infection prevention
infection prevention
By Katherine Lunt , MPH , MBA , CIC , HEM
Navigating the Environmental Protection Agency ’ s Lists of Disinfectants
Cleaning is the physical removal of visible dirt , blood , body fluids , and other foreign material from objects and surfaces and must be performed prior to disinfection .
Disinfection is the process of destroying microorganisms , such as bacteria , viruses , and fungi .”
In healthcare , cleaning and disinfection are extremely important to prevent the spread of infections . Cleaning is the physical removal of visible dirt , blood , body fluids , and other foreign material from objects and surfaces and must be performed prior to disinfection . Disinfection is the process of destroying microorganisms , such as bacteria , viruses , and fungi . There are three levels to categorize disinfectants : low-level , intermediate-level , and high-level disinfectants . High-level disinfectants are intended to be used for critical and semi-critical medical devices and instruments ; high-level disinfectants are regulated exclusively by the Food and Drug Administration ( FDA ) and are not intended to be used on environmental surfaces . Intermediate-level disinfectants are intended to be used on some semi-critical items and non-critical items . Low-level disinfectants , such as environmental surface chemical disinfectants , are intended to be used on noncritical items . Intermediate-level and low-level disinfectants are regulated by the Environmental Protection Agency ( EPA ) and have EPA registration numbers .
The Environmental Protection Agency ( EPA ) and Chemical Disinfectants
There are several types of disinfection methods used in healthcare . The most common method of environmental disinfection is chemical disinfection . Chemical disinfection is a process that uses chemicals to destroy microorganisms . Some common chemical disinfectants for environmental surface disinfection used in healthcare include alcohols , quaternary ammonium compounds , phenolics , and sodium hypochlorite ( i . e ., bleach ). In the United States , the EPA regulates pesticides , including chemical disinfectants , used in healthcare to ensure they are safe and effective . An EPA-registered chemical disinfectant has been evaluated by the agency and certifies that the disinfectant is effective against the pathogens specified on the disinfectant ’ s label . Appendix A outlines the lists of antimicrobial products registered by the EPA .
The EPA requires laboratory potency testing for products to support product label claims . Chemical disinfectants labeled as “ hospital disinfectant ” have passed potency testing for activity against three representative organisms : Staphylococcus aureus , Pseudomonas aeruginosa , and Salmonella cholera suis . Hospital disinfectants that demonstrate potency against mycobacteria may include “ tuberculocidal ” on the label as well and are considered an intermediate-level disinfectant . A chemical disinfectant labeled as a hospital disinfectant without a tuberculocidal claim is considered a low-level disinfectant .
Selecting a Disinfectant on an EPA-Registered Disinfectant List
Chemical disinfectants are often marketed and sold under different brands and product names . To find out more information about a specific chemical disinfectant , locate the EPA-registration number on the product label . The EPA-registration number is listed on the product as EPA Reg . No . and is followed by two or three sets of numbers on the label . Search the EPA-registration number in the specific EPA-Registered Disinfectant List of the pathogen you are trying to kill exactly as the number appears on the label . If the disinfectant is EPA-certified , it will populate on the list and include the following information :
The Registration number is listed on the product . This is to help you identify the product on the EPA disinfectant lists .
The Active Ingredient / s is the ingredient in the disinfectant that destroys the pathogen .
The Product Name is the common name of the product .
The Company is the manufacturer of the disinfectant .
The Contact Time in Minutes (“ dwell time ” or “ wet time ”) is the amount of time that the surface must remain wet for the disinfectant to work effectively .
The Formulation Type denotes whether the disinfectant is ready-to-use or requires a dilution for safe use .
The Surface Types describes the type of surfaces that this disinfectant can be used on . For example , many disinfectants can only be used on hard , nonporous surfaces , which would include most high-touch surfaces .
The Use Sites ( Hospital , Institutional , Residential ) are the settings where the product is intended to be used .
If there is not an EPA-registered disinfectant list available for a specific multidrug-resistant organism ( MDRO ), search for a product claim against the organism or bacteria itself . It is important to highlight that MDRO denotes that the organism is resistant to treatment , not disinfection . MDROs are still susceptible to disinfection . Occasionally , a disinfectant will include kill claims against a specific MDRO . If the chemical disinfectant is effective against a drug-resistant form
10 july 2023 • www . healthcarehygienemagazine . com