Issuu

SERVING THE FACILIT Y CLE ANING & MAINTENANCE INDUSTRY

DECEMBER 2016

� PPE BEST PRACTICES � CLEANING WITH COLOURS � OCCUPATIONAL SKIN DISEASE

REAL DEAL

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� CONTENTS DECEMBER 2016

PHOTOS BY LING WANG

SPOTLIGHT 14 Rise of the Robots Hospital automated guided carts increase efficiency, reduce operating costs by Garry A. Koff 16 Breaking the Chain of Infection Best practices for cleaning, disinfecting environmental surfaces to control HAIs by Nicole Kenny

INFECTION PREVENTION 18 Public Enemy Combatting communityacquired infections by Lori Strazdas

COVER STORY 10 A Shining Standard CFS’s John Tsertos aspires to achieve long-lasting success on road less travelled by Clare Tattersall

IN EVERY ISSUE 8

Editor’s Letter A Change of Seasons

20 Expert Q+A Does Colour Matter?

HEALTH & SAFETY 22 Gear Up for Safety The importance of PPE for cleaning, environmental personnel by David L. Smith 26 Skin Matters How to keep the body’s largest organ healthy by Armand Coppotelli 28 Weathering Winter Snow, ice management plan helps relieve season’s woes by Phill Sexton

30 Clean Matters Let it Snow

It is estimated that more than 200,000 Canadians acquire a healthcareassociated infection each year and that 8,000 of them die as a result.

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December 2016

Facility fights bedbugs with creative invention

Addressing Legionella risk in buildings

Bedbugs are becoming a huge concern in North America, spreading throughout hotels, stores, offices, apartment buildings, on transit (buses and subways) and even in healthcare facilities. Bedbugs are not particularly fussy about where they reside.

Common building systems, such as cooling towers, hot water tanks, faucet aerators, shower heads, hot tubs and decorative fountains, all produce fine water droplets that can harbour Legionella bacteria growth.

Improving hand hygiene in healthcare facilities Anyone who sets foot in a health facility hopes to leave healthier than, or as healthy as, when one came in. The problem is that health facilities are under constant threat of healthcare-associated infections (HCAIs), described by the World Health Organization (WHO) as one of the most frequent harmful situations during care delivery.

All the Buzz

From the Green Bin

Expert Advice

Social Media

Advances in fire alarm technology

U of Calgary’s green cleaning program awarded CIMS-GB certification from ISSA

Tips for reducing radon in the workplace

Connect with us on

Tyco’s Peter Redfern shares the benefits of addressable notification systems

For their dedication to highquality environmental health standards.

The winter season brings increased levels of radon in the workplace and is a prime time to address any issues.

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/ editor’s letter /

A CHANGE OF SEASONS Four months ago, in the heat of summer, the Farmers’ Almanac released its winter weather report in which it predicted exceptionally cold if not downright frigid temperatures and snow for much of the country. Environment Canada’s winter outlook was not as bleak, forecasting a soft start to the season. However, after hearing my former stomping ground, Vancouver, has already suffered a twoweek cold snap and several dumps of snow, and my hometown of Toronto is currently in a deep freeze (at time of writing) after digging out from its third snowstorm in one week, it looks like North America’s oldest continuously published periodical is on point. Now that Old Man Winter is back — last year the season seemed to be on vacation — it’s important to have a snow and ice management strategy in place. We explore what this plan entails and why every facility manager should have one in Weathering Winter, beginning on pg. 28. Canada isn’t the only country in for a rough ride this winter. South of the border, northern and middle America is due for an oldfashioned deep freeze, according to the Farmers’ Almanac, which is also predicting shots of very cold weather will periodically reach the southern U.S. As of mid-December it already had. Houston, the hometown of Cleaning Facility Services’ (CFS) operating manager, John Tsertos, was swept by an arctic cold front Dec. 18, causing temperatures to drastically drop from 23 C to -3 C in less than 12 hours. Though born and raised in Toronto, Tsertos has become accustomed to the mild and temperate winter climate of the Texas metropolis, where he has resided for almost 30 years and from which he currently oversees CFS. We delve into what brought Tsertos to the Mississauga-based cleaning company and how he is able to effectively and profitably manage it from afar in this issue’s cover story. We then turn to our sector spotlight: Healthcare facilities. Here, we look at the use of robotic technologies in cleaning functions and best practices for cleaning and disinfecting environmental surfaces to control healthcare-associated infections. Rounding out this issue is our industry focuses, infection prevention and health and safety. Topics include communityacquired infections, colour-coded cleaning, personal protective equipment and occupational skin disease. As we close the door on 2016, I’d like to thank you for your feedback and support of the publication. If you would like to see a topic covered in a future issue, or you are interested in participating in our Expert Q+A, please e-mail me.

Editor Clare Tattersall claret@mediaedge.ca Digital Editor Rebecca Melnyk rebeccam@mediaedge.ca Publisher Tristan Cater tristanc@mediaedge.ca Senior Designer Designer

Annette Carlucci Jennifer Carter

Production Manager Rachel Selbie rachels@mediaedge.ca Contributing Writers Armand Coppotelli

Nicole Kenny Garry A. Koff Phill Sexton David L. Smith Lori Strazdas Circulation Maria Siassina circulation@mediaedge.ca

Facility Cleaning & Maintenance is published six times a year by:

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Copyright 2016 Canada Post Canadian Publications Mail Sales Product Agreement No. 40063056 ISSN 1712-140X Circulation ext. 234 Subscription Rates: Canada: 1 year, $50*, 2 years, $80*, US $75 International $100, Single Copy Sales: Canada: $12* * Plus applicable taxes Requests for permission to reprint any portion of this magazine should be sent to Melissa Valentini

