Disinfection of Norovirus
Materials Needed:
Disposable gloves, masks, eye protection or face shields, and gown or protective clothing. Please don all materials before beginning cleaning procedure.
General Warning:
Chlorine bleach may damage fabrics and other surfaces. Please spot test area before applying to visible surface.
Examples of items to disinfect:
Doorknobs, faucets, sinks, toilets, commodes, bath rails, phones, counters, chairs (including backs), tables, hand rails, elevator buttons, light switches, keyboards, mattress covers, aprons, uniforms, linens, bedding and ice machines.
What works best: Chlorine bleach (sodium hypochlorite -NaOCl)
Chlorine bleach concentrations and mixing instructions:
• 200ppm (parts per million) - 1:250 dilution
• Use for stainless steel, food/mouth contact items, toys
• 1 Tablespoon of bleach in 1-gallon water
1000ppm (parts per million) - 1:50 dilution
• Use for non-porous surfaces, tile floors, counter-tops, sinks, toilets
• 1/3-cup bleach in 1-gallon water
5000ppm (parts per million) - 1:10 dilution
• Use for porous surfaces, wooden floors
• 1 and ½ cup bleach in 1-gallon water
Stability of Chlorine Bleach
• Open bottles of concentrated chlorine bleach will lose effectiveness after 30 days. Change bottles of bleach every 30 days for accurate concentrations. For disinfecting, use an unopened bottle of chlorine bleach. Prepare a dilution of fresh bleach every day of use and discard unused portions.
Bleach dilutions clarified with household measurement terms
Bleach Solution | Dilution Exact | Chlorine (ppm) | Dilution approximate | Household (ppm) Approximate | Application |
5.25% - 6.15% | Concentrate | 52,500 - 61,500 | Concentrate | 52,500 - 61,500 | * Patient Care |
5.25% - 6.15% | 1:10 | 5,250 - 6,150 | 1.5 cups / 1 gallon | ~6000 | * Patient Care |
5.25% - 6.15% | 1:100 | 525-615 | 0.25 cup / 1 gallon | ~600 | * Patient Care |
5.25% | 1:200 | 263 | 1 tablespoon / 1 gallon | <200 | Dietary |
5.25% - 6.15% | 1:1000 | 53-62 | 1 teaspoon / 1 gallon | ~50 | Dietary |
The glossary in the CDC guidelines provides bleach dilutions using household measurementterms and equivalent parts per million (ppm) that can be used to translate recommendations foruse in the patient care setting for environmental decontamination after cleaning, e.g., forClostridium difficile. Premier’s Safety Institute has expanded the information to include the useof chlorine bleach as a sanitizing agent in dietarysettings consistent with EPA U.S Gov’tregulations (21 CFR Part 178).
Other effective disinfectants
• A phenolic environmental disinfectant (Lysol® or Pinesol®) may be effective, but may require a concentration of 2-4X the manufacturer’s recommendation. The use of this product at the higher concentration may pose a significant health risk to children, workers, pets or yourself. Use extreme caution when using these products. Please read the manufacturer’s warning.
• Environmental Protection Agency (EPA) -registered disinfectants
Note: Some of these products now include quaternary ammonia-based disinfectants but in combination with alcohols. These claims of effectiveness are based on in-vitro studies usually using feline calicivirus; field effectiveness in the context of outbreaks has not been evaluated.
NOT ALL DISINFECTANTS SHOWN ON EPA LIST ARE APPROVED FOR USE IN FOOD FACILITIES.
Health Concerns with using Chlorine Bleach
Mixing hazards
• USE ONLY IN WELL-VENTILATED AREAS. Adverse effects of inappropriate mixtures of household cleaners usually are caused by prolonged exposure to an irritant gas in a poorly ventilated area. The most common inappropriate mixtures of cleaning agents are bleach with acids (like vinegar) or ammonia (Windex ®). Potential irritants released from such mixtures are chlorine gas, chloramines, and ammonia gas.
Health hazards
• Chlorine bleach is corrosive and irritating to all mucosal tissue, skin, eyes and upper and lower respiratory tract. Avoid spray bottle application with any disinfectant. However, “pour” or “pump” bottles that do not produce aerosols are highly recommended.
Personal protective equipment
• Disposable gloves, masks, eye protection or face shields, and gown or protective clothing.
• Environmental cleaning using a more concentrated disinfectant will require a heavier duty glove than a simple non-sterile latex/vinyl glove.
Specific Clean-up Procedures
For cleaning large spills of vomitus or stool, a two-step process should be used. Put on personal protective equipment before cleanup.
1. Pre-cleaning of visible/organic debris with absorbent material (double layer and placed in a plastic bag to minimize exposure to aerosols) should precede the disinfection process.
2. Liberally disinfect area and objects surrounding the contamination with an appropriate environmental disinfectant (multiple applications may be required).
*Ensure appropriate dilution and contact times for the appropriate environmental disinfectant.
Hard surfaces
• Disinfect with bleach, rinse with water if food preparation area.
Carpet / Upholstered Furniture
• Visible debris should be cleaned with absorbent material (double layer) and placed in a plastic bag to minimize exposure to aerosols - disinfecting with bleach may discolor carpet – steam clean (heat inactivation) 158°F for 5 minutes or 212°F for 1 minute for complete inactivation.
Linens / clothing / textiles
• If soiled, vomit or stool should be carefully removed to minimize aerosols. Keep contaminated and uncontaminated clothes separated. Minimize disruption of soiled linens and laundry. Aerosols created may pose a risk for transmission. Wash items in a pre-wash cycle, then use a regular wash cycle using detergent and dried separately from uncontaminated clothing at high temperature greater than 170°F. Ensure segregation of clean and soiled linens/clothing/textiles.
Surfaces Corrodible/damageable by bleach
• EPA-registered phenolic solutions (concentrated Lysol® or concentrated Pinesol®) mixed at 2-4X the manufacturer’s recommended concentration.
Posted in: DISINFECTION OF NOROVIRUS
0 comentarios:
Post a Comment