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Here is some information from the Department of Education on cleanliness I thought you would like.
facilities/environmental issues
Cleaning Up: Battling Germs
in School Facilities
By Charles P. Gerba, Ph.D.
Typically, precautions have fo -
cused on flu shots and other preventative
care. Although these measures
are im portant, school administrators
should also focus on the way their
school is being cleaned. Often, the
custodians responsible for cleaning
schools are not properly trained in
the latest techniques to combat germs
and are using outdated cleaning methods
that don’t completely eradicate
bacteria.
Good hygiene practices, such as
hand washing and using hand sanitizers,
along with proper cleaning of
school environments, can significantly
reduce the number of infections
each year and keep teachers and students
in the classrooms.
The Challenge
Germs are capable of changing
rapidly and developing resistance
to antibiotics used to treat infections.
As a result, these new variations are
more likely to cause illness and re -
sult in more serious infections. Two
examples that continue to challenge
I
t’s inevitable. Every
school year, parents,
teachers, and administrators
must deal with an
overwhelming number of sick
children. In fact, according to
the Centers for Disease Control
and Prevention, the average
child catches at least eight colds
a year, and kids in the United
States miss as many as 189 million
school days annually due
to colds.
education institutions are the norovirus and MRSA
(methicillin-resistant Staphylococcus aureus), often
referred to as a “superbug.”
Interestingly, school -
teachers have 20 times
more bacteria on their
desks and work areas
than any other profession
we studied.
Norovirus is the most common cause of viral diarrhea
in young children and adults. New variations became evident
a few years ago, causing more serious illnesses than
in previous years. The illness usually lasts only one or two
days and spreads easily by feces and vomit.
Because 70% to 80% of those infected with norovirus
vomit, the illness is difficult to control in institutions and
public places. When people vomit, norovirus can spread
through the air to contaminate surfaces that people may
later touch. The virus is easily spread from hand to mouth.
Norovirus can lurk on surfaces for weeks or even
months. Outbreaks have been traced to the use of public
restrooms and other shared facilities. It quickly became
the curse of the cruise ship industry as it spread rapidly
through the passengers, requiring some ships to cancel
their cruises and return to port. Norovirus has also
caused the closing of schools, child-care facilities, universities,
dormitories, summer camps, and even hospital
emergency rooms.
MRSA is a bacterium that has spread rapidly across
the United States to become the most common cause of
skin infections among individuals seeking medical attention.
It is estimated that more than 17,000 people may
die from MRSA infections each year in the United States,
which is more than those reported for AIDS. Although
most of these deaths result from infections acquired in
hospitals or other types of health care institutions, serious
infections also occur in the general population. One
study showed that 85% of MRSA infections were
acquired in the community (Klevens and others 2007).
Once MRSA enters the body—often through a
lesion—it can invade other tissues and cause life-threatening
infections. Most are skin infections that are easily
treated; however, it is a virulent organism and can spread
easily to other organs.
One of the problems with combating the spread of
MRSA is that people who are not ill can carry the germ
in their nose. During a normal day, they can effectively
spread it by skin-to-skin contact or by touching hard surfaces
throughout the day. A fairly hardy organism,
MRSA can survive in the environment for long periods.
For example, it has been found to survive on tabletops
for 12 days.
The Centers for Disease Control lists five factors that
contribute to the spread of MRSA in schools:
• Crowding
• Frequent skin-to-skin contact
• Compromised skin (cut and abrasions)
• Contaminated items and surfaces
• Improper cleaning
MRSA has been recognized as an increasing problem
among high school athletes. A recent survey of 186 high
school athletic departments in Texas found that 60 had
reported MRSA infections among their athletes (Barr,
Felkner, and Diamond 2006).
Germy Classrooms
So just how germy are our schools?
Although only a few types of bacteria cause illness,
knowing where the greatest numbers of these bacteria
occur in a school reveals where the greatest risk of exposure
to potential disease-causing microbes lies. Resear -
chers at the University of Arizona have conducted a number
of studies that examined where germs were most concentrated
in schools and demonstrated the importance of
effective cleaning in controlling the spread of infections
among schoolchildren.
Interestingly, schoolteachers have 20 times more bacteria
on their desks and work areas than any other profession
we studied (doctors, lawyers, accountants, news
reporters, bankers)! This is probably because they work
with children who experience more infections than adults
and because a large amount of material crosses their
desks every day.
In one study, bacteria were found in the greatest numbers
on the following surfaces, in order from highest to lowest:
• Water fountain toggles. Children with respiratory
infections and diarrhea spend more time here.
