Which type of facility is the most complex to maintain in terms of hygiene?
We asked this question to different industry experts and the answer was unequivocally this - HEALTHCARE. 

Hospitals, clinics, and long-term care facilities are thronged by hundreds of patients and visitors everyday and because of this never ending footfall, they face challenges in maintaining hygiene, as high-touch surfaces, airborne microbes, and environmental contamination contribute to infection risks.

While cleaning and hygiene SOPS have always come to the rescue, the complex environments in healthcare demand groundbreaking innovations. We discuss some of these innovations in detail with experts, Tabrikah Mohamed, Founder and Chairperson of Emirates Infection Prevention & Sterilization Society and Ali Al Jabri, Vice-President WFHSS World Federation for Hospital Sterilization Sciences MΕΝΑ FHSS Board Member HSPA MENA Chapter.

Tabrikah Mohamed, Founder and Chairperson of Emirates Infection Prevention & Sterilization Society

Effective infection control is essential in healthcare settings to prevent hospital-acquired infections (HAIs) and minimize the spread of pathogens. Hospitals, clinics, and long-term care facilities face challenges in maintaining hygiene, as high-touch surfaces, airborne microbes, and environmental contamination contribute to infection risks. While traditional cleaning and disinfection methods remain fundamental, emerging technologies are revolutionizing hygiene protocols, making infection control more effective and efficient.

I am going to highlight three key innovations in healthcare hygiene that are transforming infection prevention strategies:

• Disinfection Fogging Machines
• High-Intensity Narrow-Spectrum (HINS) Light
• Smart Surfaces

1. Disinfection Fogging Machines: Enhancing Surface & Air Disinfection

Fogging machines disperse fine mist or aerosolized disinfectants to eliminate pathogens from air and surfaces, reaching hard-to-clean areas.

Types of Fogging Systems:

Electrostatic Sprayers – Positively charged disinfectants for even coverage.

Dry Fogging – Ultra-fine mist effective in open inpatient wards.

Hydrogen Peroxide Vapor (HPV) Systems – Used for deep sterilization in hospitals.

Effectiveness & Considerations of Vapor or Mist-Based Disinfection

A recent study evaluated dry fogging in inpatient wards and found:

Daily dry fogging significantly reduced microbial loads (SE = 64.484, p = 0.002).

Airborne contamination decreased over time (SE = 19.192, p < 0.001).

Surface contamination was reduced, despite frequent recontamination (p = 0.010).

These results confirm dry fogging’s role as a valuable supplement to routine cleaning (Jalali et al., 2024).

Regulatory & Safety Considerations

A joint statement by APIC, SHEA, and AHE (2011) noted that while fogging applications are generally safe, improper room sealing and lack of planning can pose risks to workers. The EPA must ensure proper exposure limits and re-entry guidelines, while manufacturers must provide clear safety measures for handling disinfectants.

Additionally, studies indicate that hydrogen peroxide vapor (HPV) disinfection can delay room availability by up to 4 hours, potentially affecting hospital efficiency and emergency department workflows (APIC, SHEA, & AHE, 2011).

CDC Recommendations

The CDC supports EPA-approved disinfectants for fogging but emphasizes that fogging should not replace manual cleaning, as organic matter can reduce its effectiveness (CDC, 2021).

2. High-Intensity Narrow-Spectrum (HINS) Light: Continuous Disinfection

HINS light, at 405 nm wavelength, is bactericidal yet safe for humans, allowing continuous use in occupied hospital spaces.

HINS-Light in Healthcare Settings

A clinical study on HINS-light EDS demonstrated:

27% to 75% bacterial reduction in inpatient rooms (p < 0.05).

61% surface contamination reduction in outpatient clinics (p = 0.02).

These findings highlight HINS-light’s effectiveness as an additional infection control tool (Bache et al., 2012).

CDC Recommendations

The CDC supports ultraviolet germicidal irradiation (UVGI) for airborne disinfection and suggests that light-based systems should supplement, not replace, standard cleaning (CDC, 2021).

3. Smart Surfaces: Reducing Pathogen Survival on High-Touch Areas

Types of Smart Surfaces:

Copper-infused surfaces – Kill bacteria like E. coli and MRSA within hours.

Self-cleaning nanotechnology coatings – Use photocatalysis to break down microbes.

Hydrophobic coatings – Prevent bacterial adhesion, making cleaning easier.

CDC Recommendations

The CDC acknowledges copper and silver-infused surfaces as effective but stresses that they should complement manual cleaning and disinfection (CDC, 2021).

Conclusion: A Multilayered Approach to Infection Control

Innovations like dry fogging, HINS-light, and smart surfaces significantly improve hygiene in healthcare environments. However, they should be integrated alongside traditional infection control measures, including:

✔ Hand hygiene compliance

✔ Proper PPE usage

✔ Routine manual cleaning

✔ Air filtration and ventilation improvements

By combining these advanced disinfection technologies with established protocols, healthcare facilities can create safer environments for patients and staff, reducing the risk of hospital-acquired infections.

