The American Industrial Hygiene Association (AIHA) has issued new guidelines on healthcare surface disinfectants, emphasizing that the effect on workers and patients must be factored into the equation.

AIHA’s “Guidelines on the Selection and Use of Environmental Surface Disinfectants in Healthcare” states that “disinfectants have the potential to not only inactivate microbes, but to harm patients and workers. It is essential that the use of disinfectants is monitored and that steps be taken to minimize exposures and adverse health effects. Exposures to these chemicals can vary based on frequency and duration of the chemical’s use. It is also important to note that it is not only the employee that is using the chemical to disinfect, but patients who may be in the room during or shortly after cleaning, who have potential to be exposed.”

John Martinelli, healthcare practice director at Forensic Analytical Consulting Services in Citrus Heights, CA, outlined the new AIHA guidelines recently in Portland at the annual meeting of the Association for Professionals in Infection Control and Epidemiology (APIC).

“Typically [guidelines are] organism- and compatibility-based: Will it kill bacteria and viruses, and will it do it without ruining the surface that we’re trying to clean?” he said. “That’s generally how things are selected. There are some other factors — cost. Rarely, do we look at the impact on healthcare workers. In some instances, the products will get out into the industry before we even know the impact of health effects on the workers who are using it, to the staff members exposed to the vapors, and to patients. We looked at those risk factors as well.”

Remember, patients may have a continuous exposure from the time they are admitted, rather than a worker’s intermittent exposure to a disinfectant, the AIHA notes.

The guidelines list the types of chemicals used in surface disinfection and discuss their advantages and disadvantages. The AIHA also identifies occupational exposure limits for chemicals, if possible.

“The objective of the guidelines is to provide assistance to health and safety professionals and others — specifically, those working in healthcare settings,” Martinelli says. “[The document] provides a basic understanding of the organisms that are important in surface room disinfection — gram negatives, gram positives, spores, molds, et cetera. It discusses common disinfectants that are used for surface disinfection and [explains] exposure assessment strategies. How do we know that the workers or the patients are not being adversely affected?”

The AIHA guidelines also address the efficacy of disinfectants.

“Will it kill, and how quickly?” he said. “How hard is it to use? One of the things we find quite frequently is that if environmental services workers don’t like working with a product, it is probably not going to be very effective.”

Editor’s note: The AIHA disinfectant guidelines are available for purchase ($65 for nonmembers) at: