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Mops and Buckets Spread Germs
"Bucket solutions become contaminated almost immediately during cleaning, and continued use of the solution transfers increasing numbers of microorganisms to each subsequent surface to be cleaned.
"...Another source of contamination in the cleaning process is the cleaning cloth or mop head, especially if left soaking in dirty cleaning solutions."
CDC
By Philip C. Carling, Lou Ann Bruno-Murtha, Jeffrey K. Griffiths
Background
Norovirus infection outbreaks (NoVOs) occur frequently in closed populations, such as cruise ship passengers. Environmental contamination is believed to play an important role in NoVO propagation.
Methods
Trained health care professionals covertly evaluated the thoroughness of disinfection cleaning (TDC) of 6 standardized objects (toilet seat, flush handle or button, toilet stall inner handhold, stall inner door handle, restroom inner door handle, and baby changing table surfaces) with high potential for fecal contamination in cruise ship public restrooms, by means of a previously validated novel targeting method.
Results
Fifty-six cruise ships (30% of 180 vessels operated by 9 large cruise lines) were evaluated from July 2005 through August 2008. Overall, 37% (range, 4%–100%; 95% confidence interval, 29.2%–45.4%) of 8344 objects in 273 randomly selected public restrooms were cleaned daily. The TDC did not differ by cruise line and did not correlate with the Centers for Disease Control and Prevention (CDC) Vessel Sanitation Program inspection scores (r2, .002). More than half the vessels had overall TDC scores <30%, although several of these low-scoring ships had near-perfect CDC sanitation scores. The mean TDC of the 3 ships evaluated within 4 months before a NoVO (10.3%) was substantially less than the mean TDC of the 40 ships that did not experience NoVOs (40.4%).
Conclusions
An objective evaluation of public restroom environmental hygiene on 56 cruise ships found that only 37% of selected toilet area objects were cleaned on a daily basis. Low TDC scores may predict subsequent NoVO-prone vessels. Enhanced public restroom cleaning may prevent or moderate NoVOs on cruise ships.
Authors
Philip C. Carling - 1,2
Lou Ann Bruno-Murtha - 3,4
Jeffrey K. Griffiths - 5
1 - Carney Hospital
2 - Boston University School of Medicine
3 - Cambridge Health Alliance
4 - Harvard Medical School
5 - Tufts University Schools of Medicine, Nutrition, and Engineering, Boston, Massachusetts
Reprints or correspondence: Dr Philip C. Carling, Carney Hospital, 2100 Dorchester Ave, Boston, MA 02124 (pcarling@comcast.net).
Clinical Infectious Diseases 2009;49:1312–1317
© 2009 by the Infectious Diseases Society of America. All rights reserved.
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