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Nicole Kenny (4)

Nicole Kenny

Nicole Kenny, HBSc, Assoc Chem Vice President, Professional and Technical Services

Twitter Tracking Tummy Troubles
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Book Review - The Germ Code: How to Stop Worrying and Love the Microbes
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Swimming - Sharks are the least of our worries!


I live in Ontario where we are blessed with the Great
Lakes and the Trent-Severn Waterway, a meandering 386 km river and lake
system with locks that is absolutely gorgeous, but then I spend every weekend
on the Trent so am a bit biased.   We have
fish, water snakes (I'm not so partial to those), osprey, beavers, fishers,
crows and of course our share of bugs and noxious weeds such as poison ivy that
we need to worry about, but the water is clear, clean and cooling when we want
to take a dip!  To my knowledge there are
no parasites or bacteria that we need to be wary of.

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The Sweet Sweat of Summer

For those of us who live in a climate where we have to suffer through winter, we generally cannot wait until the warmth of summer arrives.  Inevitably we are also the same people that after several days of scorching heat complain that it's too hot.  I may be hot, I may be sweaty, but by gosh, I'd rather be warm than cold... well within reason of course!  Summer is also a time for many to hit the gym.  Whether its university students returning home for the summer looking to see and be seen or those of us not blessed with naturally formed bikini bodies, summer and the gym are synonymous - as we get older if we want to enjoy that extra beer and burger we need to do a few more miles on the treadmill and extra crunches to keep our stomachs in check.

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I fly, You fly we all share bugs together!
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Book Review: Clean Hands Save Lives
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Mattresses - A Secret Storage Sinkhole
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And the answer is COLLABORATION!
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Improving Infection Prevention through FREE Education!
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Disposables: Time and Money Savers!

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APIC 2014 - Warmth, Sunshine and perhaps some knowledge acquisition too!
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Sustainability through Green Killing
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Brace yourself Halifax! 3 days before IPAC-Canada starts!
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HELP!! IT'S HERE!! I need a disinfectant effective against MERS!

While I am likely dating myself, when the first case of
MERS was reported to hit the US, followed by a second, and then one emerged in
Canada the scene from Poltergeist where Carol Anne Freeling (played by Heather
O'Rourke) say's "They're Here!" instantly jumped into my head.  Only for MERS - it was more like "It's
Here!"

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Disinfection Selection Made Easy
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The little devil or the little angel, which do you choose?
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RUST - the new cost of doing business?
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#FF - Follow Friday

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Is PPE a necessary evil?

In putting together a "surprise" for the
IPAC-Canada and APIC conferences it dawned on me that while Lee & I have
talked around the various areas that one should consider with respect to
determining the safety profile of a disinfectant chemistry we have not gotten
into the nitty-gritty of PPE.   In my
travels, I have had many a HCW tell me they use "the CANCER wipe" and
that they would NEVER use the wipe without gloves (goggles and in some cases
even masks).  However, try as a I may, I
have been unable to find a wipe commercially branded under that name. 

It is true that some of the chemicals used in the
manufacturing of disinfectants such as phenols and 2-Butoxyethanol are listed
by governing bodies as being carcinogens. 
It is also true that some chemistries are known sensitizing agents, are
known to cause occupational asthma and are known skin, eye or respiratory
irritants.  In fact, it is the toxicity
(safety) profile that determines what PPE needs to be worn when working with
disinfectants.  In later blogs we'll
delve into more detail of how safety profiles are determined.  For the purposes of this blog, I want to
focus on the concept of HMIS Ratings (Hazardous Materials Identification
System) and Precautionary Statements found on EPA or Health Canada registered
disinfectants and how they should be interpreted to ensure the safe (and
economic) use of disinfectants.

HMIS ratings as you may have surmised help identify the
risk of the product in terms of health concerns, flammability and physical
hazards which in turn determine what type of PPE a user needs to wear and if
there are any specific needs in terms of storage or handling of the
disinfectant.  On a MSDS they are
represented by a numerical rating system generally as "X/X/X" and are
rated from 0 (minimal risk) to 4 (severe hazard).  The health risk is represented by the first
number and helps determine what PPE (gloves, goggles and/or respiratory protection)
is needed.  For OBVIOUS reasons, the
lower the number the better!  A
disinfectant with a HMIS rating of 0/0/0 would be considered pretty benign and
safe for the user to handle without any form of PPE.

To help illustrate safety differences between
disinfectant chemistries the following table summarizes HMIS ratings and PPE
requirements for the most commonly used disinfectant wipes:
 
 
 
 
The need or lack thereof for PPE varies widely.  You'll also note that while a MSDS may
indicate that no PPE is required, the EPA label may specify that the product
can in fact cause eye irritation or even irreversible eye damage.   In my books, that means eye protection
should be worn. 

