A lot has been spoken about highly touched surfaces over the past months. Everyone - from facility owners to service providers to guests have been super aware of them in wake of the pandemic. Everyone is focussing on cleaning methods, equipment and chemicals more than ever. This also brings wipers under the scanner. The cleaning industry has largely relied on wipers in the past couple of years. But, are they effective in combating the virus that has taken the world by a storm? Are they reliable anymore?
Clean Middle East spoke to industry experts Ahmad Abublan, General Manager, Kimberly Clark Professional; Denise Hanson, Head of Technical Services, British Institute of Cleaning Sciences; and Dr. Prashant Nassa, Head of Department, Critical Care Medicine, Chairperson for Prevention and Infection Control, Antimicrobial Stewardship at NMC Speciality Hospital, Dubai; in an exclusive webinar 'Cleaning and Disinfecting with Wipers.' Here is an excerpt.
Regular tools for surface cleaning
In the commercial cleaning industry, generally microfiber cloths, muslins, disposables and semi disposables are used for cleaning surfaces, depending upon the particular site requirements (type of surface, duration of cleaning, etc).
In the Middle East healthcare industry, there were times when most of these conventional ways of cleaning such as cloth towels and rags were being used, but now it has changed to lint free microfiber cloths owing to the sensitivity of the industry. There are wipers pre impregnated with solutions, which are active against most of the bacteria and viruses. The main purpose of wipers is to remove contamination from surfaces. Additionally, some wipers may provide some antimicrobial activity by the inclusion of a disinfectant, although this activity might be limited based on contact time, type of surface and contamination present.
The different types of wipers
The commercial cleaning market offers a plethora of wipers, each having a different application. Here are a few:
• Single-use wipers
Also known as limited use wipers, these can be used once with a disinfectant or detergent. Tey are paper based and easy to use. You simply wiper a surface with them and throw them after use.
• Semi-disposable wipers
Also known as extended use wipers, these are cloth-based wipers that can be laundered for a certain amount of time. They are durable for extended use with detergent or disinfectant. However, after a few uses, you will have to dispose of it. Generally, extended wipers are color coded to avoid cross contamination.
• Microfiber wipers
These can absorb upto 8 times their weight in liquid. Microfiber wipers are perfectly reusable for cleaning. They can be laundered and reused for upto 300 times. There are wipers that are impregnated with solutions and some that aren’t. Whichever type of wiper you are using, you also have to consider the solution being used alongside so that it does not degrade the quality or result of the wiper. Talking about the application of each wiper, it entirely depends upon the segment or industry you are in (area of use).
Why is it important to consider wiper selection?
• Efficacy
Properly selected and used wipers can be an effective method of decontamination.
• Popularity
Pre-prepared wipers are convenient and often more practical than a traditional bowl of water and detergent. Many wipers available contain disinfectant ingredients, which users may assume are more effective for infection prevention interventions, making them a popular option.
• Cost
A significant cost can be attributed to the volume of wipers used. Cleaners should have a reasoned approach to product selection and consequent expenditure.
Selecting a wiper or wipers for trial
As a facility owner or a cleaning service provider, it may be your responsibility to source and select wipers for a given facility. Given the importance of selecting the right product for the intended purpose and the need for assurance as far as possible for its effectiveness, the following points should be considered for wipers selection:
Investigate all available products for information on the following and review
• Compatibility with local infection prevention policies
• Equipment manufacturers’ guidance on cleaning and disinfection
• Active ingredients
• Dermatological assessment for impact on the skin of staff
• Manufacturer’s data on testing methods and results
• Manufacturer’s safety data sheets
• The level of support required for training on use of wipers and the cleaning/disinfection procedure – including who provides this support (supplier or in-house teams) and whether this input is a ‘one-off’ or needs to be repeated as staff changes.
Selection and use of wipers - A checklist
The following checklist can be used to help you in the selection and use of wipers in your facility.
• Do your research first. What is the intended purpose for using the wipers?
• Refer to local policies and procedures regarding cleaning and disinfection to determine if a wiper can be used.
• Check any relevant manufacturer’s guidance to determine if wipers can be used (applies mostly to medical equipment).
• Consult with your local infection prevention team for advice and guidance.
• Consider whether detergent and/or disinfectant wipers are required.
• Investigate manufacturer’s information and efficacy claims carefully.
• Consider potential product limitations, for example, efficacy limited by active ingredients (if disinfectant used) and exposure time.
• Trial a number of different wipers if possible before making an informed decision on their suitability.
• Review any potential dermatological effects on staff using the wipers and liaise with occupational health advisers.
• Consider any training requirements for wipers use and who will provide this.
• Consult staff during trials so they can inform the team about any purchase decisions.
• Evaluate any trial thoroughly
• Ensure processes are in place for stock checks and rotation to ensure the product’s continued suitability and effectiveness in practice.
Managing wipers in everyday use
The following key points should be considered and managed so that wiper products maintain their effectiveness and are used properly:
• Ensure compliance to manufacturer’s instructions (how to use, where to store and length of storage life)
• Ensure stock rotation and undertake regular checks for wipers in packets/containers to make sure these have not dried out or expired in cases where wipers are impregnated with disinfectants or solutions.
• Consider the need to clean wipers containers/ packets depending on risk of contamination of external container surfaces.
• Ensure wipers are only used for their intended purpose according to government guidelines.
• Ensure all staff who will use wipers have received training on how and when to use them (the process of wiping as part of cleaning training) to help guarantee consistency and efficacy of use in practice.
Using wipers in a healthcare setting
In a healthcare setting, a number of steps are to be followed to achieve optimum disinfection.
Physical removal of contamination and disinfection
A surface needs to be clean in order to be disinfected properly. There is no standard test that simulates the physical removal of dirt or microbes by wipers. However, best practice recommends that surfaces should be physically clean prior to disinfection inorder for any disinfectant to be effective.
There is currently no evidence supporting the use of disinfectant wipers containing detergents as being superior in action over a two stage (cleaning and disinfection) process. After a surface has been thoroughly cleaned, the next and most important step is disinfection.
Disinfectants used in wipers
The most common disinfectants used in wipers are chemicals such as alcohols or surfaceactive disinfectants – quaternary ammonium compounds (QACs) or triamines. These biocides will achieve limited disinfection within the exposure times that are achieved in practice (typically a few seconds). It should also be noted that the microbicidal activity will be further compromised if soiling (dirt, vomit, blood, faeces, etc.) is present.
Other wipers, usually substantially more expensive, can contain chlorine dioxide orperacetic acid. These may have activity against spores and nonenveloped viruses, but again their efficacy will be limited by exposure time, how well the disinfectant is applied tosurfaces (coverage), and the presence of contamination.
Overall, wipers are a pretty effective tool to use in cleaning and disinfecting - it is just important to know how to use them and how to get the best out of them!