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June 2010

Most frequently transmitted by skin-to-skin contact, MRSA (Methicillin-resistant Staphylococcus aureus) is a type of Staph bacteria that causes difficult-to-treat and serious bacterial infections, many of which manifest themselves as skin blemishes, rashes and boils with resistance to penicillin-type antibiotics. With employees often packed into close quarters, the risk of MRSA outbreaks in the workplace can increase and become a serious concern for employers in any environment.

Company management can work together to reduce the spread of MRSA in facilities by practicing a proactive prevention strategy. Coupling employee education with five crucial cleaning practices can help reduce the risk of MRSA transmission both at the source (contact with an infected individual) and from office surfaces, which can become contaminated via airborne droplets from the coughing of an infected employee or also from the open sores of infected employees.

Preventing the Spread of MRSA in the Workplace
OSHA offers the following information to help employers protect workers against infection from MRSA.

How can I prevent the spread of MRSA in my workplace?
Methods for preventing the spread of MRSA in the workplace depend on the workplace type. Infection control is key to stopping MRSA spread in healthcare settings. Employees in other work settings should be encouraged to practice good personal and hand hygiene to prevent MRSA spread in the workplace:
• Keep hands clean by washing thoroughly with soap and water, or by using an alcohol-based sanitizer when soap and water is not immediately accessible.
• Keep cuts and scrapes clean and covered with a bandage until healed.
• Avoid contact with other people’s wounds or bandages.
• Avoid sharing personal items such as towels, washcloths, razors or clothes.
• Wash soiled sheets, towels and clothes in hot water with bleach and dry in a hot dryer.
• If a wound appears to be infected, an employee should see a healthcare provider. Treatment may include draining the infection and the administration of antibiotics.

Should an employee with a MRSA infection work?
According to CDC, unless directed by a healthcare provider, workers with MRSA infections should not be routinely excluded from going to work.
• Exclusion from work should be reserved for those with wound drainage (“pus”) that cannot be covered and contained with a clean, dry bandage and for those who cannot maintain good hygiene practices.
• Employees with active infections should be excluded from activities where skin-to-skin contact with the affected skin area is likely to occur until their infections are healed.

Additionally, an employer may want to seek guidance from an occupational healthcare provider about how to reduce additional risks to both MRSA-infected and uninfected employees. This may be important in industries where an employee is at higher risk of sustaining a skin injury such as an abrasion, burn, cut or puncture wound (e.g., agribusiness, construction, forestry/landcare, healthcare, food service).

Handwashing
Encourage employees to practice a strict protocol of hand hygiene, washing their hands frequently and for at least 30 seconds upon each visit to the sink. In addition, consider installing alcohol-based hand sanitizer dispensers and encourage employees to use the product frequently. Since MRSA is most often transmitted from person to person via contaminated hands, this is a crucial part of the strategy and helps reduce all types of germ transmission and promote general office cleanliness.

Surface Cleaning
Most offices either employ a cleaning crew designated by facility managers or an outside cleaning service. Do all cleaning services have a positive impact in reducing health risks through proper cleaning? Traditional cleaners tend to use spray-and-wipe tactics, causing cross-contamination and the spread of harmful germs in the process.

The most effective surface cleaning techniques leverage daily aseptic, health-based cleaning programs that focus on decontaminating high-touch points and preventing cross-contamination through the proper use of tools, chemicals and color-coding, including:

• EPA-registered, hospital-grade disinfectants. These are strong (but safe) disinfectants proven to kill MRSA. EPA-registered disinfectants, deployed with the proper dwell time, can reduce the risk of surface contact transmissions of MRSA and other pathogens.

• No-dip, flat mop technologies. Microfibers in flat mop technology are more effective at retaining soil and matter than traditional mops. Light¬weight flat mops are equipped with super-absorbent microfiber fabric that traps and holds dead germs. For extra insurance, no-dip flat mops use only clean solution to remove dirt and soils, increasing soil and germ removal and reducing the risk of cross-contamination because the mop surface does not come into contact with contaminated solution.

• Color-coded microfiber cloths. Cross-contamination presents a serious problem in the cleaning world. Tradi¬tional cleaning cloths or paper towels can pick up dead germs and spread them to other areas of the facility, where they may act as a food source for new bacteria. Color-coded microfiber is used in a single, designated area of a facility. It is not only more effective at removing soil and germs but also helps to reduce cross-contamination in the office.

• Bucket immersion for applying disinfectant to cleaning cloths. In lieu of pour bottles, bucket immersion guarantees that germs and bacteria on cloths are eliminated before the next surface is attended to. In fact, a 2009 study by Society for Healthcare Epidemiology of America found that enhanced cleaning protocols such as bucket immersion can reduce the spread of MRSA to hospital patients exposed to rooms in which the prior occupant had been colonized or infected.

• Touch-free, spray-and-vacuum systems. This technology provides the most complete disinfection and matter removal of any cleaning application.

No-touch spray-and-vacuum systems saturate surfaces with hospital-grade disinfectant, rinse with a high-pressure stream of fresh water after proper dwell time and recover the solution from floors with a high-power wet vacuum. The technique produces results that have been scientifically proven to reduce the presence of soils and pathogens on surfaces which are tolerant to this wet cleaning process.

Traditional Cleaning vs. Health-Based Services
Now you have the tools, but what about the strategy? A major differentiator between traditional cleaning methods and health-based services is the attention paid to specific surfaces.
MRSA can live on various surfaces, but bacteria will more likely be found living on surfaces that represent high-touch points. In the office, these include doorknobs, keyboards, phones and light switches. While traditional cleaning services seldom focus on these types of surfaces, health-based cleaners will seek out the high-touch surfaces where MRSA is more likely to hide, and will spend more time ensuring these surfaces are cleaner and more germ free, reducing the spread of MRSA in your facility.

Peter J. Sheldon Sr., CBSE, brings more than 18 years’ experience in the building services contracting industry to his position as vice president of operations of Coverall Health-Based Cleaning System (www.coverall.com). He works with sales and operations teams to help develop efficient, innovative cleaning processes.

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