If you’ve been in the cleaning business for any length of time, you are probably familiar with the terms “cleaning for appearance” and “cleaning for health.” In recent years, cleaning for health has been a way for building services contractors to differentiate themselves from their competitors and to proactively respond to societal concern about environmental safety and human health. This article will attempt to clear up some of the confusion surrounding this popular term and to anticipate the way that this movement is evolving.
Getting Our Definitions Straight
Cleaning for health can mean different things to different people. For some, cleaning for health is entirely synonymous with green cleaning. Its goal is to protect the environment, janitorial workers, and building occupants from the effects of harsh cleaning chemicals by using green, non-toxic alternatives that promote environmental sustainability and indoor air quality. For others, cleaning for health may incorporate some of the above, but is centered on a more mainstream medical model of cleaning. Cleaning for health from this standpoint hinges on disinfecting properly in order to stop the chain of infection.
The first, more mainstream, definition of cleaning for health is a much easier sell, primarily because this approach is fairly cost-effective. For example, green cleaning agents with low or no VOCs (volatile organic compounds) are much cheaper and more effective than they were 10 years ago, as are many cleaning tools, such as backpack vacuums with HEPA filters, that can help reduce the amount of dust in the air.
Some companies claim to take cleaning for health in commercial facilities one step further until it resembles something akin to what one would find in a hospital. Though this is a nice idea, cleaning an office the way one would a medical facility is nearly impossible to do at a profit.
The cleaning process in a hospital isolation unit is one of the most rigorous examples of this kind of cleaning for health. Every inch of these rooms (yes, even the ceiling) is cleaned and disinfected every time a patient is discharged. While they are in these rooms, cleaning staff wear face masks and other protective gear that they immediately dispose of on their way out in order to minimize the possibility of transferring any virus or bacteria to other parts of the hospital.
Though cleaning for health does not always involve such extreme measures, there are certainly many commonalities between cleaning an isolation unit and cleaning for health in a commercial building, especially if your goal is to most effectively stop the spread of pathogens. In a word, disinfection is the name of the game. And by this I mean proper disinfection: using a hospital-grade disinfectant and using enough of it to ensure that it stays wet on the surface for the full dwell time.
So Where’s The Rub?
So far, all of this sounds good. In our germophobic culture, there are probably very few customers who would turn down the opportunity to have their facility disinfected. “Clean and disinfect my office? Why sure, go right ahead!”
Unfortunately, this scenario is not quite so simple if it involves proper disinfection. Why? For one, in a commercial facility it can be difficult to have surfaces stay wet enough for long enough (usually around ten minutes) to achieve a full-kill claim. If you switch your product out with a stronger and faster-acting disinfectant, you will encounter another set of problems, namely that your product is so harsh that it is corroding your surfaces. Hospitals tend to be full of non-porous, and frankly, boring materials like plastic and stainless steel. A lot of the more aesthetically-pleasing materials found in commercial facilities, like wood and vinyl, can’t handle being treated with these harsh chemicals.
But these aren’t the biggest obstacles facing this level of cleaning for health in commercial facilities. One of the main problems is that if you want to properly disinfect a surface, you need to take at least two and possibly three passes at it because, let’s face it: medical cleaning is not pretty. Disinfectants are prone to streaking. If you want to make the surface look nice, you have to come back after it is dry and wipe it down again with a general cleaner.
Your customers may like the idea of cleaning for health until they realize that it will take twice as much time—and therefore, twice as much money as cleaning for appearance. If you are a hospital, a medical clinic, or a dialysis center, this extra cost of medical cleaning may just be part of the cost of doing business legally and ethically. However, in a Class A office building, the necessity of this level of medical cleaning is certainly a harder sell.
What Do Customers Really Want Now and What Will They Want in the Future?
In my 20 years of experience, I can say that, time and time again, what customers really want in commercial facilities is consistent and high quality service delivery. But even more than that, what ultimately controls their decision when it comes to selecting janitorial services is affordability. This means that most commercial customers simply don’t want to pay for cleaning for health if it includes proper disinfection. Cleaning for appearance is a necessity, cleaning for health in a green sense may also be important, but cleaning for health to stop infection is still by-in-large a luxury simply because it is so cost prohibitive.
What makes this whole discussion so interesting is that I believe we are entering a time in which medical cleaning may become increasingly necessary outside of medical facilities because of the general pervasiveness of serious pathogens that we are unable to treat with our standard arsenal of medicines.
In a press briefing earlier this year, the director for the U.S. Center for Disease Control and Prevention, Dr. Tom Frieden, warned of dangerous new superbugs known as carbapenem-resistant enterobacteriaceae, or CRE, that have already been reported in 42 states:
“CRE are nightmare bacteria. They pose a triple threat. First, they're resistant to all or nearly all antibiotics. Even some of our last-resort drugs. Second, they have high mortality rates. They kill up to half of people who get serious infections with them. And third, they can spread their [antibiotic] resistance to other bacteria such as E. coli. . . [which] is the most common cause of urinary tract infections in healthy people. So we only have a limited window of opportunity to stop this infection from spreading to the community and spreading to more organisms.”
Dr. Frieden followed up with several practical measures that the healthcare community could take to help stop the spread of CRE. However, as Maryn McKenna, author of Superbug, points out, “None of [these measures are] required, and none of this is funded”. There is currently no way of providing hospitals with the resources to carry out these preventative measures or regulatory checks to enforce their adoption. This is something that doctor and blogger Eli Perencevich, who specializes in infectious disease and epidemiology, calls “a national tragedy.”
Is it entirely far-fetched and fear-mongering of me to suggest that in the not so distant future, our entire society, not just hospitals, may be engaged in preventing the spread of superbugs, such as CRE? Perhaps. As Calvin Coolidge once said, “If you see ten troubles coming down the road, you can be sure that nine will run into the ditch before they reach you.” However, if this risk is not effectively kept at bay, which I think is not entirely unlikely, we may soon be inhabiting a world where cleaning for health, in the true medical sense of the term, may in fact be widely appealing to customers, despite the extra expense.