• Pencil sharpeners. A hard grip leaves a lot of germs.
• Computer keyboards. Does anybody ever clean them?
• Faucet handles. Washing your hands is a good idea,
but you have to turn the water on first.
• Student desktops. They need cleaning.
• Classroom doorknobs. It is not a good idea to be the
last person entering the classroom.
In these same classrooms, we most commonly found
influenza virus and norovirus on students’ desktops, followed
by faucet handles and classroom doorknobs.
Influenza virus was detected on up to 50% and norovirus
up to 22% of the surfaces throughout the day during the
winter when these viruses are common.
Battling Bacteria
Can good hygiene and effective cleaning practices reduce
illness in schoolchildren? This question is not easy to
16 FEBRUARY 2009 | SCHOOL BUSINESS AFFAIRS www.asbointl.org
answer. Children may pick up germs and infections at
home, on the playground, or during other activities outside
school. Therefore, it’s difficult to prove the effect of
proper cleaning and disinfection in school facilities. In
general, however, hand washing and the use of hand sanitizers
have been shown to reduce illness and absenteeism
rates among children and adults by 30% to 50%.
It is essential to emphasize
the importance of “proper
cleaning.”
To demonstrate the effect of proper cleaning and disinfecting,
we cleaned and disinfected classroom desks of
first, fourth, and fifth graders at the end of each school
day for 12 weeks and found that we could reduce absenteeism
by 50% compared with classrooms where this
was not done.
In another study, researchers found that providing an
alcohol-based sanitizer and disinfecting key surfaces in
the classroom reduced the occurrence of noroviruses on
surfaces by more than 50%. Not surprisingly, student ab -
senteeism due to diarrhea declined (Sandora, Shih, and
Goldmann 2008).
It is essential to emphasize the importance of “proper
cleaning.” Improper use of cleaning tools (mops, clothes)
can actually increase contamination. We discovered that
after an outbreak of norovirus at a major university, the
cleaning crews actually increased the number of surfaces
in dorm rooms contaminated with norovirus! Thus, pro -
per use of cleaning tools and disinfectants is essential in
reducing the spread of disease-causing microbes.
Districts should ensure that facilities are cleaned with
hospital-grade disinfectants, color-coded microfiber clean -
ing cloths, and flat mops that reduce cross-contamination.
In addition, facilities managers and custodians should be
knowledgeable about the proper ways to clean. For a list
of products registered by the Environmental Protection Ag -
ency as effective against norovirus, MRSA, and other patho -
gens, visit http://epa.gov/oppad001/chemregindex.htm.
A Way Forward
The benefits of good hygiene and proper cleaning can be a
hard sell because they are not clearly visible in the short
term. However, the benefits for our students are huge in
reduced absenteeism and reduced health care costs.
Germs continually reinvent themselves to outwit the
use of antibiotics and resist the development of vaccines
for common infections. Two lines of attack that have
never let us down are good hygiene and proper cleaning
of our environment. No disease-causing organism transmitted
through the environment has developed an ironclad
defense against them yet.
References
Barr, B., M. Felkner, and P. M. Diamond. 2006. High school athletic
departments as sentinel surveillance sites for communityassociated
methicillin-resistant staphylococcal infections. Texas
Medicine 102 (4): 56–61.
Klevens, R. M., M. A. Morrison, J. Nadle, S. Petit, K. Gershman,
S. Ray, L. H. Harrison, R. Lynfield, G. Dumyati, J. M. Townes, A.
S. Craig, E. R. Zell, G. E. Fosheim, L. K. McDougal, R. B. Carey,
and S. K. Fridkin. 2007. Invasive methicillin-resistant
Staphylococcus aureus infections in the United States. Journal of
the American Medical Association 298 (15): 1763–71.
Sandora, T. J., M. C. Shih, and D. A. Goldmann. 2008. Reducing
absenteeism from gastrointestinal and respiratory illness in elementary
school students: A randomized, controlled trail of an
infection-control intervention. Pediatrics 121 (6): 1555–62.
Charles Gerba, Ph.D., is an internationally recognized environmental
microbiologist and professor of environmental microbiology
in the Departments of Microbiology and Immunology,
and Soil, Water and Environmental Science at the University of
Arizona. He also is a spokesperson for the Coverall HealthBased
Cleaning System™.
www.asbointl.org SCHOOL BUSINESS AFFAIRS | FEBRUARY 2009 17