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CLARE TATTERSALL claret@mediaedge.ca

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/ cover story /

A SHINING STANDARD

CFS’s John Tsertos aspires to achieve long-lasting success on road less travelled

by Clare Tattersall

or much too long, the contract cleaning industry has been largely ignored despite the fact that there are more than 27,000 companies operating in this sector Canada-wide. While it’s easy to understand why most people don’t give building cleaning much thought — in many cases, it’s performed out-of-sight at night — failure to recognize its value has proven a disservice to the industry and its workforce. “As long as the industry remains in the shadows, there are companies that will continue to cut corners to stay afloat in a highly competitive market that faces downward pressure from clients to keep bids low,” says John Tsertos, operating manager of CFS Corp., a commercial contract cleaning company that serves the Greater Toronto Area. “This typically involves skimping on services and unsavoury employment practices.” Subcontracting labour to immigrant workers (often via a shell company, where the owner is legal but its labourers are not) is rampant in the cleaning industry, says Tsertos, as they’re willing

10 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

to work under the table for a low wage. Unfortunately, in doing so, they sacrifice their rights in the workplace and are often mistreated. But so long as this practice protects the profits of unscrupulous building service contractors — labour is the biggest percentage of a business’ costs — and their clients are willing to turn a blind eye to get what they want at the cheapest possible price, it will continue, he says. “The cleaning business has become a dirty business,” says Tsertos, frankly. “It’s frustrating because there are legitimate companies that run the risk of losing business by asking higher prices, even though these prices accurately reflect the services rendered.” CFS, an acronym for Cleaning Facility Services, is one such company. Headquartered in Mississauga, Ont., the janitorial service provider was established in 1996, by Tsertos’s late brother George. Like most entrepreneurs, George started the business solo and then grew its workforce as he garnered more contracts. By 2009, the year of

/ cover story /

“As long as the industry remains in the shadows, there are companies that will continue to cut corners to stay afloat in a highly competitive market that faces downward pressure from clients to keep bids low.”

his untimely passing, George’s ‘mom-andpop’ shop had almost tripled in size and was on the verge of exploding. “It’s a sad story,” says Tsertos, who got involved in the company at his parents’ request to keep his brother’s legacy alive. Thankfully, he was able to keep CFS’s momentum going but the ride hasn’t been without its bumps. Some of the most formidable challenges the restructured company has faced presented themselves early on. Though born and raised in Toronto, Tsertos lived in Houston, where he had put down familial roots and operated a successful real estate development company. It was from here that he would manage CFS — more than 2,400 kilometres from the company’s head office and clients, which span multiple sectors and include office, retail, educational, healthcare and multi-residential properties. On top of this, Tsertos had limited knowledge of the cleaning industry at the time, beyond being a consumer of the product. “My real estate development company has janitorial contracts in place at multiple properties so I knew the business from the client’s perspective,” he explains. An astute professional, Tsertos quickly got up to speed on the service side of the sector and ensured the right people were in place at the company’s home base so that he could effectively manage two companies at the same time. Of course, Tsertos still likes to be hands on and travels frequently to Toronto, though the number of trips has diminished in recent years to approximately once per month thanks to its proprietary software, CFSLogix. “I can do a lot of things remotely now because of the systems we’ve put in place,” he explains. Shortly after taking over CFS’s reins, Tsertos searched for commercial cleaning software to help him profitably manage the

company from afar. After coming up empty-handed, he decided to go the custom design route, resulting in CFSLogix. The innovative cloud-based management system is comprised of seven modules that work together to increase efficiency and ensure excellence for the company’s clients. They include production scheduling, quality control, personnel management, financial management, inventory management, program evaluation, and deficiency tracking and reporting. What’s more, the platform allows clients to track and monitor their portfolio 24-7, and provides access to the latest information on products, equipment, work processes, and codes and regulations. “The client portal is a crucial operational tool that assists with our own internal monitoring processes and allows complete transparency of contract service delivery, which is a valued part of a successful clientcontractor relationship,” says Tsertos. At first, however, CFSLogix was nothing more than a glorified time clock. Using biometric technology, the system allowed Tsertos to track employee movements in real-time, including attendance, working hours and time spent on specific tasks. Soon after its implementation, Tsertos happened upon some concerning anomalies. Of note, multiple workers were pretending to be someone they weren’t. On further investigation, he discovered several employees had the same social insurance number. Without hesitation, Tsertos moved away from utilizing subcontractors for janitorial services, opting to hire a bona fide cleaning staff instead — a decision influenced by a past experience that “shook him to the core.” “In the late ‘90s, one of my concrete guy’s labourers was electrocuted on a construction project of mine and it almost cost me my entire net worth,” Tsertos divulges. “While the incident was through

12 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

no fault of my company, my insurance provider almost bailed on me because although my concrete guy was legal, his people weren’t. From there on in, I decided I’d rather do it the right way and not have as much business instead of the wrong way and not be able to sleep at night.” Tsertos’s conscientious choice has been both a curse and a blessing. Switching from the subcontractor to employee model meant CFS had to pass its higher labour costs on to its clients to remain profitable. In instances where clients were unable to understand why the company was charging more money for the same services, Tsertos had to let them go. However, this then provided CFS the opportunity to go after quality clients — those that appreciate the company’s value proposition. Today, CFS services 28 locations, totalling six million square feet of cleanable space. “We’ve had more setbacks than success by adopting this philosophy but the clients we have now are a better fit,” notes Tsertos. “They recognize you get what you pay for.” And with CFS, that’s quite a bit. CFS works in close partnership with its clients to develop customized commercial cleaning programs that yield measurable results by improving quality and safety, and containing costs. As a CITS-certified (Cleaning Industry Training Standard) company, CFS is committed to providing its clients with highly trained employees who can properly perform their jobs. CITS is an International Sanitary Supply Association (ISSA) initiative that measures the quality of a company’s existing training programs and verifies that they adhere to a strict set of standards. Those who obtain the designation have the ability to certify frontline cleaning professionals within their organization. The company is also dedicated to creating healthier, high performance facilities.

