54
Sanitation Essentials: Guidelines for an Effective Cleaning and Disinfecting Program October 13, 2010 Presented by Procter & Gamble Professional
Sanitation Essentials: Guidelines for an
Effective Cleaning and Disinfecting Program
October 13, 2010
Presented by
Procter & Gamble Professional
Table of Contents
• Cold and Flu Season Overview
• Current Risks
• Workplace Productivity
• Breaking the Cycle of Disease Transmission
• Behavioral Strategies
• Reinforce Healthy Habits
• Resources
2
Objectives
• Help prepare your business
for the upcoming cold/flu
season and other health risks
• Discover efficient and
effective practices to
maximize cleaning program
performance
• Pinpoint barriers and
implement solutions to inspire
employee compliance to
proper cleaning procedures
3
Our Experts
• Jeff Lange, Ph.D.
– Epidemiologist, P&G Healthcare
• University of Iowa, Environmental and Occupational Health
• Cincinnati Health Department Board Member
• Craig Monsell
– R&D Manager, P&G Professional
• Massachusetts Institute of Technology (MIT), Chemical Engineering
• Certified Professional – Food Safety (CP-FS)
• Jeff Anderson, Ph.D.
– Public Health and Sanitation Consultant, P&G Professional
• The University of Arizona, Chemistry
• Certified Professional - Food Safety (CP-FS) Trainer
• Matt Koloseike
– Assistant Brand Manager, P&G Professional
• Cleaning Industry Management Standard (CIMS), ISSA Certification
Expert4
Picture
Unavailable
5
Jeff Lange, Ph.D.Epidemiologist
Procter & Gamble, Healthcare
30-year increase• 5 years due to medical advancement
• 25 years from reduction in infectious
disease due to vaccination and
better sanitation/hygiene
Efforts in better hygiene continue• H1N1 pandemic experience raised
hygiene awareness
Trends in Health
6
0
10
20
30
40
50
60
70
80
1910 2010
Source:
CDC MMWR 48(12);241 (1999)
Bunker JP et al, Milbank Quarterly 72:225 (1994)
Large increase in average life expectancy over the last 100 years
• Question
What is the effect of promoting
household hand washing with
soap on diarrheal disease and
respiratory disease?
• Intervention
– 300 houses (1,640 children)
received education and
soap
– 306 houses (1,528 children)
were controls
Better Health through Hand Washing
7
Source:
Luby SP et al, JAMA. 291:2547-54 (2004)
Luby SP et al, Lancet. 366:225-33 (2005)
Proof in protecting yourself and others
Research study conducted by
• U.S. Public Health Service
• Procter and Gamble
Pakistan
ResultsIncidence of Diarrheal Disease and Respiratory Disease
Better Health through Hand Washing
8
Source:
Luby SP et al, JAMA. 291:2547-54 (2004)
Luby SP et al, Lancet. 366:225-33 (2005)
Diarrhea Control Soap
Ages < 1 8.4% 5.2% ↓ 39%
Age 5 - 15 1.7% 0.7% ↓ 57%
Pneumonia
Ages < 5 4.4% 2.2% ↓ 50%
Importance of Sanitation and Hygiene
U.S. Statistics
• Respiratory Illness– Each year, 1 in 5 adults have the flu
– ≈ 250,000 hospitalizations
– 3,000 - 50,000 deaths; severity dependent
– Each adult has about 2 colds per year
• Gastrointestinal illness– Each year, 1 in 3 adults have a foodborne illness
– ≈ 325,000 hospitalizations
– 5,000 deaths
9
Source:
CDC MMWR 59 (33);1057 (2010)
Thompson WW et al, JAMA 292:1333 (2004)
Mead PS et al; EID 5:607 (1999)
Importance of Sanitation and Hygiene
Effects of Influenza on the Workplace
• Lost Productivity – 17 million workdays are lost
due to Influenza – Estimated loss of ~$6.2 billion
• Cost to Employers – $10.4 billion in direct costs
for employee hospitalizations and outpatient visits
10
Source:
http://www.cdc.gov/workplacehealthpromotion/evaluation/topics/immunization.html
http://www.pandemicflu.gov/professional/business/toolkit20102011.html
Importance of Sanitation and Hygiene
Causes of Respiratory Illness
11
VirusPercent of all respiratory illness
caused by each virus
Vaccination
available?
