Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.

Our expertise is utilized by Infection Preventionists, Public Health Experts, First Responders, Dentists, Physicians, Nurses, Veterinarians, Aestheticians, Environmental Services professionals and janitorial product distributors to develop more sustainable cleaning and disinfection practices in North America.

Our commitment to providing chemical disinfectant education is more than business, it is a passion.

Wednesday, February 22, 2012

Finding Clarity on Clean Information…

A few years back, I became hooked on Trashopolis. It’s an incredible look at some of the world’s major cities and their relationship with trash. While an interesting part of the story is that some civilizations not only lived amidst but also in some cases, such as Mexico City and Mumbai, advanced with the help of trash, there are far more stories about how trash and a lack of cleanliness equated to certain death.

A History of Trash and Disease

Looking back over the ages, the spread of infection was almost entirely linked to unsanitary conditions but the longevity of these times was due primarily to a lack of clear and appropriate information. In Rome, the destruction of the aqueducts by the Goths in 537 AD led to the cessation of a clean water supply. It took almost a millennium before the onslaught of disease was curbed by Pope Nicholas V. The miasma theory of London suggested that highly impoverished areas where infection and death was common led to contamination of the air itself. Hundreds of years passed before experts such as Sir Francis Bacon, John Snow and Thomas Crapper found ways to improve water quality and sanitation, ending both the theory and the scourge. Even the city of New York wasn’t immune as it dealt with cholera outbreaks in 1832 and 1849, partly thought to be due to the spread of miasma from Europe. Two dozen years later, Stephen Smith realized that poor sanitary conditions were the real reason behind the outbreaks and strived to democratize sanitation for all.
Visionaries and experts have continually led the road to a better life for all and the same can be said for cleanliness. Thanks to these individuals and many others not listed here, the world became a safer place.

A Clean Case of Confusion

Unfortunately, misinformation can also work to increase fear and worry and in the Age of Information, we are surrounded by conflicting views all competing for your attention.
If you’re mindful of advertisements, we live in a ‘white glove’ society where even the slightest bit of dirt is anathema. Television commercials promote an immaculate sense of cleanliness. Radio and newsprint continue to spread the word that good health is directly related to the cleaning agent we buy and social media is replete with companies all vying to turn your dollar into better health.
If you listen to the news, infections are more common than ever and our lives are continually at risk. We hear of outbreaks in hospitals, on cruise ships and even at the Super Bowl. Not a single week goes by without an infectious outbreak making the headlines. No matter how clean we may think we need to be, we continue to be losing ground against pathogens.
If you follow environmentalists and ecologists, we’ve become overzealous in our cleanliness. These people refer to the hygiene hypothesis, which states that we are suffering with increases in allergies and abnormal immune responses due to over-cleaning. Proponents here suggest that we need to cut back on our cleaning behaviour and start to live more naturally.
Without a doubt, between the advertisements, the headlines and the special interests, the only real outcome anyone can have regarding being clean is confusion.

A Case Study: The 99.9% Kill

In 2010, I was asked to write a piece on what 99.9% kill really means in terms of being clean. The need came as a result of an internet meme partly popularized by pop superstar Justin Bieber. The quote refers to a well-known disinfectant that “…kills 99.9% of germs.” But it was the next statement that really gained popularity. “That 0.1% germ is a Legend.” Twitter ran amuck with people quite badly interpreting the claim and forecasting a horrible future in which that 0.1% would somehow find a way to kill us all.
The article explained that 99.9% is a statistical value based on the results of standardized disinfection test procedures that quantify the efficacy of microbial kill or inactivation. In these tests an extremely high level of challenge is used, much higher than what would be expected in the real world, such that efficacy can be calculated based on the number of survivors. The level of survival is then calculated to a reduction in logarithmic magnitudes. A 3 “log” reduction in counts would equate to 99.9% kill. Thus, unless a surface had more than 1000 microbes, nothing would be expected to survive.
While the explanation was scientific, the gist of the message was to prevent panic about a non-existent legend. Moreover, people should understand that disinfectants are well tested and that by following the instructions on the label, they will adhere to good hygiene practice and have no problem staying clean.
After the article came out, I was asked a rather simple question, “Where can I learn more about this stuff?” The answer to the question was simple – I’ve done the testing and know the calculations; ask me! But that wasn’t the real spirit of the question. So, I decided to try an experiment. I would act as if I knew nothing and then go searching for anything that could give me the right answers.
What I learned was that the idea of looking for the real reason behind 99.9% kill was akin to finding a needle in a haystack. Despite a Google search leading to some 1.5 billion pages, I could not find a direct and trusted answer.
It got me thinking that even in this information age; we are no better off than the miasma forewarnings of the past. The internet is rife with ideas, suggestions and opinions but there are few places that I would trust. I could only imagine the frustrations that someone truly wanting to find answers would face.