/ cover story /

This goes beyond employing environmentally preferable cleaning solutions, tools, equipment and processes to also include the regular use of adenosine triphosphate (ATP) testing to guarantee “what looks clean is actually clean.” Considered one of the most reliable methods of measuring cleanliness today, ATP testing can rapidly detect the amount of organic matter that is present after cleaning any surface. The amount of ATP detected, and where it’s detected, indicates areas and items that may need to be re-cleaned, and the possible need for improvement in the facility’s cleaning process.

“Ensuring a healthy environment has never been more important,” says Tsertos. “With recent public health threats such as H1N1 and SARS, facility managers have an increasing responsibility to ensure that they are doing everything to defend against the spread of contaminants and, resultantly, a possible outbreak.” This is where cleaning plays a crucial, albeit all too often underrated role, he continues — one that CFS is working diligently to bring into plain sight. Daytime cleaning, of which CFS is a strong proponent, is one way to raise awareness of and appreciation for janitorial

work. Making cleaning staff visible puts a face on an often forgotten industry and serves to professionalize it. Further, it fosters mutual respect between cleaning crews and building occupants, imbues a sense of pride that is currently in short supply among workers and provides a desirable improvement in job conditions. “We got involved in daytime cleaning because of the myriad of benefits it offers our workers and clients, both financial and non-financial,” says Tsertos. “But more importantly, it ties into what we’re trying to achieve — a higher industry standard and total transparency.” / www.REMInetwork.com / 13

RISE OF THE ROBOTS Hospital automated guided carts increase efficiency, reduce operating costs by Garry A. Koff

anual hospital cart transportation is not only wasteful and inefficient but also completely avoidable today thanks to mobile robots. These batterypowered machines, commonly referred to as automated guided vehicles (AGVs), are capable of performing a wide variety of cleaning-related tasks, including moving dirty linens, trash and other materials as needed. TECHNOLOGY AT WORK

AGVs drive under carts, automatically taking them to specified destinations. They have an operational speed of approximately 200 feet per minute — the speed of walking pedestrians — which allows them to safely

traverse hospital corridors and interface with elevators. AGVs can slowdown automatically in areas as desired, and are equipped with audible devices and flashing lights. Most units are outfitted with a laser bumper sensor to detect objects in their path. Typically, the sensor can be programmed for range and width of coverage. Anything detected in the path of the AGV will slow and stop the unit. The AGV will only resume its travel when the object is clear of the detection range. AGVs communicate with a central system controller, which provides ‘missions’ — for example, where to pick up and deliver a cart — and keeps track of their locations so logistics management knows where

14 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

the units are and what they are doing at all times. The units can be readily removed or rerouted since no physical ‘tracks’ are required for pathways. AGVs have a virtual set of coordinates stored in their computer memories, allowing routes and station locations to be changed by simply modifying the CAD (computer-aided design) path drawing. This ‘virtual’ path navigation means they can be easily installed in both new and existing facilities. PLIGHT OF THE NAVIGATOR

Several types of navigation technologies are used to guide AGVs in a facility. Some of the most popular forms of AGV guidance

/ spotlight /

are proximity sensor, laser and inertial navigation. Proximity sensor navigation uses multiple sensors (sonic, infrared and laser, for example) to determine the vehicle’s position relative to walls and other physical objects in order to guide it through an area. Laser target navigation makes use of fixed reflective targets mounted on walls and columns in the AGV operating area. Equipped with a rotating laser transmitter/ receiver, the AGV emits a laser beam that is reflected back by multiple targets along its path. The unit then calculates the beam’s angle and distance in relation to the targets to triangulate its position and guide it on its way. Inertial navigation utilizes an electronic chip, called an inertial sensor, in the AGV. The sensor detects the slightest change in the left-right movement of the vehicle as it travels. With the aid of small reference markers, this information is used to correct the vehicle’s position and keep it on the right path. Both laser and inertial navigation systems are accurate within plus or minus one inch. CALL OF DUTY

AGV systems typically employ some type of ‘call and remote dispatch’ operation. Cleaning staff can call for an AGV by pressing a button or using a touchscreen, for example, when a cart is ready to be picked up. The central controller stores these calls and then assigns an available AGV to perform the pickup and associated delivery mission. Systems with this capability do not require an operator to be present when the AGV arrives, allowing staff to place a cart for pickup and then resume their regular responsibilities. Idle AGVs will go to automatic battery charging stations periodically, eliminating the need to change batteries. The vehicles

even ‘go to sleep’ during off shifts or low volume periods to conserve the charge level in their batteries. There are various ways to alert maintenance staff when there is a problem or notify workers when a cart is delivered to their area. The central controller can send text messages to designated personnel, for example. Graphic displays of the system path, vehicle locations and system status are also available on monitors networked with the system. HANDLE WITH CARE

AGVs require periodic maintenance. This typically involves a simple inspection, cleaning, and mechanical and electronic adjustments. Preventive maintenance should be performed quarterly. It generally requires one to two hours per vehicle. The skill level required to maintain an AGV is similar to that of an electrician/mechanical facility engineer. AGV uptime is quite high. With proper maintenance, vehicles sustain 97 to 99 per cent uptime. Fleet sizing for larger systems includes spare AGVs to allow for planned maintenance and unplanned vehicle downtime. System-wide failure is extremely rare because the central controller normally includes a backup controller. INVESTING IN THE FUTURE