Rhinovirus 30 - 50%
Coronavirus 10 - 15%
Influenza virus 5 - 15% Usually
Respiratory syncytial virus 5 - 10%
Parainfluenza virus 5%
Adenovirus 5%
Metapneumovirus < 5%
Enterovirus < 5%
unknown 20 – 30%
Importance of Sanitation and Hygiene
Causes of foodborne illness
12
VirusPercent of all illness caused
by each pathogen
Vaccination
available?
Bacteria 15%
eg. Salmonella, Campylobacter
Parasite 10%
eg. Giardia, Cryptosporidium
Virus 75%
eg. Norwalk-like, Hepatitis A Some virus types
Source:
Mead PS et al, EID 5:607 (1999)
Importance of Sanitation and Hygiene
Other pathogens are also gaining attention as they, too,
are easily transmitted
13
Salmonella
E-Coli
MRSA
Staphylococcus
Aureus
Chain of Infection
14
Causative Agent
Reservoir
Portal of exit
Mode of transmission
Portal of entrance
Susceptible host
Breaking Infection Chain at Reservoir
Policies Cleaning and disinfecting
surfaces especially highly
touched areas
15
Breaking Infection Chain at Transmission
Personal Hygiene
16
Breaking Infection Chain at the Host
The Centers for Disease Control and Prevention recommends
that adults, depending on their risks, be routinely immunized
against 14 disease
17
Source:
http://www.cdc.gov - adult immunizations
Vaccine Recommendation
Influenza All adults every year
Tetanus, Diphtheria, Pertussis All adults for booster shots for tetanus and
diphtheria every 10 years
Hepatitis A Recommended for travel in areas where
food may be contaminated
Meningococcal disease Recommended for young adults living in
group settings, eg. dormitories
18
Craig MonsellR&D Manager
P&G Professional
Break the Cycle of Disease Transmission
19
Sick
Sneeze
AirborneSurfaces
Hands
Helpful Tip:
Break the cycle at multiple points
for maximum effectiveness!
Spread of Germs
– Infectious virus is airborne from
person
– Airborne virus deposits on
surfaces
– Virus survival on the surface for
8+ hours
– Virus transmits from surface to
person
– More people are exposed
Break the Cycle
1. Employee work rules
2. Hand hygiene
3. Cleaning for health
20
Break the Cycle: Work Rules
• Don’t force or encourage workers to work when
they are ill
• False economy!
• Proper “sick days” policy
• Proper supervision
21
Break the Cycle: Hand Hygiene
• Hands are the most important “vector” of
disease transmission
• Encourage frequent, proper hand washing
• Enable proper use of hand sanitizer
22
Break the Cycle: Hand Hygiene
Frequent, proper hand washing
Frequent– After using the restroom
– Before meals
– Between meetings w/ clients
– Whenever hands become soiled
Proper– Use soap and warm water
– Lather for 10-20 seconds
– Rinse thoroughly
– Dry with single-use towel or air dryer 23
Appropriate Use of Hand Sanitizer
• NOT a substitute for hand washing
• NOT for “dirty” hands
• NOT to use when hand washing is possible
• Proper use
– Apply thoroughly to clean hands
– Allow to air dry
24
Helpful Tip:
Use hand sanitizer to supplement
proper hand washing
Break the Cycle: Cleaning for Health
• P&G Professional’s comprehensive sanitation programs are designed
to help prevent the general transmission of viruses and other
pathogens that cause illness
• We recommend cleaning and disinfecting surfaces with P&G
Professional, EPA-registered hospital detergent/disinfectants, paying
particular attention to those that are highly touched areas (HTO).
