Poll: School disinfection strategies need to be improved
Contributed by Darrel Hicks, co-founder and contributor of InfectionControl.tips
A survey of 1,155 K-12 school staff was asked about their use of disinfectants to mitigate the spread of COVID-19 in schools. They reported frequent use of disinfectants, often using unknown products, and received little or no training in safe and effective use. Participant concerns included student involvement in disinfection, inadequate ventilation, surface contact time, and potential health effects.
According to the National Center for Education, the SARS-CoV-2 virus has significantly affected 60 million U.S. children and school personnel in Kindergarten to Grade 12 classrooms since March 2020. To minimize the spread of COVID-19 in educational institutions, Centers for Disease Control and Prevention (CDC) have provided recommendations, including regular disinfection of areas with high contact with Environmental Protection Agency (EPA) N list products or a bleach solution.
The disinfectants that kill SARS-CoV-2 are most often quaternary ammonium compounds (quats), based on bleach or peroxide. Unfortunately, these products may carry a risk of skin and eye irritation, have been linked to asthma and chronic obstructive pulmonary disease (COPD), and contain chemicals related to reproductive harm, of the central nervous system and cancer. For these reasons, warning labels on disinfectants indicate the need for ventilation, gloves, and to keep children away.
According to reports, vapors can remain in the air long after a surface is dry and chemicals such as quats leave residues after drying which can become a long-term route of exposure via dust, particularly for kids. In areas where these chemicals are used, the Environmental Protection Agency has provided schools with improved ventilation advice, such as opening windows and adjusting ventilation systems.
However, many classrooms do not have windows, or the windows they do have do not open. During this time, schools with older systems or limited resources may not be able to provide adequate ventilation and filtration.
Lack of ventilation is a concern for many occupants of the school, as the use of disinfectant chemicals has increased dramatically since the start of 2020. An elementary school teacher said, âI’m in a room with no windows, so I hope to breathe in the [disinfectant] spraying every hour will be fine in the long run.
Since the start of the pandemic, teachers and other school staff have reported frequent use of disinfectants, most often without training or access to safety information. Half said they had used at least one product that is expected to kill the SARS-CoV-2 virus when “used according to label directions.” However, these products have a “contact time”, typically 2 to 10 minutes, during which the surface must remain wet to be effective. Many teachers reported that the contact time exceeded the time between lessons, so the product was wiped off early and therefore less or not effective.
A teacher replied: “[It] is supposed to be left on the surface for 10 minutes, but we were instructed to wipe it off immediately between classes.
Additionally, children who may be particularly vulnerable due to their developing respiratory system have been implicated in disinfection. According to the CDC, “Sanitizing products should not be used by or near children, and staff should ensure that there is adequate ventilation when using these products to prevent children or them – even inhaling toxic fumes “.
A high school teacher commented, âIt says on the label, ‘Keep away from children’, but teachers spray every desk after every class and students wipe their desks (seven times a day) with inexpensive paper towels. ”
In addition to question-specific comments, survey participants were given the opportunity to provide additional information via open-ended questions. Most took the opportunity to voice their concerns, while only a handful of responses were positive.
Here are some of the disturbing comments from teachers who responded to the survey:
âMy classroom seemed to fill with alcohol fumes after seven cleaning periods between classes. That night I continued to vomit to the point where I went to the emergency room.
â¢ âIt’s up to teachers and students to clean up, and I teach in grade one. “
â¢ âAfter using products in class, my asthma started and caused two trips to the emergency room. “
â¢ âOn the bottle it says ‘Do not use in food space’ but we have to use it to spray children’s desks before they eat breakfast. “
â¢ âSome days my lungs hurt. I’m afraid that one day in the future we will have lung problems because of these products.
Clearly, a balance needs to be struck between student and teacher safety and the health effects of using disinfectants. As it has become more evident that SARS-CoV-2 spreads more easily through the air than through surface contact, the CDC has updated its guidelines to dramatically reduce disinfection.
Kindergarten to Grade 12 school administrators are prudent to follow CDC guidelines for the use of disinfectants, including frequency, ventilation, gloves, child protection, and teacher and staff training. In addition, schools should select products from the EPA’s N list that:
â¢ Have a contact time equal to or less than 1 minute.
â¢ Are safe as reflected by the Hazardous Materials Identification System (HMIS) score of 0-0-0.
Ease of use is another consideration that should be used to evaluate disinfectants before purchasing. The products must be effective in the presence of environmental factors such as organic matter (i.e. blood), have an acceptable odor profile, be stable, be soluble in water, have simple instructions for use and have good cleaning properties.
Given the potential long-term effects on the health of school staff and children, adhering to these guidelines will help ensure that the use of disinfectants in schools does more good than harm.
J. Darrel Hicks, BA, Master REH, CHESP, holds a Masters Certificate in Infection Prevention (for Environmental Service Professionals), is the co-founder and contributor of InfectionControl.tips, and is the author of ” Infection Prevention for Dummies. ”
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