Evaluation of a Sporicidal Peracetic Acid/Hydrogen Peroxide–Based Daily Disinfectant Cleaner

Deshpande, Abhishek; Mana, Thriveen Sankar Chittoor; Cadnum, Jennifer L.; Jencson, Annette C.; Sitzlar, Brett; Fertelli, Dennis; Hurless, Kelly; Kundrapu, Sirisha; Sunkesula, Venkata; Donskey, Curtis J.

doi:10.1086/678416

Cited by 35 publications

(31 citation statements)

References 8 publications

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“…In the 2007 case study, the nurses who developed work-related rhinorrhea, conjunctivitis, cough, wheeze, and shortness of breath were exposed to HP, PAA, and AA vapors while sterilizing endoscopy equipment (Cristofari-Marquand et al , 2007). Recently, the mixture of HP and PAA at lower concentrations has shown promise as a novel sporicidal agent that can be used on a wide variety of surfaces (Deshpande et al , 2016). We note that the at-use concentrations for HP and PAA in Product A are lower than concentrations of HP and PAA used for high-level disinfection.…”

Section: Discussionmentioning

confidence: 99%

Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

Hawley

Casey

Virji

et al. 2017

Annals of Work Exposures and Health

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Cleaning and disinfecting products consisting of a mixture of hydrogen peroxide (HP), peracetic acid (PAA), and acetic acid (AA) are widely used as sporicidal agents in health care, childcare, agricultural, food service, and food production industries. HP and PAA are strong oxidants and their mixture is a recognized asthmagen. However, few exposure assessment studies to date have measured HP, PAA, and AA in a health care setting. In 2015, we performed a health and exposure assessment at a hospital where a new sporicidal product, consisting of HP, PAA, and AA was introduced 16 months prior. We collected 49 full-shift time-weighted average (TWA) air samples and analyzed samples for HP, AA, and PAA content. Study participants were observed while they performed cleaning duties, and duration and frequency of cleaning product use was recorded. Acute upper airway, eye, and lower airway symptoms were recorded in a post-shift survey (n = 50). A subset of 35 cleaning staff also completed an extended questionnaire that assessed symptoms reported by workers as regularly occurring or as having occurred in the previous 12 months. Air samples for HP (range: 5.5 to 511.4 ppb) and AA (range: 6.7 to 530.3 ppb) were all below established US occupational exposure limits (OEL). To date, no full-shift TWA OEL for PAA has been established in the United States, however an OEL of 0.2 ppm has been suggested by several research groups. Air samples for PAA ranged from 1.1 to 48.0 ppb and were well below the suggested OEL of 0.2 ppm. Hospital cleaning staff using a sporicidal product containing HP, PAA, and AA reported work-shift eye (44%), upper airway (58%), and lower airway (34%) symptoms. Acute nasal and eye irritation were significantly positively associated with increased exposure to the mixture of the two oxidants: HP and PAA, as well as the total mixture (TM) of HP, PAA, and AA. Shortness of breath when hurrying on level ground or walking up a slight hill was significantly associated with increased exposure to the oxidant mixture (P = 0.017), as well as the TM (P = 0.026). Our results suggest that exposure to a product containing HP, PAA, and AA contributed to eye and respiratory symptoms reported by hospital cleaning staff at low levels of measured exposure.

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Section: Discussionmentioning

confidence: 99%

Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

Hawley

Casey

Virji

et al. 2017

Annals of Work Exposures and Health

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“…13,28,29 Peracetic acid has been shown to get a log 2 (99%) reduction in pathogenic bacteria, but it was only shown to achieve only a log 1 (90%) reduction of C. difficile. 30,31 Also, peracetic acid use failed to decrease HAIs in a single hospital study. 32 Bleach is frequently used by hospitals for rooms known or suspected to be contaminated with C. difficile.…”

Section: Journal Of Health Economics and Outcomes Researchmentioning

confidence: 98%

Use of a Launderable Bed Barrier and Antibiotic Stewardship to Decrease Hospital Onset Clostridioides difficile Infections in an Acute Care Hospital: A Retrospective Pre/Post Case Study

Hooker

Mallow

McKinney

et al. 2019

Journal of Health Economics and Outcomes Research

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Background: Hospital-onset Clostridioides difficile infection (HO-CDI) is a major source of morbidity and mortality. The objective of this research was to evaluate the reduction in HO-CDI through the use of a launderable bed barrier (BB) and an antibiotic stewardship program (ASP). Methods:A retrospective pre-post study was conducted at an acute care hospital in Kentucky. The preintervention period was September 2014 through March 2016. The BB and the ASP were introduced in April 2016, and the post-intervention period for this study ended September 2018. The rate of HO-CDI was calculated from the actual number of HO-CDI divided by the number of patient days each month. The number of defined daily doses of antibiotic therapy was measured each quarter. Hand disinfection compliance, length-of-stay (LOS), case mix index (CMI), and average age of patients were collected to control for confounding in the regression models.Results: There were 34 HO-CDIs and 42 672 patient days in the pre-intervention period and 31 HO-CDIs and 65 882 patient days in the post-intervention period. The average monthly count of HO-CDI was 1.79 (SD 1.51) and 1.03 (SD 0.96) during the pre-and post-periods, respectively. The average monthly rate (per 10 000 patient-days) was 7.94 (SD 6.30) in the pre-intervention period and 4.71 (SD 4.42) during the post-intervention period. The use of antibiotics decreased by 37% (p <0.0001) over the study period. The combination of the BB and the ASP were associated with a 59% (95% CI 36-96%, p 0.034) reduction in HO-CDI. Conclusions:The use of a launderable BB and the ASP were associated with a statistically and clinically significant reduction in HO-CDI in the acute care hospital setting.

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“…Furthermore, the potential for microrganisms to recover from the sanitization treatment and grow may exist due to the decomposition of PAA into acetic acid (Stampi et al, 2001;Kitis, 2004). This rapid decomposition can result in a short shelf life of a few days to weeks if not refrigerated or placed away from light (Deshpande et al, 2013(Deshpande et al, , 2014Walsh et al, 2018).…”

Section: Peracetic Acid and Hydrogen Peroxidementioning

confidence: 99%

The Implementation and Food Safety Issues Associated With Poultry Processing Reuse Water for Conventional Poultry Production Systems in the United States

Micciche

Feye

Rubinelli

et al. 2018

Front. Sustain. Food Syst.

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As human populations increase in numbers, access to clean, fresh water is becoming increasingly difficult to balance between agricultural and municipal demands. Water scarcity is a limiting factor of food production in many countries, whether they are emerging or established economies. In conventional poultry processing systems, access to water is particularly critical for the maintenance and disinfection of processing areas, as well as in processing operations such as scalding, chilling, and carcass washing. Therefore, poultry processing plants use an excessive amount of water, limiting where facilities can operate, increasing overhead costs, and ultimately resulting in potential environmental concerns. The need for sustainable alternatives to single-use water supplies is becoming increasingly more urgent. As a result, the implementation of water reuse in poultry-processing plants has emerged as an attractive alternative means to meet water requirements during processing. Because the water is reused, it is essential to decontaminate the water with chemicals, such as peracetic acid and chlorine, and improve water filtration strategies to kill and remove potential pathogens and contaminants. However, questions remain as to the efficacy of commonly used disinfectants to achieve that goal. Thus, novel strategies must be developed to improve the capabilities of poultry processing plants to counter water insecurity worldwide. These new stratagems must be economical and enable poultry processing plants to reduce their environmental footprint while meeting new food safety challenges. The current review will focus exclusively on water reuse in conventional poultry processing in the United States. The specific objectives of this review are to discuss the approaches for treating processing water in poultry processing systems, including reuse water systems, as well as investigate possible substitutes for maintaining food safety.

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Evaluation of a Sporicidal Peracetic Acid/Hydrogen Peroxide–Based Daily Disinfectant Cleaner

Cited by 35 publications

References 8 publications

Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

Respiratory Symptoms in Hospital Cleaning Staff Exposed to a Product Containing Hydrogen Peroxide, Peracetic Acid, and Acetic Acid

Use of a Launderable Bed Barrier and Antibiotic Stewardship to Decrease Hospital Onset Clostridioides difficile Infections in an Acute Care Hospital: A Retrospective Pre/Post Case Study

The Implementation and Food Safety Issues Associated With Poultry Processing Reuse Water for Conventional Poultry Production Systems in the United States

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