The science of safe surfaces

Effective disinfection protocols are essential to support infection prevention strategies in hospitals. Environmental surfaces contaminated with pathogens have the potential to become sources of infection. Cleaning and disinfection are key interventions to reduce contamination levels on surfaces. However, the efficacy of these interventions is determined not only by the methods used but also by the type of surface being cleaned and where it is situated.¹ Therefore a risk stratified approach should be considered when determining protocols, based on a number of factors which are examined in this article.

Viruses and bacteria are the most common causes of infectious diseases acquired in hospitals and cause a considerable negative impact on the health of patients. Healthcare associated infections (HCAIs) also known as “nosocomial” infections are defined as infections that occur in patients during the process of care in a hospital or other healthcare facility, which was not present or incubating at the time of admission. Such infections increase morbidity and mortality, as well as presenting significant extra costs.² The most recent UK data3 estimates a prevalence in hospitals in England of 6.4%. Although a recent study estimated that 5%-15% of hospitalised patients in high-income countries acquire an HCAI.⁴

In hospitals, the direct transmission of pathogens generally occurs from person to person, but indirect transmission through contaminated surfaces is also recognised.¹ Surfaces can become contaminated by hands, objects, and the settling of virus containing aerosols or contaminated fluids.⁵ Therefore, these surfaces can play an important role for transmission of pathogens in healthcare settings.⁵ Transmission of pathogens by a person touching a contaminated surface has been demonstrated to be possible.⁶