While AGVs have been widely used in the industrial sector for more than 40 years (where company survival is tightly coupled with operating costs), they have been mostly overlooked in the healthcare industry; that

is, until now. Tightening budgets and rising healthcare costs have prompted hospitals to look at new ways to reduce non-value added labour. AGVs increase productivity, improve cart delivery response times, eliminate lost/ delayed cart deliveries and help cut operating costs. What’s more, newer technologies have greatly lowered the investment cost of these systems, making them a viable option for nearly all facilities. Today, the payback period for vehicle automation can often be less than two years. Hospitals that employ AGV cart transportation systems have seen a positive return on investment of 1.25 to 1.5 full-time equivalents (FTEs) per AGV per shift. Even a system with just a few AGVs can reduce labour by three to five people per shift. The price of an AGV system can vary widely, depending on its size and vendor. A small system with three vehicles will cost between $300,000 and $400,000 US, while a larger system with approximately 15 vehicles will range from $1.5 to $2.5 million US. The cost includes the AGVs, system controls, system engineering services, and system installation and startup. If the initial cost of a small system of three AGVs is approximately $350,000 US, for example, it provides a FTE reduction of three per shift, two shifts per day and a FTE cost of $45,000 US per year. A hospital could see a reduction in its operating budget of $270,000 US per year. This would result in an investment payback of less than 18 months. More importantly, the savings per annum continues every year the system is in operation. /

Garry A. Koff is president of Savant Automation Inc. He has more than 35 years’ experience in the automatic guided vehicle system business. Garry can be reached at 616-485-6300 or garry.koff@savantautomation.com.

www.REMInetwork.com / 15

/ spotlight /

BREAKING THE CHAIN OF INFECTION Best practices for cleaning, disinfecting environmental surfaces to control HAIs by Nicole Kenny

eeping a hospital clean used to be a fairly straightforward process that was entrusted to the housekeeping department. But with the emergence of healthcare-associated infections (HAIs), tremendous pressure has been placed on healthcare organizations, particularly environmental services departments, to ensure their facilities are properly cleaned and disinfected. Today, disinfection of surfaces is a vital part of any facility’s environmental hygiene program. Choosing the right disinfectant product can support its overall success and have a dramatic impact on program costs. Until recently, however, it was difficult to find a single product among those available for use in Canada, that kills all pathogens quickly and effectively without presenting a health hazard to humans or damaging equipment and other surfaces. Fortunately, this is no longer the case. Combined with training methods to improve cleaning procedures and the use of validation tools to assess cleaning effectiveness, safer disinfectants have created new opportunities for facilities to achieve better outcomes. This includes a greater reduction in the incidence of HAIs, less injury resulting from product use and dramatic cost savings. Developing a cleaning and disinfection program to address current best practices can be a daunting task due to the reams of scientific studies and infection prevention and control guidelines. However, there are five key steps that every healthcare facility should follow.

STEP 1: DEFINE CLEAR ROLES AND RESPONSIBILITIES

This is imperative to ensure the program’s success. The functional groups responsible for cleaning patient care environments and equipment need to work together to determine who is responsible for cleaning each surface and piece of equipment in a patient room as well as the cleaning frequency. If this division of responsibilities does not occur, surfaces or devices will be overlooked. Since environmental surfaces and shared patient care equipment have been linked to the transmission of HAIs, it’s necessary to ensure cleaning is done right each and every time. STEP 2: CHOOSE A DISINFECTANT

Germicidal efficacy, realistic contact (or dwell) time, surface compatibility and the safety of the product should all be taken into consideration when making this decision. STEP 3: TRAIN STAFF ON PROPER DISINFECTANT USE

A 2010 study published in the Journal of AOAC International illustrates the importance of using products in accordance with label instructions. Products that dried before the recommended contact time — the length of time the surface needs to stay wet in order to achieve the level of kill listed on

the product label — did not achieve optimal disinfection. STEP 4: MAKE THE PRODUCT READILY AVAILABLE

If the disinfectant is locked in a housekeeping closet several feet from where it needs to be used, the area and shared patient care items are less likely to be properly disinfected. STEP 5: IMPLEMENT COMPLIANCE MONITORING

This is necessary to ensure cleaning and disinfecting best practices and facility protocols are being followed. It involves the use of an ultra-violet (UV) reflectance product or an adenosine triphosphate (ATP) bioluminescence device. The method chosen should be based on who will be conducting the validation, and how the results will be interpreted and presented. Compliance monitoring should be implemented for hightouch surfaces as well as shared patient care equipment. This objective measurement of cleanliness and disinfection allows the environmental services department manager to give positive feedback when a job is done well. More importantly, it provides an opportunity to coach and improve cleaning practices if surfaces or shared patient care equipment were missed. /

Nicole Kenny is vice-president of professional and technical services at Virox Technologies Inc. She has 20 years’ experience as a technical consultant, educator and author working in the field of environmental hygiene and chemical disinfection for infection prevention.

16 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

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PUBLIC ENEMY Combatting community-acquired infections by Lori Strazdas

nfectious diseases are a leading cause of illness and death worldwide. The germs that cause them — bacteria, viruses, parasites and fungi — can be spread, directly or indirectly, from one person to another and they’re not just a problem in healthcare facilities. In any number of public and commercial settings, people unknowingly carry and spread germs as they go about their day. Germs in public settings

can increase the risk of getting sick and impact a business in a variety of ways, including worker absenteeism and reputation. Facility managers and their cleaning staff play a critical and perhaps underappreciated role in protecting public health. Armed with the right information, tools and training, they can help prevent the spread of community-acquired infections.

