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Hygiene in the non-clinical environment

Hygiene in the non-clinical environment. Dirk Bockmühl. Hygiene at home ?. Gerd had rather spent more money in toilet cleaning agents …. Home hygiene: the consumer’s view. Hygiene threats are mostly found outside my home.

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Hygiene in the non-clinical environment

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  1. Hygiene in the non-clinical environment Dirk Bockmühl

  2. Hygiene athome? Gerd hadratherspentmoremoney in toiletcleaningagents…

  3. Home hygiene: the consumer’s view Hygiene threatsaremostlyfound outside myhome Accordingto a GfK surveyforthe „Apotheken-Umschau“ 2006

  4. Notifiable infections in Germany (2008) Source: RKI

  5. Household-associated infections Krause et al.: EmergInf Dis 13(10) (2007)

  6. The key message • The domestic environment is one of the most important sources for infectious diseases • These infections are predominately food-borne

  7. The riskofinfectionathome Risk Source: IFH 7

  8. The riskofinfectionathome Risk Source: IFH

  9. Decontaminationoffoodcontactsurfaces

  10. The dishwasher: a risk?

  11. Dishwashershostblackyeasts

  12. Dishwashershostblackyeasts Zalar et al. (2011)

  13. ? But is there a risk of infection?

  14. Estimation of infection risk Pathogenicmicrobes? Routesofinfection? Exposition? Riskfactors?

  15. Groups of higher risk: YOPIs Old Young Pregnant Immunocompromised

  16. Antibacterialeffectofhanddishwashing Time neededtoreduce 99,9% ofSalmonella Water Soaking time [min] Water + Detergent Temperature [°C] Matticket al.: Int J Food Microbiol85 (2003) 213– 226

  17. The „killer“ sponge 102 – 107 microbialcells per gramm SEM-photograph: A. Hinnemann, Rhine-Waal University of Applied Sciences Enriquezet al. DairyFood Environ. Sanitation. 17:20-24.

  18. Howtosanitize a kitchensponge Sharma et al. Food Control 20 (2009) 310–313

  19. The dishwasher kills…

  20. The dishwasher kills… …bacteria! Thus itis an importantmeanstoensuredecontaminationoffood-contactsurfaces

  21. The riskofinfectionathome Risk Source: IFH

  22. The washingmachineassourceofgerms

  23. Will we all die now?

  24. Infections and laundering Fungalinfections (Athlete‘sfoot, Candida) Viral infections (Noroviruses)

  25. InactivationofNorovirus via laundering Detectionof viral RNA on fecallycontaminated textiles Lemm et al. Tenside, Surfactants, Detergents (submitted)

  26. Challenge: lowtemperatures Medium washingtemperature T [°C] % Textiles washedat ≥60°C Survey on germanhouseholds Source: IKW Sustainability Report 2010

  27. Hygiene in the wash- and use-cycle Wearing Storage Washing Drying

  28. Hygiene in the wash- and use-cycle Input ofmicroorganisms Wearing Storage Washing Reductionofmicroorganisms Drying

  29. Hygiene in the wash- and use-cycle Input ofmicroorganisms skinflora excretions biofilms cross contami-nation fungal spores dust Wearing Storage Washing Reductionofmicroorganisms Drying chemistry mechanics temp. dehydration dehydration temperature

  30. Challenges

  31. Challenges Wichmicrobes? Quantity?

  32. Challenges Machineimpact?

  33. Challenges Impact ofdrying and ironing?

  34. Whathappenswhenyouwashyourtowels? cfu/cm2 After use After laundering After drying Blümkeet al., EDC conference 2011

  35. Whathappenswhenyouwashyourtowels? cfu/cm2 After use After laundering After drying Blümkeet al., EDC conference 2011

  36. Whathappenswhenyouwashyourtowels? cfu/cm2 After use After laundering After drying Blümkeet al., EDC conference 2011

  37. The washing machine as a reservoir for germs • Microbialcolonisationoftherinsingchamberisindependentofthechosentemperature • Contamination after themainwashcycle

  38. Another real-lifestudy… Analysis ofLaundry in NurseryHomes

  39. Analysis ofLaundry in NurseryHomes cfu / 100 cm2 After laundering After drying Beforelaundering Survey on 16 nurseryhomes in thedistrictof Kleve Bertelmann et al., DGHM conference 2012

  40. Individual reductionfactors Log reduction (before/after laundering) Nurseryhome # Bertelmann et al., DGHM conference 2012

  41. Impact factors on laundryhygiene Bertelmann et al., DGHM conference 2012

  42. Impact factors on laundryhygiene Bertelmann et al., DGHM conference 2012

  43. Impact factors on laundryhygiene Bertelmann et al., DGHM conference 2012

  44. Impact factors on laundryhygiene Bertelmann et al., DGHM conference 2012

  45. Impact factors on laundryhygiene Bertelmann et al., DGHM conference 2012

  46. Analysis ofLaundry in NurseryHomes Verylowcounts after tumbledrying cfu / 100 cm2 After laundering After drying Beforelaundering Bertelmann et al., DGHM conference 2012

  47. Do hygienerinsershelp? Hygiene + Source: Forum Waschen

  48. Do hygienerinsershelp? Claim: Kill 99,9(99)% ofgerms Substantiated via suspensiontests Source: Forum Waschen

  49. Efficacy in thewashingmachine? • Additional detergencyeffect • Textile effect • Different germs • etc.

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