Ali Al Jabri, Vice-President WFHSS World Federation for Hospital Sterilization Sciences MΕΝΑ FHSS Board Member HSPA MENA Chapter.

Infection control remains a critical concern in modern healthcare, especially in the wake of global health crises and the rise of antibiotic-resistant pathogens.

Traditional hygiene measures, while effective, are often labor-stressful and susceptible to human error.

As a result, the industry is embracing innovations that enhance efficiency, reduce contamination risks, and support sustainability.

Among these advancements, three key areas stand out: steam vapor cleaning, hygienic wearables and PPE, and robotics with artificial intelligence (AI).

Steam vapor cleaning is emerging as a chemical-free, highly effective disinfection method. Utilizing superheated steam, this technique denatures proteins in bacteria, viruses, and spores, effectively neutralizing threats such as MRSA.

Unlike chemical disinfectants, steam vapor cleaning eliminates the need for toxic agents, reducing both environmental impact and occupational exposure risks.

Additionally, its deep penetration into porous surfaces enhances coverage, making it a valuable tool in healthcare facilities. However, challenges persist, including its incompatibility with heat-sensitive materials and the time-intensive nature of ensuring thorough coverage.

Despite these limitations, hospitals worldwide are increasingly adopting steam vapor cleaning. Innovations in this area continue to evolve, integrating sensors that validate surface temperatures and exposure times to enhance reliability.

In parallel, advancements in hygienic wearables and personal protective equipment (PPE) are redefining staff and patient safety. Smart badges, leverage IoT sensors to track hand hygiene compliance, issuing real-time alerts when protocols are missed. Additionally, antimicrobial fabrics infused with copper or nanoparticles actively inhibit microbial growth, reducing the risk of cross-contamination in high-contact environments.

Reusable PPE, including next-generation silicone N95 respirators, offers durability and waste reduction, aligning with sustainability goals. While these innovations enhance compliance and hygiene monitoring, they also introduce challenges such as increased costs and the need to balance comfort with functionality.

The future of wearables may include UV-C self-sanitizing capabilities or biosensors capable of detecting pathogen exposure, fostering a more proactive approach to infection prevention. 

Robotics and AI further optimize healthcare hygiene by automating disinfection, monitoring compliance, and predicting infection risks. UV-C disinfection robots, autonomously sanitize hospital rooms. AI-driven surveillance systems analyze hand hygiene trends, while predictive models use electronic health records (EHR) to identify outbreak risks before they escalate.

Delivery robots minimize human contact in supply transport, further reducing contamination opportunities. Despite the high upfront costs and concerns regarding privacy, these technologies provide consistency, precision, and valuable data-driven insights. Looking ahead, AI is expected to evolve with federated learning for cross-institutional analytics, while emerging solutions like germicidal drones could enable large-scale disinfection in public spaces.

The future of infection prevention lies in integrating these innovations into a cohesive, intelligent hygiene ecosystem. AI could coordinate robotic disinfection during facility downtime, while wearables transmit compliance data for real-time monitoring. As regulatory bodies fast-track approvals and sustainability become a growing priority, healthcare institutions must strategically balance innovation with practical implementation. Through continued collaboration among engineers, clinicians, and policymakers, healthcare hygiene can transition from a reactive approach to an anticipatory, data-driven defense against emerging pathogens, ensuring a safer environment for patients and medical professionals alike.

References

APIC, SHEA, & AHE. (2011). Joint Letter to the EPA on Fogging Applications for Disinfectants. Retrieved from APIC Website.

Bache SE, Maclean M, MacGregor SJ, Anderson JG, Gettinby G, Coia JE, Taggart I. Clinical studies of the High-Intensity Narrow-Spectrum Light Environmental Decontamination System (HINS-light EDS), for continuous disinfection in the burn unit inpatient and outpatient settings. Burns. 2012 Feb;38(1):69-76. doi: 10.1016/j.burns.2011.03.008. PMID: 22103991.

Jalali Y, Kološová A, Džupa K, Pavlovič P, Jalali M, Rácek P, Zicháčková N, Kyselovič J, Vasiková A, Glodová K, Payer J. Efficacy of Antimicrobial Dry Fog in Improving the Environmental Microbial Burden in an Inpatient Ward. Antibiotics (Basel). 2024 Dec 6;13(12):1187. doi: 10.3390/antibiotics13121187. PMID: 39766577; PMCID: PMC11672662.

Centers for Disease Control and Prevention (CDC). Infection Control Guidelines and Disinfection Strategies. Available at: https://www.cdc.gov.