18 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

COMMON CONTAGIONS

The first step in combatting contagious germs is to become familiar with those found in public spaces: rhinoviruses, influenza, norovirus, Staphylococcus aureas (S. aureaus) and Methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile (C. difficile). Rhinoviruses are the leading cause of common colds. They are spread through the air and contact with contaminated

/ infection prevention /

surfaces. It has been estimated that the common cold leads to approximately 189 million missed school days, 126 million missed workdays for parents who stay home to care for sick children and 70 million workdays missed by employees suffering from colds. The total economic impact of common colds has been estimated to exceed $40 billion annually in the U.S. alone. Flu can spread through the air from up to six feet away via droplets from coughs or sneezes. It can also spread when people touch contaminated soft and hard surfaces — where it can survive for up to 12 hours and 48 hours, respectively — and then touch their own mouth or nose. Five to 20 per cent of Americans contract the flu annually, and more than 200,000 people are hospitalized for seasonal flu-related complications each year, according to the U.S. Centers for Disease Control and Prevention (CDC). Norovirus is the most common cause of gastroenteritis. It spreads quickly, is particularly contagious because it only takes a few viral particles to infect another person and it can persist on environmental surfaces for weeks. The CDC reports that norovirus causes, on average, 21 million illnesses, 71,000 hospitalizations and up to 800 deaths each year. S. aureus are bacteria commonly carried on the skin or in the nose of healthy people. MRSA is a type of S. aureus bacteria that is resistant to antibiotics. In the general community, both S. aureus and MRSA most often cause skin infections. However, if left untreated, they can lead to sepsis and even death. MRSA has been shown to survive on surfaces for up to seven months. C. difficile is a spore-forming, drug-resistant bacterium that the CDC has classified as an “urgent threat” to public health. Infection can range from mild to severe intestinal illness to death. C. difficile spores are resis-

tant to many disinfectants and can persist on hard surfaces for months. Community-onset infection is increasing, with a recent study of U.S. hospitals finding that these rates increased at a much higher rate than hospitalonset cases. STOPPING THE SPREAD OF GERMS

Cleaning and disinfecting is the first line of defence against familiar threats such as influenza viruses and norovirus, as well as evolving challenges posed by emerging pathogens. A growing body of research has linked environmental contamination with increased risk of infections, in part because pathogens can survive on surfaces for months. Cleaning and disinfecting helps eliminate environmental reservoirs and combat cross-contamination, which occurs when micro-organisms are transferred from one surface to another. There are a multitude of products on the market today that can help prevent the spread of germs in public settings. However, to achieve best results, cleaning professionals need to be armed with the right products for their facility’s unique needs. Whether product selection is managed in-house or facility cleaning services and supplies are provided by an outside vendor, it is important that disinfectants are specifically formulated to kill illnesscausing bacteria, viruses and fungi, and are approved by or registered with the appropriate regulatory bodies. In the U.S., look for disinfectants that carry an Environmental Protection Agency (EPA) registration number on the product label. In Canada, disinfectants used on envi-

ronmental hard surfaces and inanimate objects are regulated by Health Canada and identified by a drug identification number (DIN) on the product label. When evaluating surface disinfectants, select products that have broad spectrum antimicrobial activity, are fast acting (in other words, have a short contact or dwell time) and can keep surfaces visibly wet for the full contact time so the product is able to kill the specific illness-causing germs. Also, consider the product format and relative advantages and disadvantages of readyto-use products compared to dilutables with regard to efficiency, cost and compliant usage. Regardless of products selected, make sure cleaning staff is properly trained on their use in accordance with label instructions. This ensures safety and product efficacy. Beyond this, it is critical that proper cleaning and disinfection practices are carried out correctly and consistently. Implementation of infection prevention and control protocols is key to protecting staff and building occupants, and promoting compliance. Everyone involved in facility cleaning and maintenance needs to understand their role and responsibilities. Successful training programs should clearly outline expectations, including what needs to be cleaned, who is responsible for cleaning and disinfecting certain areas, and when and how those areas should be cleaned. Establishing standardized procedures and cleaning protocols is key to delivering consistent, high-quality results. It is also important to remember quality improvement requires collaboration, and to be impactful, training and education efforts must be ongoing. /

Lori Strazdas is a public health and safety specialist with Clorox Professional Products Co., where she supports scientific and clinical research as well as product design and development.

www.REMInetwork.com / 19

/ infection prevention /

DOES COLOUR MATTER? Q+A: The huge value of labelling by hue

olour-coded cleaning is not a new concept; however, it is garnering much attention again thanks to increased concern about crosscontamination in healthcare facilities and the food service sector. Here, cleaning industry consultant Ron Segura discusses the concept, its benefits and how to ensure implementation is a success.

What is colour-coded cleaning?

Colour-coded cleaning is a system of separating cleaning equipment and supplies, in both high and low-risk areas, based on their task and areas of use. The British Institute of Cleaning Science (BICSc) is credited for developing the first formal system of colour-coded cleaning approximately 20 years ago. It was designed to be used in healthcare facilities as follows: red dot labels for restrooms; green for food service areas; blue for general cleaning; and yellow for isolation areas. Today, colour-coding is used in a variety of facilities. While some follow the BICSc’s colour designations, there is great variation in how the program is used and the colour schemes implemented.

Why should facility managers/cleaning contractors adopt colour-coding?

In 1971, following a massive spread of bacterial contamination throughout Ottawa General Hospital, a study was undertaken to determine the source of contamination and to institute measures of control. It was found that mops, stored wet, supported bacterial growth to very high levels and could not be adequately decontaminated by chemical disinfection. This meant that if a contaminated mop was used to clean floors in an operatory area, for instance, and then used in a public restroom, germs and bacteria collected on the mop in the operatory area could spread — and indeed did spread — to floors in the public restroom. Hospital administrators determined that an effective way to help prevent cross-contamination would be to use only certain tools in specific areas, and a relatively simple way to do this was to implement a colour-coded system. Can you provide a colour-coding success story?