Back to the Future

Reflecting on the successes of history, there is one common denominator that is missing in our modern society when it comes to being clean: a trusted expert. I am happy to say that there are several such experts who are just waiting to share their knowledge with the world. Most of them are members of excellent organizations that are committed to improving cleanliness and hygiene worldwide and information at these sites is both clear and trusted. They include the International Scientific Forum on Home Hygiene, the Water Supply, Sanitation and Hygiene Development group at the World Health Organization and the American Cleaning Institute.
Of course, there is also the Talk Clean to Me blog.
No matter where you look, the key is to find cleaning and hygiene experts who are willing to share their knowledge, dispel myths and more importantly, bring peace of mind so that you can live confidently clean.

Get In the Conversation

There is one more lesson from history that we can all learn and that is talking clean is a two way street. Without your questions, your curiosities and concerns, these experts will have no idea how to help. So here’s a challenge: think of something that perplexes you when it comes to hygiene or at being clean and share it below in the comments section. Don’t worry about jargon or language; your view is the reason this blog exists. Then, when an answer arrives, share it with your friends and bring them to the blog and ask them to do the same. Help to start the conversation and increase the knowledge sharing.
Eventually, as I’ve learned, the myths of the historical and recent past will be busted and you will find a way to live not only in a clean world, but also with a clean mind.

Jason “Germ Guy” Tetro has been involved in the scientific research community for nearly 25 years. He has worked on diagnostic technologies and has expertise in the food, water, air and bloodborne fields. He is currently Coordinator for the Emerging Pathogen Research Centre (EPRC) and the Centre for Research on Environmental Microbiology (CREM) both housed at the University of Ottawa. Jason is also known in public as the “Germ Guy” and has touched over 10 million viewers internationally on television, in print and through social media. The “Germ Guy” strives to increase awareness of hygiene and improve health worldwide. His blog can be found at http://germguy.wordpress.com/

Thursday, February 16, 2012

Miss Manners’ proper etiquette for filling bottles

How many times over the course of your life have you been asked “May I top up your coffee? Would you like more water? Can I get you another refill of pop?” I bet nine times out of ten you respond “YES PLEASE!” Has it ever occurred to you that by mixing new or fresh with old we could be creating an inferior product?

Take coffee as an example. Restaurants are notorious for providing mugs that are too small. I mean who wants a cup of coffee that is gone in five sips – certainly not I! I’m a StarBucks Venti kinda gal…give me enough to last and I’m happy to drink the bottom quarter cold. But at a restaurant when the waitress asks “can I top your coffee off” I almost always say yes and that simple, seemingly innocent agreement creates an inferior product. I have just knowingly agreed to add hot coffee to my now luke warm cup screwed up the optimal drinking temperature and completely thrown off my cream to coffee ratio!

If we are predisposed to ruin a perfectly good cup of coffee, is it any wonder that housekeeping staff can without thought top off their bottle of disinfectant? Housekeeping staff are trained to be prepared. We instruct them to make sure they have all of the products they are going to need on their carts and as a result many housekeeping staff prefer to see their bottles full and not half empty….so they “top up” their bottles during the day and at the end of each shift. The end result is a bottle that does not have the right concentration of disinfectant because new product has been mixed with old. I’ve affectionately dubbed this efficient group the Top-Off Artists.

A complete training program for housekeeping staff MUST include a discussion as to the proper etiquette for filling disinfectant bottles. It’s not sufficient enough to say “Don’t top up”, we need to arm our staff with the reasons behind why we should NEVER top up. If they understand the consequences of topping up and the potential that they can unknowingly contribute to hospital acquired infections they may think twice before topping up.

Now perhaps I’ll take my own advice and just say NO! the next time I’m asked if I would like my coffee topped up.

Bugging Off!


Friday, February 10, 2012

The Unintentional Consequences of Improving Infection Prevention

Would you select a single cleaning product to use on all surfaces in your home? One product to clean your stainless steel fridge, hardwood dining table, glass coffee table and leather sofa? If I were to hazard a guess, I would assume you’ve all responded with a resounding, “NO!!”. Am I right?

It seems obvious, why would we ever consider something so impractical as to expect a single chemical to be compatible with those various surfaces. So why is it that we have this expectation when disinfectants are used in commercial settings such as healthcare? The sad state of affairs is that disinfectants are expected to be 100% compatible with all surface materials and devices that they may be applied to. In reality, that is a chemical impossibility. Particularly so, when you factor in that disinfectants need to be formulated to kill the various classes of microorganisms in rapid and realistic contact times. No disinfectant is ever going to be compatible with every surface material we encounter in the vast world of healthcare.

So what then of compatibility issues that may crop up from the use of disinfectants? Well as the title implies, these are often the unintentional consequences of improving infection prevention. With the increasing prevalence of antibiotic resistant pathogens and more virulent strains of various microorganisms, the focus has shifted from being reactive in nature to that of a proactive, preventative position. With this comes the use of potentially more aggressive disinfectant chemistries to address these troublesome pests on an ongoing basis. As identified by the CDC and Ontario’s Provincial Infectious Disease Advisory Committee (PIDAC), disinfectants should ideally be effective against a broad spectrum of microorganisms, elicit this effect in a rapid and realistic contact time, remain safe to use (non-toxic and non-irritating) and carry wide material compatibility. The disinfectants that perform equally well across all criteria will prevail. However, compatibility issues are likely to still be encountered despite following PIDAC and CDC’s recommendations for the reasons listed earlier. What then?

