Hospital Waste Reduction and Management Conference
Green Cleaning Options
for Hospitals
Eliminating hazardous cleaning products and integrating sustainable
cleaning practices and products into health care facilities
By
Roger McFadden
Vice President Technical Services
Coastwide Laboratories
Benefits of Cleaning and Disinfection
Helps Break the Chain of Infection
Provides a Cleaner, Safer and Healthier Building
Can Improve Productivity
Correcting Myths and Misconceptions About
Cleaning, Sanitizing and Disinfection
More FACTS!
Cleaning agents are not designed to kill pathogenic germs!
Bleach is not the only best way to kill pathogenic germs!
Sanitizer is not another name for disinfectant!
Stronger odor does not equal a stronger disinfectant!
Mixing disinfectants stronger than label directions does not increase
its germ killing power.
Correcting Myths and Misconceptions About
Cleaning, Sanitizing and Disinfection
More FACTS
Full "contact time" is very important when using disinfectants!
Mixing a cleaner with a disinfectant will not improve its effectiveness! In
fact, it can reduce its effectiveness.
Strong acid toilet bowl cleaners should not be used daily to control the
spread of pathogenic germs!
Applying floor finish to bathroom floors will not help prevent germs!
Four Different
Decontamination Procedures
Sterilization
Disinfection
Sanitizing
Cleaning
Sterilization
Elimination of all microbial forms of life, including
spores and viruses.
Active Ingredients Used in Chemical Sterilants
稥thylene Oxide Gas (CAS Number: 75-21-8)
稧luteraldehyde (CAS Number: 111-30-8)
Hazards: Ethylene oxide is carcinogenic and gluteraldehyde is
highly corrosive to skin and eyes.
Disinfection
The destruction or removal of most pathogenic
microorganisms from environmental surfaces and inanimate
objects.
Active Ingredients Used in Chemical Disinfectants
稴odium Hypochlorite (Chlorine Bleach Solution)
稱uaternary Ammonium Compounds ("Quats")
稩odophors
稰henolics
Hazards: Sodium hypochlorite can be irritating to eye and nose and very reactive with
other chemicals including ammonia and acid bowl cleaners. Quats can be corrosive.
Sanitizing
Reduces the microbial population to a safe level as determined by
local public health standards. Primarily used in food preparation
and food processing plants.
Active Ingredients Used in Chemical Sanitizers
稴odium Hypochlorite (Chlorine Bleach Solution)
稱uaternary Ammonium Compounds ("Quats")
稥thyl or Isopropyl Alcohol ?Hand Sanitizers
Hazards: Sodium hypochlorite can be irritating to eye and nose and very
reactive with other chemicals including ammonia and acid bowl cleaners.
Quats can be corrosive. Some hand sanitizers can be flammable.
Cleaning
Cleaning is the process of removing pollutants from the environment and putting them in
their proper place. Cleaning agents work by suspending dirt and grease. They do not
kill harmful microorganisms but they remove soils from a surface to allow the
disinfectant to work more efficiently.
Active Ingredients Used in Cleaning Products
稴urfactants
稧lycol Ethers
稨ydroxides
稰hosphates
Hazards: Some nonionic surfactants (NPEs) are not readily biodegradable and can produce endocrine
disruption; Glycol ethers are volatile organic compounds that can contribute to poor indoor air quality;
Hydroxides are very corrosive to skin, eyes and respiratory system; Phosphates contribute to eutrophication
Disinfectants & Sanitizers
Higher ? Chlorine / Sodium Hypochlorite
Very effective antimicrobial
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Corrosive to eyes and skin
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Damage floor finishes, carpets, clothing, etc.
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Respiratory irritant
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Environmental concerns from production, contaminants, byproducts
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Mixing can create poisonous gas
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Risk Continuum
?Phenols
Effective against TB ?HBV assumed
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Corrosive to eyes and skin
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Damage floor finishes and other surfaces
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Strong pungent odor ?respiratory irritant
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Environmental concerns. Possible estrogen mimic.