One of the most striking examples of the health benefits of colour-coding was uncovered in a Chicago-area hospital. Flat mops were

20 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

labelled by colour to designate area of use in the facility: blue for patient rooms, orange for washrooms and yellow for isolation rooms. Implementation of this colour-coding system, combined with other measures to improve overall cleaning effectiveness, reduced the rate of C. difficile in the hospital by more than 50 per cent, well below the U.S. national average. Is colour-coding only used to match products with designated tasks and areas?

No. Colour is recognized by everyone, regardless of one’s native tongue, so the process of colour-coding is used in many parts of North America today to help eliminate language barriers. How can facility managers/cleaning contractors ensure staff stick to a colourcoded program?

Above all else, training and re-training is key. While colour-coding is easy to understand, it’s important that staff appreciate why it’s an essential part of the cleaning process. Clear identification, by colour-coding, of cleaning equipment and supplies is considered an effective method of restricting these tools to individual areas and tasks, thereby reducing the risk of cross-contamination. /

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GEAR UP FOR SAFETY The importance of PPE for cleaning, environmental personnel by David L. Smith

leaning may not be perceived as a high-risk occupation but statistics tell another story. Cleaning workers frequently experience cuts, bruises, burns, slip and fall incidences, lifting injuries, physical, chemical and biological hazards, and often high levels of workplace stress, according to the Canadian Centre for Occupational Health and Safety. The U.S. Department of Labor cites similar statistics and identifies cleaning workers as having a higher rate of injury and illness than the national average. Despite the fact that cleaning and environmental staff are required to use chemicals and a wide range of cleaning tools and equipment, often there are

few measures taken to ensure the right personal protective equipment (PPE) is being worn consistently on the job. There is little or no in-field follow-up, and no specific accountability. So, although the required protocols are often in place, employees who were trained when they were hired simply fall out of the habit of wearing PPE. It may be because they fail to see its importance, find it cumbersome or inconvenient, believe it takes additional time that they just don’t have, or find it uncomfortable or unattractive. Too often, it takes a life-altering injury to act as a wake-up call to cleaning professionals and their employers. To avoid that sad reality, creating a culture of safety is vital.

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GET WITH THE PROGRAM

Planning, developing and implementing a PPE program is the foundation for a safetyfocused business. A good PPE program includes several components, including a workplace safety audit, appropriate product selection, personal fitting, implementation, management and supervisory support, program maintenance, ongoing communication, and periodic program review and update. To begin, engage a qualified safety consultant from a reputable PPE supplier to conduct a thorough safety audit. This will include a review of cleaning processes, physical and chemical agents routinely encountered during cleaning tasks, cleaning

/ health & safety /

activities carried out in each work area and control measures in the work environment. It will also involve a review of relevant Safety Data Sheets (SDSs) to ensure all hazards associated with specific cleaning products are identified and accounted for. Product types will be recommended based on safety regulations associated with each type of hazardous substance or condition workers may be exposed to. In Canada, two of the best-known standards that apply to personal protection in the workplace are CSA Group and Bureau de Normalisation du Québec (BNQ) standards. They outline the types of PPE recommended for particular work hazards, classify protection according to the hazard and establish PPE categories to aid in selecting the products best-suited to the risks of a specific job. PPE requirements for relatively lowrisk environments may be limited to basic hand, eye and ear protection. However, if certain types of chemicals, biohazards and airborne pollutants are present, specialized

equipment such as aprons, face shields, gowns, suits, boots and shoe covers may also be required. Some hazards will require multiple PPE solutions. For example, working with chlorine requires both eye and respiratory protection because the chemical is irritating to both the eyes and respiratory tract. Once the types of PPE have been specified, request different models for employee testing and feedback. Involve cleaning and environmental staff members in the selection process to ensure proper fit, comfort and acceptability, particularly when multiple forms of PPE must be worn together. If PPE is heavy, poorly fitted, unattractive or uncomfortable, compliance is likely to be poor. Where possible, offer flexibility in the choice of PPE (while still meeting required legislation and standards) to encourage compliance. After the PPE program has been developed, it is important to clearly document it in the facility or company’s health and safety policy. Develop a training manual

to help employees understand the nature of the risks they encounter in the course of their work, how their PPE will function to protect them, how it should fit when worn correctly, the specific tasks for which it is required, and what to do in the event PPE is damaged or not available. TIME TO GET DRESSED

A well-planned implementation process, which includes an employee communication program, is key to success. The facility or company’s PPE provider should conduct training sessions with all cleaning staff. Cleaning hazards specific to the environment should be explained, along with the function of the various pieces of PPE. The proper fit and use of each product should be demonstrated. Workers should also be educated on the degree to which risk increases when PPE is removed, even if only for short periods of time. For example, if safety glasses are worn halfway down the nose, protection from flying particles is significantly reduced or may even be eliminated altogether.