25
Helpful Tip:
The more times someone touches a
contaminated surface and then touches areas
on their face (eyes, nose or mouth), the
greater the chance for transmission of human
microbial pathogens.Source: CDC
Cleaning Performance Matters
• Choose effective cleaning products
• Soil removal is critical to hygiene
• Residual soil can shelter organisms
26
Insight
Effective cleaning eliminates the
soil that harbors germs and
thereby reduces germ re-growth
Helpful Tip
For the best value, chose
products that both clean and
disinfect in a single step
EPA-Registered Disinfectant
• Use EPA-registered disinfecting products according to
label instructions
• U.S. EPA regulates disinfecting and sanitizing products
• Look for EPA registration number on the front of the label
• Follow label instructions
• Kill time claims
27
28
Jeff Anderson, Ph.D.Public Health & Sanitation Consultant
P&G Professional
Sanitation and Hygiene
Performance Factors
• Soil
• Surface
• Chemical action
• Mechanical action
• Temperature
• Time
• Water quality
• Person
29
Helpful Tip:
Labor costs is 50-90 percent of
overall cleaning costs
Pinpoint the Barriers
• Self-reported, Perceived and Observed:– Expectation not clear
– Do not know how and why
– Too busy/insufficient time
– Disagreement with recommendations
– Lack of institutional safety
– Lack of institutional priority
– Lack of role models
30
Helpful Tip:
Set employees up for success:
create habits that enable them
to do the right thing
Survey Findings
Biggest barrier keeping employees
from performing their best:
Effective Training
31Source:
Conducted December 2009
Improve Employee Compliance
• The following are known to increase compliance– Engineering controls
• Design of equipment and facilities
• Procedures, products, tools
– Education (How and Why)
– Monitoring and Feedback
– Reminders in the workplace
– Administrative sanctioning/rewarding
– Enhance individual and institutional level self evaluation
– Improve institutional safety climate
– Improve work place safety climate
– Avoid understaffing and excessive workload
– Combine several of the above
32Source: Morbidity and Mortality Weekly Report; CDC, Oct 25, 2002, Vol. 51, N. PR-16
Engineering Controls
Equipment and Facility Design
• Purchase Cleanable Equipment/Materials– Easy to clean
– Corrosion resistant
– Durable to cleaning processes
– Smooth surfaces
– Movable
– Don’t always rely on equipment certification stamps
• Cleanability criteria in purchasing considerations
• Design and maintenance of facilities– Similar cleanability criteria as above
– Convenient locations
• Sanitation, equipment and facility design vendors can help
33
Engineering Controls
Cleaning and Sanitation Procedures
• Evaluate cleaning needs and create necessary cleaning
procedures that work
• Master Cleaning Schedule– Task, frequency, ownership, procedure
• Validation and Criteria– Performance
– Cost (labor, chemicals, tools, etc)
– Worker safety, etc.
• Consider conducting time in motion studies
• Periodically reevaluate because things change!!
34
Helpful Tip:
Standardized products and
procedures reduce confusion.
Engineering Controls
Cleaning and Sanitation Tools
• Identify sanitation tools that improve performance and
efficiency– Towels
– Scouring pads
– Brushes
– Mops
– Scrapers
– Squeegees
• Tools should not damage/scratch surfaces
• Tools can be sources of cross contamination– Manage tools properly
– Proper sanitation procedures of tools after use
35
Engineering Controls
Cleaning and Sanitation Compounds
• Not all cleaners are the same– Many cleaners are not sanitizers or disinfectants
• Can compensate for poor cleaning practices
• Multipurpose and work across a broad class of
soils and task areas
• Balance performance with worker safety
36
Engineering Controls
37
Time: 00:00:00 Time: 00:00:09 Time: 00:00:15
Time: 00:00:26 Time: 00:00:37 Time: 00:00:49
Education and Training
Learning Styles
• Reading/writing learner
• Auditory learner
• Visual learner
• Kinesthetic learner
38
Helpful Tip:
Develop training programs that
incorporate all learning styles
Education and Training
39
Source:
1. Journal of Food Protection, Vol. 69, No. 11, 2006, Pages 2697–2702; 2. Morbidity and Mortality Weekly Report;
CDC, Oct 25, 2002, Vol. 51, N. PR-16; 3. Beegle, 2004
Cleaning and Sanitation Education
• Public Health Education and Compliance:– Positive correlation between training and improved compliance
• Teach why, how, and when
• Settings for training:– Classroom
– Computer based
– Store level
– Interactive/demonstrations
• Other effective training tools:– Storyboards, causing and effect posters, testimonials,
demonstrations, activities, games, videos, etc.