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?Quats
?Typically not proven effective against spores
?Less toxic then Phenols ?eye, skin and surface corrosivity
?Toxic to aquatic life
?Peroxide
?EPA Sanitizer. Long term stability concerns.
?Superior health & environmental profile compared to phenols and quats
Lower
Five Ways That Help
Disinfectants Work Better
Make certain gross soils have been cleaned from the surface prior
to disinfecting
Scrub the surface vigorously to loosen sticky, stubborn or
embedded soils
Accurately mix or dilute the disinfectant
Allow the disinfecting solution adequate "contact time"
Immediately replace contaminated disinfectant solution
Safety Assessment of
Cleaning Products
? How is the product diluted and how frequently is it being used?
? What is the product's intended use?
? What is the likelihood it will be misused?
? What is the experience level of users?
? What are the hazard ratings for the product?
? What does the MSDS say about the product safety?
? Does the product present an acceptable level of risk?
? What do others report about the product safety?
Cleaning and Disinfecting
Safety Reminders
Properly train appropriate workers
Require and promote frequent hand washing
Mix and use products according to label directions
Carefully apply and use disinfectants
Keep all equipment clean and well maintained
Properly label all secondary containers
Never mix or allow products to be mixed
Wear gloves and eye protection as recommended
Ask for assistance when you are not certain about the use of a
disinfectant
Impact of Cleaning
on People and the Planet
Impact of Cleaning on
Cleaning Professionals
? Annually institutional cleaning products acutely injure 6% of
housekeeping workers.
? Respiratory system irritation and burns to eyes and skin can be
caused by cleaning and disinfecting products in health care
facilities.
? Patients and professional health care workers frequently
complain about odors and respiratory problems associated with
cleaning products and processes.
? Annually $75 million are spent for medical expenses and lost
time wages due to these cleaning product chemical injuries.
www.wrppn.org
Impact of Cleaning on
Building Occupants
? Occupants commonly complain about unpleasant or annoying smells associated with cleaning products
or cleaning activities.
? Some occupants have asthma and other breathing disorders and are sensitive to particles in the air,
volatile organic compounds and vapors produced by the cleaning processes being used around them.
? Some occupants are highly sensitive to current types of solvents and organic vapors than can irritate
eyes, nose and throat.
? Occupants complain about unsanitary conditions in public restrooms and food preparation or serving
areas.
? Occupants get ill and miss work when they are exposed to pathogens and unhealthy conditions because
of poorly maintained or areas that are not properly disinfected.
Impact of Cleaning on
our PLANET
? Millions of pounds of alkyl phenol ethoxylates (APEs) used in many
cleaning products are annually discharged into our waste streams.
? Hundreds of thousands of pounds of phosphates formulated into cleaning
products end up in our waterways and adversely effects aquatic life.
? Volatile organic compounds (VOCs) evaporate from cleaning products
before, during and after their use, contributing to poor indoor air quality.
Source: Northeast Waste Management Officials' Association (NEWMOA)
June 27, 2004
What Types of Cleaning Products
Are Commonly Used in Medical Facilities?
DISINFECTING & SANITIZING
HARD FLOOR CARE
? Floor Cleaner ? Disinfectant Cleaners
? Floor Sealer and Finish ? Chemical Sterilants
? Wax Stripper ? Bowl Cleaner-Disinfectants
? Baseboard Cleaner
? Washroom Disinfectants
? Spray Buffing Compound
? Chlorine Bleach Solutions
CARPET CARE GENERAL CLEANING PRODUCTS
? General Purpose Cleaner
? Carpet Cleaner Conc.