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/ health & safety / Request individual fitting sessions by the PPE provider’s safety consultant. Each employee should be personally fitted for their own PPE and shown how to properly wear and maintain it. Employees should be given a period of time to become accustomed to wearing their new PPE (unless, of course, there is exposure to hazardous atmospheres, or a significant and immediate risk of serious injury in the absence of PPE). SET AN EXAMPLE

Management and supervisory staff must be committed to making safety a part of every employee’s day. Lead by example by wearing PPE, ask employees about their PPE, praise attention to safety and highlight its importance at every opportunity. Appoint an employee representative as a program coordinator with the responsibility to ensure each of the elements of the program is in place and operational. This has been shown to dramatically increase PPE program success. DON’T FORGET TO TAKE CARE

Without proper maintenance, the effectiveness of PPE is uncertain. Maintenance should include care, cleaning, repair and proper storage. The most important part of maintenance is continuous inspections to identify damaged or improperly functioning equipment before it is used. PPE that is not performing up to manufacturers’ specifications (such as safety glasses with scratched lenses, which compromise their ability to withstand impact) must be discarded. Establish procedures to enable workers to obtain replacements or replacement parts for damaged PPE, and to keep it clean. Respiratory protection devices, for example, require a regular program of repair, cleaning, storage, filter replacement and periodic testing. PROGRESS IMPOSSIBLE WITHOUT CHANGE

Once the PPE program has been implemented, set targets for compliance and injury reduction, and frequently communicate through the facility or company’s management team. People are creatures of habit, so post reminders in areas where hazardous materials are routinely accessed and hold education programs regularly. The most common reason for lack of PPE program compliance is the inability to overcome objections to wearing it. Listen to employee feedback and act on it. Address specific problems individually and make broader changes to address issues that affect a high percentage of employees. This demonstrates commitment to the program and responsiveness to employee concerns. Recognize consistent program compliance, and communicate and celebrate successful reductions in cleaning and environmental staff injuries. The effectiveness of the PPE program should be monitored by auditing procedures and reporting on results. Compare safety performance before and after program implementation. Conduct a survey among cleaning staff members to obtain feedback on their use of PPE. Determine how successful the program has been and look for opportunities to improve. /

David L. Smith is director of cleaning, hygiene and sanitation for Bunzl Canada, a global distributor of a wide range of personal protective equipment through its specialized safety division, McCordick Glove and Safety. He can be reached at 613-449-2146.

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SKIN MATTERS

How to keep the body’s largest organ healthy by Armand Coppotelli

ere’s the skinny on worker skin safety: One out of every four workers is exposed to some form of skin irritant in the workplace, according to the National Institute for Occupational Safety and Health (NIOSH). These irritants can cause numerous skin problems, from simple dry skin to more advanced, painful and costly skin problems such as dermatitis. HIGHER EDUCATION

Employees often think having cracked or dry skin is simply part of the job, not realizing it can lead to more severe problems

because it allows harmful substances to more easily penetrate the skin’s outer layer. In order to prevent skin damage, workers must be educated about the importance of maintaining healthy skin and how doing so can prevent doctor visits and lost work time. They need to know the potential hazards of the substances they work with and how those substances can affect their skin. Education on how to safely and effectively remove those substances from their hands during and after the workday is also critical. A three-step program can help prevent skin irritation. The program should be specific to the substances being handled

26 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

and include a before work cream, a cleaner and an after work skin conditioner. BEFORE WORK BEGINS

A before work cream should be used to help maintain the integrity of the outer skin layer. Before work creams that are hazardspecific, with efficacy studies to confirm the results, are the key, rather than all-purpose creams. Proper selection of a before work cream is important. It should be matched to the specific work environment. Encouraging employees to apply a cream prior to work can be a challenge. The idea is to help maintain the integrity of the outer

/ health & safety /

skin layer, which is only three red blood cells thick. Without proper protection, everyday use of common workplace chemicals, degreasers and solvents, as well as just plain abrasion will take its toll. Again, education is key. Potential skin irritants and sensitizers must be identified. Employees need training to better recognize them and the precautions to take. Once identified, the appropriate before work creams should be dispensed from a location easily accessible to employees. Small, portable sample sizes tend to get misplaced. A wall-mounted dispenser near the washup area or locker room is preferable. Training in proper use of before work creams is also important. Make sure employees are instructed in correct application. The back of the hand is often missed when applying creams. The skin is thinner than the skin of the palm, making it that much more important to cover well. Also, instruct employees to apply cream between the fingers, in the nail beds, and on the wrists and forearms. Forearm skin is particularly sensitive.

In addition, training posters, pamphlets and instructional videos help support the education of employees on the proper use of before work skin creams. CLEANERS: WHAT TO AVOID

The type of hand cleaner chosen is vitally important to skin health. Common cleaners such as paint thinner, abrasive powders and solvent should be avoided. According to the NIOSH, organic solvents such as xylene, found in common paint thinner, appears in the body within 15 minutes of skin contact. Borax and pumice-based abrasive hand cleaners strip away the skin’s natural barrier, the stratum corneum, making it more susceptible to rashes and dermatitis. Petroleum-based solvents may cause a defatting action on the skin, while hand cleaners that contain d-limonene may cause allergic as well as dry skin conditions.

WHEN THE WORK DAY IS DONE

Frequent skin contact with hazardous substances requires an effective after work cream in order to help the skin heal and regenerate. Most people are familiar with the benefits of using a good skin moisturizer to replace lost moisture and oil, especially during winter months when the lower humidity often results in additional moisture loss. In addition, the use of a harsh hand cleaner can aggravate the condition. Even the most skinfriendly hand cleaner can leave the skin dry with frequent use. Offer a moisturizing product formulated for workplace conditions. Most conditioning products sold at the retail level contain approximately 90 per cent water. A product containing 15 to 30 per cent fats or oils, dependant on degree of skin dryness, is preferable for working skin. /

Armand Coppotelli is manager, business development and training, at Deb USA. He has more than 25 years’ experience advising best practices to maintain good skin health.

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1. Are ventilation systems working properly? 2. Have new chemicals, materials or processes been introduced to the workplace recently? 3. Is personal protective equipment individually fitted and assigned to employees? 4. Are mild or lanolin-type soaps and soft hand towels provided in wash-up areas? 5. Are employees prohibited from using solvents to clean oil and grease from skin surfaces? 6. Are employees who work with chemicals provided with a change of clothes or required to change work clothes daily? 7. Are new hires screened for skin irritation problems and assigned work that will not further irritate the condition? 8. Are solvent-soaked rags kept in separate drums or containers for removal by a cleaning service?