Speaking from experience, it is often more than a case of “Solution A” being incompatible with “Surface B”. In the vast majority of situations, it is the process with which that disinfectant is used on that surface that determines if any ill effects are encountered. It is this process, or the art of cleaning and disinfecting as one might call it, that may need to be modified to mitigate the issue.

In those rare cases where the disinfectant solution is in fact incompatible with the surface material, alternatives to both(surface or disinfectant) should be investigated. The alternative selected should be based upon which choice reduces the level of compromise needed. Will a different surface or device serve the same purpose without the disinfectant needing to be changed? Or, if the disinfectant needs to change, can the alternative fulfill the same performance and safety profiles? Or, is it a case where the alternatives require too great a compromise and the “incompatibility” becomes a cost of doing business in today’s world?

If you were faced with such a situation, how would you address it?

The Germinator

Thursday, February 2, 2012

I golf; therefore I am a golfer….

I’m a self-taught golfer. I thought I was pretty decent, I can drive well if I ignore the fact that I slice to the right and rarely land on the fairway, I can putt and bunkers don’t faze me in the least, but my short game is crap. As I primarily play with men and being “slightly” competitive, I got to the point I wanted to improve so started taking lessons. I now have a new grip, a new swing and I SUCK!!! Why? I had bad habits. If I want to be truthful, I was doing it all wrong, but because I could hit the ball off the tee and putt into the cup I thought I knew how to golf. The same goes for everyone we hire into our Environmental Services programs. It’s virtually impossible to hire someone who has no experience cleaning. Everyone at some point in their life has likely done dishes, tidied their bedroom or cleaned a bathroom and all done without any formal education on how to properly use the cleaning chemicals our mom’s had handed us.

As we concluded in the “Top 10” blog, the number one abuse or misuse of disinfectants in 2011was lack of training. We CANNOT expect our staff to know how to correctly use the products and tools to do their jobs unless we TEACH them how to use them. Certainly in some aspects of our life, such as learning to walk or talk or in my case learning to swim (my mother quite literally “threw” me in the pool as was the rage for teaching babies when I was 4 months old), the concept of THE SINK OR SWIM SQUAD can be an effective learning process. For driving, practicing medicine, ensuring public safety through public health and I dare say for using cleaning and disinfecting chemicals a formal, comprehensive and reproducible education system needs to be in place. Isn’t that the concept behind Young Drivers of Canada or the myriad of Medical or Public Health Schools around the world? Why then is there not a Healthcare Environmental Services School?

If we teach everyone the where’s, what’s, why’s and how’s to using disinfectants and cleaning chemicals we won’t have any stories of how we have seen them used and abused. The goal of any Environmental Services Department within a healthcare facility should be to prevent the spread of infectious agents among patients and healthcare workers by meticulous cleaning and disinfection of environmental surfaces and patient care equipment. To reach this goal the EVS department will need to have a comprehensive training program, the objective of which should be to provide EVS staff with the information they need to do their jobs safely. The training program should be a part of the big picture - “how to protect yourself”. At a minimum the training program should include a formal written plan for each of the following topics:

1. Identification of Occupational Risks and Hazards associated with handling infectious waste

2. Sharps Safety

3. Blood Borne Pathogens

4. Infection Control Training (Microbiology and Transmission)

5. Hand Hygiene

6. Personal Protective Equipment (PPE) including donning & doffing

7. MSDS and Hazards associated with using chemicals (cleaning agents, disinfectants etc)

8. Product Usage Training including proper cleaning and disinfection techniques

It’s likely that now you, the person responsible for developing the program, is overwhelmed at the thought of the amount of work that needs to be done! Don’t panic. A quick Google search of “Sharps Safety Training for North America” found 76,600,000 hits. Rest assured there is a plethora of information out there so you do not need to reinvent the wheel. Remember to delegate! Talk to your Infection Preventionist and ask for their help in writing the Infection Control and Hand Hygiene segments (there’s section 4 & 5 completed). Talk to Purchasing to find out what company you are purchasing needles or other sharps from and find out who the sales rep is. I can guarantee that a company who sells sharps will have a training program developed (that’s section 2 out of the way). Now call up your chemical sales rep, any reputable company who sells product for cleaning and disinfection should have training material for handling, cleaning and disinfection of blood borne pathogens and who better than to come in and do the product usage training (section 3 and 8 are now complete!). Use your Occupational Health and Safety rep to help create the Occupational Risks and Hazards, MSDS and Personal Protective Equipment training (that takes care of section 1, 6, and 7). With a few telephone calls and a little collaboration the program is done.

My ultimate dream would be to see the development of an Environmental Services Certification Course that becomes the industry standard and prerequisite for anyone who is hired to clean in healthcare facilities. While I do not expect this to happen this year, I certainly hope your top priority for 2012 is to educate your staff on how to correctly use cleaning and disinfectant products.

Bugging Off!