At Elan, we specialise in renting floor cleaning equipment. Therefore, you won’t be surprised that we recommend paying extra attention to the cleanliness of floors. But what is shocking is how businesses routinely neglect their floors when it comes to deep cleaning, especially in light of the current pandemic.
The Western attitude to floor hygiene is, frankly, odd. Across much of the world, it’s customary to remove shoes when entering a shared space. We, however, learn as children that it’s OK to wander in from the street in our shoes, with only the stiff bristles of the welcome mat to prevent us treading muck throughout the premises.
Although there are exceptions — for example, those drawstring bootees that cleanroom businesses issue to their workers — most workplaces inherit this neglectful attitude. We see plenty of kitchens where the worktops are disinfected daily while the floors get just a weekly scrub. We wouldn’t want any catering staff reading this blog to abandon their existing cleaning regimes completely, but we’d certainly encourage a rethink.
We take cues from the medical profession, so, as an example, it was initially disappointing to find that the guideline issued by the U.S. Centers for Disease Control and Prevention (CDC) kicks off its section on surface cleaning with the assertion that “extraordinary cleaning and decontamination of floors in healthcare settings is unwarranted.” However, detailed reading suggests that a major shift in attitude is under way.
The CDC guidelines were originally issued in 2003, and they’ve been revised many times over the intervening decades. Added sections reference pretty much every floor hygiene regime you can imagine as being worthy of consideration, and end up recommending “methods that produce minimal mists and aerosols or dispersion of dust in patient-care areas.”
Those additions echo changes taking place elsewhere in the medical profession. The years since the millennium have seen a deluge of influential studies on dirty floors, cleaning and footwear policies, including those of Gupta et al. (2007), Ali et al. (2014), Koganti, et. al. (2016), Rashid et al. (2016), Galvin, et al. (2016), Mahida and Boswell (2016), and Deshpande et al. (2017).
Deshpande’s paper in particular presents an account of widespread floor contamination that would give any charge nurse sleepless nights, recounting routine discoveries of “methicillin-resistant staphylococcus aureus (MRSA), VRE, and clostridium difficile… of 100 occupied rooms surveyed, 41 per cent had one or more high-touch objects in contact with the floor. These included personal items, medical devices, and supplies.” Yuk!
Businesses have been a little slow to learn the corresponding lessons, but COVID-19 seems likely to shift attitudes. The details of the virus’ modes of transmission remain disputed, but medics concur that it can remain outside the body in an active state — and that the ‘aerosol droplets’ spread by infected persons are just as likely to persist on floor tiles as on surfaces. An influential study by Kampf et al. (2020) crunched 22 other papers to arrive at the conclusion that coronavirus can persist on inanimate surfaces like metal, glass or plastic for up to nine days … but can be ‘efficiently inactivated’ by thorough disinfection procedures.
Should we expect a government mandate for businesses to clean their floors and walls as well as their worksurfaces? In 2019, we might not have believed that we’d be asked to wear facemasks in public places. 2020 might be a good time to get that new floor cleaning regime started…
Further reading:
CDC ‘Guidelines for Environmental Infection Control in Health-Care Facilities’, https://www.cdc.gov/infectioncontrol/pdf/guidelines/environmental-guidelines-P.pdf
Gupta et al, ‘Impact of Protective Footwear on Floor and Air Contamination of Intensive Care Units’, Medical Journal Armed Forces India. Vol. 63, No. 4. Pages 334-336. October 2007.
Ali et al, ‘To determine the effect of wearing shoe covers by medical staff and visitors on infection rates, mortality and length of stay in intensive care unit’, https://pubmed.ncbi.nlm.nih.gov/24772125/
Koganti et. al, ‘Evaluation of hospital floors as a potential source of pathogen dissemination using a nonpathogenic virus as a surrogate marker’, Infect Cont & Hosp Epidemiol, 2016: 37 (11): 1374-1377
Rashid et al, ‘Shoe soles as a potential vector for pathogen transmission: a systematic review’, J Appl Microbiol. Nov;121(5):1223-1231. 2016.
Galvin et al., ‘Patient shoe covers: Transferring bacteria from the floor onto surgical bedsheets’, Am J Infect Control, 2016; 44: 1417-1419.
Mahida and Boswell, ‘Non-slip socks: A potential reservoir for transmitting multidrug resistant organisms in hospitals’, J of Hosp Infect, 2016; 94: 273-295.
Deshpande A et al, ‘Are hospital floors an underappreciated reservoir for transmission of healthcare-associated pathogens?’, Am J Infect Cont, 2017; 45: 336-338.
- Kampf et al, ‘Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents’, https://www.journalofhospitalinfection.com/article/S0195-6701(20)30046-3/fulltext