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WEATHERING WINTER Snow, ice management plan helps relieve season’s woes by Phill Sexton

inter brings with it the beauty of the first snowfall but the awe-inspiring event is shortlived. Soon after comes the headache of having to continuously move (and remove) the ‘white stuff’ to provide safe travel for motorists and pedestrians. There is a way to alleviate this pain, though, but it requires some forethought. Facility managers need to work with their snow removal contractor to develop a snow and ice management strategy before Old Man Winter makes its presence felt.

PICTURE OF PRIORITY

A basic snow site engineering plan establishes first priority snow clearing areas, which is particularly helpful when responding to heavier storms or blizzard conditions. Plowing priorities include designated parking lots, walkways, sidewalks, building entrances, emergency exits and egresses, fire hydrants and pathways to utilities. The plan also identifies safe snow stacking and storage areas. Snow should be piled outside of drivers’ line of sight, and away from handicapped parking spaces, catch basins, manhole covers and areas where it will create drifting issues or it may melt and

refreeze. Drainage locations and sensitive waterways or water systems should also be avoided as increased salinity levels from salt may pose an environmental risk. Particular attention should be paid to parking deck drains where flooding can create extreme ice and load conditions. SNOWY CONSEQUENCES

An effective snow and ice management strategy also includes a response plan that addresses not just snowstorms and blizzards but other conditions that may occur as a result of the initial snowfall. These include road closures, which may prevent snow removal vehicles and designated resources from reaching the property; power outages that cut-off communication and potentially impact the ability of snow removal vehicles to refuel; icy conditions or freezing rain, which may change de-icing materials depending on the weather conditions; and an emergency situation, such as a fire or medical incident, that requires immediate and uninterrupted access to and from the property. CYCLE TIME RATE

Planning necessary resources in a snow operation can be very tricky due to the

28 / FACILITY CLEANING & MAINTENANCE / DECEMBER 2016

variability of conditions and expectations. Facility managers need to understand cycle time rate, and the estimated capacity and costs necessary to minimize safety risks. Cycle time rate is simply the amount of time it takes to meet building occupants’ expectations. A typical assumption is that primary lots and walkways will be clear by 7 a.m., granted that snowfall occurred overnight. If a snowstorm or squall begins at 3 a.m., and produces 10 centimetres of snow over two hours, for example, facility managers must have the proper equipment and manpower to cycle through all parking areas and walkways within 1.5 hours, and allow for 15 minutes of de-icing operations, to meet a 7 a.m. ‘all clear’ expectation. SNOW REMOVAL RESOURCES

When developing estimates of required resources and costs for a particular site, surface area and time calculations must be made. Typically, a snow removal contractor with an eight to nine-foot plow can clear five centimetres of snow at an average rate of one hour per acre; 7.5 centimetres at 1.5 hours per acre; and 10 centimetres at two hours per acre. Depending on specific site expectations (related to tolerance levels for accumulation

/ health & safety /

and time of day), a 10-centimetre snowfall may need to be cleared one, two or even three times in one day. CAPACITY PLANNING

Facility managers can verify the capacity of planned equipment and manpower based on estimated resources using an average five-centimetre cycle time requirement. If a snowstorm begins at 3 a.m., and produces five centimetres of snow per hour over a two-hour period, then an eight-acre site will require three trucks with eight to nine-foot plows to complete ‘all clear’ conditions by 7 a.m. Enormous budget variations are often the case for snow removal operations. From a cost standpoint, facility managers benefit when they budget and equip for worst-case scenarios, even when there is only a small chance of a heavy snowstorm or years with little to no snow. Over the course of five to 10 years, the cost of being improperly equipped far exceeds that of always being prepared with the proper capacity of equipment and human resources.

READY, SET, INSPECT

It is important that facility managers inspect their property after each snow clearing to ascertain whether the snow removal contractor fulfilled their contractual obligation and to determine if any damage was caused by the snowfall that requires immediate attention. Heavy snow is known to cause damage to trees, light poles, signage, walkways, curbs and safety bollards. A good contractor will provide a snow removal report that documents and verifies the snow removal process after each visit to the property. The report should include start and end times of the snowstorm, site conditions, weather conditions, amount of accumulation and snow removal services performed. Both the facility manager and contractor should signoff on each report, which acknowledges the service was satisfactorily rendered and absolves the contractor of any future liability. /

Phill Sexton is director of education and outreach for the Snow & Ice Management Association (SIMA).

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LET IT SNOW

There’s something mesmerizing about a thick layer of freshly fallen snow. On a sunny day, the fluffy white flakes glitter on the ground like diamonds, washing all your cares away. Unfortunately, the serene moment is short-lived, with the crunch of snow underfoot as you trudge to work bringing you back to reality. In the City of Toronto, like many municipalities, business owners are required to clear the snow and ice from sidewalks in front of, alongside and at the rear of their properties within 12 hours of a snowfall. Steps, landings, walkways, driveways, parking spaces and ramps must be cleared within 24 hours of a snowfall to provide safe access and egress for persons and vehicles. Failure to do so could result in a fine. After the removal, if any portion of the sidewalk becomes slippery, the owner must immediately and as often as necessary apply to the sidewalk ashes, sand, salt or some other suitable material so as to completely cover the slippery surface. An owner is also required to keep roofs and roof structures free from any dangerous accumulation of snow and ice and any loose objects that may constitute a hazard (for example, icicles). Normal seasonal accumulations of snow and ice need not be addressed.

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