Education
Education Strategies
• How/Why:– Procedural training
– Technique based training
– Hands-on, activity based
– Demonstrate the wrong and correct ways
• Technique based training, concepts– Surface Disinfection – Scraping
– Hand washing – Wiping
– Hand Sanitizing – Rinsing
– Scouring
40
Helpful Tip:
Use training materials in native
language of workers to optimize
effectiveness
Education
41
Education Strategies (continued)
• Active participation of managers and employees is critical
• Continual and refresher training is important
Education
42
English Spanish
Education and Training
Sanitation Measures for Training
• Sensory – clean to sight and touch
• Other effective measures that go
beyond site and touch– ATP bioluminescence test
• Importance of process or compound– Sanitizer concentration testing to
ensure proper strength
• Other residue tests
43
Monitoring and Feedback
Task Analysis
• Continual education and reminders important to
maintain and improve behaviors
44Source:
Haring, T. et al. Journal of Applied Behavior Analysis 1988, 21, 207-215
Monitoring and Feedback
45
• Monitoring provides opportunities for improvement
and feedback/education– Employee Knowledge Check
– Observation of Knowledge
• Managers AND other employees providing
feedback must be highly skilled
• Develop very short demonstrations
4646
Matt KoloseikeAssistant Brand Manager
P&G Professional
Back to Basics
Global Handwashing Day is October 15
Goal: Make hand washing with soap an automatic
behavior performed everywhere
P&G is a proud sponsor of Global Handwashing Day
Learn more at www.globalhandwashingday.org
47
Products for Your Cleaning Program:
Safeguard
48
Scenario:
Need a simple, safe and effective
solution to keep hands clean and
your business healthy
Solution:
Safeguard® Hand Soap
• Effective against many common bacteria
• New foaming line-up meets all E2 rating criteria
• No dyes or perfumes
• Mild to skin even after repeated use
Products for Your Cleaning Program:
Safeguard
49
Solution:
Safeguard® Antibacterial Hand Sanitizer Gel
• 62% isopropyl alcohol
• Works on contact without water
• Effective against many common bacteria
Scenario:
Need a convenient and effective addition to
your existing hand washing program?
Products for Your Cleaning Program:
Spic and Span
50
Scenario:
Need to clean and disinfect dry
surfaces, touch points, shiny
surfaces and glass?
Solution:
Spic and Span® Disinfecting All-Purpose Spray and Glass
Cleaner
• Hospital-grade disinfectant, bactericide, fungicide,
deodorizer and virucide
• Powerful 3-in-1 all-purpose cleaner
• Designed to leave surfaces streak-free
Scenario:
Need to clean and disinfect wet
surfaces, while removing tough soils
complexed with hard water minerals?
Solution:
Comet® Disinfecting Bathroom Cleaner
• Safely cleans most surfaces with nonabrasive formula
• Powers away soap scum and hard water stains without
scrubbing
• Hospital-grade disinfection for critical surfaces
Products for Your Cleaning Program:
Comet
51
Scenario:
Need an extra tough cleaning solution
to keep finished floors shiny and clean?
Solution:
Mr. Clean® Finished Floor Cleaner
• Dissolves and removes tough ground-in dirt from finished
floors without leaving a dulling residue
• Delivers shine and extends time between strips by
effectively removing grimy soils
• Multipurpose floor cleaner for a wide variety of shiny floor
finishes52
Products for Your Cleaning Program:
Mr. Clean
Additional Resources
Contact a P&G Professional
ISSA CIMS Certified Expert:
(800) 332-7787
• Alabama – Amanda Gilbert
• Albany, NY – Chris Gaunt
• Atlanta, GA – Patricia Robles
• Atlanta, GA – Tom Scallan
• Atlanta, GA – Bob Dameron
• Charlotte, NC – John Howard
• Charlotte, NC – Tom Ellis
• Chicago, IL – Lee Starks
• Cincinnati, OH – Alan Tomblin
• Cincinnati, OH – Matt Koloseike
• Cincinnati, OH – Vivian Nwoha
• Dallas, TX – Greg Fries
• Houston, TX – Jim Waugh
• Los Angeles, CA – Joe Borges
• New Orleans, LA – Johnnie Alexander
• New York, NY – Tom Finocchio
• Phoenix, AZ – James Timberlake
• Tampa, FL – Ken Harwood
53
For more information visit www.pgpro.com
