently no widely-accepted definitions
or criteria for "environmentally preferred" disinfectant
products. It should be recognized that criteria for
cleaners may not be appropriate for disinfectants.
For example, "non-toxic" is an unrealistic criterion
for disinfectants since, by definition, they must
be effective at killing microorganisms.
Additional research is needed to improve disinfection
practices and illness prevention.
programs should support targeted research and evaluation
of disinfection practices, to encourage continuous
improvement in illness prevention measures.
all infectious disease agents on surfaces in the indoor
environment are of equal risk to people. For a particular
microbe, risk is dependent on factors such as its
infectivity, ability to cause severe disease and survival
capability. The susceptibility of the person who contacts
the microbe is also a factor. Therefore, it is necessary
to develop a framework for addressing high-risk infectious
agents, as well as an inventory of critical microbes.
Disinfection efficacy should be evaluated and addressed
in terms of orders of magnitude reductions (e.g.,
capable of reducing norovirus by 99.9999%).
Inactivation of organisms is time, microbe, surface
and disinfectant dependent. Efficacy studies show
a tailing effect, meaning that some proportion of
the microbial population is robust and survives longer
than others. The risks of this residual contamination
and risk reduction through enhanced disinfection need
to be addressed.