The economic impact to facilities with respect to
Occupational Exposure to chemicals is very real.
  A 2010 report by the CDC highlighted that the
most common active ingredients responsible for illnesses were Quats (38%),
glutaraldehyde (25%), and sodium hypochlorite (18%).  The majority of the types of injuries
associated with the use of disinfectants were: 222 as eye injuries, 130
neurologic injuries (headaches etc) and 121 respiratory injuries.  Of particular interest (at least to me) is
that only 15% of the time did the injured worker wear eye protection.....how
many products listed above require eye protection when using?  How often do you see HCWs (EVS, nurses,
clinical therapists etc) wearing eye protection?

The economic burden of occupational injuries and
illnesses are sizable, at least as large as the cost of cancer. Particularly if you know what the cost per
claim is.   In the US, the cost per claim
for eye injuries, neurologic injuries and respiratory injuries are $118,024,
$85,012 and $64,495 respectively. Using
the numbers from the CDC study that equates to $26,201,328 for eye injuries,
$11,051,560 for neurologic injuries and $7,803,895!  That's a whopping $45 MILLION spent over a 5
year period in just 4 US states!

Employers have a legal responsibility to provide a safe
working environment.  The use of
disinfectants has a direct and very costly impact on worker safety.   In an era where we are constantly talking
about the bottom line and focusing on the cost of HAIs, perhaps we should also
be considering the cost of Occupational illness and cost of PPE.  Choosing an effective disinfectant with the
safest HMIS profile will save your facility a considerable amount of money -
particularly when the cost of a pair of gloves can be more than the cost of the
wipe the HCW is using to clean and disinfect!

 

Bugging Off!

Nicole

 
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Disinfection - It's more than the juice you use!
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Ebola - the stuff my dreams are made of!!
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What's your definition of Sterilization?

At times, nothing can be more polarizing
than the discussion of how to reprocess semi-critical and critical
devices.  I've experienced this first
hand as a member of the Reprocessing Subcommittee for the
CSA
Z314.8-14
standard.  A room full of
experts with differing opinions on the concept of
A0
is something to behold (not quite as good as a fight between siblings mind you),
but passion abounds around A0

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Bugs, NOT Robbers Close Police Station!
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Measles - just when we thought they were "wiped" away!
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Bugs make for good conversations!
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ESBL + Male Gender = Dirty Environment
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H1N1, H5N1, H10N8, H7N9, H5N8 - What Influenza strain will we see next?
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Stuffies - Children's Comfort Toys and Home to Bacterial Burden!
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PEDv Pooping Pigs Pose Pharaonic Problems!
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Norovirus - It's a game of Cat and Mouse
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ACMNPV - the new, but not so catchy HAI acronym!
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2014 - the Year of the Horse and Theme-Based Blogs
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TCTM’s 2013 Top 10 Blogs

It's unfathomable that 2013 is almost at a close.  In writing this, our last and 52nd blog of
the year Lee and I wanted to review the year and share what we and others think
the Top 10 Talk Clean To Me blogs were. 
In writing the blog, I'm undecided if you should keep David Letterman's
Top 10 in mind (Lee's pick) or because I'm singing along to Christmas Carols if
perhaps the 12 Days of Christmas or The Sound of Music's "These are a few
of my favorite things" should be the theme song to hum while you read (obviously
I vote for humming!).  I'll leave the
decision to you and hope you agree with our Top 10 picks.

10. Burnt Bums Call for Ban on Disinfectants:
Disinfectant residue determined to be the cause for chemical burns on a child's
bottom.  Perhaps rather than calling for
a ban on the use of  disinfectants and sanitizing agents in schools
perhaps the better alternative is to lobby for the use of disinfectants and
sanitizing agents that do not leave harmful residues behind.  For example,
hydrogen peroxide breaks down into water an oxygen - that sounds pretty safe to
me!

9.  It’s getting harder and harder to breathe!:Custodians
and cleaners have the highest incidence of work related asthma.  What steps do you have in place to reduce the
potential exposure to harmful and potentially asthma causing chemicals?  Does your product selection committee
consider safer cleaning and disinfectant options or employ practices and
protocols that will reduce a user’s chance of triggering occupational asthma?

8. ATTENTION LADIES! There is scientific proof of why men should put the toilet seat down!: 
Lidless conventional toilets may increase the risk of C. difficile
environmental contamination.   Should public toilets have lids?  Certainly, they may help reduce potential
spread of "stuff" being flushed, but will very likely become
contaminated themselves upon flushing.  Do you want to lift the lid
knowing someone's "stuff" is on it?

7. Safe, Safer, Safely, Safest – Who knew they were “Bathroom” words!:  Safe, Safely, Safer,
Safest, Green, Non-Toxic, Harmless... are wonderfully simple yet descriptive
words that clearly impart in plain English a meaning that the general
population can understand, however, when it comes to adjectives used to
describe EPA registered disinfectants they are banned, they are taboo, they are
to be avoided at all costs and if used....there can be hefty
repercussions. 

