sanitation essentials: guidelines for an effective ...safeguard 48 scenario: need a simple, safe and...

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)


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


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%


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)


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


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.


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


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


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


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


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

http://www.globalhandwashingday.org/

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


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?


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


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


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

http://www.pgpro.com/

Questions and Comments

54

For more information visit www.pgpro.com

http://www.pgpro.com/

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