? Glass Cleaner
? Carpet Prespray
? Stainless Steel Cleaner/Polish
? Spotters
? Furniture Polish
Betadine?Remover
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? Graffiti Remover
? Defoamer
? Drain Maintainer
? Odor Eliminator
Hazardous Substances Formulated Into
Conventional Cleaning Products
Carcinogens and Reproductive Toxins
Neurotoxins
Skin and Eye Irritants and Corrosives
Skin Sensitizers
Respiratory Irritants
High Levels of Phosphates
Endocrine Disruptors
Environmental Pollutants/Hazardous Waste
Ozone-Depleting Chemicals
Flammables and Combustibles
Highly Reactive Chemicals
Poorly Designed Packaging
Carcinogens Can Be Found
in Some Cleaning Products
Although not common as a primary ingredient, formaldehyde is present as a
Formaldehyde
contaminant in many institutional cleaning products. It is an extremely potent
CAS Number: 50-00-0 carcinogen and respiratory irritant and may appear as a preservative. Products
containing this chemical should be considered unacceptable. Can be found in
floor finishes and deodorizers.
Crystalline silica is carcinogenic and acts as an eye, skin and lung
Crystalline Silica Quartz
irritant. Can be found in floor sweeping compounds
CAS Number: 14464-46-1
Trichloroethane 1,1,1 Carpet Spotters; Graffiti Removers; Laundry Spotter
CAS Number: 71-55-6
Paradichlorobenzene Deodorant blocks placed into urinals
CAS Number: 106-46-7
Amaranth (Red dye #2) Colorant used in some cleaning products
CAS Number: 915-67-3
Styrene Acrylic Finishes
CAS Number: 100-42-5
Saffrole Fragrance or ingredient of a fragrance used in some
cleaning products
CAS Number: 94-59-7
Poisons Can Be Found
in Some Cleaning Products
Oxalic Acid Can be found in rust removers and toilet, tub & tile cleaners.
CAS Number: 144-62-7
Methanol A solvent derived from wood, natural gas, or petroleum,
methanol is acutely toxic and can cause blindness. Can be
CAS Number: 67-56-1
found in glass cleaners.
Corrosives Can Be Found
in Some Cleaning Products
Hydrofluoric Acid Used to remove mineral stains from toilet and urinal surfaces.
CAS Number: 7664-39-3
Hydrochloric Acid A strong mineral or "inorganic" acid. In high concentrations, it
is extremely corrosive. Used at high levels (23%) in Heavy
CAS Number: 7647-01-0
Duty Toilet Bowl Cleaners
Phosphoric Acid Used at high levels (20%) in Heavy Duty Toilet Bowl
Cleaners; Tub and Tile Cleaners
CAS Number: 7664-38-2
Sodium Hydroxide Used in heavy duty cleaners and degreasers
CAS Number: 1310-73-2
Potassium Hydroxide Used in oven cleaners and drain openers
CAS Number: 1310-58-3
Ammonium Hydroxide Wax strippers, all purpose cleaners and glass cleaners.
CAS Number:1336-21-6
Monoethanolamine Used in wax strippers, floor cleaners and kitchen degreasers.
CAS Number: 141-43-5
Skin Absorbers Can Be Found
in Some Cleaning Products
2-butoxyethanol A toxic synthetic solvent and grease cutter that can irritate mucous
membranes and cause liver and kidney damage. It is reported to be a
CAS Number: 111-76-2
neurotoxin that can depress the nervous system and cause a variety of
associated problems.
Inhalation Irritants Can Be Found
in Some Cleaning Products
Ammonia is an irritant that affects the skin, eyes and respiratory
passages. The symptoms of ammonia exposure are: a burning
Aqua Ammonia
sensation in the eyes, nose and throat; pain in the lungs; headache;
CAS Number: 1336-21-6
nausea; coughing; and increased breathing rate.
Endocrine Disrupters Can Be Found
in Some Cleaning Products
Nonylphenol Ethoxylates Can be found in all purpose cleaners, glass cleaners, floor cleaners,
disinfectant cleaners.
CAS Number: 9016-45-9
Dibutyl phthalates A plasticizer that can be found in floor finishes and sealers.
CAS Number: 84-74-2
VOCs Can Be Found
in Some Cleaning Products
Glycol Ethers Can be found in all purpose cleaners, glass cleaners, floor
cleaners, disinfectant cleaners.
Methanol Alcohol used in glass cleaners, windshield wash and some
surfactants
Ethanol Alcohol used in disinfectants, sanitizers
Isopropyl Alcohol Alcohol used in glass cleaners and all purpose cleaners
Xylene Solvent used in graffiti and spot removers
Toluene Solvent used in tar and oil removers
Odorless Mineral Spirits Spotters and heavy duty cleaners
How to Determine if Cleaning Products Are
Hazardous or Contain Hazardous Substances
Review ingredients on material safety data sheet (MSDS). You can check
products or ingredients against the following databases or lists.
IARC ?International Agency for Research on Cancer www.iarc.fr
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NTP ?National Toxicology Program http://ntp-server.niehs.nih.gov
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OSHA ?Occupational Safety and Health Administration www.osha.gov
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IRIS ?EPA Integrated Risk Information System www.epa.gov/iris
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NIOSH ?National Institute of Occupational Health and Safety www.cdc.gov/niosh
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ACGIH ?American Conference of Governmental Industrial Hygienists www.acgih.org
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? CleanGredients Database ?Green Blue Institute www.greenblue.org
Green Seal ?www.greenseal.org
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EPA DfE ?EPA Design for the Environment www.epa.gov/dfe/pubs/projects/formulat/index.htm
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IRCHS ?Indiana Relative Chemical Hazard Score www.ecn.purdue.edu/CMTI/IRCHS/
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What's the Alternative?
Traditional Environmental Protection Approach
Cradle-to-Grave
Take Make Waste
Landfill,
Raw material Manufacturing,
incineration
extraction and production,
synthesis distribution, use
More Effective Environment Protection Approach
Cradle-to-Cradle
This is How Nature Does it This is How Humans Can Do it
Green Cleaning Product Design Should
Incorporate the Following Objectives
?PERFORMANCE ?Perform as well or better than leading
national brands of conventional products.
?PEOPLE ?Meet the highest international and domestic
standards for health and safety.
?PLANET ?Based on sound science, independently tested and
third-party certified to comply with the strictest environmental
standards.
?PRICE ?Priced competitively with the leading national brands
of conventional products.
Green Cleaning Products
Should Mean Good!! Not Less Bad
Minimize human and environmental hazards
Improve indoor air quality
Eliminate hazardous waste treatment and disposal
Reduce environmental pollutants
Lower the aquatic, plant and animal toxicity
Reduce VOC emissions inside and outside buildings
Reduce the regulatory burden
Protect the cleaning worker
Help earn points toward U.S. Green Building Council LEED
Certification for existing structures
Alternative Chemical Ingredients Used in Green
or Sustainable Cleaning Products
Polyglucosides and Alcohol Ethoxylates Surfactants replace
NPEs and APEs
Hydrogen Peroxide replaces Harsh Acids and Alkali Builders
Corn Based Esters replace petroleum distillates
Vegetable Derived Surfactants replace petroleum derived
surfactants
Fruit Derived Solvents and Acids replace hazardous petroleum
solvents and harsh acids
How to Know a Cleaning Product
is Certified Green
U.S. Environmental Protection Agency
www.epa.gov/dfe
Green Seal
www.greenseal.org
Environmental Choice Canada
www.environmentalchoice.com/
Why Microfiber?
Why Microfiber Mops and Wipers?
? Better cleaning performance
? Water use reduction
? Cleaning chemical reduction
? Ergonomically preferable
Microfiber Pilot Test Results
Swedish Hospital ?Seattle Washington
? Water/Chemical Usage Before Microfiber: 36 Gallons Per Day
and 18 oz. Of Cleaning Chemical
? Water/Chemical Usage Post Microfiber: 9 Gallons Per Day and
4.5 oz. Cleaning Chemical
? Staff Satisfaction: Cleaner Floors, No Mop Wringers, Reduction
of Shoulder and Arm Strain Injuries
Source: Mike Smith, Swedish Hospital, Seattle Washington
Thank You!
Time for your
Questions
Contact Information
Roger McFadden
Vice President Technical Services
Coastwide Laboratories
Wilsonville, Oregon
www.coastwidelabs.com
roger.mcfadden@cexp.com
rmcfadden@coastwidelabs.com
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