Environmental and body contamination from cleaning vomitus in a health care setting: A simulation study

• Published in: American journal of infection control 2018-04, Vol.46 (4), p.397-401
• Main Authors: Phan, Linh, Su, Yu-Min, Weber, Rachel, Fritzen-Pedicini, Charissa, Edomwande, Osayuwamen, Jones, Rachael M.
• Format: Article
• Language: English
• Subjects: Environmental service workers; Equipment Contamination; Floors and Floorcoverings; Fluorescein; health care; Health Facility Environment; Hospitals; Housekeeping, Hospital - standards; Humans; Infection Control; infectious diseases; Patients' Rooms; Personal Protective Equipment; Vomiting
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2017.10.003

•Contamination remained on the floor after cleaning in most experiments, but was lower when participants used towels to remove bulk fluid.•Fluorescein was rarely quantified in the air during cleaning.•The soles of participants' shoe covers were contaminated in most experiments.•Glove contamination was ubiquitous, and was not associated with the number or frequency of environmental surface contacts.•Contamination on the body, when it occurred, most commonly occurred on the legs. Environmental service workers may be exposed to pathogens during the cleaning of pathogen-containing bodily fluids. Participants with experience cleaning hospital environments were asked to clean simulated, fluorescein-containing vomitus using normal practices in a simulated patient room. Fluorescein was visualized in the environment and on participants under black lights. Fluorescein was quantitatively measured on the floor, in the air, and on gloves and shoe covers. In all 21 trials involving 7 participants, fluorescein was found on the floor after cleaning and on participants' gloves. Lower levels of floor contamination were associated with the use of towels to remove bulk fluid (ρ = −0.56, P = .01). Glove contamination was not associated with the number or frequency of contacts with environmental surfaces, suggesting contamination occurs with specific events, such as picking up contaminated towels. Fluorescein contamination on shoe covers was measured in 19 trials. Fluorescein was not observed on participants' facial personal protective equipment, if worn, or faces. Contamination on other body parts, primarily the legs, was observed in 8 trials. Fluorescein was infrequently quantified in the air. Using towels to remove bulk fluid prior to mopping is part of the recommended cleaning protocol and should be used to minimize residual contamination. Contamination on shoes and the floor may serve as reservoirs for pathogens.