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Infection Control

What custodial workers should know about hand hygiene

September 19, 2010
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All cleaning workers have one thing in common: They run the risk of being exposed to biological hazards that can include disease-causing pathogens.

These hazards obviously have the potential to harm the health of cleaning workers and many of them can easily be transferred from one area to another via a custodial worker’s hands or gloves.

Therefore, it is vitally important for cleaning professionals to have a clear understanding of what pathogens are, the types of diseases that pathogens can cause, how we may become exposed to them, and, most importantly, what we can do to avoid the transfer of disease.

What are pathogens?
The Food and Drug Administration defines a pathogen as any microorganism that is infectious or toxigenic and has the potential to cause disease.

Pathogens include harmful bacteria (not all bacteria are harmful), viruses, parasites, and some fungi/yeasts.

For most of us, restrooms are the first areas that come to mind when we consider where pathogens might be found.

But, some studies have actually shown that “high touch” areas, such as light switches, handrails, elevator buttons, and telephone handles are more pathogen-ridden than many restroom surfaces and fixtures.

The following are examples of different types of pathogens:
  • Viruses: These are very small “packages” of genetic material that need a living host, such as a human being, in order to reproduce. Diseases that can result from exposure to viruses include HIV, influenza, and the common cold.
  • Bacteria: These one-celled organisms do not need a host in order to reproduce. Examples of the kinds of bacteria that cleaning workers might encounter include E. coli and salmonella.
  • Fungi: These are yeasts and molds that can cause infections. One such mold, Stachybotrys, can be fatal to infants. Molds commonly cause a variety of respiratory problems in children and adults.
  • Parasites: Parasites are organisms that live on or within a living host. Parasites can cause a variety of intestinal illnesses, nausea, facial swelling, muscle pain, and malaria.
Exposure and transmission
The primary routes of entry into the human body for pathogens include inhalation, ingestion in food or water, and direct contact with infected blood or other bodily fluids.

Contracting an illness as a result of inhaling pathogens is not common among cleaning personnel due to the fact that, with some exceptions, most workers do not come into direct contact with many people while performing their duties.

Coming into contact with infected blood or other bodily fluids can be an occupational hazard for some cleaning workers; this type of exposure is obviously more likely in a medical setting.

Workers with cuts or breaks in their skin are at a higher risk of exposure.

It is not uncommon for cleaning professionals to accidentally ingest pathogens.

In one case, several cleaners maintaining day care centers in Atlanta, GA, contracted hepatitis A.

It was later revealed that several teachers who worked in those same centers also came down with the disease.

Apparently, they had all touched surfaces where the disease-causing pathogens were living and then subsequently touched food they were eating, thereby ingesting the microorganisms.

It is quite likely that in this case the transmission of hepatitis A could have been prevented through proper and effective hand-washing.

In fact, hand-washing is without question the no. 1 way cleaning workers can protect themselves from disease and prevent its spread to others.

Hand hygiene
Many cleaning workers now wear gloves when they perform their duties.

Although this helps to protect them from exposure to pathogens, gloves themselves can become contaminated, causing workers to spread disease organisms from one surface to another.

Further, workers may not always remove their gloves properly, which allows pathogens to transfer from gloves to fingers and the skin under fingernails.

Hand-washing can help prevent this transfer of pathogens, but the key to disease prevention is performing hand-washing properly.

“Ordinary detergent soap and water doesn’t really kill germs,” says Jim Glenn, CEO of Meritech Inc. “They work by mechanically removing unwanted material and disease-causing pathogens from hands, essentially pulling unwanted material off the skin, into the water, and down the drain.”

It is actually the agitation of hand-washing, an important element in all cleaning, that helps remove unwanted material from hands, taking harmful pathogens with it.

Why problems continue
Preventing the spread of pathogens seems simple.

So why does it continue to be such a problem?

“Many workers simply have not been trained to properly clean their hands,” says Glenn. “Often, custodial training involves learning how to use new cleaning equipment, techniques and systems, but proper hand hygiene is not often discussed.”

Additionally, even if they have been trained in proper hand hygiene techniques, workers often slip back into old habits, either forgetting to wash their hands or simply not doing so properly.

This is why a number of facilities are now automating hand-washing, making it quick, easy and thorough.

Developed nearly 20 years ago, automated hand-washing equipment is becoming more and more commonplace.

“The system takes just 12 seconds to reduce transient pathogens on the hands by as much as 99.9 percent,” says Glenn. “Hands, as well as gloved hands, are safely inserted into a rotating cylinder, where a high-pressure, low-volume spray of water effectively cleans them.”

He adds that the system works best with hand-washing solutions — which also moisturize hands — specially developed for the system.

The process not only kills virtually all potentially dangerous pathogens quickly, but also helps keep hands sanitized for several hours.

“Cleaning workers must take increased precautions now more than ever,” says Glenn. “Fortunately, greater awareness and better training and technologies can help prevent the spread of pathogens on hands and keep all of us healthier.”

Dawn Shoemaker is a writer for the professional cleaning industry and may be reached at

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