6. ATTENTION PLEASE!! ATP CANNOT be used to compare different disinfectant chemistries!:  If
you're looking to change cleaning and disinfecting products and are looking at
the use of ATP to determine which product works better I hope you'll think
twice!  ATP CANNOT AND SHOULD NOT 
be used to compare cleaning or disinfection effectiveness between difference
chemistries. 

5. ESKAPE Stops Here!: 
When it comes to disinfection, antibiotic resistant bacteria should be
no more of a challenge to kill with hospital grade disinfectant than the
non-resistant strains. Ultimately, ESKAPE pathogens can have a major impact on
the treatment options available to healthcare professionals, but in the world
of cleaning and disinfection - it’s just another day at the office.

4. Viruses  - They cause more infections than you think!: 
Did you know that some of the most commonly transmitted viruses are not
killed by the disinfectant you may be using on a day to day basis?  Is your infection control program prevention
or intervention based?  Infection
PREVENTION measures such as changing of disinfectant solutions or increased
cleaning and disinfection during winter months can certainly be implemented
with relative ease and will contribute to fewer infections.  The alternative of course is having to
implement INTERVENTION measures to help combat a viral outbreak! 

3. iPads, iPhones and Blackberries….oh My!:   Electronic devices such as smart phones,
tablets and portable computers have become increasingly important tools for the
delivery of healthcare services   and certainly pose a very serious risk
of becoming contaminated and acting as a source for the transmission of
microorganisms.  How then do we develop
and infection prevention program for 
devices that were not developed with healthcare use in mind?

2. The Ugly Truth – 24/7, 365 = the optimal time for bacterial growth:  The ugly truth is
despite our best efforts hospital associated infections (HAIs) continue to
occur. A research team showed that within 6.5 hrs after cleaning/disinfecting,
the bacterial burden found on bedrails had rebounded back by 30% – 40%!    Housekeeping budgets are largely comprised
of man hours, cutting back on housekeeping are perhaps not the best way to save
a facility money.  Is anyone brave enough
to go ask for more money in order to hire more cleaning staff and increase the
frequency of cleaning?

1. Cotton – it absorbs more than just water: Did you know
Quats and cotton do not mix?  Perhaps
your current VRE or MRSA outbreak is not due to poor cleaning, but due to the
fact that while the name of the product may contain the word "Disinfectant"
the cleaning process you are using may counteract and inhibit the ability for
disinfection to actually occur. 

We hope you agree with our Top 10 picks (and if you
haven't read them, we hope you'll take the time to read them now!)   Thank you from both Lee and I for your
continued support of the Talk Clean To Me blog! 
We hope 2014 is full of health and happiness for all!

Bugging Off!

Nicole

 

 

 

 

 

 

 

 

 

 
Read More
Holiday Madness & Celebrating Microbes!
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Environmental Contamination - is the cloth more concerning than the patient?
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Cotton - it absorbs more than just water!
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RSV - Is it more common that the cold?
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#FF - Micro Blog's Viral Misfortunes
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The Burden of You and the Flu
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Viruses - they cause more infections than you think!

I'm not one for themes - well unless it comes to planning
birthday parties: CARS, Angry Birds or surprise parties for "big"
milestones.  In writing our weekly blogs,
Lee and I have tried to weave a story about the use of disinfectants for
infection prevention.  However
unintentional, this month, as I plan out topics for the blog, I'm seeing a
theme develop - viruses. 

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CLEANING, HAND HYGIENE & VACCINATION a few of my favorite INTERVENTIONS for Flu Season!
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Infection Control Week - 7 days of focused prevention!
This week is International Infection Prevention Week
(IIPW) around the world. As many of you
will know from reading past blogs, Infection Prevention and Control programs
have been widely recognized as a corner stone to preventing and controlling the
spread of infections both within the community and within healthcare
facilities.  IIPW is a week to not only
promote infection prevention practices but celebrate with healthcare workers
for the work and efforts put forth the other 51 weeks of the year to stop the
spread of infection.
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Disinfectant Chemistry Report Card #17 - Silver and Copper as Antimicrobial Surface Agents
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A little Salmonella with your Chicken?
I'm almost getting too paranoid to travel. In August I blogged about the Cyclospora
outbreak that was affecting 16 states and linked back to lettuce used by
several restaurant chains including one that I had eaten at while on a trip to
Michigan and Massachusetts. I just got
back from San Fran on Sunday and wouldn't you know it, by Monday I was reading
about a Salmonella outbreak that is currently circulating around 17 states
across the US with California being the hardest hit.   I was under the weather for a few days while
on this trip. I did eat some chicken
while there, but can't say that food was the true cause.
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A New Claim on the Block?
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Porous versus Non-Porous: Who wins the trophy for most effective transmission?
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Cleaning and Disinfection Works!
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#FF - Follow Friday!
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It’s getting harder and harder to breathe!
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School Absenteeism Due to Illness - Fact or Fiction?
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