Cleaning and disinfection have long been routine in any facility. Of course, the COVID-19 pandemic has further highlighted these operations since SARS-CoV-2 can persist on various surface materials for hours or days. Facilities have sought to improve these cleaning and disinfection practices. Therefore, it is imperative that this process be orderly. Therefore, this article addresses the importance of cleaning before disinfecting. Cleaning and disinfection should be a 2-step process to reduce the risk of transmission of environmental infections.
Clean first! Why?
Primum nitidare – “D’abord nettoyer (Clean First)”. It is a book that my coworker, Gaétan Lanthier, wrote in 2019. It is to say that this is not a new subject!
Centers for Disease Control and Prevention (CDC) cites: “cleaning is “the necessary first step of any sterilization or disinfection process” or, more
simply, you must clean first before you can disinfect.”
The CDC adds: “Cleaning is the necessary first step of any sterilization or disinfection process. Cleaning is a form of decontamination that renders
the environmental surface safe to handle or use by removing organic matters, salts, and visible soils, all of which interfere with microbial inactivation.”
It’s in the mechanical action (friction)
As the CDC mentions it: “The physical action of scrubbing with detergents and surfactants and rinsing with water removes large numbers of
microorganisms from surfaces.”
Studies have shown that friction or mechanical action is at the heart of cleaning. This facilitates the effective removal of dirt, debris, microbes and soiling, making a surface ready for disinfection if necessary.
It’s a matter of interference
The CDC defines cleaning as the “necessary first step” in any disinfection process for “at least two” important reasons: it removes any barrier between the disinfectant and the target pathogen, and it removes materials that could potentially inactivate the disinfectant.
In order to effectively kill pathogens, disinfectant chemicals must have direct contact with the pathogen; however, soils, dirt, and debris can coat or
protect microorganisms, essentially serving as a protective barrier between the chemical and the target.
The build-up to biofiolms
Another important reason to clean first before disinfecting has less to do with the immediate action of a disinfectant on a surface. Rather, it is in prevention of a future problem, namely the buildup to biofilms.
Biofilms are populations of microorganisms attached to a solid surface and protected by a “viscous layer”. This layer is an extracellular matrix of polysaccharides and non-cellular materials.
Biofilms can virtually form on any hard surface, from the countertop to the water pipe. They are involved in a range of infectious diseases.
What about touch-free technology?
Although research has shown that many of these systems, from ultraviolet light (UV-C) to hydrogen peroxide vapor (HPV) to electrostatic sprayers, can reduce microbial contamination, experts caution that they should be used as a complement to standard manual cleaning and disinfection rather than as a replacement.
Organic matters, dirt and grimes are a limiting factor for UV-C technology.
A light or heavy organic load has a significant negative impact on the destructive efficiency of the devices.
In short, clean first with mechanical action (friction) to remove dirt, debris and microbes. The disinfection step is to be done when the interferences are removed by cleaning in order to kill microbes. This reduces the risk of transmission of environmental infections by keeping surfaces clean.
Loose translation of Rubbermaid TWO STEPS FOR A REASON:
THE CASE FOR CLEANING PRIOR TO DISINFECTION